Archives: Medical Student Finals

MSFinals-0564

A 17-year-old pupil comes in with rapid breathing, lack of fluids and high blood sugar levels. What evidence would most strongly suggest a diagnosis of type 1 diabetes?

MSFinals-0565

A patient is rushed into the Emergency department after being attacked with a baseball bat by an unknown assailant. The patient is unconscious and in critical condition. An urgent CT scan is ordered and reveals the presence of a subdural hematoma. The scan also shows a fracture through the left pterion.

Which blood vessel is likely responsible for the bleeding in this case?

MSFinals-0566

A 44-year-old man has suffered a stab wound to his right forearm, resulting in an inability to extend his fingers. Fortunately, there is no sensory or vascular damage. Which nerve do you suspect has been affected?

MSFinals-0567

A 40-year-old male patient presents to the Emergency department with signs of pneumonia. Upon examination, a right middle lobe pneumonia is detected on his chest X-ray. Where is the optimal location to auscultate breath sounds from the affected lobe?

MSFinals-0535

What is the odds ratio of mortality between patients treated with drug A and those treated with drug B in a randomised controlled trial for acute myocardial infarction, where 100 patients were assigned to each group and the mortality rate in group A was 20% and in group B was 30%?

MSFinals-0536

What is the number of patients that need to be treated with sunscreen A to prevent one case of skin cancer compared to placebo?

MSFinals-0537

A trial is proposed to see whether excess alcohol use is a risk factor for osteoporosis in older adults.
It is decided to perform a case-control study rather than a cohort study.
What is an advantage of a case-control study in this context?

MSFinals-0539

A 36-year-old man presents to the Emergency department with complaints of severe lower back pain. He reports that the pain started after he lifted a heavy box at work. The pain is radiating to his right buttock and thigh, but he has not experienced any urinary symptoms.

During the examination, the patient was able to straight leg raise to 90 degrees on the left side, but only to 30 degrees on the right. The sciatic stretch test was positive. He had difficulty plantarflexing his right ankle and reported abnormal sensation on the plantar aspect of the foot. Additionally, his right ankle reflex was absent, but all other reflexes were normal. There were no other sensory disturbances noted.

What is the likely diagnosis?

MSFinals-0540

A 54-year-old male with a history of chronic alcohol abuse is brought to the Emergency department after being found in the street.

On examination, he appears dishevelled and drowsy, with a pulse of 116 bpm and a blood pressure of 110/60 mmHg.

His blood tests reveal a pH of 7.29 (7.36-7.44), PaO2 of 12.0 kPa (11.3-12.6), PaCO2 of 3.0 kPa (4.7-6.0), standard bicarbonate of 18 mmol/L (20-28), base excess of −9 mmol/L (+/−2), lactate of 1.6 mmol/L (0.5-2.2), blood glucose of 3.9 mmol/L (3.0-6.0), and urine dipstick Ketones+++.

What is the probable diagnosis?