Archives: Medical Student Finals

MSFinals-6343

A 29-year-old man with a history of alcohol misuse disorder presents to the Emergency Department complaining of vomiting and abdominal pain. He reports that the pain has been present for six hours and is focused in the epigastric region, with radiation to the back. The following blood test results were obtained:
– WBC: 18.2 * 109/L (normal range: 4.0 – 11.0)
– Albumin: 26 g/L (normal range: 35 – 50)
– Calcium: 1.9 mmol/L (normal range: 2.0-2.5)
– Glucose: 14 mmol/L
– Amylase: 2000 U/L (normal range: 30-118)

What is the most accurate statement regarding the usefulness of measuring serum amylase in this condition?

MSFinals-6344

A 35-year-old male is being seen on the surgical ward round, four days after his abdominal surgery. He complains of a peculiar sensation over the wound while shifting in bed. Upon removing the dressings, it is discovered that the wound is gaping open, with visible internal organs. Despite this, his vital signs are all normal, and he does not seem to be bothered by the situation. The wound is covered with gauze impregnated with saline. While waiting for additional surgical assistance, what other urgent treatment should be provided?

MSFinals-6345

A 26-year-old male is brought to the emergency department following a car accident where he sustained injuries to his cervical spine and left tibia. Upon assessment, his airway is open, but he is experiencing difficulty breathing. However, his chest is clear upon auscultation, and he has a respiratory rate of 18 breaths/min with an oxygen saturation of 96% in air. He appears flushed and warm to the touch, with a heart rate of 60 beats/min and blood pressure of 75/45 mmHg. What is the appropriate treatment for the likely cause of his presentation?

MSFinals-6346

A 54-year-old male arrives at the emergency department complaining of acute left-sided flank pain that extends to the groin. The pain is colicky and accompanied by nausea, but no fever or vomiting. The patient has a history of anxiety and depression and is currently taking sertraline. What is the recommended first-line analgesic for this probable diagnosis?

MSFinals-6347

A 35-year-old female presents to the emergency department with persistent right upper quadrant pain and jaundiced sclera, three weeks after undergoing laparoscopic cholecystectomy. She is anxious about the possibility of a surgical complication requiring revision surgery.
What is the probable cause of her symptoms?

MSFinals-6348

A 27-year-old man is in a physical altercation outside the hospital and loses consciousness after being struck in the head, hitting the ground with his head first. A junior doctor is alerted and needs to take action to protect his airway. Despite some minor bruising and scratches, there are no visible injuries or bleeding.

What should the junior doctor do next to ensure the patient’s airway is safeguarded?

MSFinals-6349

You are summoned to the neonatal ward to examine a newborn experiencing bilious vomiting. The infant was delivered at full term, has been diagnosed with Down’s syndrome, and is now four hours old. A double bubble sign is evident on an abdominal x-ray. What is the probable reason for the bilious vomiting in this neonate?

MSFinals-6350

A 48-year-old man comes to the emergency department complaining of sudden onset epigastric pain that radiates to his back. He has vomited multiple times and admits to heavy drinking in the past two weeks. The patient is admitted and blood tests are taken. After receiving supportive treatment with intravenous fluids, he reports that the pain has subsided and he no longer feels nauseous or vomits.

What is the initial step to be taken regarding nutrition for this patient?

MSFinals-6351

A 49-year-old man presents with recurrent loin pain and fevers. Upon investigation, a staghorn calculus of the right kidney is discovered. Which organism is most likely responsible for the infection?

MSFinals-6352

A 35-year-old woman experiences a sudden and severe headache followed by collapse. Imaging reveals a subarachnoid hemorrhage, but there are no signs of increased intracranial pressure. What medication should be given?