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3,531 questions
7/15 A 31-year-old man is admitted following an assault outside a nightclub. During the fight, he was hit by a blunt object across the side of the head. On admission his Glasgow Coma Scale score is initially 12/15 but falls to 8/15 during his evaluation. The decision is taken to perform a computed tomography head scan, which identifies a lens-shaped space-occupying lesion within the cranial vault. The diagnosis is?
A 27-year-old patient presents with a 3-month history of increasing difficulty in swallowing. He first noticed the problem when drinking fluids, but is now commonly experiencing it when eating food as well. He has presented as regurgitation off ood is becoming a problem and he has noticed unintentional weight loss. A chest radiograph shows a widened mediastinum. What is the most likely diagnosis?
A 52-year-old man who sustained a severe intra-articular fracture of the right shoulder as a young man now presents with increasing pain, stiffness and weakness of the shoulder. What is the most likely diagnosis?
Which of the foUowing is not a recognized complication of severe burn injury?
Which of the following syndromes is associated with multiple duodenal ulcers not amenable to conventional medical therapy?
A 32-year-old woman twists her right ankle, sustaining an isolated Weber B undisplaced lateral malleolus fracture with no displacement of the ankle mortice. What is the best next step in management of this patient?
An 18-year-old man sustained an assault injury to his face and neck with a broken glass bottle. This was sutured as an emergency and healed primarily. The scar is unsightly and he wishes further surgery. What is the diagnosis of this patient?
A man presents after a game of squash with pain in the back of the calf and heel that was of sudden onset and difficulty weight bearing. On calf-squeeze test, the ankle does not dorsiflexion. What is the best next step in management of this patient?
interferes with steroid hormone receptor interaction with DNA, thus preventing the growth induction by this class of hormone
A 28-year-old secretary presents with a lump in the midline of the neck that has grown progressively larger over the past several months. On examination, there is a palpable lymph node in the left submandibular region. An aspirate is taken, comrrming a malignant cancer of the thyroid gland. The origin of this is most likely to be?
A 6-year-old child with cerebral palsy is toe-walking and is referred for assessment and management to aid her to walk on the soles of her feet (plantigrade). What is the most likely diagnosis?
You are told that a 45-year-old woman, who presented to the vascular surgery clinic, has a positive tourniquet test in the left leg. On the basis of the information conveyed to you, choose the most likely diagnosis that is associated with a positive tourniquet test?
A 15-year-old girl presents with pain at the base of the second toe. Radiographs demonstrate an abnormal second metatarsal bead with flattening. What is the most likely diagnosis?
You are asked to see a 48-year-old woman who has been admitted to the emergency department with sudden onset of right upper quadrant pain. Your registrar liaises with you, after having seen this patient, and tells you that the patient has 'Charcot's triad'. From the information conveyed to you, what is the most likely diagnosis that you should be thinking of?
A 40-year-old man presents with chronic Jumbar back pain, with acute pain radiating down the left leg to his foot. On examination he has weakness of extensor hallucis longus on the left, with diminished sensation over the dorsum of the foot and the lateral side of the calf. What is the most likely diagnosis?
A displaced intra-articular distal radial fracture is being reduced under general anaesthetic and held with a volar plate. What is the best next step in management of this patient?
Yoar colleague consults you with regard to a 56-year-old patient who has suffered an episode of amaurosis fugax. From the list below, choose the most likely site of pathology which may give rise to amaurosis fugax?
A 75-year-old man, who suffers from chronic atrial fibrillation, is admitted to the emergency department with a sudden onset of severe central colicky abdominal pain and vomiting. The patient has been bleeding from the rectum. The blood is dark in colour and has an altered consistency. On examination the patient is pale, has cold peripheries and is tachycardic. The abdomen is diffusely tender and bowel sounds are decreased. What is the likely diagnosis?
A patient has a hyperextension injury. X-ray shows a small chip of bone off the front of a vertebral body next to the disc space. What is the most likely diagnosis of this patient?
You are asked to see a 67-year-old woman admitted with severe limb ischaemia. Your senior colleague asks you to examine the patient and report your findings. What are the two most likely clinical features that suggest the patient has severe limb ischaemia?