middle-aged man
Practice targeted AMC-style multiple-choice questions on middle-aged man.
Related Topics
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 male presents to his GP complaining of a swelling in his right groin that has been present for several months. He states it is more noticeable when he is standing or coughing and sometimes causes a dull ache, but it is easily pushed back in when he lies down. He denies any fever, nausea, or acute pain. His vital signs are stable. Physical examination reveals the finding shown in the image. Considering the patient's history and the physical examination finding depicted, 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 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, which of the following developments would most strongly necessitate urgent urological intervention?
A 52-year-old man presents with right groin discomfort, worse with standing. Examination reveals the finding in the image. What is the MOST appropriate next step?
A 38-year-old man presents with sudden onset severe left flank pain radiating to the groin, associated with nausea. He is afebrile, blood pressure 140/90 mmHg, heart rate 95 bpm. Urinalysis shows microscopic haematuria. Serum creatinine is 80 µmol/L. An ultrasound is performed. Considering the clinical presentation and the findings demonstrated in the provided image, which of the following best explains the mechanism of the patient's pain?
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. Considering the patient's history, acute presentation, and the findings on the abdominal CT scan, what is the most appropriate immediate management strategy?
A 58-year-old male with cirrhosis secondary to alcohol abuse presents for routine surveillance. His AFP is 25 ng/mL. A contrast-enhanced ultrasound is performed, as shown. What is the MOST appropriate next step in 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 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 58-year-old male presents to the emergency department complaining of right groin pain that started approximately 6 hours ago. He reports noticing a bulge in his groin for several months, which he could usually push back in. However, today he is unable to reduce it, and the pain has become progressively severe. He denies any fever, nausea, or vomiting. His past medical history includes hypertension and hyperlipidemia, both well-controlled with medications. On examination, his vital signs are stable: blood pressure 130/80 mmHg, heart rate 80 bpm, respiratory rate 16 bpm, and temperature 37.0°C. Abdominal examination is benign. Examination of the groin reveals the finding shown in the image. The area is tender to palpation. Which of the following is the MOST appropriate next step in the management of this patient?
A 32-year-old male with a history of Crohn's disease presents with worsening abdominal pain, diarrhea, and a low-grade fever. He reports that his symptoms have been progressively worsening over the past few weeks despite being compliant with his prescribed mesalamine. A CT scan of the abdomen and pelvis is performed, as shown. What is the MOST appropriate next step in management?
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 45-year-old male presents with intermittent abdominal pain and melena. The provided image was obtained. What associated cutaneous finding is most likely?
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 50-year-old man presents with a slowly growing nasal lesion. Examination reveals the image shown. What is the MOST appropriate initial management?
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 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 context and the findings demonstrated in the provided image, what is the most appropriate recommendation regarding subsequent investigation of the colon following resolution of the acute symptoms?
A 45-year-old male presents with a painless lesion on his nose that has been present for 6 months. He denies any trauma or previous skin conditions. Examination reveals the lesion seen in the image. What is the MOST appropriate next step in management?
A 58-year-old male presents with fatigue and iron deficiency anemia. Colonoscopy reveals the image shown. Biopsies are taken. Assuming pathology confirms malignancy, what is the MOST appropriate next investigation to determine disease stage?
A 55-year-old male presents with LLQ pain, fever, and increased WBC. A CT scan is performed. He is hemodynamically stable. Based on the image, which of the following is the MOST appropriate initial management strategy?
A 32-year-old male with a 10-year history of Crohn's disease presents with worsening abdominal pain and increased frequency of bowel movements. He reports no fever or weight loss. Physical examination reveals mild tenderness in the right lower quadrant. His inflammatory markers are elevated. Review the provided imaging. What is the MOST appropriate next step in management?
A 62-year-old male presents with bilateral breast enlargement for 6 months. He denies pain, discharge, or skin changes. He reports taking saw palmetto for BPH. Examination reveals the findings in the image. What is the MOST likely cause?
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. Considering the patient's presentation and the findings demonstrated in the provided image, the most likely primary mechanism responsible for the severe pain experienced by this patient is:
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 62-year-old male presents with a 6-month history of a painless swelling in his right groin, visible especially when standing. Examination reveals the finding in the image. The mass reduces when lying down. What is the MOST appropriate initial management?
A 63-year-old man presents with increasing postprandial fullness and epigastric discomfort. A CT scan of the abdomen is performed. Based on the image, what is the MOST appropriate next step in management?
A 58-year-old male presents to his GP complaining of bilateral breast enlargement over the past year. He denies any pain or tenderness. He takes no medications and reports no significant past medical history. Examination reveals the findings in the image. What is the MOST appropriate initial investigation?