Question bank

A 24-year-old man is stabbed in the face and sustains a deep wound extending from his right medial lower eyelid to his mid cheek. What is the most likely diagnosis of this patient?

Which of the following syndromes is associated with multiple duodenal ulcers not amenable to conventional medical therapy?

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 60-year-old homosexual man presents with a 6-month history of passing fresh blood per rectum and anal pain. His presentation has been precipitated by the recent loss of continence to faeces. The blood coats the stool and he had noticed it on the paper after wiping. On rectal USMLE Surgery2e/Diagnostic examination the patient has an empty rectum. You identify a third-degree haemorrhoid in the 11 o'clock position, as well as two further second-degree haemorrhoids. No other masses are palpable. The diagnosis is?

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 55-year-old man, with a 2-year history of dyspepsia, is brought to the emergency department following a sudden onset of severe epigastric pain. The pain is made worse on movement and the patient has also experienced one episode of haematemesis. On examination, the patient is cold, sweating profusely and taking shallow breaths. The abdomen is rigid and bowel sounds are absent. A plain film chest radiograph reveals free air 11nder the diaphragm. The most likely diagnosis is?

: Les glandes composées ont une partie sécrétrice ramifiée comme les glandes de Brüner du duodénum.

Which of the foUowing is not a recognized complication of severe burn injury?

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?

A SO-year-old woman presents with an acute episode of epigastric pain, vomiting and fever. The registrar, who has already clerked and examined the patient, tells you that 'Murphy's sign is positive'. Despite not having seen the patient, from the information conveyed to you, what is the most likely top differential diagnosis that is running through your mind?

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?

One week after sustaining a severe TBI, the patient remains intubated. Fluid balance has been persistently negative over 72 hours, and the serum sodium has dropped from 130mEq/L to 122mEq/L on the day's routine blood tests. The patient is clinically dehydrated. What is the most likely diagnosis of this patient?

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?

mutation in the domain of pRB to which E2F binds, the consequences of which lead to constitutive E2F activity

A 23-year-old long-distance runner spontaneously develops a pain over the head of her second metatarsal. Radiographs reveal an undisplaced fracture across the neck of the second metatarsal. What is the most likely diagnosis?

A worried 23-year-old woman, who started taking the combined contraceptive pill 3 months ago, presents with a 1-day history of discovering a painless lump in the right breast. The patient states that the lump was not there a month ago. On examination, a slightly mobile, discrete, well-defined, non-tender, firm 1 cm diameter lu1np is found. There is no lymphadenopathy. The most likely diagnosis here is?

A 33-year-old, non-smoking, breastfeeding woman is 10 days postpartum. She has a 4-day history of a slight crack on the surface of her left nipple. She presents with a 2-day history of severe continuous pain in the left breast, spiking pyrexia up to 38.8 with rigours which has prevented her from sleeping. On examination, you find the outer quadrants of the left breast to be red, warm and tender with a hard 3 cm lump at the edge of the left nipple. The most likely diagnosis is?

A 65-year-old nulliparous woman presents to your clinic with a I11mp in her left breast, which was discovered 7 months ago. On examination you find a hard, ill-defmed, non-tender, 3.5 cm lump behind the left nipple. The patient has also had bloody, non-purulent discharge from a single duct on the left nipple for over 3 months. The most likely diagnosis here is?

A 10-year-old African Caribbean boy is referred to the orthopaedic team with an acutely painful arm. On examination, there is a notable swelling of the limb above and around the elbow joint. There is no reduced range of passive movement of the joint, but the boy is holding his arm very still and will not actively move the limb. Investigations include haemoglobin 8.3 g/dL, white cell count 10.5 x 109/L, and C-reactive protein 12 mg/L. The child is apyrexial with a blood pressure of 110/75 mmHg, and a pulse rate of 85 beats/min?

A 64-year-old male who had laparoscopic colectomy for cancer presents with a lump at the port site. The lump is painless and hard. There is no cough impulse and it is not reducible. Which one is the complication of this laparoscopy?