Archives: Medical Student Finals

MSFinals-1242

You are a fully registered doctor working in a small hospital in the Highlands of Scotland. You have been called to the reception where your teenage patient being treated for acute Crohn’s disease appears very anxious. He is demanding to go home because he is hearing voices that are telling him that everyone in the hospital is going to kill him. The patient is making threats of harm towards his parents, not present, who ‘got’ him ‘into this.’ He is not currently violent towards staff. He does not appear septic.
What is your best course of action?

MSFinals-1243

A 42-year-old factory worker has contacted his GP, reporting that he has been feeling unwell for the past ten days. He has been experiencing back pain, which he believes is due to bending over at work. The patient visited the Emergency Department five days ago due to the pain and is worried about his ability to go back to work.
What is the most suitable course of action for managing this patient’s condition?

MSFinals-1244

A 65-year-old patient attends their general practitioner (GP) having been discharged from hospital the day before. They are due to fly to Rome in three days’ time for a friend’s wedding and have asked for a letter saying they are fit to fly.
Which of the following reasons for admission would be a contraindication to them flying?

MSFinals-1245

A man with mild dementia has just been admitted to the Emergency Department unit in Scotland following a fall. He has total external rotation of his left leg, indicating that he has a fractured neck of femur. He refused to be taken into the ambulance at home, and the GP successfully applied to a Justice of the Peace for a warrant to remove him to hospital. He still does not want any treatment, and will not allow examination of his hip.
What is the best legal option to take?

MSFinals-1246

An 88-year-old man is admitted with severe community-acquired pneumonia, CURB-65 score is 4. He has been an inpatient on the ward where you are working as an FY1 for two weeks. His condition has progressively worsened, and the decision is made to switch to a palliative approach of management. He passes away the following morning, with his wife by his side. You confirm his death on the ward. He has a past medical history of ischaemic heart disease, mesothelioma, hypertension, type 2 diabetes and benign prostate hypertrophy (BPH).
Which of the following should you do when completing his death certificate?

MSFinals-1247

You are an FY1 in a busy A&E department. In your haste to finish all the jobs in time, you attain a needle stick injury while taking blood samples from a patient. The patient is known as an IV drug user.
Which of the following is the most appropriate action?

You are an FY1 in a busy A&E department. In your haste to finish all the jobs in time, you attain a needle stick injury while taking blood samples from a patient. The patient is known as an IV drug user.
Which of the following is the most appropriate action?

MSFinals-1248

You are a general practice trainee at a surgery in London. A 14-year-old girl attends the surgery and requests the ‘morning-after pill’ following sexual intercourse with her 20-year-old boyfriend. She appears mature for her age and you assess her as being Fraser-competent. She says that there was an accident on this occasion and, in future, she will ensure her and her boyfriend use contraception. She doesn’t want you to discuss emergency contraception or her relationship with her parents.
What is the best course of action?

MSFinals-1249

A 70-year-old man with dementia is assessed and found to lack capacity. As per the Mental Capacity Act 2005, decisions will need to be made on his behalf by a Court-Appointed Deputy in his best interests.

MSFinals-1250

A 30-year-old woman comes to your General Practice Clinic with her partner. She is currently eight weeks pregnant and has been experiencing heavy bleeding for the past 36 hours since falling down the stairs. She appears very upset and withdrawn, and her partner does most of the talking. She mentions that she has been feeling clumsy lately and fell down the stairs while rushing and missing a step.

Upon reviewing her medical records, you discover that she had a miscarriage three months ago. Given her symptoms, you refer her to the Early Pregnancy Unit for further evaluation, suspecting that she may be experiencing another miscarriage.

What would be the primary cause to consider during this initial assessment?

MSFinals-1251

A client’s family purchases the ward a box of chocolates but presents you with a separate card containing a £50 voucher for all your assistance. What is the most suitable course of action?