A 32 year old male construction worker presents with sudden onset chest pain after lifting some steel frames. He describes a 7/10 ache which is worse on movement and his chest wall is tender on the right side. His ECG shows a sinus tachycardia and his observations are otherwise normal. Initial troponin = 6, 3h = 9 (<10). What is the most likely diagnosis?

A 70 year old lady attends with a cough and shortness of breath. On examination you note dullness to percussion in the left base with increased vocal resonance. What is the most likely diagnosis?

A 17 year old girl attends with severe wheeze, shortness of breath and tachypnoea. You give her back to back salbutamol nebulisers, IV hydrocortisone and magnesium and check a blood gas on 6L oxygen 45 minutes after treatment. pH 7.35, PO2 9 (11-14), pCO2 5.8 (4.5-6), HCO3- 26. What is the most appropriate management at this stage?

A 55 year old man has been suffering extreme bouts of anxiety, headaches and flushing. He has lost 5kg in weight over the last two months when the symptoms began. He takes two anti-hypertensives but is otherwise well. BP 190/105mmHg, HR 96. Which single hormone or hormone group is likely to be responsible for his symptoms?

A 45 year old man attends the endocrine clinic for review. He describes weight gain over the last 4 months and has abdominal striae. He has no PMH but drinks 30 units of alcohol per week. A low dose dexamethasone suppression test confirms Cushing syndrome. High dose test: cortisol before = 850, cortisol after = 200. What is the most likely cause of this man’s excess cortisol?

Which of the following is a sign specifically seen in Graves’ disease?

A 39 year old lady attends with continuous RUQ pain, fevers and nausea. She says her symptoms have developed over the past week and are worse after eating greasy foods. Her WCC is 14 (<12), CRP 46 (<5) and her amylase is 99 (<100). What is the most likely diagnosis?

A 24 year old student attends A&E after falling on a night out. He is intoxicated and can’t remember the fall but tells you his right wrist is very sore and you notice grazes on his right palm. He is very tender at the base of his right thumb on extension. After being cleared of any head injury he has an XR of his wrist which looks normal. How should this patient be managed?

Mr. Jones attends the GP with a rash. On examination the GP notes a widespread rash with discrete, raised lesions which are circular and domed and around 2cm in diameter. Which of the following best describes the lesions?