Archives: Medical Student Finals

MSFinals-6157

A 19-year-old man is brought into the emergency department after being involved in a motorcycle accident. He is minimally responsive, visibly pale, and groaning in pain.

Key findings from the initial A-E approach are:

Airway Patent
Breathing Chest clear and equal air entry bilaterally, respiratory rate 30 breaths per minute, oxygen saturation 95%
Circulation Heart rate 160 beats per minute, blood pressure 80/50 mmHg
Disability GCS 9/15, blood glucose 7 mmol/L, pupils equal and reactive to light
Everything else Tense abdomen with diffuse tenderness

You make several attempts at siting a cannula but fail.

What is the most appropriate next step in the management of this patient’s hypotension?

MSFinals-6158

A 30-year-old man with a past medical history of chronic constipation complains of sudden perianal pain. The pain has been persistent for a week and worsens during bowel movements. Additionally, he reports observing a small amount of bright red blood on the toilet paper after wiping.
Upon examination, the abdominal region appears normal, but rectal examination is not feasible due to the patient’s discomfort.
What is the probable diagnosis?

MSFinals-6159

A 68-year-old man presents with a three-month history of typical dyspepsia symptoms, including epigastric pain and a 2-stone weight loss. Despite treatment with a proton pump inhibitor, he has not experienced any relief. He now reports difficulty eating solids and frequent post-meal vomiting. On examination, a palpable mass is found in the epigastrium. His full blood count shows a haemoglobin level of 85 g/L (130-180). What is the probable diagnosis?

MSFinals-6128

A 50-year-old man with a history of gallstone disease comes to the clinic complaining of pain in the right upper quadrant for the past two days. He reports feeling like he has the flu and his wife says he has had a fever for the past day. During the examination, his temperature is 38.1ºC, blood pressure is 100/60 mmHg, pulse is 102/min, and he is tender in the right upper quadrant. Additionally, his sclera have a yellow-tinge. What is the most probable diagnosis?

MSFinals-6136

A 28-year-old male patient complains of a tender swelling in the natal cleft that has been present for two days. Upon examination, three midline pits are observed, and there is a fluctuant swelling to the right of the natal cleft. What is the probable diagnosis?

MSFinals-6137

In 2015, NICE released guidelines on preventing venous thromboembolism (VTE) in hospitalized patients. What would be considered a risk factor for VTE according to these guidelines?

MSFinals-6138

A 56-year-old woman presents with recurrent episodes of colicky, right-sided flank pain over the past few months. She has no significant past medical history but has previously received treatment. On examination, there is generalised right-sided abdominal tenderness. Blood tests reveal elevated calcium levels and a CT scan shows multiple renal stones. What measures can be taken to decrease the frequency of these episodes?

MSFinals-6139

A 35-year-old female presents with recurring abdominal pain that extends to her shoulder, especially after consuming heavy meals. She experiences nausea and vomiting during these episodes, but no chest pain or shortness of breath. There is no fever present. Upon examination, her pulse and respiratory rate are within normal limits. What is the probable cause of her symptoms?

MSFinals-6140

A 42-year-old woman undergoes a gastric bypass surgery and visits the clinic with complaints of vertigo and crampy abdominal pain after meals. What could be the possible underlying cause?

MSFinals-6141

A 65-year-old man visited his doctor complaining of painless haematuria that had been occurring on and off for three months. He has a past medical history of COPD and IHD, and has smoked 25 packs of cigarettes per year for the past 40 years. Upon examination, no abnormalities were found. However, a urine dipstick test revealed 3+ blood. What is the probable diagnosis?