MSFinals-1335
A 67-year-old malnourished patient needs to have a nasogastric (NG) tube inserted for enteral feeding. What is the primary method to verify the NG tube’s secure placement before starting feeding?
Archives: Medical Student Finals
MSFinals-1336
As the F1 on call, you have been summoned to attend to a 36-year-old man who has been admitted with decompensated alcoholic liver disease. Upon examination, you observe widespread stigmata of chronic liver disease with tense ascites and mild peripheral oedema. There is no indication of encephalopathy, and all vital signs are within acceptable limits. The most recent blood tests reveal a haemoglobin level of 115 g/L (120-140), a white cell count of 5.6 ×109/L (4.0-11.0), and a platelet count of 79 ×109/L (150-400), among other things. The patient is experiencing abdominal pain. What is the safest analgesic agent to prescribe to this patient?
MSFinals-1337
A 70-year-old female complains of abdominal pain and melaena. She has a medical history of hypertension, type 2 diabetes, and right knee osteoarthritis. Which medication could be causing her symptoms?
MSFinals-1338
A 56-year-old diabetic woman presents with malaise to her general practitioner (GP). Her GP takes liver function tests (LFTs): bilirubin 41 μmol/l, AST 46 iu/l, ALT 56 iu/l, GGT 241 iu/l, ALP 198 iu/l. On examination, her abdomen is soft and non-tender, and there are no palpable masses or organomegaly. What is the next best investigation?
MSFinals-1339
What is the most likely diagnosis for a 45-year-old woman who has had severe itching for three weeks and presents to your clinic with abnormal liver function tests and a positive anti-TPO antibody?
MSFinals-1340
A 56-year-old woman presents with abnormal liver function tests and symptoms of fatigue and itching for the past three months. She reports drinking 5 units of alcohol per week and denies any intravenous recreational drug use. She has no significant medical history and has a body mass index of 24 kg/m2. On examination, she has hepatomegaly but no jaundice. Ultrasound of the liver is normal. Laboratory investigations reveal a serum albumin of 38 g/L, serum alanine aminotransferase of 40 U/L, serum alkaline phosphatase of 286 U/L, and serum total bilirubin of 27 μmol/L. What is the most likely diagnosis?
MSFinals-1341
A 40-year-old woman presented to the gastroenterology clinic with intermittent biliary type pain, fever, and jaundice requiring recurrent hospital admissions. During her last admission, she underwent laparoscopic cholecystectomy. She has a history of ulcerative colitis for the past 15 years.
Investigations revealed elevated serum alanine aminotransferase (100 U/L), serum alkaline phosphatase (383 U/L), and serum total bilirubin (45 μmol/L). However, her serum IgG, IgA, and IgM levels were normal, and serology for hepatitis B and C was negative. Ultrasound of the abdomen showed dilated intrahepatic ducts and a common bile duct of 6 mm.
What is the most likely diagnosis?
MSFinals-1342
A 29-year-old woman with Crohn’s disease complained of abdominal pain and foul-smelling stools. She was diagnosed with anaemia and a ‘very low’ serum vitamin B12 level. In the past, she had undergone surgery for an enterocolic fistula caused by Crohn’s disease. The medical team suspected small intestinal bacterial overgrowth and decided to perform a hydrogen breath test.
What precautions should be taken before conducting this test?
MSFinals-1343
A 35-year-old woman visits her General Practitioner (GP) complaining of diarrhoea that has lasted for 2 weeks. She mentions passing mucous and blood rectally and reports feeling generally unwell. During the examination, the GP observes aphthous ulceration in her mouth and suspects a diagnosis of ulcerative colitis (UC). The GP decides to refer the patient to a gastroenterology consultant.
What is the recommended first-line medication for patients with mild to moderate UC?
MSFinals-1344
A 30-year-old patient presents with complaints of recurrent bloody diarrhoea and symptoms of iritis. On examination, there is a painful nodular erythematosus eruption on the shin and anal tags are observed. What diagnostic test would you recommend to confirm the diagnosis?