A 65-year-old woman presented with a 12-hour history of the sudden onset of gait unsteadiness, vomiting and headache, followed by increasing drowsiness.
What is the most likely diagnosis?
A: acute cerebellar hemorr
...
A 65-year-old woman presented with a 12-hour history of the sudden onset of gait unsteadiness, vomiting and headache, followed by increasing drowsiness.
What is the most likely diagnosis?
A: acute cerebellar hemorrhage
B: acute subdural hemorrhage
C: frontal subdural empyema
D: herpes simplex encephalitis
E: pituitary apoplexy - ANSWER A
A post-marketing observational study of a new drug was conducted on 5000 patients following clinical trials.
What best describes the data generated from this type of study?
A: comparative efficacy
B: cost-benefit
C: cost effectiveness
D: potency
E: profile of adverse effects - ANSWER E
A 79-year-old woman was admitted for elective hip replacement surgery. On examination, she was pale. There was 2-cm splenomegaly and there were small discrete axillary lymph nodes.
haemoglobin 107 g/L (115-165)
white cell count 34.5 × 109/L (4.0-11.0)
platelet count 183 × 109/L (150-400)
What is the most likely diagnosis?
A: acute myeloid leukaemia
B: chronic lymphocytic leukaemia
C: chronic myeloid leukaemia
D: myelodysplasia
E: myelofibrosis - ANSWER B
A 17-year-old boy presented with a non-blanching rash over his legs, a swollen knee and painless, visible haematuria.
Urinalysis showed blood 3+, protein 1+.
serum creatinine 210 µmol/L (60-110) urine culture negative ultrasound scan of kidneys normal
What glomerular abnormality is most likely to be present at renal biopsy?
A: focal segmental sclerosis
B: foot process fusion
C: linear deposition of IgG on the basement membrane
D: mesangial deposition of IgA
E: thickening of basement membranes - ANSWER D
A 75-year-old woman developed a spreading cellulitis on her left leg secondary to ulceration.
blood cultures MRSA
In addition to vancomycin, what is the most appropriate antibiotic?
A: amoxicillin
B: azithromycin
C: flucloxacillin
D: metronidazole
E: rifampicin - ANSWER E
A 45-year-old woman presented with right flank pain. She had a 4-year history of hypertension and progressive cognitive impairment.
On examination, she had livedo reticularis and tenderness in the right flank. Her BP was 185/105 mmHg. Urinalysis showed blood 3+, protein 1+.
Hb 129 g/L (115-165) WCC 8.7 × 109/L (4.0-11.0) PlTs 83 × 109/L (150-400)
serum creatinine 106 µmol/L (60-110)
What antibody test is most likely to be positive?
A: anticardiolipin
B: anticentromere
C: anti-glomerular basement membrane
D: antimitochondrial
E: anti-neutrophil cytoplasmic
E: anti-neutrophil cytoplasmic - ANSWER A
A 37-year-old woman presented with a history of intermittent lightheadedness. Examination was normal.ECG normal
24-hour ambulatory ECG tracing
atrial and ventricular premature beats; nocturnal bradycardia and Mobitz type 1 atrioventricular block, and supraventricular tachycardia
Which abnormality on the 24-hour ambulatory ECG is clinically most important?
A: atrial premature beats
B: profound sleep-associated bradycardia
C: supraventricular tachycardia
D: transient Mobitz type 1 atrioventricular block
E: ventricular premature beats
E: ventricular premature beats - ANSWER C
A 28-year-old man presented with a 1-month history of weight loss, abdominal distension, flatulence and foul-smelling diarrhoea following a visit to India.
anti-tissue transglutaminase antibodies negative
stool cultures and microscopy negative
What is the most likely diagnosis?
A: acute HIV seroconversion illness
B: coeliac disease
C: giardiasis
D: hookworm infection (ancylostomiasis)
E: viral gastroenteritis - ANSWER C
A 30-year-old woman presented with a 6-month history of tremor and difficulty in speaking.
On examination, she was found to have increased muscle tone in all four limbs, bradykinesia and 4-cm hepatomegaly.
What laboratory finding would best support a diagnosis of Wilson's disease?
A: increased incorporation of radioactive copper into caeruloplasmin
B: low hepatic copper content
C: low serum caeruloplasmin concentration
D: low serum free copper concentration
E: low urine copper concentration - ANSWER C
Question 10
What dietary substrate is broken down into glucose and galactose by the action of intestinal enzymes?
A: fructose
B: lactose
C: maltose
D: mannose
E: sucrose - ANSWER B
A 16-year-old girl presented with non-scaly, discrete areas of hair loss on the scalp. She had a past history of atopic eczema and had a number of depigmented areas on her hands and around her eyes.
What is the most likely diagnosis?
A: alopecia areata
B: hypothyroidism
C: lupus erythematosus
D: seborrhoeic dermatitis
E: trichotillomania - ANSWER A
A 72-year-old man presented following an episode of collapse. There had been two similar episodes recently, each lasting about 1 minute. He had had an anterior myocardial infarction 4 years previously.
On examination, he was orientated and symptom-free with a regular pulse of 80 beats per minute. His BP was 140/80 mmHg and the apex beat was displaced to the left. There was an apical systolic murmur. There were no signs of trauma.
ECG sinus rhythm; anterior Q waves and anterior ST-segment elevation without reciprocal depression
What is the most likely diagnosis?
A: acute anterior myocardial infarction
B: cerebral embolism
C: epilepsy
D: pulmonary embolism
E: ventricular tachycardia - ANSWER E
A 26-year-old woman presented with unequal pupils.
On examination, the right pupil was larger than the left and did not react to light, directly or consensually. On conver
[Show More]
