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?

A 32-year-old male with Crohn's disease presents with worsening abdominal pain and diarrhea despite being on maintenance infliximab. The provided imaging was obtained. What is the MOST appropriate next step in management?

A 32-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 of the small joints in her hands. Laboratory tests reveal a positive antinuclear antibody (ANA) and anti-double-stranded DNA antibodies. What is the most likely diagnosis?

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 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 likely underlying pathology responsible for the patient's symptoms and the observed bowel findings?

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 28-year-old woman with a mother diagnosed with colorectal cancer at 45 and a maternal uncle at 50 seeks advice. She is otherwise well. What is the most appropriate next step in her management?

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 32-year-old woman presents to her GP complaining of a new, intensely itchy rash on her elbows, knees, and scalp. On examination, the GP notes symmetrical, erythematous papules and plaques with overlying silvery scales. The patient reports a family history of similar skin conditions. What is the most likely diagnosis?

A 25-year-old man with Crohn's disease presents with increased abdominal pain and frequent diarrhea. He is on azathioprine. Stool studies are negative for infection. Which of the following is the most appropriate next step?

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 35-year-old man with PTSD is experiencing severe nightmares despite being on an SSRI. What medication can be added to target this symptom?

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 35-year-old male presents with left flank pain and dysuria. An ultrasound is performed. 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 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 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 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 28-year-old immunocompetent patient presents with a chronic cough and low-grade fever. Initial investigations, including sputum microscopy, are negative. A PET-CT scan was performed (image shown). What is the MOST appropriate next step?

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 30-year-old veteran presents with recurrent nightmares, flashbacks of combat, and hypervigilance. He avoids crowded places and has difficulty sleeping. His symptoms have persisted for over 6 months and are affecting his daily functioning. What is the most likely diagnosis?

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

A 33-year-old lady has an HNPCC gene mutation and two sisters with bowel cancer. She reports no change in bowel habits. What is the best surveillance for bowel cancer in this patient?

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

A 32-year-old woman presents to the emergency department with severe right lower quadrant abdominal pain, nausea, and vomiting. She reports her last menstrual period was 6 weeks ago. On examination, she has tenderness and guarding in the right lower quadrant. A urine pregnancy test is positive. What is the most appropriate next step in management?

A 28-year-old male with a history of Crohn's disease presents with increased abdominal pain and non-bloody diarrhea. He is currently on azathioprine. The provided imaging was obtained. What is the MOST appropriate 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 7-year-old boy is brought to the GP by his parents due to poor performance at school. Teachers report that he is inattentive, easily distracted, and frequently interrupts others. What is the most appropriate first-line treatment?

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?

29-year-old lady with postpartum hair loss, sparse hair, positive pull test, and normal scalp. Diagnosis?