Archives: Medical Student Finals

MSFinals-1324

A 20-year-old male has been referred by his doctor due to experiencing severe bloody diarrhoea on and off for the past three months. After undergoing a barium enema, it was discovered that he has multiple ulcers and signs of inflammation that extend from his rectum to the mid transverse colon. A colonoscopy was performed and biopsies were taken from various sites, revealing acute and chronic inflammation that is limited to the mucosa. What is the most probable diagnosis for this patient?

MSFinals-1325

A 50-year-old male patient presents with dyspepsia of 4 weeks’ duration. Other than a 15-pack year history of smoking, he has no other medical history and reports no prescribed or over-the-counter medications. Endoscopy reveals features of gastritis and a solitary gastric ulcer in the pyloric antrum. A rapid urease test turned red, revealing a positive result.
What would be a suitable treatment for this patient?

MSFinals-1326

A 67-year-old man presents with a complaint of passing small amounts of fresh red blood with his stool. He also reports a small amount of mucous discharge with his stool and feeling pruritic and sore around his anus for the past couple of days. The patient denies any pain but has been more constipated than usual over the past few months. He denies any recent weight loss and has a BMI of approximately 35. The patient has a history of hypercholesterolaemia and chronic obstructive pulmonary disease. He recently completed a 7-day course of amoxicillin for a lower respiratory tract infection 5 days ago. What is the most likely cause of his rectal bleeding?

MSFinals-1327

A 10-month-old girl comes to the paediatric outpatient clinic with a four month history of bloating, diarrhoea and failure to gain weight. Her development is otherwise normal. What is the most suitable screening antibody test for her?

MSFinals-1328

A 62-year-old retiree comes to the clinic with complaints of abdominal pain and bloating. He reports recurrent belching after meals and a loss of taste for Chinese food, which he used to enjoy. This has been ongoing for the past 8 years. The patient had an upper GI endoscopy 6 years ago, which was reported as normal. He has tried various over-the-counter remedies and was prescribed medication by his primary care physician, but with little relief. What is the next recommended course of action for this patient?

MSFinals-1301

A 42-year-old man is brought to the Emergency Department with a head injury after a bar fight. He initially tells the doctor that he fell, but later admits that he was assaulted by a group of men. He expresses fear of retaliation if the police are involved and asks the doctor to keep this information confidential.
In which of the following situations may doctors breach patient confidentiality?

MSFinals-1302

A teenager attends the Emergency Department after being involved in a school fight. During the incident, he was stabbed in the arm. Fortunately, the knife wound is superficial. He states that he does not want you to talk to the school authorities about the incident and does not know the assailant.
Select the most appropriate action to take in this case.

MSFinals-1303

An 80-year-old man visits his doctor requesting a form to confirm he is ‘fit to fly’. He plans to take a 3-hour flight to Italy in three days’ time. He has a medical history of cardiovascular disease.
What would be the safest diagnosis for air travel in this case?

MSFinals-1304

You are a medical senior house officer seeing a patient called Edith with your consultant. Edith is a very frail 88-year-old lady with urinary sepsis and a history of metastatic bladder carcinoma. Your consultant completes her ward round and is of the opinion that cardiopulmonary resuscitation (CPR) would be unsuccessful if Edith were to have a cardiac arrest. After the round, a nurse asks you to complete a Do Not Attempt Resuscitation order (DNAR), which will mean that Edith would not undergo CPR in the event of a cardiac arrest. Edith does not currently have mental capacity to make decisions about her care. You have not discussed resuscitation with Edith or her family and do not have any more information available to you at this time. Her son has been appointed Power of Attorney, which includes provision for him to make decisions about Edith’s welfare and medical care.
Select the most appropriate action to take in this case.

MSFinals-1305

You are a FY2 doctor working in a district general hospital in Scotland. You have recently detained your 19-year old patient who was admitted a flare up of ulcerative colitis. He was demanding to go home because he is hearing voices that are telling him that everyone in the hospital is going to kill him. He tells you that his mother is the instigator and needs to be punished for her actions. You do note that he is delirious secondary to sepsis. You have contacted a psychiatrist, who has told you that she will be there within the next 6 hours. The patient is sitting peacefully in bed, making no attempts to leave, but appears to be responding to auditory hallucinations and talking about harming his mother.
You wish to give the patient a sedative. Can you do this?