young adult

A 25-year-old man presents to the emergency department with sudden onset of severe testicular pain on the right side. He reports no trauma or previous episodes. On examination, the right testis is swollen, tender, and lies higher in the scrotum compared to the left. The cremasteric reflex is absent on the affected side. What is the most appropriate next step in the management of this patient?

A 35-year-old male presents to his general practitioner with a lesion on his nose that has been present for approximately 3 months. He initially thought it was a persistent pimple but it has not resolved and seems to be slowly growing. He denies pain, itching, or bleeding from the lesion. He has no significant past medical history and takes no regular medications. He works outdoors but reports using sunscreen inconsistently. On examination, vital signs are stable. The lesion is as shown in the image. There are no other skin lesions noted elsewhere. Regional lymph nodes are not palpable. Based on the appearance of the lesion shown, what is the most appropriate next step in the management of this patient?

A 32-year-old woman presents to the clinic with a 2-week history of a persistent cough and shortness of breath. She has no significant past medical history and is a non-smoker. On examination, she has bilateral wheezing and reduced breath sounds. A chest X-ray shows hyperinflation of the lungs. What is the most likely diagnosis?

A 32-year-old woman presents to the emergency department with a 2-day history of fever, chills, and right flank pain. She has a history of recurrent urinary tract infections. On examination, she is febrile with a temperature of 38.5°C, her heart rate is 110 bpm, and her blood pressure is 110/70 mmHg. There is tenderness on palpation of the right costovertebral angle. Urinalysis shows pyuria and bacteriuria. What is the most appropriate initial management for this patient?

A 40-year-old patient with PTSD is started on sertraline but develops sexual dysfunction as a side effect. What is the next step in management?

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 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 17-year-old teenage girl presents with menorrhagia and a family history of heavy periods and hysterectomy, suggestive of Von Willebrand Disease (VWD). Which statement about VWD is correct?

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 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 months despite being on maintenance therapy with azathioprine. A CT scan of the abdomen and pelvis is performed, as shown. Based on the imaging findings, which of the following is the MOST appropriate next step in management?

A 28-year-old male with Crohn's presents with increased abdominal pain, non-bloody diarrhea, and fatigue for 3 weeks. He denies fever. Exam shows mild RLQ tenderness. Labs show elevated CRP. Imaging is shown. What is the MOST appropriate next step?

A 28-year-old woman presents with a palpable lump in her left breast, noticed two weeks ago. It feels smooth, mobile, and non-tender. No family history of breast cancer. On examination, a 2cm, firm, mobile mass is noted. Considering Australian guidelines for a palpable breast lump in this age group, what is the most appropriate initial investigation?

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

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 32-year-old woman presents to her general practitioner with a 3-month history of intermittent abdominal pain and bloating. She reports that the pain is crampy, occurs mainly in the lower abdomen, and is often relieved by defecation. She also notes a change in her bowel habits, alternating between constipation and diarrhea. She denies any weight loss, fever, or blood in her stool. Her medical history is unremarkable, and she is not on any medications. On examination, her abdomen is soft with mild tenderness in the lower quadrants but no palpable masses. Blood tests, including a complete blood count and C-reactive protein, are normal. What is the most appropriate next step in the management of this patient?

A 28-year-old woman presents with pelvic pain that started suddenly 2 days ago. Her periods are regular. She denies fever or vomiting. The shown CT was performed. What is the MOST 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 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 25-year-old woman with a history of sexual assault presents with intrusive thoughts, avoidance behaviors, and emotional numbness. She is diagnosed with PTSD. What is the first-line pharmacological treatment for this condition?

A 28-year-old male is brought to the emergency department after a high-speed motor vehicle accident. He is unconscious with a Glasgow Coma Scale (GCS) score of 6. His blood pressure is 90/60 mmHg, heart rate is 120 bpm, and respiratory rate is 28 breaths per minute. On examination, there is bruising over the left chest and decreased breath sounds on the left side. What is the most appropriate immediate management step?

A 28-year-old male with Crohn's presents with increased abdominal pain, non-bloody diarrhea, and fatigue for 3 weeks. He denies fever. Exam shows mild RLQ tenderness. Labs show elevated CRP. Imaging is shown. What is the MOST appropriate next step?

A 28-year-old male presents with a persistent cough and fatigue. A PET-CT scan was performed. What is the MOST likely diagnosis?

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 35-year-old woman presents to the emergency department with a 3-day history of fever, chills, and a productive cough with greenish sputum. She has a history of asthma and is currently on inhaled corticosteroids. On examination, her temperature is 38.5°C, blood pressure is 120/80 mmHg, heart rate is 110 bpm, and respiratory rate is 24 breaths per minute. Auscultation of the chest reveals wheezing and crackles in the right lower lung field. A chest X-ray shows consolidation in the right lower lobe. What is the most appropriate initial antibiotic therapy for this patient, considering her asthma and current presentation?

A 30-year-old woman presents with fever, hemoptysis, and night sweats. A chest X-ray shows a round lesion with an air-fluid level. What is the most likely diagnosis?

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 28-year-old woman presents to the clinic with a 2-week history of fever, night sweats, and a non-productive cough. She has recently returned from a trip to rural Queensland. On examination, she has crackles in the right upper lung field. A chest X-ray shows a cavitary lesion in the right upper lobe. 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 32-year-old woman presents to her general practitioner complaining of a persistent, intensely itchy rash on her elbows, knees, and scalp for the past 6 months. She reports that the itching is worse at night and after hot showers. She has tried over-the-counter hydrocortisone cream without relief. On examination, the GP notes symmetrical, excoriated papules and plaques on the extensor surfaces of her elbows and knees, as well as some scaling on her scalp. The patient also mentions a history of recurrent mouth ulcers. Which of the following is the MOST appropriate initial investigation to confirm the suspected diagnosis?

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 28-year-old woman presents to the clinic with a 3-day history of fever, sore throat, and difficulty swallowing. She has no significant past medical history and is not on any medications. On examination, she has swollen, tender anterior cervical lymph nodes and erythematous tonsils with white exudates. A rapid antigen detection test for group A Streptococcus is positive. What is the most appropriate treatment for her condition?

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 35-year-old woman with a family history of BRCA1-associated breast cancer is considering genetic testing. She is asymptomatic and has no personal history of cancer. What is the MOST appropriate initial step in her management?

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 32-year-old woman presents to the clinic with a 2-week history of palpitations, anxiety, and weight loss despite an increased appetite. She also reports feeling hot and experiencing increased sweating. On examination, she has a fine tremor, warm moist skin, and a diffusely enlarged thyroid gland. Her heart rate is 110 bpm. Blood tests reveal suppressed TSH and elevated free T4. What is the most appropriate initial treatment for her condition?

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 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 30-year-old woman presents to her GP with fatigue, weight gain, and cold intolerance over the past 6 months. She also reports constipation and dry skin. On examination, she has a slightly enlarged, non-tender thyroid gland. Her TSH level is elevated, and free T4 is low. What is the most appropriate treatment for this condition?

A 28-year-old woman presents to the emergency department with sudden onset of severe right lower abdominal pain. She reports nausea and vomiting but denies fever or urinary symptoms. Her last menstrual period was two weeks ago, and she is sexually active. On examination, she has tenderness in the right lower quadrant with guarding. A pelvic ultrasound reveals a 5 cm right ovarian cyst with free fluid in the pelvis. What is the most likely diagnosis?

A 32-year-old woman presents to her general practitioner with a 2-month history of fatigue, weight gain, and feeling cold all the time. She also reports hair loss and constipation. On examination, her heart rate is 58 bpm, and she has dry skin and a delayed relaxation phase of the deep tendon reflexes. Her thyroid function tests reveal a high TSH level and low free T4. She has no significant past medical history and is not on any medications. Which of the following is the most appropriate initial management for her condition?

A 28-year-old woman presents to her general practitioner with a 2-week 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 and mild swelling in her hands. Laboratory tests reveal a positive antinuclear antibody (ANA) test and elevated anti-double-stranded DNA antibodies. What is the most likely diagnosis?