Archives: Medical Student Finals

MSFinals-6293

A 49-year-old woman presents with severe epigastric pain radiating to her back. She has no significant past medical history. On examination, her epigastrium is very tender but not peritonitic. Observations are as follows: heart rate 110 beats per minute, blood pressure 125/75 mmHg, SpO2 96% on air, and temperature 37.2ºC.

Blood results are as follows:

Hb 125 g/L Male: (135-180)
Female: (115 – 160)

Platelets 560 * 109/L (150 – 400)

WBC 14.2 * 109/L (4.0 – 11.0)

Calcium 1.9 mmol/L (2.1-2.6)

Creatinine 110 µmol/L (55 – 120)

CRP 120 mg/L (< 5) Amylase 1420 U/L (40-140) What feature suggests severe disease?

MSFinals-6294

A 56-year-old homeless man is discovered unresponsive on the pavement. Upon arrival at the emergency department, blood tests are conducted, revealing an abnormality – Amylase 1100 U/l. An ultrasound is performed, indicating no biliary tree dilatation. What is the probable reason for this man’s condition?

MSFinals-6295

A 36-year-old woman presents to the hospital with severe epigastric pain and profuse vomiting. She has a history of sarcoidosis currently being treated with prednisolone. She drinks 40 units of alcohol per week. Bloods showed a serum amylase of 3000 U/L. The patient is treated with IV fluids and anti-emetics and is admitted under general surgery.

During your overnight review of the patient, you order urgent blood tests, including an arterial blood gas (ABG). Which blood result would be the most concerning and prompt you to consider an intensive care review?

MSFinals-6296

A 38-year-old male suddenly cries out, grabs the back of his head, and collapses in front of a bystander. After receiving appropriate treatment, he is now recovering in the hospital. As you assess his condition, you begin to consider potential complications that may arise. What is the most probable complication that he may experience due to his underlying diagnosis?

MSFinals-6297

A 36-year-old man arrives at the emergency department complaining of abdominal pain. He had been at a store that specializes in exotic pets when he was stung by a scorpion. He has no medical history to report.

During the examination, he displays severe abdominal pain that extends to his back. There is tenderness and guarding in the epigastric region.

What is the predictive factor for a more severe disease course in this likely diagnosis?

MSFinals-6298

A 9-year-old is admitted with suspected appendicitis and undergoes a laparoscopic appendicectomy. He is given 0.45% sodium chloride for postoperative care. Upon review by the surgical team, he presents with symptoms of headache, confusion, and gait disturbance. The following laboratory results are obtained: Na+ 128 mmol/l, K+ 4.0 mmol/l, urea 5 mmol/l, creatinine 60µmol/l, and glucose 4.0mmol/l. What is the most likely diagnosis?

MSFinals-6299

A 21-year-old man is assaulted outside a nightclub and struck with a baseball bat on the left side of his head. He is taken to the emergency department and placed under observation. As his Glasgow coma score (GCS) declines, he falls into a coma. What is the most probable haemodynamic parameter that he will exhibit?

MSFinals-6300

A 36-year-old male comes to the Emergency Department complaining of abdominal pain that has been bothering him for 10 hours. He feels the pain on his right side and it radiates from the side of his abdomen down to his groin. Upon urinalysis, blood and leukocytes are detected. He requests pain relief. What is the most suitable analgesic to administer based on the probable diagnosis?

MSFinals-6272

A 32-year-old woman who has a history of Crohn’s disease complains of painful rectal bleeding. She reports that the bleeding happens after passing stool and it is bright red. What could be the probable cause of the bleeding?

MSFinals-6273

A 24-year-old woman is brought to the Emergency Department following a car accident. She has sustained blunt trauma to her abdomen and is experiencing central back pain. Upon assessment, her blood pressure is 87/58 mmHg, heart rate is 106 bpm, and respiratory rate is 17/min. Her peripheries are warm, and she has generalised abdominal tenderness and localised tenderness over T3. Despite being conscious, she is distressed and reports numbness in her feet. Her ECG is normal. What type of shock is most likely affecting this woman?