Archives: Medical Student Finals

MSFinals-6259

A 25-year-old male patient visits his GP with concerns about a lump in his right testicle. He reports no other symptoms and has no significant medical or family history. Upon examination, a firm, distinct nodule is detected on the lateral aspect of the right testicle that does not trans-illuminate, while the left testicle appears normal. The physician suspects testicular cancer and orders serological tumour markers and an ultrasound investigation. What is a possible association with the probable diagnosis?

MSFinals-6260

A 50-year-old male with a history of heavy alcohol consumption presents with sudden onset epigastric pain that spreads to the right side. During examination, his sclera appear yellow, and he experiences tenderness in the right upper quadrant of his abdomen with localized guarding. His vital signs are as follows: heart rate 95/min, blood pressure 80/50 mmHg, saturation 99% on 2L, temperature 39.5ºC, and Glasgow coma score 14/15 (confused speech). Which of the following diagnoses could account for these symptoms?

MSFinals-6261

A 25-year-old male law student arrives at the emergency department complaining of severe pain in his right upper quadrant. He reports that the pain is sharp and worsens when he takes a breath. Over the past few days, he has been feeling fatigued and experiencing shortness of breath, and he has been coughing up bloody, purulent sputum. He has a fever, tachycardia, and tachypnea. He recently returned from a week-long vacation during which he consumed 20 units of alcohol per day. What is the most probable cause of his presentation?

MSFinals-6263

A 50-year-old woman visits her GP with a complaint of sudden anal pain. During the examination, the doctor notices a tender, oedematous, purplish subcutaneous perianal lump. What is the probable diagnosis?

MSFinals-6264

A 67-year-old male undergoes a Hartmann’s procedure for a sigmoid cancer. On day 2 post-op, nurses are concerned as his colostomy has not passed any wind or stool yet and he is complaining of increasing bloatedness. You review the patient and witness him vomit profusely.

What is the appropriate management for this common postoperative complication?

MSFinals-6265

A 56-year-old man, who is a known alcoholic, is admitted to the surgical assessment unit with acute pancreatitis. What is the most appropriate scoring system for this patient?

MSFinals-6266

A 75-year-old man is scheduled for an elective knee replacement surgery the following day. He has type 2 diabetes and is the first patient on the surgery list. His doctor has advised him to continue taking his once-daily dose of metformin and his new anti-diabetic medication on the day of the operation. The patient’s physician recently changed his diabetes medication due to hypoglycemic episodes with his previous medication. What is the most probable new antidiabetic medication he is taking?

MSFinals-6267

A 67-year-old man is admitted for a routine cholecystectomy. He has a history of type two diabetes mellitus and takes metformin once daily in the morning. His most recent HbA1c was taken last month and returned as below. He has no other significant medical history.

HbA1c 48 mmol/mol Personal target 48 mmol/mol

The surgery is scheduled for early the next morning, and the patient will be fasting from midnight. What is the appropriate management of his diabetic medication before the surgery?

MSFinals-6268

What is the mechanism of action of goserelin in treating prostate cancer in elderly patients?

MSFinals-6269

A 35-year-old man with a past medical history of internal hemorrhoids presents with a recent exacerbation of symptoms. He reports having to manually reduce his piles after bowel movements. What grade of hemorrhoids is he experiencing?