Archives: Medical Student Finals

MSFinals-1123

A 14-year-old boy presents with bilateral gynaecomastia. He stands at a height of 150 cm and weighs 60 kg, which is at the 50th centile. His sexual maturity rating is stage 2. What is the most probable cause of his gynaecomastia?

MSFinals-1124

A 45-year-old patient is undergoing treatment with recombinant human growth hormone (GH). What is a known side effect of GH therapy?

MSFinals-1126

A 38-year-old female patient visits her doctor’s office for a follow-up appointment. She was recently diagnosed with hypothyroidism and is currently taking a daily dose of 100 micrograms of thyroxine. The doctor has access to the patient’s thyroid function and other test results from the previous week.

Which test would be most effective in monitoring the patient’s progress and treatment?

MSFinals-1127

A 60-year-old man with a previous diagnosis of multiple endocrine neoplasia type 2 (MEN 2) presents to you 2 days after having undergone a total thyroidectomy. He reports experiencing cramps in his calves and thighs and tingling around his lips. Upon examination, you observe positive Chvostek’s sign and Trousseau sign. Further investigations reveal his serum calcium level to be 2 mmol/l and his serum phosphate level to be 1.8 mmol/l. What is the most likely explanation for these findings?

MSFinals-1128

A 26-year-old woman presents to the Emergency Department with confusion and decreased consciousness. Upon examination, she has a respiratory rate of 30/min and is tachypnoeic. Oxygen saturations are 98%. Urgent blood gases reveal a pH of 7.04, pO2 16.0 kPa, pCO2 2.6 kPa, HCO3- 3 mmol/l. What is the probable diagnosis?

MSFinals-1129

On a set of MRI scans being examined for a 21-year-old woman suspected of having Cushing syndrome due to weight gain and excess facial hair, which structure would be found posterior to the left suprarenal (adrenal) gland?

MSFinals-1130

A 40-year-old woman visits her primary care physician (PCP) complaining of depression. During the examination, the PCP notices a lump in the center of her neck and proceeds to conduct a cardiovascular and thyroid assessment. The patient displays signs of fatigue and has a subdued mood. Her heart rate is 68 bpm and her blood pressure is 112/82 mmHg, and there is paleness in the conjunctivae. The lump is symmetrical without skin alterations, moves upward when swallowing, and has a nodular consistency.
What is the most appropriate initial test to perform for diagnostic assistance?

MSFinals-1131

A 40-year-old woman visits her primary care physician (PCP) complaining of depression. The PCP observes a lump in the center of her neck and proceeds to conduct a cardiovascular and thyroid function assessment. During the examination, the patient appears sluggish and has a subdued mood. Her heart rate is 68 bpm and her blood pressure is 112/82 mmHg; there is paleness of the conjunctivae. The lump is symmetrically enlarged without skin alterations; it moves upward when swallowing and has a nodular consistency.
What is the most appropriate initial test to perform for diagnostic assistance?

MSFinals-1132

A 27-year-old female office assistant comes to you with complaints of palpitations, restlessness, fatigue, and excessive sweating. She also mentions that she has been experiencing irregular periods and has lost some weight recently. Upon examination, you notice that she has tachycardia and tremors, and her reflexes are hyperactive. Blood tests reveal that she has hyperthyroidism. Further examination of her neck shows multiple small nodules in an enlarged thyroid gland.

What would be the best initial approach to manage this patient?