Archives: Medical Student Finals

MSFinals-6792

A 56-year-old man visits his doctor with complaints of difficulty maintaining an erection, which has been ongoing for some time and is causing problems in his relationship. He is generally healthy, except for high blood pressure that is managed with amlodipine. He reports still experiencing morning erections and has not noticed any changes in his sex drive. During the examination, his blood pressure is measured at 145/78 mmHg, and his BMI is 30 kg/m2. His abdominal, genital, and prostate exams are all normal. What is the most crucial test to rule out any organic causes for his difficulty maintaining an erection?

MSFinals-6793

A 25-year-old man who has received a transplant of the left kidney is exhibiting symptoms that suggest hyperacute rejection of the transplant. What is the probable time frame for this type of rejection to occur?

MSFinals-6794

A 25-year-old man presents to the Emergency Department with a 4-hour history of sudden-onset pain in his left scrotum that makes walking difficult. On examination, his left testicle is firm and diffusely tender.
What is the most urgent management option?

MSFinals-6795

A 35-year-old man presents to the Emergency Department (ED) in extreme pain. He reports one day of pain in his right loin spreading round into the groin. The pain comes in waves and he says it is the worst pain he has ever experienced. The ED doctor suspects a diagnosis of renal colic.
What investigation finding would be the most consistent with this diagnosis?

MSFinals-6796

A 19-year-old man comes to the clinic complaining of a painful swelling in the area of his glans penis that has been present for 6 hours. Upon examination, the glans penis is red, oedematous, and extremely tender. The foreskin is pulled back, but there is no evidence of scrotal or penile necrosis or redness.

What is the best course of action for treatment?

MSFinals-6797

A 30-year-old man presents with left scrotal discomfort and a feeling of tightness. Upon examination, there is mild swelling of the left scrotum with varices resembling a bag of worms in the overlying skin that appears dark red. Scrotal ultrasound confirms the presence of a varicocele on the left side. Which structure is most likely dilated in this patient?

MSFinals-6763

A 50-year-old man arrived at the Emergency Department with massive haematemesis. An emergency endoscopy revealed a bleeding gastric ulcer located on the lesser curvature of the stomach. Which vessel is most likely affected?

MSFinals-6764

A 50-year-old man presents with sudden onset of upper abdominal pain and vomiting. His vital signs are stable upon triage.
During the physical examination, he appears to be in significant distress and has a tense abdomen upon palpation.
What initial test should be performed to confirm a perforation?

MSFinals-6776

A 68-year-old man presents to the Urology Clinic with a 4-month history of difficulty initiating micturition and poor flow when passing urine. He reports waking up 2-3 times a night to urinate and has not experienced any changes in bowel habits. He denies any visible blood in his urine and is generally feeling well. There is no family history of prostate cancer. During digital rectal examination (DRE), a slightly enlarged and smooth prostate is detected. Urinalysis shows protein + but is negative for blood, ketones, glucose, nitrites, and leukocytes. Full blood count, urea and electrolytes, and liver function tests all come back normal. His prostate-specific antigen (PSA) level is 1.3 ng/ml. What is the most appropriate management plan?

MSFinals-6777

A 42-year-old man presents to his General Practitioner with a 6-month history of erectile dysfunction. He also reports that he has noticed galactorrhoea and is experiencing headaches, usually upon waking in the morning. He has no significant past medical history. His blood test results are as follows:
Investigation(s) Result Normal range
Haemoglobin (Hb) 142 g/l 130–180 g/l
White cell count (WCC) 5.0 × 109/l 3.5–11 × 109/l
Sodium (Na+) 138 mmol/l 135–145 mmol/l
Potassium (K+) 4.1 mmol/l 3.5–5.3 mmol/l
Thyroid-stimulating hormone (TSH) 3.8 mU/l 0.27-4.2 mU/l
Prolactin 5234 mU/l 86-324 mU/l
Which of the following further investigations should be requested?