17 y/o man presented with visible haematuria. Denies hx of abdominal pain / loin pain. Develops symptoms after 2 days of upper respiratory tract infection.

A 30 y/o fisherman presented to the Emergency Department with shortness of breath and right-sided chest pain of sudden onset after having been involved in a gang fight. The most likely cause of this presentation is

24 y/o male, active smoker, syncope after playing football, has family history of sudden death. Brother death at 36 y/o. Soft systolic murmur, ECG show LV hypertrophy. What is the most possible diagnosis?

A 45 y/o obese lady, post right hip surgery, with sudden onset of SOB and left sided chest pain. She is hypoxic. On auscultation the lung is clear.

An old man with pneumonia was treated in hospital. After 10 days, he presented with abdominal distension, bloating, and bloody diarrhoea. What is the most possible organism?

Female joint pain, with inherited skin disease running in the family but she is not sure what disease is that. She have onycholysis.

Patient with pallor. She have hand pain while cold. What are the expected finding. (can’t really rmb trigger)

A bartender, who was a chronic alcoholic, presented with yellowish colour of skin and mild hepatomegaly. There were IVDU mark on arm.

Female, presented with rash on sole and palm. (forgot le)

Patient presented with neck stiffness and fever. Which procedure you would like to done?

Patient presented with hb 8, as a attending dr what u would do next?

Patient with Cushingoid appearance, not suppressed by low dose DEXA, with low ACTH. Which is the most appropriate investigation to localise cause?

A female teenager, presented with multiple episodes of shortness of breath. Early morning wheezing, normal during afternoon and able to carry out sports activity. What is the most appropriate investigation?

Graves disease most specific antibody

Female, after labour, presented with SOB. The most appropriate investigation:

A 60-year-old woman presented with progressive lethargy for a month. Her haemoglobin level was 8 g/dL. Which among the following is the most appropriate action for the treating doctor?

A 50-year-old man diagnosed to have liver cirrhosis had a few bouts of vomiting and slowly became delirium. Flapping tremor was present. His per rectal examination revealed black tarry stools. Which among the following is the most likely diagnosis?

A 45-year-old truck driver presented after getting into a motor vehicle accident. He did not see a car on his right side in the side mirror. On further questioning, he admitted to having bumped into things “in his way” while walking for the past 1 year. He also noticed that he could no longer wear his wedding ring and needed to change into bigger shoes recently. Which of the following hormones is most likely to be raised in him?

25-year-old lady, underlying schizophrenia on medication, presented with amenorrhea and galactorrhea for 4 months. Her serum prolactin is elevated. Her urine pregnancy test is negative. Most likely diagnosis?

A 70-year-old man with long standing hypertension and smoking history presented with vertigo, vomiting, and right hemiplegia. Examination shown that he had lower motor neuron type facial palsy at the left side. Which of the following is the most likely diagnosis?

A 56-year-old man presented with haematemesis and malaena for 10 times last night. His blood pressure was 80/60 mmH. There was moderate ascites and gynaecomastia. Which is the MOST important investigation that should be done in this patient?

Smoker with underlying diabetes and hypertension experienced vertigo, vomiting, right sided...+weakness on left side of the face

A 30-year-old logging camp worker with fever, chills and rigor for 5 days associated with yellow skin discolouration. On examination, there was a mild tender hepatomegaly.

Mr C was in the clinic with complaints of progressive shortness of breath and fever for one week. Physical examination revealed a very ill patient with tachypnoea. Trachea was deviated to the left. There was bulging of the right side of the chest with reduced movement and stony dullness. CXR showed haziness in the whole of right hemithorax.

A 35-year-old woman presents with stiffness of both hands, difficulty in swallowing and shortness of breath for 1 month. She also reports that she used to take hot spicy foods. On examination, her blood pressure is found to be high at 200/120 mmHg. Which of the following is the most likely cause of her condition?

A 26 y/o woman presented with calf pain, ultrasonography shows DVT. Thrombolysis therapy was given and she was discharged. 2 days after discharge, she was admitted with complaint of pansystolic murmur at the left lower sternal edge. ECG shows p mitrale wave.

A man who is heavy alcoholic comes across to the hospital complaint of fever, myalgia and arthralgia. Upon history taking, he had affair with both male and female in past months. What is the investigation most likely to be done?

A 26 year old farmer presented with bilateral lower limb weakness, which was progressive. His lower limbs were hypotonic and areflexic. Which among the following is the most likely dx in this case?

A 60 y/o chronic smoker, presented with cough, haemoptysis, loss of weight and SOB. On examination, right supraclavicular lymph node is enlarged, right arm tenderness, right pupil looks smaller than that of left. Right eyes also looked smaller than left. What is the most likely dx?

An old man complained of pain at his spine. It was worst in the morning and got better with stretching and exercise. He also had enthesitis at the Achiles tendon insertion. What would be the most likely dx?

A man presented with swelling at cervical, axillary and inguinal lymph node. What is the best modalities for examination?

ikely dx?

The disease which typically presents with disseminated intravascular coagulopathy is

A man presented with paraoxysmal headache, palpitation and sweating. He is found to have raised blood pressure during the episode. At other time, his blood pressure is found to be normal. Which of the following is the best investigation to diagnose his condition?

A 30-year old man complained of chronic backache. It was worst in the morning and got better with stretching and exercise. He also had enthesitis at the Achiles tendon insertion. What would be the most likely diagnosis?

Which of the following is the best to assess the SLE (disease activity)?

A 33-year-old university student presented with recurrent episodes of shortness of breath and wheezing particularly upon waking up in the early morning. During daytime, she was well and able to participate in sports. The most important investigation for her is:

A 50-year-old farmer presented with fever and cough. Chest X-ray showed both upper zone cavitation and fibrosis. On further questioning, he also had on-off abdominal pain and vomiting. He easily felt hungry associated with sweating and palpitation. The most likely extrapulmonary tuberculosis manifestation is:

Mr. B, 25-year-old, previously well, complained of sudden shortness of breath while watching TV. It was for the first time. On physical examination, he was tall and slim. Right side of his chest moved little during deep breathing. Hyper-resonance on percussion, and diminished breath sound on the right side of the chest were noted. The most likely diagnosis is

A 35-year-old manual worker presented with progressive bilateral lower limb weakness. Which among the following features would positively suggest a diagnosis of transverse myelitis in this case?

A 70-year-old man with long-standing hypertension and smoking history presented with a sudden onset vertigo, vomiting and a right sided hemiplegia. Examination also revealed a lower motor neurone type facial palsy on the left side. Which among the following is the most likely current diagnosis?

A 48-year-old lady was admitted for pneumonia. Ten days after treatment, she complained of abdominal pain, and distension with bloody diarrhoea. Which of the following is likely the cause of her underlying symptoms?

A 45-year-old man presented with fever and confusion. He had headache for past 3 days associated with vomiting. On examination, he had neck stiffness with upgoing plantar reflex bilaterally. Which of the following is the most useful diagnostic investigation?

A 25-year-old women presented with fever, nausea, malaise, and haematuria for 4 days. On examination there was pedal oedema. She had been taking antibiotics for sore throat from her physician 10 days ago. Name MOST likely diagnosis is:

A 30-year-old man presented to a general practitioner clinic with gross haematuria and hypertension. His urine analysis showed dysmorphic RBCs, red cell, and white cell casts. What is the best investigation for a definitive diagnosis?

Which among the following diseases typically presents with disseminated intravascular coagulation?

A 27-year-old woman, who had been well with no past medical history of significance and not taking any regular medication, presented with sudden onset of bruising. There were no abnormal physical findings except for purpura. Initial blood test showed a platelet count of 8 x 109/L, a normal white cell count and normal Hb. Which of the following is the most likely diagnosis?

A 45-year-old man with liver cirrhosis presented with a rapid increase in abdominal distension and fever. His abdomen was tender on palpation. His ascitic fluid examination showed polymorphonuclear leucocytosis. His MOST likely diagnosis is:

A 45-year-old woman, known case of ulcerative colitis, presents with jaundice, pruritus and intermittent abdominal pain of 1 week. She has hepatosplenomegaly and mild ascites. Her MOST likely diagnosis is:

A 25-year-old lady with underlying schizophrenia on treatment presented with galactorrhea and amenorrhea of 4 months’ duration. Her serum prolactin was elevated and her urine pregnancy test negative. Which of the following is the most likely diagnosis in her?

A 50-year old gentleman with risk factors for type 2 diabetes comes for investigation. He is asymptomatic. Which of the following is diagnostic of diabetes mellitus in him?

A 30-year-old man was brought to hospital for an episode of syncope while playing futsal. On examination: BP 120/70 mmHg and pulse 70/min. On auscultation there was an ejection systolic murmur heard at left sternal edge which was louder on Vasalva manoeuvre. On further history, his father had history of sudden death at the age of 40. What is the most likely diagnosis?

A 70-year-old man with a history of long-standing hypertension presented with acute severe chest pain while having breakfast. On arrival to the emergency department, his BP was 190/110 mmHg and HR 110 bpm. His right radial pulse was feeble. ECG showed a slight ST elevation in leads II, III, and aVF. Chest X-ray showed mediastinal widening. (inferior MI) What is the most likely diagnosis?

A 25-year old woman is diagnosed to have systemic lupus erythematosus and is on maintenance medication. She presented with shortness of breath and pedal oedema for the past 2 days. On examination, there was a raised jugular venous pressure and pedal oedema up to the mid-shin. Auscultation of the lungs were clear. The S1 and S2 were soft. ECG showed a varying QRS amplitude. Chest X-ray showed a large cardiac shadow. What is the most likely diagnosis?

Which of the following is the MOST common cause of duodenal ulcer

A 60yo man with diabetes presented to Emergency Department with severe compressing chest pain for past 4 hours. His ECG showed an ST elevation in lead V1-V3. He also has a history of intacranial bleed due to an aneurysm more than 10 years ago. Operation was done and he had no residual deficit. He has no recent history of GI bleed and his coagulopathy screen is negative. What would be the best option for his treatment?

A 45-yo man presents with 2-days history of central chest pain which is worse with breathing. He has a background history of chronic low back pain and stiffness which is particularly worse in the morning. The most likely cause of his chest pain is:

23 YO woman is seen in clinic for recurrent funny turns. She is not aware of them, but her family and friends have noticed them. They say she looks around blankly, then start picking at her clothes and sometimes yawn, then she is back to normal after a minute. After some episodes, she is also noted to be drowsy. What seizure type is she having?

What seizure type is she having?

A 29 yo man presented with intermittent fever for 2 months, a/w lethargy and loss of weight. There was no localizing symptoms. On examination, he was cachectic. There was cervical lymphadenopathy. He also had oral candidiasis. Which of the following investigation is most useful in diagnosing his condition?

28 YO presented with 3 weeks history of intermittent fever and an audible murmur on physical examination, investigation showed a positive blood culture and echocardiogram showed a small vegetation in the mitral valve. He was started on IV antibiotics and his fever subsided. However, on day 5 of treatment, he developed a seizure. On physical examination post ictal, he was not moving on the left side of his body. What is likely cause?

Which is the best lymph node biopsy method to diagnose lymphoma?

A 23-yo woman is seen in clinic for recurrent funny turns. She is not aware of them, but her family and friends have noticed them. They say she looks around blankly, then start picking at her clothes and sometimes yawns, then she is back to normal after a minute. After some episodes, she is also noted to be drowsy. What seizure type is she having?

45 yo presents with 2 days history of central chest pain which is worse with breathing. He has a background history of chronic low back pain and stiffness which is particularly worse in the morning. The most likely cause of his chest pain is

35 yo gentleman with young hypertension was diagnosed with phaeochromocytoma after blood and imaging studies. Which of the following treatment should be initiated on diagnosis?

A 60 years old man, presented with cough and SOB for 2 months, with occasional wheezing and worsens at night. What is the appropriate investigation to be done?

60 yrs old, hypertension, diagnosed stroke. Right hemiplegia & left facial weakness & left drooping eyelid. Where is the lesion?

38 yrs old female, fluctuating muscle weakness, drooping eyelid and diplopia. Which one should be done for investigation?

A 30-year-old lady who has lupus nephritis is found to be pregnant during follow-up. Which of the following is contraindicated in her?

A 50-year old chronic alcoholic presented with bleeding per rectum for days. They were palmar erythema and spider naevi.

30 y/o steward presented with fever, occasional flu, cough, myalgia, lost 10kg in weight, he is pink, cachexic, no lymphadenopathy or organomegaly, CXR is normal, TWC is 2.2x10*9 with lymphopenia, plt 154, what is the most useful ix?

68 yrs old woman presented with mucosal bleeding, petechiae and gum bleeding. BP 89/47 mmHg, tachycardia 125 beats/min, SPO2: 96%. What is the initial mx?

70 y/o male Alzheimer dx with BPSD. Severe physical and verbal aggression despite non-pharmacological approach. Most suitable mx

A 65 y/o gentleman, worked as an accountant previously. He visited memory clinic because of his memory decline over these 5 years. He had lacunar stroke 2 years ago and he recovered fully. He had diabetes, HPT & dyslipidemia. Recently, his wife noted he became more forgetful and had difficulty in managing daily life. Most possible dx

19 y/o lady presented with multiple painful, erythematous and nodular lesions on both shins for 2 days. She had hx of fever, joint pain, cough & sore throat about 2 weeks ago. What is the most likely cause of her lower limb lesions?

20 yo man, nkmi, sudden onset palpitations. Was watching TV and drinking coffee. Recalled last year similar presentation but lasted less than a minute. O/E he appeared well. ECG showed narrow complex tachycardia and HR 150/min. At ETD, the most suitable drug given:

50 y/o gentleman with u/l IHD presented at ETD with palpitation after watching TV. Previous NYHA 1 and CCS 1. While talking to the patient, he became less responsive. BP 80/50 HR 150 ECG showed broad complex tachycardia. Which is the most appropriate treatment for him at ETD?

40 year old man, chronic smoker p/w SOB & palpitation. On examination he had barrel chest, reduced liver cardiac dullness. What is the first line management?

Following features most indicative of Horner's syndrome:

Which of the following is strongly indication of thrombolytic therapy after stroke?

A 65 years old is admitted as an emergency, after renal function being assessed 1 month after starting ACE inhibitor therapy for hypertension. Examination reveals abdominal and carotid bruits, she is clinically euvolemic. Her BP is 156/88 mmHg. ECG on admission is unremarkable. His baseline serum creatinine 1 month ago is 120 micromol/L and now his creatinine has risen to 370 micromol/L. What is most appropriate management?

38 years old man, his father has history of haemochromatosis. He came to clinic for screening before getting married. What is the first screening test for haemochromatosis?

36yo, lorry driver, intermittent fever for 2 months, a/w lethargy, LOW, diarrhoea. Normal colonoscopy. PE: cachexic, cervical lymphadenopathy, multiple umbilicated skin lesion, oral thrush, no abdominal mass. What's the next investigation?

Rheumatoid Arthritis treat with methotrexate, palor reduce hb, however normal mch mcv mchc.

55 y/o female with rheumatoid arthritis came with pallor, on methotrexate and celecoxib Hb low normal mcv mchc n reticulocyte. What is the cause of anemia?

60 year old lady came to clinic. Dexa T scan -2.6 First line therapy is:

Patient had stroke one year ago. Currently had reduced memory impairment but no psychotic feature. No progression of development of the symptom.

60 years old woman presented with scaly itchy skin lesion. There is bilateral varicose vein, what is the dx?