MSFinals-0962
A 55-year-old male with type 2 diabetes mellitus has been diagnosed with a spot urinary albumin:creatinine ratio of 3.4 mg/mmol.
Which medication can be prescribed to slow down the advancement of his kidney disease?
Archives: Medical Student Finals
MSFinals-0963
A 50-year-old woman has been diagnosed with Addison’s disease. What would be advantageous to prescribe for her along with hydrocortisone?
MSFinals-0964
A 54-year-old Hispanic male presents to his primary care physician complaining of fatigue. He has noticed a slight increase in weight and has been feeling increasingly tired over the past year. The patient has a history of asthma and manages it with inhaled salbutamol as needed, typically no more than once a week. He also has type 2 diabetes that is controlled through diet.
During the examination, the patient’s blood pressure is measured at 172/98 mmHg, his body mass index is 29.7 kg/m2, and his pulse is 88 beats per minute. No other abnormalities are noted. Over the next month, his blood pressure readings are consistently high, measuring at 180/96, 176/90, and 178/100 mmHg.
Which medication would be recommended for the treatment of this patient’s high blood pressure?
MSFinals-0965
A 55-year-old male with a six year history of type 2 diabetes has been diagnosed with ischaemic heart disease and started taking atorvastatin 80 mg daily to manage his cholesterol level of 6.2 mmol/L. However, he has returned to the clinic complaining of muscle aches and pains, and his liver function tests have shown elevated levels from his baseline. His pre-treatment ALT was 60 IU/L, and now it is 95 IU/L. He is concerned about the side effects of the statin and asks if he should stop taking it. What is the most appropriate next step to manage his hypercholesterolaemia?
MSFinals-0966
A 50-year-old woman from the UK presents with lethargy, and dizziness when she gets out of bed in the mornings and stands from sitting. She has noticed that her appetite has been reduced for the last month but has not noticed any weight loss. On examination you notice that she has an area of hypopigmented skin on her back, but hyperpigmented skin around her mouth, and you suspect a diagnosis of Addison’s disease.
What is the most common cause of Addison’s disease in the UK?
MSFinals-0967
A 42-year-old teacher visits her GP, complaining of hot flashes and night sweats. She suspects that she may be experiencing symptoms of menopause. Can you identify which set of results below are consistent with postmenopausal values?
A: FSH (follicular phase 2.9-8.4 U/L) 0.5
LH (follicular phase 1.3-8.4 U/L) 1.1
Oestrogen (pmol/L) 26
Progesterone (pmol/L) <5
B: FSH (follicular phase 2.9-8.4 U/L) 0.5
LH (follicular phase 1.3-8.4 U/L) 1.2
Oestrogen (pmol/L) 120
Progesterone (pmol/L) 18
C: FSH (follicular phase 2.9-8.4 U/L) 68
LH (follicular phase 1.3-8.4 U/L) 51
Oestrogen (pmol/L) 42
Progesterone (pmol/L) <5
D: FSH (follicular phase 2.9-8.4 U/L) 1.0
LH (follicular phase 1.3-8.4 U/L) 0.8
Oestrogen (pmol/L) 250
Progesterone (pmol/L) 120
E: FSH (follicular phase 2.9-8.4 U/L) 8.0
LH (follicular phase 1.3-8.4 U/L) 7.2
Oestrogen (pmol/L) 144
Progesterone (pmol/L) <5
MSFinals-0928
A 70-year-old patient with type 2 diabetes and stable ischaemic heart disease presents with palpitations lasting for 4 days. The patient is currently taking metformin 500 mg tds, aspirin 75 mg daily, ramipril 2.5 mg daily, and simvastatin 40 mg daily. Upon examination, the patient’s pulse rate is 140/minute and blood pressure is 128/98 mmHg. There is no chest pain or evidence of acute heart failure, but the ECG confirms atrial fibrillation. What is the most appropriate treatment for managing the patient’s atrial fibrillation?
MSFinals-0929
As the orthopaedic foundation year doctor, you have been requested by the nurse in charge to assess a patient who is experiencing acute shortness of breath and right-sided chest pain 8 days after undergoing total knee replacement surgery. The patient is a 66-year-old builder with a medical history of COPD and high cholesterol. He has a BMI of 35 and currently smokes 30 cigarettes per day. His vital signs are as follows: regular heart rate of 115 beats per minute, blood pressure of 135/60 mmHg, and oxygen saturation of 91% on room air. What is the most effective diagnostic test to perform on this patient?
MSFinals-0930
A 63-year-old male presents with a sudden onset of double vision that has been ongoing for eight hours. He has a medical history of hypertension, which is managed with amlodipine and atenolol, and type 2 diabetes that is controlled through diet. Upon examination, the patient displays watering of the right eye, a slight droop of the eyelid, and displacement of the eye to the right. The left eye appears to have a full range of movements, and the pupil size is the same as on the left. What is the probable cause of his symptoms?
MSFinals-0931
A 16-year-old boy comes to the emergency department after taking 60 of his father’s fluoxetine tablets about four hours ago.
Which of the following symptoms is consistent with his reported ingestion?