Archives: Medical Student Finals

MSFinals-1859

A 35-year-old woman comes to the clinic asking for the progesterone-only injectable contraceptive. She reports that she has used it before and it has been effective for her. However, she has a medical history of migraines with aura and irritable bowel syndrome. She is currently undergoing treatment for breast cancer and is awaiting further tests for unexplained vaginal bleeding. Additionally, she is a heavy smoker, consuming around 20 cigarettes per day. What makes this contraceptive method unsuitable for her?

MSFinals-1860

A 75-year-old woman comes to the clinic complaining of urinary incontinence when she coughs or sneezes for the past 6 months. Despite doing pelvic floor exercises for the last 4 months, she has not seen any improvement. She expresses concern about undergoing surgery and prefers medical treatment for her condition. What is the initial pharmacological therapy recommended for her urinary incontinence?

MSFinals-1861

A 60-year-old female visits the clinic with a complaint of urinary incontinence. She reports experiencing unintentional urine leakage when coughing or laughing. No urinary urgency or nocturia is reported, and a routine pelvic exam reveals no abnormalities. Despite consistent pelvic floor muscle exercises for the past five months, the patient’s symptoms have not improved. She expresses a desire to avoid surgical interventions. What is the most suitable treatment option for this patient?

MSFinals-1862

A 20-year-old female patient visits your clinic after having unprotected sex 3 days ago. She is concerned about the possibility of getting pregnant as she is not using any form of contraception. The patient has a medical history of severe asthma and major depression, and is currently taking sertraline 25mg once daily, salbutamol inhaler 200 micrograms as needed, beclomethasone 400 micrograms twice daily, and formoterol 12 micrograms twice daily. She is currently on day 26 of a 35-day menstrual cycle. What is the most appropriate course of action to prevent pregnancy in this patient?

MSFinals-1863

A 25-year-old woman visits her local pharmacy with concerns about needing the emergency contraceptive pill. She explains that she had unprotected sex with her partner of 5 years 2 days ago and did not use any form of contraception. She recently gave birth to a baby boy 4 weeks ago and is currently formula-feeding him.

What advice would be most suitable in this situation?

MSFinals-1864

A 35-year-old woman has been experiencing cyclical mood swings and irritability, which typically occur one week before her period and subside a few days after. She visited her GP, who prescribed a combined oral contraceptive pill (COCP) after reviewing her symptom diary. However, after three months of treatment, she returns to her GP and reports that her symptoms have not improved during her menstrual cycle. She is feeling like a bad mother as she is losing her patience with her children easily when symptomatic and is seeking further treatment options. What is the most appropriate treatment for her?

MSFinals-1865

A 30-year-old woman is diagnosed with an unruptured ectopic pregnancy. What medication is typically used for medical management of this condition?

MSFinals-1866

A 28-year-old woman visits her GP complaining of abdominal pain and bleeding that has persisted for three days. Upon conducting a pregnancy test, it is discovered that she is pregnant. She is immediately referred to the emergency department where an ultrasound scan confirms a right-sided tubal ectopic pregnancy with a visible heartbeat.

The patient has previously had an ectopic pregnancy that was managed with a left-sided salpingectomy. Although she has no children, she hopes to have a family in the future. There is no history of any sexually transmitted infections.

What is the most appropriate course of action for management?

MSFinals-1867

You are seeing a teenager for her 6-month follow up appointment following a normal vaginal delivery. She wishes to stop breastfeeding as her baby requires specialised formula feeds.

Which medication can be prescribed to suppress lactation in this scenario?

MSFinals-1868

A 26-year-old female patient arrives at the emergency department complaining of constant pain in the left iliac fossa and nausea that started a day ago. She reports vomiting once but denies any other symptoms. The patient has a menstrual cycle of 28 days, and her last period began 5 days ago. She is sexually active and has consistently used condoms for contraception. There is no vaginal bleeding. What is the probable diagnosis?