SECTION B
Structured Answer Essay Questions
Instructions: Please write the answer in the space provided only. Note that marks
vary for each response. Correct precise answers gain full marks. Responses that are
close may be given partial marks.
1. You are called to see a 23-year old male who sustained a single stab
wound to the left chest in the mid-clavicular line, just below the level of
the nipple. His only complaint is shortness of breath. His vital signs are
as follows: Heart rate- 90/min, Blood Pressure- 130/70, Respiratory rate
-25 breaths per minute. On physical examination his trachea is central,
heart sounds S1 & S2 are clearly audible. However decreased breath
sounds are heard in the left lung base.
a) Name (6) possible organs or structures that could have been injured (6
marks)
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b) Outline the immediate steps in the management of this patient (6 marks)
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c) What investigations would you order (if any)AND explain why?(4 marks)
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University Of the West Indies
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b) What are the different risk factors associated with the MOST likely diagnoses?
( 4 marks)
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c) What laboratory studies would you order in this case? ( 4 marks)
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d) List four (4) radiologic imaging or hearing investigations that may be useful
in this patient AND explain the rationale behind any two (2) investigations
chosen (6 marks)
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You are the doctor assigned to a busy paediatric surgery unit. You
receive a call from your paediatric medicine colleague to review a 1
month old baby with feeding intolerance, copious diarrhoea and
significant abdominal distension. On examination the neonate has
low set ears, up slanting palpebral fissures and a cardiac murmur
a) Are there any other questions you would ask about this patient?
c) What investigations would you order initially AND what result would
you be looking for?
g) List two (2) complications that may result from surgical intervention
h) The deletion in the long arm of which chromosome is thought to be responsible for
this disease