A 17-year-old man presents with visible haematuria but no abdominal or loin pain. Symptoms developed 2 days after an upper respiratory tract infection. Which is the most likely diagnosis?

A 30-year-old fisherman presents to the Emergency Department with sudden-onset shortness of breath and right-sided chest pain after a physical altercation. Which is the most likely cause?

A 24-year-old male smoker collapses while playing football. He has a family history of sudden cardiac death; his brother died at age 36. Examination reveals a soft systolic murmur and ECG shows left ventricular hypertrophy. What is the most likely diagnosis?

A 45-year-old obese woman, post-right hip surgery, presents with sudden-onset shortness of breath and left-sided chest pain. She is hypoxic and has clear lung fields on auscultation. What is the most likely diagnosis?

An elderly man is treated in hospital for pneumonia. Ten days later, he develops abdominal distension, bloating, and bloody diarrhoea. What is the most likely causative organism?

A woman presents with joint pain and a family history of an unspecified inherited skin disease. She has onycholysis. What is the most likely diagnosis?

A woman presents with pallor and hand pain in cold weather. Which associated finding is most likely?

A bartender with a history of chronic alcoholism presents with jaundice and mild hepatomegaly. He has injection marks on his arms. Which is the most appropriate investigation?

A woman presents with a rash on her soles and palms. Which is the most likely diagnosis?

A patient presents with neck stiffness and fever. Which procedure should be performed?

A patient’s haemoglobin is 8 g/dL. As the attending doctor, what is the most appropriate next step?

A patient with a Cushingoid appearance does not show cortisol suppression with a low-dose dexamethasone test and has low ACTH levels. Which investigation is most appropriate to localise the cause?

A teenage girl presents with recurrent episodes of shortness of breath. She experiences early morning wheezing but is normal in the afternoon and can participate in sports. Which is the most appropriate investigation?

In Graves’ disease, which antibody is most specific?

A woman develops shortness of breath after labour. Which is the most appropriate investigation?

A 60-year-old woman presents with progressive lethargy for one month. Haemoglobin is 8 g/dL. Which is the most appropriate next step?

A 50-year-old man with liver cirrhosis has several bouts of vomiting, becomes delirious, and has a flapping tremor. PR examination reveals black tarry stools. Which is the most likely diagnosis?

A 45-year-old truck driver is involved in a motor vehicle accident. He did not see a car on his right and reports bumping into objects while walking over the past year. He has recently needed larger shoes and cannot wear his wedding ring. Which hormone is most likely elevated?

A 25-year-old woman with schizophrenia on medication presents with amenorrhoea and galactorrhoea for 4 months. Serum prolactin is elevated and urine pregnancy test is negative. What is the most likely diagnosis?

A 65-year-old man presents with sudden-onset left-sided weakness and slurred speech lasting 20 minutes. He recovers fully. What is the most likely diagnosis?

A 40-year-old woman presents with progressive weakness and shortness of breath on exertion. Examination reveals bilateral ptosis that worsens by evening. What is the most likely diagnosis?

A 55-year-old man presents with chest discomfort on exertion, relieved by rest. ECG is normal. What is the most likely diagnosis?

A 45-year-old woman presents with central obesity, purple striae, and hypertension. Low-dose dexamethasone suppression test shows no cortisol suppression. ACTH is low. Which is the most likely diagnosis?

A 60-year-old man presents with fever, productive cough, and pleuritic chest pain. Sputum culture shows gram-positive diplococci. Which is the most likely organism?

A 35-year-old man presents with weight loss, tremor, and diarrhoea. Thyroid is diffusely enlarged. Which antibody is most specific for the diagnosis?

A 25-year-old woman presents with recurrent oral ulcers, arthritis, and photosensitive rash. ANA is positive. Which is the most likely diagnosis?

A 65-year-old man presents with bitemporal hemianopia. MRI shows a pituitary macroadenoma. Which hormone excess is most likely if he also has acromegalic features?

A 30-year-old man presents with fever, night sweats, and painless cervical lymphadenopathy. Lymph node biopsy shows Reed–Sternberg cells. Which is the most likely diagnosis?

A 50-year-old man with COPD presents with worsening shortness of breath. ABG shows pH 7.28, PaCO₂ 8.5 kPa, PaO₂ 6.5 kPa. What is the most likely diagnosis?

A 28-year-old man presents with urethral discharge. Gram stain shows gram-negative intracellular diplococci. Which is the most likely organism?

A 35-year-old woman presents with polyuria and polydipsia. Serum sodium is 150 mmol/L. Urine osmolality is low and does not increase with water deprivation. Which is the most likely diagnosis?

A 55-year-old woman presents with bone pain and elevated ALP. X-ray shows thickened cortex and enlarged bone. Which is the most likely diagnosis?

A 50-year-old man presents with chest pain, sweating, and ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?

A 40-year-old woman presents with weight gain, hirsutism, and menstrual irregularity. Testosterone is mildly elevated. Which is the most likely diagnosis?

Testosterone is mildly elevated. Which is the most likely diagnosis?

A 25-year-old man presents with cough and haemoptysis. CXR shows bilateral hilar lymphadenopathy. Serum ACE is elevated. Which is the most likely diagnosis?

A 70-year-old man presents with difficulty initiating urination and weak stream. PSA is elevated. Which is the most likely diagnosis?

A 40-year-old woman presents with fatigue, dry eyes, and dry mouth. Anti-Ro and anti-La antibodies are positive. Which is the most likely diagnosis?

A 55-year-old man presents with severe chest pain and ECG shows diffuse ST elevation. Which is the most likely diagnosis?

A 50-year-old woman presents with dysphagia and iron-deficiency anaemia. Which is the most likely diagnosis?

A 35-year-old woman presents with heat intolerance, weight loss, and palpitations. Thyroid scan shows diffuse increased uptake. Which is the most likely diagnosis?

A 60-year-old man presents with progressive shortness of breath and orthopnoea. Echocardiogram shows a dilated left ventricle with reduced ejection fraction. Which is the most likely diagnosis?

A 45-year-old man presents with jaundice, pruritus, and fatigue. ALP is elevated and antimitochondrial antibody is positive. Which is the most likely diagnosis?

A 28-year-old man presents with chest pain and shortness of breath. ECG shows sinus tachycardia, D-dimer is elevated. Which is the most likely diagnosis?

A 28-year-old man presents with haematuria following an upper respiratory tract infection. Which is the most likely diagnosis?

A 40-year-old man presents with chronic cough and night sweats. CXR shows right upper lobe cavitation. Which is the most likely diagnosis?

A 55-year-old man presents with hypertension and low potassium. Plasma renin is low, aldosterone is high. Which is the most likely diagnosis?

A 65-year-old woman presents with postmenopausal bleeding. Endometrial biopsy shows adenocarcinoma. Which is the most important risk factor?

A 30-year-old man presents with progressive dyspnoea and cough. CXR shows bilateral hilar lymphadenopathy. Which is the most likely diagnosis?

A 50-year-old woman presents with pruritus, jaundice, and elevated ALP. AMA is positive. Which is the most likely diagnosis?

A 45-year-old man presents with epigastric pain relieved by food. Endoscopy shows a duodenal ulcer. Which is the most likely cause?

A 55-year-old man presents with weight loss, diarrhoea, and a thyroid nodule. Calcitonin is elevated. Which is the most likely diagnosis?

A 40-year-old woman presents with fever, right upper quadrant pain, and tender hepatomegaly. Ultrasound shows a hypoechoic lesion in the right lobe. Which is the most likely diagnosis?

A 28-year-old man presents with polyuria, polydipsia, and weight loss. Random blood glucose is 18 mmol/L, ketones are present. Which is the most likely diagnosis?

A 45-year-old man presents with chronic cough, night sweats, and haemoptysis. CXR shows upper lobe cavitation. Which is the most likely diagnosis?

A 60-year-old woman presents with severe epigastric pain and weight loss. CT abdomen shows a pancreatic head mass. Which is the most likely diagnosis?

A 35-year-old woman presents with proximal muscle weakness that improves with repeated activity. Which is the most likely diagnosis?

A 40-year-old man presents with chronic diarrhoea, recurrent oral ulcers, and perianal fistulas. Which is the most likely diagnosis?

A 55-year-old man presents with sudden-onset tearing chest pain radiating to the back. BP difference between arms is noted. Which is the most likely diagnosis?

A 50-year-old woman presents with constipation, depression, and kidney stones. Labs: hypercalcaemia, low phosphate, high PTH. Which is the most likely diagnosis?

A 25-year-old man presents with haematuria, sensorineural deafness, and family history of kidney disease. Which is the most likely diagnosis?

A 65-year-old man presents with progressive dysphagia and weight loss. Endoscopy reveals a distal oesophageal mass. Which is the most likely diagnosis?

A 40-year-old man presents with recurrent renal stones and hyperuricaemia. Which is the most likely diagnosis?

A 55-year-old woman presents with hoarseness, dysphagia, and weight loss. She is found to have a laryngeal mass. Which is the most likely diagnosis?

A 70-year-old man presents with progressive gait disturbance, urinary incontinence, and dementia. CT brain shows enlarged ventricles without cortical atrophy. Which is the most likely diagnosis?

A 35-year-old man presents with haemoptysis, haematuria, and positive anti-GBM antibodies. Which is the most likely diagnosis?

A 28-year-old woman presents with abdominal pain, weight loss, and hyperpigmentation. Labs: hyponatraemia, hyperkalaemia, low cortisol. Which is the most likely diagnosis?

A 60-year-old man presents with progressive dyspnoea, orthopnoea, and bilateral leg oedema. Echocardiogram shows dilated ventricles with reduced EF. Which is the most likely diagnosis?

A 45-year-old woman presents with haematemesis and splenomegaly. Endoscopy shows oesophageal varices. Which is the most likely cause?

A 30-year-old man presents with recurrent oral ulcers, pustular skin lesions, and positive pathergy test. Which is the most likely diagnosis?

A 50-year-old woman presents with dysphagia and Raynaud phenomenon. Examination shows tight skin over fingers and face. Which is the most likely diagnosis?

A 60-year-old man presents with anaemia, hypercalcaemia, and renal impairment. Skeletal survey shows lytic bone lesions. Which is the most likely diagnosis?

A 35-year-old man presents with pleuritic chest pain and pericardial friction rub. ECG shows diffuse ST elevation. Which is the most likely diagnosis?

A 55-year-old woman presents with pruritus, jaundice, and elevated ALP. Antimitochondrial antibody is positive. Which is the most likely diagnosis?

A 40-year-old man presents with fever, back pain, and urinary retention. Which is the most likely diagnosis?

A 28-year-old woman presents with photosensitive rash, alopecia, and proteinuria. ANA is positive. Which is the most likely diagnosis?

A 60-year-old man presents with painless progressive vision loss. Fundoscopy shows cupped optic disc. Which is the most likely diagnosis?

A 30-year-old man presents with jaundice after fasting. Labs: unconjugated hyperbilirubinaemia, normal LFTs. Which is the most likely diagnosis?

A 45-year-old woman presents with proximal muscle weakness and rash on the knuckles. Which is the most likely diagnosis?

A 70-year-old man presents with confusion, dehydration, and plasma sodium 165 mmol/L. Which is the most likely cause?

A 55-year-old man presents with cough, fever, and right lower lobe consolidation on CXR. Sputum culture grows Klebsiella pneumoniae. Which is the most likely risk factor?

A 55-year-old woman presents with difficulty swallowing, skin tightening over the fingers, and Raynaud phenomenon. Which is the most likely diagnosis?

A 70-year-old man presents with memory loss, bradykinesia, and visual hallucinations. Which is the most likely diagnosis?

A 30-year-old man presents with haematuria and sensorineural hearing loss. Which is the most likely diagnosis?

A 50-year-old man presents with chronic cough, copious sputum, and recurrent chest infections. Which is the most likely diagnosis?

A 40-year-old woman presents with episodic headache, sweating, and palpitations. BP during episodes is 200/120 mmHg. Which is the most likely diagnosis?

A 65-year-old man presents with leg pain on walking relieved by rest. ABI is 0.6. Which is the most likely diagnosis?

A 35-year-old woman presents with proximal muscle weakness and a heliotrope rash. Which is the most likely diagnosis?

A 25-year-old man presents with high fever, confusion, and neck stiffness. Which is the most appropriate immediate investigation?

A 50-year-old man with hypertension develops sudden severe headache and loss of consciousness. CT brain shows basal ganglia haemorrhage. Which is the most likely cause?

A 60-year-old woman presents with macrocytic anaemia and peripheral neuropathy. Which is the most likely deficiency?

A 30-year-old man presents with haemoptysis and haematuria. Anti-GBM antibodies are positive. Which is the most likely diagnosis?

A 28-year-old woman presents with infertility, hirsutism, and oligomenorrhoea. Which is the most likely diagnosis?

A 55-year-old man presents with anaemia, hypercalcaemia, and renal impairment. Skeletal survey shows lytic bone lesions. Which is the most likely diagnosis?

A 45-year-old woman presents with severe epigastric pain radiating to the back. Amylase and lipase are markedly elevated. Which is the most likely cause?

A 35-year-old man presents with jaundice and right upper quadrant pain after fatty meals. Ultrasound shows a dilated common bile duct with gallstones. Which is the most likely diagnosis?

A 25-year-old woman presents with acute onset of chest pain and shortness of breath. ECG shows sinus tachycardia, D-dimer is elevated. Which is the most likely diagnosis?

A 60-year-old man presents with a chronic cough and blood-streaked sputum. CXR shows a mass in the right upper lobe. Which is the most likely diagnosis?

A 40-year-old man presents with polyuria, polydipsia, and nocturia. Fasting glucose is 9 mmol/L. Which is the most likely diagnosis?

A 70-year-old woman presents with a painful swollen knee. Synovial fluid is cloudy with negatively birefringent needle-shaped crystals. Which is the most likely diagnosis?

A 55-year-old man presents with severe chest pain radiating to the back. BP in the right arm is higher than the left. Which is the most likely diagnosis?

A 35-year-old man presents with diarrhoea, weight loss, and recurrent abdominal pain. Colonoscopy shows skip lesions and cobblestoning. Which is the most likely diagnosis?

A 65-year-old man presents with headache, jaw claudication, and visual disturbance. ESR is 100 mm/hr. Which is the most likely diagnosis?

A 50-year-old woman presents with jaundice, ascites, and spider naevi. Which is the most likely underlying cause?

A 25-year-old woman presents with fever, malaise, and a maculopapular rash starting on the face and spreading to the trunk. Cervical lymphadenopathy is present. Which is the most likely diagnosis?

A 30-year-old man presents with recurrent headaches, palpitations, and sweating. BP is intermittently high. Which is the most likely diagnosis?

A 70-year-old man presents with progressive dysphagia for solids then liquids. Barium swallow shows a bird-beak appearance. Which is the most likely diagnosis?

A 60-year-old woman presents with chronic cough and wheeze. She has never smoked. HRCT shows bronchial wall thickening and tram-track opacities. Which is the most likely diagnosis?

A 55-year-old man presents with a resting tremor, bradykinesia, and cogwheel rigidity. Which is the most likely diagnosis?

A 35-year-old woman presents with fatigue, pallor, and glossitis. MCV is 110 fL. Which is the most likely diagnosis?