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3,531 questions
A 24-year-old woman presents to you with a one-month history of intense burning and itch in her buttock area. On examination, you notice patches of small erythematous papulo-vesicular blisters in the patient's buttock area. There is obvious evidence of scratching with some areas of bleeding. The signs are typical of dermatitis herpetiformis. Which one of the foilowing conditions is associated with this dermatological presentation?
A 26-year-old man presents to you with multiple patches of macular hyperpigmentation which have been present since he was an infant but now are increasing in number. In addition he has several small, soft, violaceous nodules on his trunk which tend to catch on clothing causing discomfort. What is the pattern of inheritance in this condition?
A 40-year-old woman presents with a 36-hour history of developing erythematous boils on her trunk. Some of them have burst leaving what seems to be painful wounds on her chest. On examination of the chest you notice three very painful ulcerating wounds with undermined edges and surrounding erythema. The lesions are closely associated with a condition that the patient was diagnosed with 15 months ago. Which one of the following conditions is associated with the above described cutaneous lesions?
Following genetic profiling and clinical examination, you diagnose an 18-year-old woman with tuberous sclerosis. She initially presented with cutaneous lesions which were suspicious of this diagnosis. Which one of the following skin lesions is associated with tuberous sclerosis?
A 45-year-old woman presents to you with a 3-day history of an ovoid patch of tender erythema, on the posterolateral aspect of her left calf, which.has been increasing in size. She recalls injuring her left leg a week ago while gardening. On examination, the patient is afebrile and on inspection of the left calf, the patch of erythema measures roughly 3 x 3 cm with poorly demarcated edges. On palpation the zone of erythema is warm and very tender. Full blood count reveals a white cell count of 20.1 with a neutrophil count of 15.0. Which of the following organisms is the most likely cause of this condition?
A 49-year-old woman is diagnosed with a malignant melanoma which was excised from her right leg. She has been doing some research on the internet regarding the different types of malignant melanoma. Which one of the foilowing variants of malignant melanoma is considered to be the most common?
A 40-year-old woman who you referred for excision biopsy of a suspected malignant melanoma on her right leg returns for a follow up of her results. The results of the biopsy return confirming a superficial spreading melanoma with a Breslow thickness of <1 mm. What five-year survival rate does a Breslow thickness of <1 mm correspond to?
A 54-year-old investment banker presents to accident and emergency with a 5-day history of productive cough of green sputum, fevers and feeling generally unwell. On examination, there is bronchial breathing in the left lower zone. Chest x-ray demonstrates left lower zone consolidation. What is the most likely causative organism?
A three-year-old boy presents, with his mother, to his GP with a 2-day history of fevers, vomiting and diarrhoea. His mother mentions that several other children at the nursery have been off sick this week with the same problem. What is the most likely cause?
A nine-year-old boy presents to his GP with a 2-day history of sudden onset itchy rash over his face, scalp, neck and trunk, On examination, his temperature is 38°C and there is a widespread vesicular rash. What is the most likely infective organism?
A 23-year-old man presents to accident and emergency with a 1-day history of severe headache, discomfort when looking at the lights and neck stiffness. There is a non-blanching rash observed on his trunk. He has recently recovered from chicken pox. On examination he is pyrexial at 39°C. The most likely causative organism is:
A 90-year-old man presents to accident and emergency with a 2-week history of fevers, lethargy and night sweats. He has recently had crowns fitted at the dentists. He has a past medical history of hypertension, gout and type 2 diabetes mellitus. On examination his temperature is 39°C, his pulse is 120 bpm and splinter haemorrhages are seen in the nails. On auscultation of the heart a pansystolic murmur is audible. A diagnosis of endocarditis is suspected and blood cultures are taken. What organism is most likely to be grown?
A 20-year-old man presents to accident and emergency with extreme pain in the right knee. On examination, his temperature is 38.5°C and the knee is hot and swollen. He is unable to move his knee due to pain. The joint is aspirated and blood cultures are taken. The patient is admitted and started on intravenous antibiotics. Gram staining of the joint aspirate shows gram-negative diplococci. What is the most likely responsible organism?
A 74-year-old man presents to accident and emergency with extreme pain in the left knee. On examination, his temperature is 39°C and the knee is swollen and hot. He is unable to move the joint due to pain. The joint is aspirated and the patient is admitted and started on intravenous antibiotics. What is the most likely causative organism?
A 42-year-old man presents to accident and emergency with a 3-week history of shortness of breath, dry cough, fevers and malaise. He has presented as his exercise tolerance has deteriorated. He mentions that he has been HIV positive for ten years. On examination, there are fme crackles throughout both lung fields. Chest x-ray demonstrates bilateral perihilar interstitial shadowing. What is the most likely causative organism?
A 42-year-old man presents to accident and emergency with a 3-week history of retrosternal discomfort after swallowing. He mentions that he has been unable to keep any food down at all. He has been HIV positive for ten years. He is admitted and endoscopy shows areas of ulceration throughout the oesophagus. What is the most likely causative organi.sm?
A 55-year-old woman presented with truncal obesity, easy bruising, a dorsal fat pad and depression. She denies any headaches, weight loss or any other abnormalities. An ultrasound scan showed bilateral adrenal atrophy. The most likely cause is:
You see a 21-year-old woman on your ward round who has been admitted for further investigation for longstanding iron deficiency anaemia. You are told by your registrar that colonoscopy revealed multiple hamartomatous polyps suggestive of Peutz-Jeghers syndrome. From the list below, which one of the following is the most likely mode of inheritance of Peutz-Jeghers syndrome:
A 60-year-old man presents to you with some signs and symptoms which may be associated with pulmonary sarcoidoisis which was diagnosed nine months ago. From the list below which of the following is not an extrapulmonary manifestation of sarcoidosis?
A 38-year-old woman with a history of classical migraine is admitted with a right hemisphere ischaemic stroke. She has optimal blood pressure and a very favourable lipid profile, and duplex scanning of the carotids shows total absence of atheromatous plaque. Echocardiography, however, reveals an abnormality which may be relevant. Which of the following is it likely to be?