Archives: Medical Student Finals

MSFinals-1101

A 50-year-old man presents to a psychiatrist with complaints of recent mood swings and increased irritability towards his spouse. He reports experiencing diarrhea, a significant increase in appetite, weight gain, and difficulty standing up from a seated position. Upon examination, an irregularly irregular heartbeat is noted.
What is the most probable diagnosis?

MSFinals-1102

A 35-year-old man is referred by his GP to the endocrine clinic after a blood test revealed hypercalcaemia. The man originally presented to his GP following episodes of abdominal pain and loin pain.
A thorough history from the patient reveals that his father had similar symptoms which started at the age of 49 but he later passed away from a pancreatic tumour. The patient’s grandfather also had a high calcium level, but the patient does not remember what happened to him. The Endocrinologist explains to the patient that he suffers from a disease which runs in the family and part of his treatment would involve the surgical removal of the majority of the parathyroid glands.
Which of the following should this patient also be considered at risk of?

MSFinals-1103

Which substance, when found in high levels in the bloodstream, hinders the production and release of parathyroid hormone (PTH)?

MSFinals-1094

A 50-year-old baker presents with a history of increasing thirst and polyuria over the past two months. He has put on some weight over the past few years and has been trying to exercise, but with little success. He has a body mass index (BMI) of 32 kg/m2. He is otherwise well without other medical history to note.
He mentions that his father has diabetes, as does his older brother. The patient is concerned that he may also have the condition.
Which of the following is the most common finding in a patient presenting with undiagnosed type II diabetes?

MSFinals-1095

A 32-year-old male with type 1 diabetes presents with pain, swelling, and redness in his left middle finger for the past two days. He experienced this after pricking his finger while gardening and pruning a bush. Despite his diabetic control being reasonable with a HbA1c of 54 mmol/mol (20-46) on basal bolus insulin consisting of Lispro tds and Humulin I in the evenings, he is now diagnosed with cellulitis. On examination, his middle finger is painful, red, and swollen, with the redness extending to the metacarpophalangeal joint. However, his hand movements are intact, and he is clinically stable with normal observations.

What is the most appropriate initial treatment for this patient?

MSFinals-1096

A 54-year-old woman complains of lethargy and mild headaches. You decide to perform a thyroid function test to investigate further.

The results of the test are as follows:
– Free T4: 9 pmol/l (normal range: 9.8-23.1)
– TSH: 0.33mU/l (normal range: 0.35-5.50)

What would be the best course of action for this patient?

MSFinals-1097

A 21-year-old woman is brought to the Emergency Department following a fall over the curb. She tells you that she is a refugee from Afghanistan. Imaging reveals a fracture of the pubic rami.
What is the most probable reason for this injury?

MSFinals-1098

What is the underlying cause of primary hyperthyroidism associated with Graves’ disease?