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3,531 questions
A 35-year-old man presents with episodic severe upper abdominal pain radiating to back for 5 months. He has increased thirst with polyuria and passage of bulky pale stools. He consumes tapioca as a staple diet. On examination, there is no abnormality. His fasting blood sugar level is 18 mmol/L; plain abdominal x-ray shows !in.ear calcification in the upper abdomen across the spine. What is the diagnosis of this patient?
A 45-year-old man presents with anorexia with pain in the upper abdomen associated with high-grade fever, night sweats and general malaise for 5 days. The pain has been constant in the USMLE Surgery2e/Diagnostic right upper abdomen and is exacerbated by movement and coughing. He had bloody diarrhoea over the preceding 3 to 4 weeks. On examination there is tender hepatomegaly 5 cm below the right costal margin with intercostal tenderness in the right 5th, 6th and 7th spaces. What is the diagnosis of this patient?
A 78-year-old man complains of gnawing backache associated with urinary frequency and poor stream for 4 months. Transrectal ultrasound (TRUS) biopsy showed a carcinoma of prostate. What should be the first investigation?
A 43-year-old man presents with su.dden right arm and leg weakness. He is normotensive. CT demonstrates a substantial haematoma in the left frontoparietal region. What is the most likely diagnosis of this patient?
A 75-year-old man underwent a low anterior resection. Five days postoperatively he became toxic. A contrast CT scan showed an anastomotic leak. The diagnostis of this patient is?
A 45-year-old man presents with thunderclap headache. He gives a history of longstanding right-side headaches and a rushing sound in the right ear in time with his pulse. What is the most likely diagnosis of this patient?
Several weeks after sustaining a severe traumatic brain injury managed medically, a 25 year old patient has been extubated but is failing to progress, with somnolence and failure to interact. Routine bloods are unremarkable. What is the most likely diagnosis of this patient?
A 12-year-old boy is hit in his left eye with a ball. There is minimal soft tissue injury and no palpable deformity. Eye movement is painful and restricted on upward gaze. What is the most likely diagnosis of this patient?
A 32-year-old female patient presents with a 6-week history of bloody bowel motions. She has noticed significant weight loss over the preceding 6 weeks with increasing lethargy and fatigue. She has previously had constipation and admits to regular laxative use. What is the most likely diagnosis?
A 14-year-old boy presents with pain in the foot. On examination, there is a flatfoot deformity that does not correct when he stands up on tiptoes. What is the most likely diagnosis?
A 45-year-old patient presents in shock complaining of sudden-onset generalized upper abdominal pain radiating to the right iliac fossa and the tip of his right shoulder. He reports one episode of vomiting, but none since. He has no past medical problems. On examination, his abdomen is rigid and bowel sounds are absent. The diagnosis is?
You are called to see an 85-year-old female patient as the nursing staff is concerned that the patient has not passed stool for 4 days. The patient has been admitted after family members became increasingly concerned regarding her general deterioration in health and level of function. She is orientated but frail and complains of increasing abdominal discomfort. On examination bowel sounds are increased. The abdomen is distended with generalized tenderness, but no rebound or guarding. There is a firm palpable mass in the left iliac fossa. Digital rectal examination shows an empty rectum. What diagnosis must be excluded?
A 20-year-old male student attends the surgical outpatient clinic with a pulsatile ovoid swelling just behind the anterior edge of the sternocleidomastoid (SCM) muscle at the level of the hyoid bone. It is elastic in consistency and can be moved from side to side only. This is likely to be a?
A 67-year-old woman presents with severe left knee pain affecting her mobility and quality of life. Radiographs of the knee demonstrate tricompartmental idiopathic osteoarthritis of the knee. What is the best next step in management?
A 47-year-old perimenopausal woman presents with a 3-week history of green discharge from the right nipple. On examination, the right nipple is non-tender, has a 'slit-like' appearance and is retracted. The most likely diagnosis is?
A 30-year-old victim of a road-traffic accident is GCS El Vl M4 with midsize reactive pupils at admission; the left fixes and dilates in the CT scanner. A diffuse concave extra-axial bleed is evident over the surface of the left hemisphere. What is the most likely diagnosis of this patient?
A patient is being investigated for sciatica. On detailed neurological examination you elicit the following signs: sensory loss over the outer calf and dorsum of foot, weakness in dorsiflexion of toes, normal ankle reflexes, normal knee reflexes, painful straight leg raise, normal femoral nerve stretch test. At which level is the disc protrusion?
A 41-year-old woman is found collapsed in her bathroom. She is lucid in the emergency department but complains of severe headache. Right complete third nerve palsy is evident. What is the most likely diagnosis of this patient?
A 40-year-old female resident of Myanmar complains of progressive deformity affecting both of her hands over the past 3 to 4 years. She also complains of numbness of the tips of her fingers and non-healing ulcers involving several of them. There is no history of any trauma. On examination, there is bilaterally symmetrical clawing of all the digits of both the hands with non-healing ulcers over the tips of several of the digits. There are multiple hypoaesthetic and anaesthetic areas involving both the forearms and hands. Incidentally, she is also found to have lost her eyebrows. What is the diagnosis of this patient?
A 45-year-old female business executive presents with a swelling in the midline of the neck and features of hyperthyroidism secondary to Graves' disease. Following a course of antithyroid medication, a subtotal thyroidectomy is performed. Raised titres of which immunoglobulin would be expected in this individual?