Archives: Medical Student Finals

MSFinals-1945

As you review your daily results, you come across a cervical smear test for a 32-year-old patient. The result indicates that it is a repeat test and states that she is ‘high-risk human papillomavirus (hrHPV) negative’. Upon further examination of her medical records, you discover that this is her second repeat test after an abnormal result during a routine screening two years ago. Her last test was 12 months ago, where she tested ‘hrHPV positive. Cytologically normal’. Interestingly, she has never been invited for a colposcopy. What would be the most appropriate next step in this situation?

MSFinals-1922

Liam is a 22-year-old man who has had unprotected sexual intercourse and has taken levonorgestrel 2 hours ago. He has vomited once since and is uncertain about what to do next. What is the most crucial advice to give Liam regarding his risk of pregnancy?

MSFinals-1923

You are the surgical FY1 discussing with a patient in her 50s about her upcoming vaginal hysterectomy with antero-posterior repair. What is a potential long-term complication of this procedure?

MSFinals-1924

A 35-year-old woman without prior pregnancies is referred to a fertility clinic after attempting to conceive for 12 months. Upon initial examination, it is determined that she is ovulating and her partner’s semen analysis is normal. However, due to a history of menorrhagia, a transvaginal ultrasound is conducted which reveals a significant uterine fibroid causing distortion in the uterine cavity.

What would be the most suitable course of action to take next?

MSFinals-1925

A 63-year-old woman visits her GP complaining of urinary incontinence that has been ongoing for 2 years. She experiences sudden urges to urinate, followed by uncontrollable leakage ranging from a few drops to complete bladder emptying several times a week. She also reports increased urinary frequency, including waking up twice at night to urinate. The patient denies dysuria or haematuria and has never experienced involuntary urination during exertion, sneezing, or coughing. She declines a physical examination due to embarrassment. What is the most appropriate course of management?

MSFinals-1926

A 26-year-old woman comes to the emergency department worried that she cannot locate the threads of her intra-uterine device and is unable to schedule an appointment with her primary care physician. She reports no pain, fever, or unusual discharge. She has a regular menstrual cycle of 28 days, and her last period was a week ago.

During a speculum examination, the threads are not visible, so a transvaginal ultrasound is performed. The device is detected, and the threads are discovered to have retracted into the cervical canal. The threads are brought back into view. Additionally, a 4 cm multiloculated cyst with strong blood flow is found in the right ovary.

What is the most appropriate course of action?

MSFinals-1927

A 27-year-old woman comes to your clinic with a positive urine pregnancy test result. She underwent a medical termination of pregnancy using mifepristone and misoprostol three weeks ago when she was eight weeks pregnant. She reports no ongoing pregnancy symptoms and only slight vaginal bleeding since the procedure. What advice would you give her?

MSFinals-1928

A 16-year-old female presents to your GP clinic with complaints of per vaginal bleeding and urinary incontinence. She recently returned from a trip to Somalia to visit her family. During the examination, you notice signs of recent genital trauma, leading you to suspect female genital mutilation.
What is the best course of action in this situation?

MSFinals-1929

As a junior doctor working in a GP practice, a 14-year-old girl comes to see you seeking a prescription for the oral contraceptive pill. Upon further inquiry, she discloses that she is sexually active with her 15-year-old boyfriend. She refuses to discuss the matter with her parents and asserts that she will continue to engage in sexual activity even if she does not receive the pill. She has no medical issues, and her blood pressure is normal. What is your course of action?

MSFinals-1930

A 32-year-old woman has reached out for a phone consultation to discuss her recent cervical smear test results. She underwent the routine screening programme and is currently not experiencing any symptoms. Her last cervical smear was conducted 3 years ago and was reported as normal. The results of her latest test are as follows: Positive for high-risk human papillomavirus (hrHPV) and negative for cytology. What should be the next course of action in her management?