young adult

A 28-year-old female presents with a chronic cough and fatigue. She has no significant past medical history but reports recent travel to Southeast Asia. A chest PET-CT was performed. What is the MOST appropriate next step in the management of this patient?

An 18-year-old teenage girl presents with a sudden change in behavior at a music festival, appearing confused and aggressive after consuming 5-6 vodkas, with uncertainty about illicit drug use. What is the most appropriate next step in her management in the Australian context?

A 25-year-old Aboriginal man presents to a remote clinic with increasing shortness of breath on exertion and palpitations over the past month. He recalls having a sore throat as a child but no specific diagnosis. On examination, his pulse is 95 bpm, blood pressure 110/70 mmHg, respiratory rate 20 breaths/min. Auscultation reveals a pansystolic murmur loudest at the apex, radiating to the axilla. There are no signs of heart failure currently. Considering the likely diagnosis and the patient's background, which of the following is the most appropriate initial investigation?

A 30-year-old woman presents to her GP with a 2-week history of a persistent cough, night sweats, and unintentional weight loss. She has recently returned from a trip to Southeast Asia. On examination, she appears thin and has crackles in the upper zones of her lungs. A chest X-ray shows cavitary lesions in the right upper lobe. What is the most likely diagnosis?

A 32-year-old woman presents to the emergency department with a 2-day history of fever, malaise, and a painful, swollen left knee. She denies any recent trauma or travel history. She has no significant past medical history and is not on any medications. On examination, her temperature is 38.7°C, heart rate is 110 bpm, and blood pressure is 120/80 mmHg. The left knee is erythematous, warm, and tender with a moderate effusion, and she has limited range of motion due to pain. Laboratory tests reveal leukocytosis with a left shift. Blood cultures are pending. What is the most appropriate next step in the management of this patient?

A 25-year-old man presents to the emergency department with a 2-day history of severe headache, photophobia, and neck stiffness. He has no significant past medical history and is not on any medications. On examination, he is febrile with a temperature of 39°C, and there is a positive Brudzinski's sign. What is the most appropriate initial investigation to confirm the diagnosis?

A 30-year-old immigrant presents with chronic cough and night sweats. Sputum is negative for AFB. What is the MOST appropriate next step in management?

A 22-year-old female presents with a strange tongue appearance after brushing her teeth, with no pain. She has a history of pustular psoriasis. What is the next step?

A 23-year-old backpacker doing farm work presents with a low-grade fever for 4 days. Q fever is suspected. What is the most appropriate diagnostic method for acute Q fever in Australia?

A 7-year-old boy is brought to his GP by his parents, who are concerned about his behaviour at school and at home. They report that he has difficulty paying attention in class, often fidgets and squirms in his seat, and frequently interrupts others. At home, he struggles to follow instructions, loses things easily, and seems forgetful. The teacher has also noted that he has difficulty staying on task and often blurts out answers before the question is finished. The parents deny any history of significant medical illness or developmental delay. On examination, the boy appears energetic and talkative, but is cooperative with the assessment. Which of the following is the most appropriate next step in the evaluation of this child?

A 32-year-old woman presents to her general practitioner complaining of a persistent, intensely itchy rash that started a few weeks ago. She reports that it began on her wrists and ankles and has now spread to her elbows and knees. She denies any new medications, travel, or changes in personal care products. On examination, you observe symmetrical, excoriated papules and plaques on her wrists, elbows, knees, and upper back. Some of the papules have small blisters. Which of the following is the most appropriate initial investigation?

A 32-year-old woman presents to the emergency department with severe right lower abdominal pain, nausea, and vomiting. She reports that the pain started suddenly a few hours ago and has been worsening. Her last menstrual period was two weeks ago. On examination, she has tenderness and guarding in the right lower quadrant. A pregnancy test is negative. What is the most likely diagnosis?

A 32-year-old male, recent immigrant from a high-TB prevalence country, presents with a persistent cough and night sweats for the past two months. He denies fever or weight loss. Physical examination is unremarkable except for mild, diffuse rhonchi on auscultation. Sputum cultures are pending. A PET-CT scan of the chest was performed, the axial view is shown. Given the clinical context and imaging findings, what is the MOST appropriate next step in management?

A 28-year-old woman presents with a palpable lump in her left breast, noticed two weeks ago. It is slightly tender, especially before her period. On examination, it is mobile, firm, and about 2 cm. No skin changes or nipple discharge. What is the most appropriate initial investigation?

A 28-year-old female, recently emigrated from Southeast Asia, presents to her general practitioner with complaints of fatigue, a persistent low-grade fever (37.8°C), and a non-productive cough that has been present for approximately one month. She denies any significant past medical history and is not currently taking any medications. Physical examination reveals slightly diminished breath sounds in the upper right lobe, but is otherwise unremarkable. Initial blood work, including a complete blood count and comprehensive metabolic panel, are within normal limits. A chest X-ray revealed a suspicious lesion in the right upper lobe, prompting a PET-CT scan, an axial slice of which is shown. Given the patient's history, clinical presentation, and the findings on the PET-CT scan, which of the following is the MOST appropriate next step in the diagnostic workup?

A 35-year-old male with a history of multiple cutaneous vascular lesions presents with recurrent episodes of crampy abdominal pain and melena over the past month. His vital signs are stable. An abdominal CT scan is performed. Considering the clinical presentation and the findings demonstrated in the provided image, what is the most appropriate next step in the management of this patient?

A 25-year-old man presents with a painless testicular lump on the left side, described as a firm intratesticular mass. What is the likely diagnosis?

A 35-year-old lady who underwent laparoscopic appendicectomy presents 3 days later with diarrhea, fever (39.5°C), and erythematous port sites. She had a 5-day course of cefotaxime. What is the most likely diagnosis?

A 28-year-old patient with autism spectrum disorder is prescribed risperidone for aggressive behavior. His parents report significant weight gain. What is the most appropriate next step?

A 28-year-old patient with PTSD is undergoing therapy. The therapist uses exposure techniques to help the patient confront traumatic memories. What type of therapy is this?

A 28-year-old female presents with a chronic cough and fatigue. She has no significant past medical history. A chest PET-CT was performed as part of her workup. The axial view is shown. What is the MOST appropriate next step in management, considering the image and her presentation?

A 28-year-old woman presents to the clinic with a 2-week history of polyuria, polydipsia, and weight loss. She has no significant past medical history. On examination, she appears dehydrated, and her blood pressure is 100/60 mmHg. Laboratory tests reveal a blood glucose level of 18 mmol/L and ketones in the urine. What is the most likely diagnosis?

A 32-year-old male presents to the emergency department with a 3-day history of worsening abdominal pain, primarily localized to the right lower quadrant. He reports associated nausea and decreased appetite but denies vomiting or diarrhea. His past medical history is significant for Crohn's disease, diagnosed 8 years ago, managed with intermittent courses of oral corticosteroids and azathioprine. He admits to poor adherence to his azathioprine regimen over the past year. On examination, he is afebrile with a heart rate of 92 bpm, blood pressure of 120/80 mmHg, and oxygen saturation of 98% on room air. Abdominal examination reveals tenderness to palpation in the right lower quadrant with guarding. Bowel sounds are normoactive. Laboratory investigations reveal a white blood cell count of 11,500/µL with neutrophilia, a C-reactive protein (CRP) of 45 mg/L, and normal liver function tests. A CT scan of the abdomen and pelvis with IV contrast is performed, the relevant images of which are shown. Given the patient's presentation and imaging findings, which of the following is the MOST appropriate next step in management?

A 28-year-old female presents to the ED with acute onset right lower quadrant pain. She reports nausea and vomiting. Her last menstrual period was 6 weeks ago, and she denies any vaginal bleeding. She is hemodynamically stable. A CT scan of the abdomen and pelvis is performed, with a relevant image shown. Considering the clinical presentation and the imaging findings, what is the MOST appropriate next step in the management of this patient?

A 30-year-old man presents to the emergency department with severe right lower quadrant abdominal pain, nausea, and vomiting. The pain started around the umbilicus and then localized to the right lower quadrant. On examination, he has tenderness and guarding in the right lower quadrant. His temperature is 38.3°C, heart rate is 100 bpm, and blood pressure is 120/80 mmHg. What is the most likely diagnosis?

A 25-year-old man and a 23-year-old woman, newlyweds, are planning a 3-week trip to South America. The woman is not on oral contraceptives and wants to conceive. They are concerned about Zika. What advice can you provide?

A 28-year-old with Crohn's presents with new fever and abdominal pain. The patient's CRP is elevated. Review the imaging. What is the MOST appropriate next step?

A 25-year-old man presents to the emergency department with severe abdominal pain that started around his umbilicus and has now localized to the right lower quadrant. He has nausea and has vomited twice. On examination, he has tenderness and guarding in the right lower quadrant. His temperature is 37.8°C, and his white blood cell count is elevated. What is the most likely diagnosis?

A 31-year-old man presents with gradual onset lateral knee pain that worsens with running. There is no history of trauma. The pain is localized above the joint line, and there is no swelling. What is the likely diagnosis?

A 16-year-old boy is diagnosed with Type 1 diabetes mellitus after presenting with polyuria, polydipsia, and weight loss. His blood tests show elevated blood glucose levels and the presence of autoantibodies against pancreatic beta cells. In contrast, a 55-year-old woman is diagnosed with Type 2 diabetes mellitus, characterized by insulin resistance and obesity. Which of the following best describes the pathophysiological differences between Type 1 and Type 2 diabetes?

A 22-year-old lady was wrongly given a B12 prescription for another patient. The error was noticed later at the pharmacy. What is the next step?

A 28-year-old female presents with sudden onset severe right lower quadrant pain, associated with nausea and one episode of vomiting. Her last menstrual period was 6 weeks ago. On examination, she is afebrile, heart rate 88, blood pressure 120/70. Abdominal examination reveals tenderness in the right iliac fossa. A CT scan of the abdomen and pelvis is performed, with a relevant axial image shown. Considering the clinical presentation and the findings demonstrated in the image, what is the MOST appropriate immediate next step in the management of this patient?

A 28-year-old woman presents to the emergency department with sudden onset of severe right lower abdominal pain. She reports nausea but no vomiting. Her last menstrual period was two weeks ago, and she is not sexually active. On examination, she has tenderness in the right lower quadrant with guarding. Her vital signs are stable. A pelvic ultrasound shows a 5 cm cyst on the right ovary with free fluid in the pelvis. What is the most likely diagnosis?

A 35-year-old woman presents with a 2cm, firm, mobile lump in her left breast, noticed two weeks ago. She is otherwise well. What is the most appropriate initial investigation?

A 25-year-old woman presents to the clinic with a 2-week history of abdominal pain and diarrhea. She reports that the pain is crampy and occurs mostly in the lower abdomen. She has also noticed some blood in her stool. She has no significant past medical history and is not on any medications. On examination, she has mild tenderness in the lower abdomen but no rebound tenderness or guarding. What is the most likely diagnosis?

A 32-year-old male presents to his general practitioner complaining of severe anal pain, especially during and after bowel movements. He also reports seeing bright red blood on the toilet paper. On examination, there is a visible tear in the anal mucosa at the 6 o'clock position. Which of the following is the MOST appropriate initial management strategy?

A 30-year-old woman with bipolar disorder is prescribed risperidone for manic episodes. She develops tremors and rigidity. What is the most likely diagnosis?

A 28-year-old male with Crohn's disease presents with increased abdominal pain, fever, and bloody stools. He is on azathioprine. What is the most appropriate next step?

A 25-year-old man with schizophrenia is started on risperidone. After a few weeks, he develops gynecomastia and galactorrhea. What is the most likely cause of these symptoms?

A 30-year-old woman presents to the emergency department with a 2-day history of fever, sore throat, and a diffuse rash. She recently started taking a new medication for her epilepsy. On examination, she is febrile at 38.2°C, with a heart rate of 100 bpm and blood pressure of 110/70 mmHg. The rash is erythematous and involves the trunk and extremities, with some areas of desquamation. Laboratory tests reveal leukocytosis with eosinophilia and elevated liver enzymes. Which of the following is the most likely diagnosis?

A 32-year-old woman presents to her general practitioner with a 3-month history of fatigue, joint pain, and a facial rash that worsens with sun exposure. She also reports hair loss and oral ulcers. On examination, she has a malar rash, mild synovitis in her hands, and no signs of organomegaly. Laboratory tests reveal anemia, leukopenia, and positive antinuclear antibodies (ANA) with a high titer. Which of the following is the most appropriate initial management for this patient?

A 28-year-old woman presents with pelvic pain that started suddenly 2 days ago. Her periods are irregular. She denies fever or vomiting. The shown CT was performed. What is the MOST likely diagnosis?

A 35-year-old patient with schizophrenia is on risperidone and develops QT prolongation on ECG. What is the next step?

A 35-year-old woman with a strong family history of breast cancer (mother and sister diagnosed before age 40) is concerned about her risk. What is the most appropriate genetic testing for this patient?

A 32-year-old male with Crohn's disease presents with increased abdominal pain and diarrhea. Review the imaging. What is the MOST appropriate next step?

A 20-year-old female medical student arrives late, parties, but is attentive in consultations. What is the next step?

A 35-year-old woman who recently underwent laparoscopic appendicectomy and completed a 5-day course of cefotaxime presents with a 3-day history of diarrhea and a temperature of 39.5°C. Her vital signs are otherwise normal, and a digital rectal exam is normal. Examination reveals erythematous port sites. Which of the following is the most likely diagnosis?

A 24-year-old lady presents with worsening right eye 'ache' and reduced vision. The symptoms worsen with eye movements, and there is no redness or fluorescein uptake. Her vision is 6/12 in the right eye and 6/6 in the left eye. There is a relative afferent pupillary defect (RAPD) on examination. What associated disease could this indicate?

A 32-year-old male presents to his general practitioner with persistent anal pain and bleeding on defecation for the past 8 months. He reports a cycle of pain, relief after bowel movements, followed by throbbing pain lasting several hours. Examination reveals a visible anal fissure at the 6 o'clock position, along with a skin tag. Which of the following is the MOST appropriate next step in management, according to Australian guidelines?

A 32-year-old woman presents to her general practitioner six weeks postpartum with distressing obsessive thoughts about accidentally harming her newborn. She reports spending excessive time checking on the baby and cleaning the nursery, which interferes with her ability to rest and care for herself. She denies any intent to harm her child and feels ashamed of these thoughts. Her past medical history is unremarkable, and she has no history of psychiatric disorders. On examination, she appears anxious but is cooperative and oriented. Which of the following is the most appropriate initial management strategy for her condition?