Archives: Medical Student Finals

MSFinals-1306

A 39-year-old male with a history of alcoholism was admitted to the hospital with jaundice and altered consciousness. He had been previously admitted for ascites and jaundice. Upon investigation, his bilirubin levels were found to be 44 µmol/L (5.1-22), serum albumin levels were 28 g/L (40-50), and his prothrombin time was 21 seconds (13 seconds). The patient had a fluid thrill in his abdomen and exhibited asterixis. Although he was awake, he was unable to distinguish between day and night. What is the patient’s Child-Pugh score (CTP)?

MSFinals-1307

A 52-year-old male taxi driver presented with altered consciousness. He was discovered on the roadside in this state and brought to the Emergency Department. He had a strong smell of alcohol and was also found to be icteric. Ascites and gynaecomastia were clinically present. The following morning during examination, he was lying still in bed without interest in his surroundings. He was able to report his name and occupation promptly but continued to insist that it was midnight. He was cooperative during physical examination, but once the attending doctor pressed his abdomen, he swore loudly, despite being known as a generally gentle person. What is the grading of hepatic encephalopathy for this patient?

MSFinals-1308

A 5-year-old girl with confirmed coeliac disease needs a 1-month prescription for gluten-free staple foods.
What would be the most suitable prescription for gluten-free staple foods?

MSFinals-1309

You see a 40-year-old office worker in General Practice who is concerned about gaining extra weight. He tells you that he is currently very mindful of his diet and avoids any ‘unhealthy foods’. He meticulously counts calories for all meals and snacks and refrains from consuming anything for which he cannot find calorie information. He would like to know the recommended daily calorie intake for an average man to prevent weight gain.

What is the recommended daily calorie intake for an average man?

MSFinals-1284

A 35-year-old man is brought to the Intensive Care Unit following a severe head injury. The medical team suspects that he has fulfilled all the requirements for brainstem death testing and wishes to verify this. What reflex is expected to persist even in the event of brainstem death?

MSFinals-1285

A general practice is auditing the prescribing of antibiotics in patients diagnosed with acute otitis media.
Regarding use of patients’ records in clinical audit in general practice, which one of the following statements is true for pediatric patients?

MSFinals-1286

You have had a long week and are looking forward to leaving work on time to meet friends. However, upon getting ready, you realize that you forgot to hand over something important to the on-call team. What is the most appropriate course of action?

MSFinals-1287

An 88-year-old man with advanced Parkinson’s disease and dementia is admitted with aspiration pneumonia. He is under the care of your team. You are the FY2. You saw this patient yesterday on the ward round with your consultant. His pneumonia has not responded to antibiotic treatment, and the decision to palliate was made by the consultant after discussion with the family. The patient passes away peacefully, with his family around him, and you verify his death. You have been asked to fill in the death certificate after your ward round. His family wish to have him cremated.
In England, which of the following is correct with regard to completing this patient’s death paperwork?

MSFinals-1288

You suspect your classmate is being bullied by their teacher. They look miserable all the time and whenever their teacher is around they freeze and look tearful.
Which is the most appropriate action?

MSFinals-1289

You suspect your colleague John has been taking more ‘sick days’ than needed. You happened to see one of his social media posts of him out for lunch when he was allegedly at home because he was sick.
Which of the following is the most appropriate action?