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3,531 questions
A 42-year-old man undergoes semen analysis as part of the investigation of subfertility with his wife. What result would most likely contribute to their subfertility?
A 56-year-old man with gastric cancer presents to his GP complaining of a lump in his belly button. On examination, there is a palpable nodule at his umbilicus. This sign is referred to as:
A 62-year-old man with known metastatic small cell carcinoma of the lung has presented to accident and emergency with sudden onset shortness of breath and arm and hand swelling. On examination, his face appears plethoric and Pemberton's sign is positive. What is the most likely diagnosis?
A 55-year-old man bas presented to his GP complaining of several episodes of spontaneous facial blushing. In addition, he mentions he has had several episodes of watery diarrhoea. On examination of the cardiovascular system, giant v waves are noted on observation of the jugular venous pressure. In addition, a pansystolic murmur is heard in the lower sternal edge on inspiration. Examination of the gastrointestinal system reveals an enlarged, irregular, non-tender liver edge. What is the most likely diagnosis?
A 75-year-old man presents to your clinic with a dark lump on his forehead which has been increasing in size over the last 6 weeks. He first noticed the lump, which initially appeared as a small pinkish-red patch of skin, over a month ago. On examination you observe a 1 x 2 cm hyperpigmented nodule with everted edges and a centrally, deep, ulcerated red base. Which one of the following is the most likely diagnosis?
A 67-year-old woman presents to you with pruritic plaques over her chest and back which are erythematous and resemble psoriatic plaques. From the patient's history you suspect that USMLE IM2e/Diagnostic the lesions are malignant. Which one of the following cutaneous malignancies resembles psoriasis in the initial stages?
A 63-year-old woman presents to your clinic with a painful wound on her left foot which has not been healing despite regular application of dressings. The patient has a history of peripheral vascular disease. On examination, you observe a 2 x 1 cm well-demarcated ulcer on the left heel of the foot. The ulcer has a 'punched out' appearance and the base appears necrotic. What is the most likely diagnosis?
A 47-year-old woman presents to clinic with a erythematous, macular, non-tender, 'wing-shaped' rash over the bridge of the nose and cheeks. Which one of the following conditions is responsible for causing this type of facial rash?
A 27-year-old woman, who has recently returned from holiday in Africa, presents to accident and emergency with a 7-day history of fevers, sweats, headache, malaise and lethargy. On examination, her temperature is 39°C. Cardiorespiratory and gastrointestinal examinations are unremarkable. What is the most likely differential diagnosis?
A 25-year-old woman, who has recently returned from holiday in Africa, presents to accident and emergency with a 7-day history of fevers, sweats, headache, malaise and lethargy. On examination, her temperature is 39°C. A diagnosis of malaria is suspected. What is the investigation of choice to confirm the diagnosis?
A 40-year-old Indian man presents to accident and emergency with a one-month history of haemoptysis. He is a non-smoker. On further questioning, he mentions that he has also been having fevers and night sweats. Chest x-ray shows nodular shadowing in the right upper zone. What is the most likely diagnosis?
A 19-year-old comes to you for some pre-conception advice. Some members of her family and her partner's family have a sickle cell anaemia. She reveals that her sister and his sister are both affecte Tests have shown that they are both carriers. What is the chance that if their child was a boy he would have sickle cell anaemia?
A 23-year-old woman medical student, who has returned home from a trip to India 1 day ago, presents to accident and emergency with profuse watery diarrhoea. This started suddenly and she describes her stool as being profuse and colourless. She is unable to quantify the number of times she has opened her bowels prior to presentation. On examination her pulse is 110 bpm. Cardiorespiratory and gastrointestinal examination are unremarkable. What is the most likely diagnosis?
A 22-year-old medical student presents to the GUM clinic with large amounts of yellow-coloured penile discharge and discomfort on urinating. He has just arrived home from his summer holiday in Ibiza. What is the most likely diagnosis?
A 30-year-old man presents to his GP with a lesion on his penis, which appeared a week ago. On further questioning, he reports a change in sexual partner 4 weeks ago. He has otherwise USMLE IM2e/Diagnostic been well. On examination, there is a painless hard ulcer on the shaft of the penis. What is the most likely diagnosis?
A 45-year-old man presents to accident and emergency, having returned from a holiday to India a week ago. He has subsequently been unwell with nausea and reduced appetite. Over the past 2 days he has become jaundiced. He mentions that his two brothers with whom he went on holiday have also become jaundiced in the last 2 days. On examination, he is apyrexial and there is a palpable liver edge. Liver function tests reveal a raised ALT, AST and bilirubin. All other blood tests are normal. What is the most likely diagnosis?
A 19-year-old medical student presents to accident and emergency with a 1-week history of fever, anorexia and a sore throat. On examination, she is pyrexial at 39°C and cervical, axillary and inguinal lymph nodes are palpable. Palatal petechiae are visible within the mouth and her tonsils appear inflamed. A full blood count reveals a lymphocytosis and a blood film reveals the presence of atypical lymphocytes. What is the most likely diagnosis?
A 41-year-old teacher presents to her GP with a 5-day history of fevers, headaches, lethargy and muscle aches. She also mentions that she is developing an expanding red rash on her left thigh. On further questioning, she mentions that she has been on a school camping trip the previous week. She is otherwise fit and well. What is the most likely diagnosis?
A 51-year-old man presents to accident and emergency with a lesion on his forearm. He mentions that he has spent the past three months travelling around South America and only USMLE IM2e/Diagnostic returned home 3 days ago. While his lesion has been present for a few weeks be was reluctant to see a doctor in South America. On examination, there is a 3 x 3 cm erythematous ulcer on the left forearm with a raised edge. What is the most likely diagnosis?
A 24-year-old man presents to accident and emergency with fevers, lethargy, myalgia and a cough. He has also developed an itchy rash on his feet. He returned home from a charity trip to Malawi last month and is worried he might have malaria. On examination, a papular rash is noted around his feet and there is a palpable liver edge. Initial blood tests show a raised white cell count with an eosinophilia. What is the most likely diagnosis?