Archives: Medical Student Finals

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?

MSFinals-6274

A 54-year-old woman presents to the emergency department after falling from a step-ladder and landing on her back. She has a medical history of type 2 diabetes and is currently taking trimethoprim for a urinary tract infection. Upon examination, her GCS is 15/15, but her heart rate is only 50 beats/min and her blood pressure is 90/45 mmHg. Despite receiving intravenous fluids, her blood pressure only increases slightly to 91/47 mmHg. However, her peripheries are warm and her capillary refill time is less than 2 seconds. What is the most likely cause of this patient’s condition?

MSFinals-6275

A 75-year-old man has come to the clinic with a recent rectal bleed. He reports passing around 200 ml of fresh blood. During the examination, he appears stable and experiences no abdominal discomfort. Rectal examination shows fresh blood on the glove. What is the probable diagnosis?

MSFinals-6276

A 50-year-old man has been diagnosed with colorectal cancer. Upon imaging, it has been found that the tumour is located in the mid-rectum and does not extend beyond it. What would be the most suitable surgical approach for a mid-rectal tumour?

MSFinals-6277

A 67-year-old presents with acute abdominal pain and is found to have a perforated sigmoid colon due to colonic cancer. He is peritonitic on examination and requires an emergency Hartmann’s procedure. What is a true statement regarding his condition?

MSFinals-6281

A 28-year-old man is evaluated by the prehospital trauma team after being in a car accident. The team decides that rapid sequence induction with intubation is necessary to treat his condition. Etomidate is chosen as the induction agent. What significant adverse effect should be kept in mind when administering this anesthetic agent?

MSFinals-6282

A 68-year-old woman presents to her GP with a shallow sore on her left leg that has not healed for 2 weeks. She is worried and seeks medical advice. Upon examination, the patient is found to be overweight with a BMI of 35.3 kg/m². An open sore measuring 5 x 3 cm is observed on the medial aspect of her left shin, superior to her medial malleolus. Additionally, an enlarged, tortuous vein is visible on her left calf, and her ABPI is 1.2 with palpable pedal pulses bilaterally. Based on this information, what is the indication for referral to vascular surgery?

MSFinals-6283

A 70-year-old female presents to breast clinic following a left total mastectomy and sentinel lymph node biopsy for breast cancer. The histological analysis reveals complete excision of the tumour and clear malignancy in all 3 lymph nodes. The tumour is an invasive ductal carcinoma of grade 1, with ER and PR positivity and HER2 negativity. What additional treatment options should be considered for this patient?

MSFinals-6284

A 35-year-old woman has been diagnosed with breast cancer and has undergone surgery and radiotherapy. Despite being HER2 -ve and ER -ve, her TNM stage is T2N2M0. Given her node positivity, what is the most suitable course of action for her management?