middle-aged man

A 62-year-old male presents with a three-month history of intermittent rectal bleeding and altered bowel habits. His past medical history is unremarkable. A colonoscopy was performed, and a still image is shown. What is the MOST appropriate next step in management?

A 55-year-old man presents with 2 days of left lower quadrant pain and mild constipation. He denies fever, nausea, or vomiting. On examination, he is afebrile, BP 120/70, HR 65, O2 sat 99% on air. There is mild LLQ tenderness without guarding or rebound. Bloods show WCC 11.5, CRP 30. A CT scan is performed. Considering the clinical presentation and the findings demonstrated in the image, what is the most appropriate initial management plan?

A 45-year-old weightlifter presents with sudden pain and a bulge in his arm after lifting a heavy weight. On examination, there is a Popeye deformity. What is the most likely mechanism of injury?

A 58-year-old male presents to your GP clinic complaining of a dragging sensation in his right groin, particularly when standing for long periods. He denies any pain, nausea, or vomiting. On examination, you note the finding in the image. Palpation reveals a soft, reducible mass. What is the MOST appropriate next step in management?

A 40-year-old man presents with fever, pleuritic chest pain, and cough. A chest X-ray shows a pleural effusion. What is the next step in management?

A 45-year-old male presents to the ED with left flank pain radiating to his groin. He reports nausea but denies fever or dysuria. Vitals are stable. A point-of-care ultrasound is performed, with the image shown. Assuming no contraindications, what is the MOST appropriate next step in management?

A 58-year-old man with a history of hypertension and left ventricular systolic dysfunction (LVSD) is being treated with an ACE inhibitor. His blood pressure is well-controlled, but he develops a persistent, dry cough that is affecting his sleep and quality of life. What is the most appropriate next step in management?

A 63-year-old man presents with dysphagia and early satiety. His BMI is 21. A CT scan is performed. Based on the image, and assuming conservative measures have failed, what surgical approach is MOST appropriate?

A 40-year-old man presents with a painless, slowly growing lesion on his nose for the past 8 months. He denies any trauma or previous skin conditions. Examination reveals the pictured lesion. What is the MOST appropriate next step in management?

A 55-year-old male presents to his GP complaining of bilateral breast tenderness and swelling over the past 6 months. He denies nipple discharge, weight changes, or other systemic symptoms. His vital signs are normal. He takes no regular medications. Considering the clinical presentation and the provided image, which of the following investigations is the most appropriate initial step in evaluating this patient?

A 62-year-old man presents to his general practitioner with a 6-month history of a bulge in his groin that appears when he strains or coughs. He reports mild discomfort but no severe pain. On examination, the GP identifies a soft, reducible mass in the right groin area that appears to emerge through the superficial inguinal ring when the patient coughs. The mass reduces spontaneously when the patient lies down. Which of the following is the most appropriate next step in management, according to Australian guidelines?

A 55-year-old male presents to the emergency department with a 2-day history of left lower quadrant abdominal pain, associated with a low-grade fever (38.1°C) and mild nausea. He denies vomiting, diarrhoea, or rectal bleeding. On examination, he has localised tenderness in the left iliac fossa. His vital signs are stable: BP 130/80 mmHg, HR 78 bpm, RR 16/min, SpO2 98% on air. Blood tests show a white cell count of 12.5 x 10^9/L and CRP 45 mg/L. An abdominal CT scan is performed (image provided). Based on the clinical presentation and the provided image, what is the most appropriate setting for this patient's initial management?

A 63-year-old man presents with increasing postprandial fullness. The provided image was obtained. What is the MOST appropriate next step in management?

A 62-year-old male presents with LLQ pain and fever. The provided image was obtained. What is the most appropriate initial management?

A 55-year-old man presents with a slowly growing lesion on his nose that he first noticed about 6 months ago. He reports occasional mild discomfort but no bleeding. He has a history of significant sun exposure due to his occupation. His medical history is otherwise unremarkable. On examination, vital signs are normal. The lesion appears as shown in the image. Regional lymph nodes are not enlarged. Considering the patient's history, risk factors, and the appearance of the lesion, what is the most appropriate initial step in the management of this patient?

A 60-year-old man presents to the emergency department with sudden onset of chest pain and shortness of breath. He has a history of chronic obstructive pulmonary disease (COPD) and is a current smoker. On examination, he is tachypneic and has decreased breath sounds on the right side. A chest X-ray reveals a large right-sided pneumothorax. What is the most appropriate initial management?

A 59-year-old male presents with a painful right groin bulge that has progressively worsened over the past week. He denies fever, chills, nausea, or vomiting. Vitals are stable. The provided image was obtained. What is the MOST appropriate next step?

A 45-year-old man presents to his GP with a 3-month history of gradually enlarging, painless swelling in the left side of his neck. He denies fever, night sweats, or weight loss. He emigrated from a region with high tuberculosis prevalence five years ago and has no known history of TB exposure or prior testing. On examination, there are multiple firm, non-tender, discrete lymph nodes in the left posterior triangle of the neck, the largest measuring about 3 cm. There are no other palpable nodes or organomegaly. His chest X-ray is clear. What is the most appropriate next diagnostic step?

A 48-year-old man presents with a 2-year history of progressive, tender breast enlargement causing significant distress. Initial investigations including liver function tests, renal function tests, and basic hormonal assays (LH, FSH, testosterone, oestradiol) were largely within normal limits, except for a mildly elevated oestradiol. He takes no regular medications and denies recreational drug use. He is otherwise well and his physical examination is unremarkable apart from the findings shown in the image. Considering the clinical presentation and the findings, what is the most appropriate next step in his management?

A 63-year-old man presents with dysphagia and epigastric discomfort. A CT scan is performed, as shown. What is the MOST likely long-term complication?

A 45-year-old male presents to the emergency department with sudden onset severe left flank pain radiating to the groin. He reports some nausea but no vomiting. His temperature is 37.5°C, pulse 88 bpm, BP 130/80 mmHg, respiratory rate 16/min, oxygen saturation 98% on room air. On examination, he has significant left costovertebral angle tenderness. Urinalysis shows microscopic haematuria and trace leukocytes. His creatinine is 90 µmol/L (baseline unknown). An ultrasound of the kidneys is performed, shown in the image. Based on the clinical presentation and the finding shown in the image, what is the most appropriate immediate next step in management?

A 63-year-old man presents with increasing postprandial fullness and epigastric discomfort. He reports occasional regurgitation of undigested food. A CT scan of the abdomen is performed. Based on the image, what is the MOST appropriate next step in management?

A 55-year-old male presents to the emergency department with a 2-day history of left lower quadrant abdominal pain, associated with a low-grade fever (38.1°C) and mild nausea. He denies vomiting, diarrhoea, or rectal bleeding. On examination, he has localised tenderness in the left iliac fossa. His vital signs are stable: BP 130/80 mmHg, HR 78 bpm, RR 16/min, SpO2 98% on air. Blood tests show a white cell count of 12.5 x 10^9/L and CRP 45 mg/L. An abdominal CT scan is performed (image provided). Considering the clinical presentation and the findings on the provided image, which of the following investigations is most appropriate to recommend for this patient *after* resolution of the acute episode?

A 45-year-old man presents to his GP with a lesion on his nose that has been present for several months and seems to be slowly enlarging. He denies pain, itching, or bleeding. He works outdoors but reports using sunscreen inconsistently. His past medical history is unremarkable, and he takes no regular medications. On examination, vital signs are stable. Regional lymph nodes are not palpable. The lesion is as shown in the image. Considering the clinical presentation, risk factors, and the appearance of the lesion, which of the following represents the most appropriate initial step in establishing a definitive diagnosis and guiding management?

A 45-year-old farmer presents with a 10-day history of fever, severe retro-orbital headache, and myalgia. He denies cough or dyspnoea. Physical examination is unremarkable. What is the most appropriate initial investigation?

A 62-year-old male with LLQ pain and mild fever has the CT abdomen shown. What is the MOST appropriate next step in management?

A 58-year-old male presents with acute onset LLQ pain, low-grade fever, and mild nausea. His vitals are stable. An abdominal CT scan was performed, the axial view is shown. What is the MOST appropriate initial management strategy?

A 62-year-old man presents with bilateral breast enlargement, as shown. He denies pain or nipple discharge. What is the MOST likely underlying cause?

A 50-year-old man presents with a slowly growing, asymptomatic nasal lesion. He reports no trauma or fever. Examination reveals the image shown. What is the MOST likely long-term outcome if left untreated?

A 45-year-old man presents to the clinic with a 3-month history of persistent cough, night sweats, and weight loss. He has a history of smoking and works as a miner. On examination, he has decreased breath sounds and dullness to percussion over the right upper lobe. A chest X-ray shows a cavitary lesion in the right upper lobe. What is the most likely diagnosis?

A 40-year-old patient with schizophrenia is started on risperidone. His GP recommends regular monitoring. What parameters should be monitored?

A 62-year-old male presents with acute onset of LLQ pain, fever, and vomiting. His WBC count is elevated. A CT scan of the abdomen and pelvis is performed. Based on the image, what is the most appropriate next step in management?

A 35-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or previous skin conditions. Examination reveals the image shown. What is the MOST appropriate initial management step?

A 62-year-old male presents with a 3-month history of rectal bleeding and altered bowel habits. Colonoscopy was performed, and a representative image is shown. What is the MOST appropriate next step in management?

A 55-year-old man with a history of hypertension and smoking presents for a routine check-up. He is concerned about his risk of cardiovascular disease and asks for advice on lifestyle modifications. Which of the following lifestyle changes would most significantly reduce his risk of cardiovascular events?

A 62-year-old male presents with jaundice and RUQ pain. An ERCP is performed, and the image is obtained. Following successful stone extraction, what is the MOST appropriate next step in managing this patient?

A 40-year-old male presents with acute, severe left flank pain. An ultrasound is performed. What is the MOST likely underlying cause of the finding on the image?

A 35-year-old male presents with hemoptysis and weight loss. PET-CT is shown. Bronchoscopy with biopsy is MOST likely to reveal which of the following?

A 55-year-old man with a history of hypertension and stable angina is prescribed a new medication. He reports experiencing a persistent dry cough since starting the medication. Which drug is most likely responsible for this side effect?

A 55-year-old male presents to the emergency department with a 2-day history of left lower quadrant abdominal pain, associated with a low-grade fever (38.1°C) and mild nausea. He denies vomiting, diarrhoea, or rectal bleeding. On examination, he has localised tenderness in the left iliac fossa. His vital signs are stable: BP 130/80 mmHg, HR 78 bpm, RR 16/min, SpO2 98% on air. Blood tests show a white cell count of 12.5 x 10^9/L and CRP 45 mg/L. An abdominal CT scan is performed (image provided). Based on the clinical presentation and the provided image, if outpatient management is deemed appropriate, which of the following antibiotic regimens is most consistent with current Australian guidelines?

A 60-year-old man, post-chemotherapy, presents with fever and abdominal pain. The images are shown. What is the MOST appropriate initial therapy?

A 62-year-old man presents to the emergency department with a history of palpitations and dizziness that started suddenly 2 hours ago. He has a history of hypertension and is on lisinopril. He denies chest pain, shortness of breath, or syncope. On examination, his blood pressure is 110/70 mmHg, heart rate is 150 bpm (irregular), respiratory rate is 18 breaths per minute, and temperature is 36.7°C. An ECG is performed, showing an irregularly irregular rhythm with no distinct P waves and a narrow QRS complex. Which of the following is the most appropriate initial management step?

A 55-year-old man presents to the emergency department with crushing chest pain radiating to his left arm and jaw. He is diaphoretic and appears anxious. An ECG shows ST-segment elevation in leads II, III, and aVF. What is the most appropriate immediate management?

A 35-year-old male presents to the ED with intermittent abdominal pain, nausea, and melena. He has multiple cutaneous hemangiomas. A CT scan is performed, as shown. What is the MOST appropriate next step in management?

A 58-year-old man presents to the emergency department with severe epigastric pain radiating to the back, which started suddenly 6 hours ago. He has a history of alcohol use disorder and has been consuming large amounts of alcohol daily for the past 10 years. On examination, he is diaphoretic and in distress, with a blood pressure of 100/60 mmHg, heart rate of 120 bpm, and respiratory rate of 22 breaths per minute. Abdominal examination reveals tenderness in the epigastric region with guarding. Laboratory tests show elevated serum amylase and lipase levels. Which of the following is the most appropriate initial management step?

A 55-year-old man presents to the emergency department with sudden onset severe abdominal pain radiating to the back. He has a history of hypertension and is a smoker. On examination, he is diaphoretic and in distress, with a blood pressure of 90/60 mmHg and a heart rate of 110 bpm. Abdominal examination reveals a pulsatile mass in the midline. What is the most likely diagnosis?

A 45-year-old male with a known history of Blue Rubber Bleb Naevus Syndrome, characterised by recurrent gastrointestinal bleeding and multiple cutaneous vascular lesions, presents to the emergency department with acute onset severe, colicky abdominal pain, nausea, and vomiting. On examination, his abdomen is distended and diffusely tender with reduced bowel sounds. Vital signs are within normal limits. An urgent abdominal CT scan is performed. Based on the clinical presentation and the findings demonstrated in the image, what is the most appropriate immediate next step in management?

A 55-year-old man presents to the clinic with a 3-month history of worsening cough, weight loss, and night sweats. He has a 30-pack-year smoking history and worked in construction for 20 years. On examination, he has clubbing of the fingers and decreased breath sounds in the right lower lung field. A chest X-ray shows a right lower lobe mass. What is the most appropriate next step in the management of this patient?

A 55-year-old male presents with chest pain that radiates to his left arm and jaw, accompanied by diaphoresis and nausea. ECG shows ST-segment elevation in leads II, III, and aVF. What is the most likely diagnosis?

A 58-year-old male, on chronic immunosuppressants, presents with vague abdominal pain. The images are shown. What is the MOST likely causative organism?