A 55-year-old man presents with a 7-week history of progressive dysphagia, initially noticed when eating meat, with food getting stuck retrosternally. What is the most appropriate initial investigation?

A 50-year-old woman presents with a right iliac fossa mass persisting for 4 months. She reports lethargy, poor appetite, and a 3 kg weight loss. What is the most likely diagnosis?

A 42-year-old alcoholic male with a recent history of pancreatitis presents with a palpable abdominal mass and mildly elevated serum amylase. What is the most likely diagnosis?

A 52-year-old man presents with a 1 cm thyroid nodule on the left lobe, confirmed as a solid lesion on ultrasound. What is the next best investigation to establish a definitive diagnosis?

What is the first priority in managing a patient with multiple traumatic injuries?

A 75-year-old man develops a fever of 39.5°C and abdominal tenderness on post-operative day 5 following anterior resection. What is the most likely diagnosis?

Which of the following is the most important criterion for distinguishing between benign and malignant tumours?

A 30-year-old woman presents with progressive dysphagia for 2 years, associated with retrosternal chest pain. Physical examination is unremarkable. What is the most likely diagnosis?

In a patient presenting with lower rectal cancer, what is the most likely clinical finding?

Which of the following is a characteristic clinical feature of fibroadenoma?

A 52-year-old obese woman presents with jaundice, fever with chills and rigors, and right hypochondriac pain. What is the most likely diagnosis?

What is the most accurate investigation to confirm the presence of urinary tract stones?

A 60-year-old man presents with progressive dysphagia and weight loss of 12 kg. He is on a liquid diet. He has a history of smoking and moderate alcohol consumption. What is the most likely diagnosis?

A 45-year-old woman with Crohn's disease underwent a right hemicolectomy. Two weeks later, she is readmitted with swinging pyrexia. What is the most likely cause?

A 27-year-old man complains of progressive right scrotal pain. He is sexually active with a female partner. Examination shows the right testis is elongated and three times larger than the left. What is the most likely diagnosis?

A middle-aged man involved in a road traffic accident presents with severe bruising and crepitus over the left leg. X-ray confirms fractures of the tibia and fibula. Initially stable, he becomes unconscious, hypotensive, and oliguric a few hours later. What is the next appropriate step in management?

A 57-year-old alcoholic man presents with sudden severe epigastric pain radiating to the back after a heavy meal. The pain is not relieved by position changes. What is the most likely diagnosis?

A 45-year-old woman presents with swelling of the left lower leg. The leg is red, warm, and tender. Passive dorsiflexion of the ankle elicits calf pain. What is the most likely diagnosis?

A 75-year-old man presents with acute urinary retention. He has a history of prostatism. Digital rectal examination reveals a hard, nodular prostate. What is the most likely diagnosis?

A 55-year-old woman presents with hematemesis and melena. On examination, her pulse is 130 bpm and blood pressure is 80/55 mmHg. Digital rectal examination reveals black tarry stool. What is the most appropriate initial management?

A 63-year-old woman presents with an ulcer on her left cheek measuring 1 cm in diameter with a rolled edge. The surrounding skin shows signs of sun damage. What is the most likely diagnosis?

A 15-year-old girl develops intermittent abdominal pain with sudden fever of 39°C. She has repeated vomiting and diarrhoea. On examination, pulse is 140 bpm and there is right iliac fossa rigidity. What is the most likely diagnosis?

A 23-year-old woman presents with a neck swelling located at the upper third of the anterior border of the sternocleidomastoid muscle. On examination, the mass measures 2x3 cm, soft and fluctuant. What is the most likely diagnosis?

A 60-year-old man presents with unexplained anaemia and vague abdominal pain. On examination, a distinct mobile mass is palpable in the right iliac fossa. What is the most likely diagnosis?

What is the most common nosocomial infection in intubated patients in the intensive care unit (ICU)?

A 35-year-old male involved in a road traffic accident sustains a splenic injury. He is admitted for supportive care and receives a blood transfusion. Within minutes of initiation, the patient becomes agitated and develops pyrexia, tachycardia, and hypotension.

Which of the following is the most appropriate immediate management?

A 40-year-old female was kept in the recovery unit after undergoing a total abdominal hysterectomy. Her hemoglobin was 6.5 g/dL, and a blood transfusion was initiated. Shortly after, she became distressed and her blood pressure began to drop. The urine in her catheter bag appeared red.

What is the MOST likely type of hypersensitivity reaction involved?

Which of the following is the best recognized preoperative abnormality related to body temperature?

A 22-year-old gentleman with known thalassemia came for a routine blood transfusion. During transfusion, he developed tachycardia (130 bpm), hypotension (80/30 mmHg), and fever (39.3°C).

What should be done immediately?

A 45-year-old man was involved in an automobile accident and presented to the Emergency Trauma Department (ETD) in shock. He was alert with normal neurological status, respiratory rate 20 bpm, SBP 60 mmHg, and pulse rate 120 bpm. The abdomen was distended with reduced bowel sounds.

What is the most likely diagnosis?

A 35-year-old gentleman sustained 14% total body surface area (TBSA) burns involving both lower limbs. The right limb has a circumferential full-thickness burn.

What is the most concerning potential acute complication?

A 37-year-old lactating woman presents with a lump under the left nipple. On examination, it is a round cystic lesion, measuring 7 cm, and non-tender.

What is the most likely diagnosis?

What is the most appropriate measure for the management of venous thromboembolism (VTE)?

A patient presents with severe renal colic and is known to have a left ureteric stone.

What is the best initial management for pain relief?

A 45-year-old man complains of severe left loin-to-groin pain for 2 days.

What is the most appropriate imaging in the A&E department?

An 80-year-old man is scheduled for elective laparotomy. Preoperative assessment highlights the importance of careful temperature regulation during the procedure.

Which site provides the most accurate indirect measurement of cerebral temperature?

A patient with pyloric stenosis is put on an NG tube, draining 1 L of gastric fluid daily.
What is the most likely acid-base disturbance?

A 32-year-old woman has a solitary thyroid nodule. FNAC confirms papillary thyroid carcinoma.
Which factor is commonly associated with this condition?

What is the best imaging to diagnose gallstones in a patient with acute pancreatitis?

A 69-year-old man presents with right inguinal pain and swelling. One year ago, he had a reducible inguinal lump. Now it is tender, tense, irreducible, and has no cough impulse.
What is the most likely diagnosis?

An 11-year-old boy presents with agonising right scrotal pain, no fever or trauma. On examination: swollen tender scrotum, testis high-riding.
Most likely diagnosis:

A 72-year-old male presents with a painless 2 cm lesion on the left lower lip. The lesion has everted edges, central ulceration, and sun-damaged surrounding skin.
Most likely diagnosis:

A 30-year-old man found collapsed at home. GCS 7/15, intubated. Pupils equal and reactive. BP 140/90, HR 52 bpm. Glucose and ABG normal.
What is the investigation of choice?

Which condition most likely causes respiratory failure due to hypoventilation?

Regarding pain assessment:

A 68-year-old man underwent right hemicolectomy for caecal adenocarcinoma. Which finding suggests poor prognosis?

Which therapy reduces mortality and morbidity in bleeding peptic ulcer?

A 16-year-old boy has 3-day history of colicky abdominal pain, vomiting, no bowel output or flatus. Hx of laparotomy for Wilms tumor. Abdomen distended, midline scar healed, vitals stable.
Likely diagnosis:

A 45-year-old man presents with LUTS secondary to BPH. Prostate 40cc, PSA 4.
Next step in management:

A patient presents with a large glans penis growth.
Most appropriate approach:

A pregnant woman has a 3 mm friable lesion on lower lip, bleeds on touch, well-defined edges.
Most likely diagnosis:

Regarding anaesthesia:

A patient with GCS 5 after head injury presents to A&E.
What is the next immediate management?

A 60-year-old man with calf claudication. Cramping pain relieved by rest, decreased walking distance.
Initial investigation:

Most important prognostic factor in malignant melanoma:

Condition most strongly associated with testicular tumor:

A 24-year-old male presents with painless swelling in upper scrotum. Translucent, separate from testis.
Most likely diagnosis:

Neuropathic pain is best described by:

35-year-old male, post-appendectomy, now with vomiting, distension, constipation.
Next investigation:

Which patient is at greatest risk of aspiration pneumonitis?

52-year-old woman had mastectomy for right breast cancer. Now presents with lump in left breast.
Initial investigation:

40-year-old man with severe abdominal pain radiating loin to groin, with nausea and urinary urgency. Normal abdominal exam.
Most probable diagnosis:

72-year-old woman with altered bowel habit, CT shows liver lesions in segments 6 & 7.
Most likely diagnosis:

80-year-old with GOO due to antral carcinoma with para-aortic LN, no distant mets.
Most appropriate management:

Regarding opioid analgesia:

Intraoperative monitoring:

Man with bilateral recurrent inguinal hernia. Best advice:

A 72-year-old man has fever, red swollen groin 6 days after hernia repair.
Most likely cause:

Woman with painful defecation, burning for 3 hours, blood on wiping, skin tag at 12 o'clock, DRE intolerable.
Diagnosis:

Shipwrecked man, 70 kg, no food for 2 days, conscious but severely dehydrated.
Best fluid management:

55-year-old man with dyspepsia despite PPI and H. pylori treatment. OGDS shows partial GOO from chronic duodenal ulcer.
Most appropriate management:

52-year-old man with hematemesis, alcoholic, spider naevi and palmar erythema.
Most likely diagnosis:

Intraoperative supraventricular tachycardia, BP 110/90.
Immediate management:

43-year-old man with fever, back pain, night sweats, left groin swelling soft and fluctuant.
Most likely diagnosis:

Trauma patient: GCS 13, BP 80/40, widened mediastinum on CXR, positive peritoneal tap.
Next step in management: