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3,531 questions
A 35-year-old man presents to his GP with diarrhoea, abdominal pain and nausea. He says he his stools have been pale and he has felt persistently bloated. His symptoms started 6 weeks ago while on a surfing holiday in Peru. What is the most likely diagnosis?
A 26-year-old Bangladeshi man presents to accident and emergency with a 1-week history of fever, headache, malaise and dry cough. He returned to the UK 2 weeks ago, having spent his summer in Bangladesh. On examination, his temperature is 39°C and a patchy maculopapular rash is seen over his trunk. On examination of the abdomen, there is splenomegaly. Blood tests reveal a low white cell count. What is the most likely diagnosis?
A 32-year-old man presents to accident and emergency with the inability to open his jaw, starting a few hours earlier. His wife mentions that he has 'had the flu' since returning from a weekend camping trip. What is the most likely diagnosis?
A 45-year-old man who lives in a homeless shelter presents to accident and emergency with an itchy rash. The itching is particularly bad at night. On examination, there is a papular rash between the web spaces of the fmgers and toes, the palms of the hands and soles of the feet, the axilla and on the genitalia. What is the most likely diagnosis?
A 42-year-old man presents to his GP with 'blotches' over his legs. He has been HIV positive for ten years. On examination, there are multiple purple and brown papules over his legs and his gums. What is the most likely diagnosis?
A 42-year-old man presents to his GP complaining of deterioration in his vision in the right eye and the presence of floaters. The change in his vision has been causing him to suffer from headaches. He has been HIV positive for ten years. Fundoscopy reveals haemorrhages and exudates on the retina. What is the most likely diagnosis?
A 42-year-old man presents to accident and emergency with a 1-day history of headache and fevers. He presents with his partner who says he has been becoming increasingly confused and disorientated. On examination, his temperature is 38.5°C. On cranial nerve examination there is a right-sided superior quadrantanopia. An urgent CT scan of the head is organized which shows multiple ring enhancing lesions. What is the most likely diagnosis?
A 43-year-old man presents with profuse vomiting, abdominal pain and a faint metallic taste in the mouth. The patient is mildly jaundiced on examination with faint green discoloration of the gums. The patient denies taking any recreational drugs, but mentions he has been away on sabbatical in rural India. The most likely diagnosis is:
A 16-year-old boy presents to accident and emergency in a confused state. He appears pale, sweaty and has a heart rate of 110 bpm and temperature of 37°C. Respiratory examination reveals good air entry and a respiratory rate of 12. He is accompanied by a group of friends who admit they had been drinking alcohol earlier and smoking marijuana. They deny he has any medical problems apart from mild asthma and deny ingesting any other recreational substances. Urine dipstick is negative for any significant findings. His blood glucose is 2.1 mmol/L. The most likely cause of the patient's symptoms is:
An 18-year-old woman presents to her GP. She appears anxious and explains she has been revising for her exams but suffered an acute severe headache this morning which left her unable to work and she has not felt well ever since. She denies any recent travelling, fever or neck stiffness. She appears tearful bot otherwise well, with no signs following a neurological examination. The most likely diagnosis is:
A 54-year-old known hypertensive male presented with a 3-day history of shortness of breath. The patient reported feeling unwell with a sharp pain in the left side of the chest and loss of appetite. His clinical findings included a heart rate of 117 bpm, blood pressure of 97/85 mmHg, temperature 37.2°C and a respiratory rate of 22 bpm. Respiratory examination showed reduced air entry and hyper-resonance on percussion. The most likely diagnosis is:
A 47-year-old man presents to accident and emergency with a 3-day history of melaena. The patient appears pale, bas a heart rate of 110 bbpm and blood pressure of 105/71 mmHg. The patient reports suffering a sprained ankle 1 week previously and bas been using NSAIDs to control his symptoms. The most likely diagnosis is:
A 21-year-old woman with dysmenorrhorea, dyspareunia and dyschezia has been scheduled for a laparoscopy to investigate possible endometriosis. You are asking for her consent and you describe the risks of laparoscopy, which include bleeding and damage to blood vessels, viscera and nerves. Which of the following is not at risk when inserting a lateral port?
A 32-year-old female has a 5-year-old child with cystic fibrosis by her ex-husband. She has re-married and wants more children. She wants to know the risk of her and the new (Caucasian) husband having an affected child. What is the risk?
A 3-day-old neonate is noted by ward staff to have had a seizure. Which of the following statements concerning neonatal convulsions is correct?
A 35-year-old female presents as she is eight weeks pregnant. She has read much about pregnancy at her age and is concerned about possible Down's syndrome. Her partner is 42. Which of the following would reflect the approximate risk of this woman having a baby with Down's syndrome?
A 30-year-old lady attends clinic for advice concerning her future cancer risk. She has been appropriately treated for CIN II. She is an ex-smoker and takes the combined oral contraceptive pill. Two of her paternal aunts died of ovarian carcinoma at the ages of 40 and 48. Which of the following is the most important predisposing factor to ovarian cancer in this patient?
A nulliparous woman is seen at the antenatal clinic 27 weeks into her first pregnancy. Routine screening with a 75 g oral glucose tolerance test for gestational diabetes mellitus (GDM) is performed. Which of the following would confirm a diagnosis of GDM?
A 34-year-old woman attends antenatal clinic for a routine ultrasound scan. Abnormalities of placentation are detected and a magnetic resonance imaging (MRI) scan is organized by the fetal medicine consultant. The MRI report shows: 'The placenta is in the lower anterior uterine wall with evidence of invasion to the posterior walJ of the bladder'. What is the most likely diagnosis?
A 6-month-old male infant presents to your clinic because the mother is concerned that he is not eating well and he has been constipated. The mother tells you that her prenatal course and delivery were uneventful. On physical examination, the infant has a puffy face, large tongue, and persistent nasal drainage. Which of the following conditions is most likely to present with these findings?