MSFinals-0090
A 7-year-old girl is scheduled for an elective tonsillectomy. Your consultant has requested that you prepare all the airway equipment. What size of endotracheal tube (ETT) do you anticipate she will require?
Archives: Medical Student Finals
MSFinals-0091
An 80-year-old woman is suffering from gastroenteritis and requires iv replacement due to her inability to tolerate oral fluids. What is the maximum flow rate achievable through a 16G cannula?
MSFinals-0092
A 32-year-old cyclist, who was in a car accident, needs to have a central venous line (CVL) inserted.
Which of the following statements is the most precise?
MSFinals-0053
A 14-year-old girl with a history of eczema and asthma suddenly experiences breathlessness, nausea, and facial swelling after eating a chicken skewer at a party. Her friends report raised red bumps all over her skin and her lips are turning blue. What is the most appropriate immediate management for this patient?
MSFinals-0054
A 25-year-old woman is admitted to the Emergency Department with vomiting. She has vague abdominal pain, and a particularly keen junior surgeon takes her to theatre for an appendectomy; the appendix is removed and is normal. In recovery, she becomes hypotensive and tachycardic and does not respond as expected to fluid replacement. On examination, she is very well tanned and slim; her blood pressure is 90/65 mmHg, with a pulse rate of 100 bpm.
Investigations:
Investigation Result Normal value
Potassium (K+) 6.2 mmol/l 3.5–5.0 mmol/l
Sodium (Na+) 127 mmol/l 135–145 mmol/l
Urea 9.1 mmol/l 2.5–6.5 mmol/l
Creatinine 165 μmol/l 50–120 µmol/l
Haemoglobin 98 g/l (normochromic normocytic) 115–155 g/l
Free T4 6.2 pmol/l (low) 11–22 pmol/l
Which of the following fits best with this clinical scenario?
MSFinals-0055
An 80-year-old man is brought to the Emergency Department from a nursing home with fever and a non-healing infected ulcer in his leg. He has a history of obesity and type 2 diabetes. He reports that his leg was extremely painful but now is no longer painful. On clinical examination, his temperature is 38.6 °C, heart rate 110 bpm and blood pressure 104/69 mmHg. Peripheral pulses are palpable on examining his legs. There is tense oedema, dusky blue/purple plaques and haemorrhagic bullae on his right leg, with an underlying venous ulcer. Palpation reveals crepitus. After taking blood cultures, treatment is commenced with intravenous (IV) antibiotics and fluids.
What is the next and most important step in management?
MSFinals-0056
A 72-year-old hospitalised man with a urinary tract infection and an indwelling bladder catheter (due to a bladder outlet obstruction) has developed episodic fever, chills and a fall in systemic blood pressure since yesterday. The episodes occur irregularly and last almost an hour, during which time he becomes delirious.
Which of the following factors plays a key role in the pathogenesis of this condition?
MSFinals-0057
A 50-year-old publican presents with severe epigastric pain and vomiting for the past 8 hours. He is becoming dehydrated and confused. Shortly after admission, he develops increasing shortness of breath. On examination, he has a blood pressure of 128/75 mmHg, a pulse of 92 bpm, and bilateral crackles on chest auscultation. The jugular venous pressure is not elevated. Laboratory investigations reveal a haemoglobin level of 118 g/l, a WCC of 14.8 × 109/l, a platelet count of 162 × 109/l, a sodium level of 140 mmol/l, a potassium level of 4.8 mmol/l, a creatinine level of 195 μmol/l, and an amylase level of 1330 U/l. Arterial blood gas analysis shows a pH of 7.31, a pO2 of 8.2 kPa, and a pCO2 of 5.5 kPa. Chest X-ray reveals bilateral pulmonary infiltrates. Pulmonary artery wedge pressure is normal. What is the most likely diagnosis?
MSFinals-0058
A 65-year-old male inpatient with an infective exacerbation of chronic obstructive pulmonary disease (COPD) has suddenly become very unwell in the space of 10–15 minutes and is struggling to breathe. The nurse tells you he is on intravenous (IV) antibiotics for this exacerbation and has been on the ward for a few days.
Which one of the following would be the most concerning observation after assessing this patient?
MSFinals-0059
A 35-year-old man arrives at the Emergency Department after smoking excessive amounts of heroin. He is unresponsive and exhibits pinpoint pupils and symptoms of respiratory depression.
What is the most suitable antidote for this patient?