Archives: Medical Student Finals

MSFinals-1195

A 38-year-old male librarian presents with sudden loss of hearing in both ears. There is no ear pain, history of recent upper respiratory tract infection or history of trauma. He has no past medical history of note and does not take any regular prescribed or over-the-counter medications. Tuning fork testing suggests right side sensorineural hearing loss. Examination of the auditory canals and tympanic membranes is unremarkable, as is neurological examination. He is referred to the acute ear, nose and throat (ENT) clinic. Audiometry reveals a 40 db hearing loss in the right ear at multiple frequencies.
Which of the following represents the most appropriate initial management plan?

MSFinals-1168

A 50-year-old woman comes to you with a thyroid lump and you suspect she may have follicular carcinoma of the thyroid. What is the most appropriate course of action in this scenario?

MSFinals-1169

A 28-year-old obese man presents to clinic. He is found to have a body mass index (BMI) of 36 kg/m2 and wants advice regarding treatment of his obesity.
Which of the following pertains to the treatment of obesity?

MSFinals-1170

A 56-year-old male presents to the general practitioner (GP) with worries about his facial appearance, which he believes has changed significantly over the past five years. He also reports that his shoes no longer fit properly, and that his hands seem larger. The GP suspects that he may be suffering from acromegaly, and the patient is referred to the Endocrinology Department for further evaluation and treatment.

Regarding acromegaly, which of the following statements is accurate?

MSFinals-1172

You encounter a 27-year-old patient who has recently found out that she is pregnant. Her medical history reveals that she was diagnosed with hypothyroidism eight years ago and has been on a stable dose of levothyroxine since then. What is the appropriate course of action regarding her medication?

MSFinals-1173

What is the hormone that is released from the posterior pituitary gland?

MSFinals-1174

A 33-year-old patient with a history of phaeochromocytoma develops a neck mass. Resection of the neck mass demonstrates a multifocal tumour with haemorrhage, necrosis and spread outside the thyroid capsule. The tumour is composed of polygonal cells in nests. Amyloid deposits are seen in the intervening fibrovascular stroma.
What is the most likely secretion of the polygonal cells?

MSFinals-1175

A 42-year-old woman complains of fatigue after experiencing flu-like symptoms two weeks ago. Upon examination, she has a smooth, small goiter and a pulse rate of 68 bpm. Her lab results show a Free T4 level of 9.3 pmol/L (normal range: 9.8-23.1) and a TSH level of 49.3 mU/L (normal range: 0.35-5.50). What additional test would you perform to confirm the diagnosis?

MSFinals-1176

A 35-year-old patient visits the Endocrinology Clinic with a complaint of worsening headache and bitemporal hemianopia for the past three weeks. The patient has a family history of multiple endocrine neoplasia (MEN) syndrome type 1. The endocrinologist considers the possibility of MEN 1 and orders the appropriate investigations to arrive at a differential diagnosis. According to the definition, which three types of tumors must be present for a diagnosis of MEN 1, with at least two of them being present?