Archives: Medical Student Finals

MSFinals-1061

A patient with diabetes who is 60 years old is admitted with confusion and is found to have a blood glucose level of 1.2 mmol/L.

Which injectable diabetes therapy is a mixed insulin?

MSFinals-1062

A 16-year-old athlete attends a routine check-up. Her past medical history is significant for type 1 diabetes since the age of 7. Her glucose is well controlled with self-administration of insulin. She reports that she is training for the upcoming national championship. She has specific questions regarding the effects and actions of insulin.
Which of the following is correct regarding the action of insulin?

MSFinals-1063

A 42-year-old man has been experiencing gradual enlargement of his hands and feet for the past 4 years, resulting in the need for larger gloves and shoes. Recently, he has also noticed his voice becoming deeper. His family has observed that he snores frequently and he has been experiencing daytime sleepiness. Over the past 6 months, he has been experiencing progressive blurring of vision accompanied by headaches and dizziness. Upon examination, his visual acuity is 20/20-2 and visual field testing reveals bitemporal hemianopias. What is the most appropriate initial investigation to confirm a diagnosis in this man?

MSFinals-1064

A 63-year-old man presents to the Acute Medicine Unit with hyponatraemia. He reports feeling generally unwell and apathetic, and has experienced a 6 kg weight loss over the past three months. He has no history of medication use and is a heavy smoker. Upon examination, he is euvolaemic and a chest X-ray reveals a right hilar mass. His blood results show a serum sodium level of 123 mmol/l (normal range: 135-145 mmol/l), serum osmolality of 267 mosmol/kg (normal range: 275-295 mosmol/kg), urine sodium of 55 mmol/l (normal range: <20 mmol/l), urine osmolality of 110 mosmol/l (normal range: <100 mosmol/kg), and morning cortisol of 450 nmol/l (normal range: 119-618 mmol/l). What is the most appropriate initial management for his hyponatraemia?

MSFinals-1065

A 26-year-old waitress presents with a 2-day history of increasing confusion. She has no significant medical history, takes only oral contraceptives, and denies any substance use. Blood and urine tests suggest a possible diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following statements regarding SIADH secretion is accurate?

MSFinals-1067

A 50-year-old man comes to the clinic with recurring headaches. He reports experiencing impotence and a decrease in libido that has progressively worsened over the past year. During visual field examination, a bitemporal hemianopia is observed. Laboratory tests show an elevation in serum prolactin levels, while serum luteinizing hormone (LH) and testosterone are reduced. What is the most probable diagnosis?

MSFinals-1068

A 72-year-old man comes to the clinic for his yearly check-up and expresses worry about osteoporosis. He has questions about bone formation and calcium homeostasis, and you explain the role of parathyroid hormone (PTH) in regulating calcium levels.
Which of the following statements about PTH is accurate?

MSFinals-1069

A 25-year-old veterinary student is being evaluated for possible Addison’s disease due to symptoms of weight loss, hypotension, and fatigue. As part of the diagnostic process, the patient undergoes testing to measure cortisol levels before and after receiving synthetic adrenocorticotropic hormone (ACTH) injection (short-synacthen test). What is a true statement regarding cortisol in this scenario?

MSFinals-1070

You review a 56-year-old man who has type II diabetes. He is taking metformin 2 g per day and his HbA1c is 62 mmol/mol. You consider adding sitagliptin to his regime.
Which of the following fits best with the mode of action of sitagliptin?