A 72 Y/O M presents for a routine annual check-up. He feels well and denies fever, weight loss, or night sweats. Hx is notable for HTN. O/E reveals palpable cervical and axillary lymph nodes, each ~1.5 cm, non-tender, and mobile. Spleen tip is palpable 2 cm below the left costal margin. Ix labs show: WBC 35,000/µL (normal 4,000-11,000) with 85% lymphocytes, Hb 12.8 g/dL, and Platelets 160,000/µL. Peripheral smear is ordered. Which of the following findings on the peripheral blood smear is most characteristic of this patient's most likely diagnosis?

An 82-year-old male with a history of chronic constipation presents with a 2-day history of crampy abdominal pain, vomiting, and obstipation. On physical examination, his abdomen is distended and tympanitic. Auscultation reveals high-pitched bowel sounds. There is no guarding or rebound tenderness, and his vital signs are stable. What is the most appropriate next investigation to confirm the diagnosis and identify the underlying cause?

A man undergoes a difficult laparoscopic cholecystectomy where a partial transection of the CBD is identified. The injury is repaired intraoperatively over a T-tube. Post-op, the patient is stable. The T-tube is scheduled for removal in 3 weeks. Prior to removal, the surgical team wants to confirm the integrity of the repair and patency of the biliary tract. Which of the following is the most appropriate investigation to perform before removing the T-tube?

A healthy 34 Y/O G3P2 at 28 weeks gestation, with a BMI of 32 kg/m ², undergoes a 3-hour 100g OGTT after an abnormal 50g GCT. Her results are as follows: Fasting: 5.8 mmol/L 1-hour: 10.9 mmol/L 2-hour: 9.1 mmol/L 3-hour: 7.5 mmol/L Based on these results, what is the most likely diagnosis?

An adult pt with a newly diagnosed 5 cm rectal villous adenoma is admitted with severe secretory diarrhea. Despite 24h of aggressive IV fluid and potassium repletion, the stool output remains >4L/day, hampering preoperative stabilization. Vitals are stable, but serum K+ remains difficult to correct. Which adjunctive medication is most appropriate to help control this pt's refractory diarrhea?

An adult M with a prosthetic aortic valve is being treated for infective endocarditis. He develops acute-onset, severe left hypochondriac pain that worsens with inspiration. O/E: Marked tenderness in the left upper quadrant. Which is the best imaging modality to investigate this specific complication?

A 6 Y/O F is brought in for early physical development. O/E: Tanner stage 3 breast development and Tanner stage 2 pubic hair are present. Ix: Basal LH and FSH levels are in the pubertal range, with a correspondingly high estradiol. Bone age is advanced by 2 years. These findings are most consistent with which diagnosis?

A patient with HIV on a stable ART regimen presents with new-onset petechiae and mucosal bleeding. Ix: Isolated severe thrombocytopenia with a platelet count of 12 x 10⁹/L. Hemoglobin and WBC count are normal. A peripheral smear shows decreased platelets with some large forms. In addition to continuing ART, what is the most appropriate initial intervention for this specific hematological complication?

A patient with hypertension and diabetes mellitus is started on Lisinopril. Routine labs are checked 2 weeks later. Which electrolyte abnormality is a well-known side effect of this medication?

A sigmoidoscopy performed for painless rectal bleeding reveals an ulcerated mass. Lab investigations show a microcytic anemia with Hb 82 g/L, low serum iron, and low ferritin. Biopsy of the mass confirms adenocarcinoma. What is the primary mechanism responsible for the patient's anemia?

A case of chronic osteoarthritis in a pregnant patient at 22 weeks' gestation requires initiation of analgesia for moderate, persistent joint pain. The goal is to select the agent with the most favorable safety profile for both the mother and fetus. What is the most appropriate first-line pharmacological agent?

Following an acute right-hemispheric stroke, a patient exhibits left hemiplegia. Speech is noted to be slurred and difficult to articulate. However, the patient demonstrates intact comprehension, correct grammar, and appropriate word choice when communicating. What is the most precise term for this patient's speech impairment?

A military recruit develops insidious-onset forefoot pain after weeks of intense training. The pain is localized over the dorsum of the foot and worsens with activity. A plain radiograph reveals a non-displaced hairline fracture through the distal shaft of the second metatarsal. This finding is best described as a:

A 45 Y/O M, a long-distance truck driver, presents with chronic low back pain, hamstring tightness, and noted hyperlordosis. His lateral lumbar spine X-ray is shown. This finding is characteristic of:

A 35-year-old female presents with a "thunderclap headache." What is the likely diagnosis based on the provided non-contrast CT scan of the head?

A 24-year-old footballer presents with knee pain and instability after a sudden twisting injury. An MRI shows a tear of the most commonly injured knee ligament. What is the most likely diagnosis?

A 48 Y/O F, G3P3, presents with a 6-month Hx of intermenstrual bleeding. Her menstrual cycles were previously regular. Pelvic exam is unremarkable. Transvaginal ultrasound was suggestive of endometrial thickening. She undergoes a diagnostic hysteroscopy, and the following image is obtained. Based on the hysteroscopic image, what is the most likely diagnosis?

A 30 Y/O F is diagnosed with a complete hydatidiform mole at 11 weeks GA. Her USG shows the classic "snowstorm" appearance with a uterine size of 16 weeks. She is hemodynamically stable but has persistent vaginal bleeding. Pre-operative workup is otherwise unremarkable. What is the most appropriate definitive management for this patient?

A 34-year-old female presents for counseling regarding her risk for thrombosis. She is asymptomatic but reports a significant family history: both her father and her brother experienced unprovoked deep vein thrombosis at ages 58 and 38, respectively. The patient is considering starting oral contraceptive pills and wishes to be evaluated for a potential underlying inherited predisposition. What is the most common hereditary thrombophilia she is at risk for?