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3,531 questions
A 17-year-old patient is referred by his GP after presenting with periorbital oedema. The patient noticed the oedematous eyes 3 days ago, but reports feeling unwell since a throat infection 3 weeks ago with nausea and vomiting in the last week. A urine dipstick is positive for protein and blood while serum creatinine and urea are mildly deranged. The most likely diagnosis is:
A 52-year-old man complains of a 3-week history of malaise and shortness of breath. He has lost weight in the last few months but attributes this to a loss of appetite possibly due to stress at work. On examination, he has a palpable mass in the right lumbar region. He has no urinary symptoms. However, the urine dipstick detected blood. The most likely diagnosis is:
A 37-year-old man presents with a 5-day history of haematuria. Abdominal examination is unremarkable. Urine analysis reveals hypercalciuria and excretion orography reveals small calculi within the papilla of the patient's right kidney. The patient has presented several times in the past with UTis and renal stones, but is otherwise healthy. The most likely diagnosis is:
A 64-year-old man is undergoing treatment for polycythaemia vera with chemotherapy, he has no other medical problems. Shortly after starting treatment, the patient becomes lethargic, feels unwell and suffers weight loss. He attributes this is to the chemotherapy. After 2 weeks, the patient becomes oliguric, complains of bilateral flank pain and becomes oedematous. The most likely diagnosis is:
A 67-year-old diabetic female is brought into accident and emergency following a collapse at her home. She was found by her daughter who said she saw the patient going to the toilet and then hearing her collapse. The patient did not lose consciousness and appears well. Her supine blood USMLE IM2e/Diagnostic pressure is 100/70 and standing 115/79. Urine dipstick is positive for glucose, nitrates, leukocytes and haematuria. The most likely diagnosis is:
An 18-year-old man presents with general malaise and lethargy for the last 2 weeks, he denies any weight loss and has maintained a good appetite. On examination, there are no abnormalities except for sacral oedema and a polyphonic wheeze. Urine dipstick is positive for protein only and blood pressure is 140/90. The most likely diagnosis is:
A 21-year-old man complains his urine has turned a faint red in the last week. He denies any significant changes in his diet or lifestyle and has no other medical problems except for sensorineural deafness diagnosed when he was young. On examination, you notice retinal flecks and urine dipstick confirms protein and blood. The most likely diagnosis is:
A 65-year-old overweight man presents with a 2-week history of haematuria. The patient denies any other symptoms and his blood pressure is 128/83 mmHg. He suffers from no other medical problems but admits to being a chronic smoker since the age of 16. He has tried to lose weight using herbal remedies for three years, but he has only noticed significant weight loss in the last week despite stopping the remedies months ago. The most likely diagnosis is:
A 53-year-old man with IDV suffers a ruptured aortic aneurysm and is rushed into theatre, he undergoes a successful operation and is recovering on the wards in a stable condition. One day after the operation, he becomes oliguric with mildly elevated urea and creatinine. After 1 week, he becomes polyuric with a GFR of 30. The most likely diagnosis is:
A 64-year-old woman with type 1 diabetes presents to clinic with several months of sinus problem and a 4-day history of oliguria. Her blood pressure is 137/80, serum results show mildly elevated urea and creatinine, absence of anti-GBM antibodies, while a C-ANCA assay is positive. Red blood cell (RBC) casts are present in the urine and her renal biopsy reveals glomerular crescents. The most likely diagnosis is:
A 66-year-old woman with poorly controlled type 2 diabetes presents to accident and emergency with a 2-day history of severe pain in the right flank, nausea and fevers that come and go. On examination, the patient appears 11nwell, sweaty and has visible rigors with a temperature of 38°C. The patient denies any recent travel. Urine dipstick is positive for protein, blood, leukocytes and nitrates. A CT scan of the abdomen reveals gas in the renal parenchyma area. The most likely diagnosis is:
A 33-year-old obese woman complains of tiredness. She has recently given birth to a healthy baby boy and is enjoying being a mother. However, she is becoming more reliant on her partner for support as she always feels exhausted and often becomes depressed. The patient has a poor appetite and often does not fmish her meals, despite this she has gained 5 kg in the last 2 weeks. The most likely diagnosis is:
A 49-year-old man presents with a history of difficulty sleeping. He reports feeling increasingly tired and general weakness which he attributes to his poor sleep pattern. Additionally, the patient has noticed he has gained weight and sweats very easily. On examination, the patient has coarse facial features. The most likely diagnosis is:
A 42-year-old woman presents with visual disturbances. She reports having double vision which was intermittent initially but has now become much more frequent. In addition, she becomes breathless very easily and experiences palpitations. On examination, raised, painless lesions are observed on the front of her shins and finger clubbing. The most likely diagnosis is:
A 16-year-old girl presents to her GP complaining of a swelling in her neck which she has noticed in the last 2 weeks. She has felt more irritable although this is often transient. On examination, a diffuse swelling is palpated with no bruit on auscultation. The most likely diagnosis is:
A 69-year-old man presents with confusion. His carers state that over the last month he has become increasingly lethargic, irritable and confused. Despite maintaining a good appetite, he USMLE IM2e/Diagnostic has lost 10 kg in the last month. Blood results are as follows: Sodium 125 mmol/L, Potassium 4 mmol/L, Urea 3, Glucose (fasting) 6 mmol/L, Urine osmolality<w:t>343 mmol/L. The most likely diagnosis is:
A 54-year-old woman presents to her GP complaining of a change in her breathing sound. She first noticed numbness, particularly in her imgers and toes, three months ago but attributed this to the cold weather. Her partner now reports hearing a high pitched, harsh sound while she is sleeping. Her BMI is 27. While measuring blood pressure, you notice the patient's wrist flexing. The most likely diagnosis is:
A 47-year-old woman complains of weight loss. She has a family history of type 1 and type 2 diabetes but has never been diagnosed herself despite the finding of islet cell antibodies. In the last few months, however, she has noticed progressively increasing polyuria and poydipsia and 5 kg of weight loss. Her fasting plasma glucose is 8 mmol/L and urine dipstick shows the presence of ketones. The most likely diagnosis is:
confirms a third degree tear. The woman is taken to theatre to repair the external anal sphincter. Which of the following is not a risk factor for third degree tear?
A 55-year-old diabetic woman presents with altered sensations in her hands and feet. She finds it difficult to turn pages of books and discriminating between different coins. When walking, the floor feels different and she likens the sensation to walking on cotton wool. The most likely diagnosis is: