Archives: Medical Student Finals

MSFinals-0126

You are asked to see a patient on the high dependency unit following an elective repair of her abdominal aortic aneurysm. Her last haemoglobin was 75 g/L (130-180) and your consultant has told you to give her four units of blood urgently.

The nurse informs you that the patient’s date of birth is incorrect on the blood she is about to give, although all other details are correct. The patient mentions that this has happened before. She has previously received six units of blood in theatre without any issues.

What course of action should you take?

MSFinals-0127

In case there is no intravenous access available, what is the next most favored way to administer adrenaline during a cardiac arrest?

MSFinals-0129

What is the estimated percentage of oxygen in the blood that is attached to haemoglobin?

MSFinals-0130

A 85-year-old, previously healthy woman comes to the Emergency department after collapsing at home. She looks pale and breathless, with a respiratory rate of 28, oxygen saturation of 98% on room air, a heart rate of 64 bpm sinus, and a blood pressure of 164/88 mmHg. Her haemoglobin level is 70 g/L (115-165), and tests are being conducted to determine the cause.

What is the best approach to enhance her oxygenation?

MSFinals-0132

A 32-year-old woman is diagnosed with mastitis by her General Practitioner (GP) and prescribed antibiotics. Which of the following descriptions is most consistent with this diagnosis?

MSFinals-0133

A 28-year-old teaching assistant presents with a lump that she discovered in her right breast. She performed a breast check after reading an article about breast cancer and was worried to find a lump in the right breast.
The lump is painless, and she has no other accompanying symptoms. She has no family history of breast cancer.
Upon examination, there is a smooth 2 cm × 2 cm lump in the upper quadrant of the right breast. There are no skin changes overlying the lump.
What is the most appropriate course of action for this patient?

MSFinals-0101

A 26-year-old man on the Medical Ward develops status epilepticus. He is immediately attended by the Foundation Year One Doctor who notices that his airway has been compromised. The patient is immediately examined and found to be haemodynamically stable, with a history of hypertension and asthma. The anaesthetist immediately performs a rapid sequence induction and intubation (RSII) to clear the patient’s airway.
Which of the following inducing agents used in RSII is most likely to be used in this patient?

MSFinals-0102

A patient is brought into the Resuscitation Room. Paramedics were called after he was found face down, unconscious on the road. He smells strongly of alcohol. He has a nasopharyngeal airway in situ (inserted by the ambulance service). There are no visible injuries, except for a small abrasion on his left knee and another on his left shoulder. He is currently on 15 l of high-flow oxygen via a non-rebreather mask.
In which of the following scenarios is a nasopharyngeal airway indicated for an elderly patient?