A 58-year-old woman presents with a unilateral, scaling rash on her left nipple that has not improved after 6 weeks of topical corticosteroid treatment. What is the most critical next step?
Anonymous Quiz
50%
Perform a full-thickness punch biopsy of the nipple lesion.
29%
Order a bilateral mammogram immediately.
17%
Prescribe a stronger topical antifungal cream.
4%
Advise the patient to stop all irritants and return in 3 months.
What is the single most common underlying malignancy associated with Paget's disease of the nipple?
Anonymous Quiz
13%
Malignant Melanoma of the Nipple
17%
Invasive Lobular Carcinoma (ILC)
47%
Invasive Ductal Carcinoma (IDC)
23%
Ductal Carcinoma In Situ (DCIS)
A 67 year old woman presents to the emergency department with pain in her left groin. She falls from a chair in the waiting area and now is in severe pain and is not able to move her left leg. She takes alendronate regularly. What is the SINGLE most likely diagnosis?
A. Pelvic fracture
B. Bursitis
C. Femoral shaft fracture
D. Femoral neck fracture
E. Posterior hip dislocation
A. Pelvic fracture
B. Bursitis
C. Femoral shaft fracture
D. Femoral neck fracture
E. Posterior hip dislocation
A 15 year old boy presents with fever and pain in the right lower thigh. The pain has been ongoing for the past one month. On examination, there is a 2 cm by 2 cm mass at the lower third of his thigh which is red, warm and tender. An X-ray shows bone destructionwith overlying onion-skin layers of periosteal bone formation and a soft tissue mass. What is the SINGLE most likely diagnosis?
A. Tuberculous arthritis
B. Ewingโs sarcoma
C. Osteosarcoma
D. Osteomyelitis
E. Fibrosarcoma
A. Tuberculous arthritis
B. Ewingโs sarcoma
C. Osteosarcoma
D. Osteomyelitis
E. Fibrosarcoma
A 15 year old boy complains of pain in his leg which usually settles within an hour of taking aspirin. The pain is described as a dull pain which is persistent but is usually worse at night.What is Dx
Anonymous Quiz
4%
A. Leiomyosarcoma
0%
B. Liposarcoma
33%
C. Chondrosarcoma
8%
D. Exostosis
54%
E. Osteoid osteoma
A 64 year old diabetic woman presents to the GP surgery with an acutely painful, swollen and hot right knee joint. There is limited range of movement and movements are painful in all directions. There is redness around the joint. An effusion surrounding the entire joint is obvious. There is no history of trauma. She has a pulse rate of 70 beats/minute, and a temperature of 37.8 C. What is the SINGLE most likely diagnosis?
A. Reactive arthritis
B. Septic arthritis
C. Viral arthritis
D. Bursitis
E. Gonococcal arthritis
A. Reactive arthritis
B. Septic arthritis
C. Viral arthritis
D. Bursitis
E. Gonococcal arthritis
67-year-old woman is admitted to a general surgical
floor with the diagnosis of a small bowel obstruction.
Which of the following is the best initial nutritional assessment?
floor with the diagnosis of a small bowel obstruction.
Which of the following is the best initial nutritional assessment?
Anonymous Quiz
6%
(A) Serum transferrin
0%
(B) Serum prealbumin
29%
(C) Serum albumin
0%
(D) Serum glutamine
65%
(E) History and physical examination
72-year-old man undergoes a subtotal colectomy for a cecal perfora-
tion due to a sigmoid colon obstruction. He has had a prolonged recovery
and has been on total parenteral nutrition (TPN) for 2 weeks postopera-
tively. After regaining bowel function, he experienced significant diarrhea.
Examination of his abdominal wound demonstrates minimal granulation
tissue. He complains that he has lost his taste for food. He also has increased
hair loss and a new perioral pustular rash. Which of the following deficien-
cies does he most likely have?
a. Zinc
b. Selenium
c. Molybdenum
d. Chromium
e. Thiamine
tion due to a sigmoid colon obstruction. He has had a prolonged recovery
and has been on total parenteral nutrition (TPN) for 2 weeks postopera-
tively. After regaining bowel function, he experienced significant diarrhea.
Examination of his abdominal wound demonstrates minimal granulation
tissue. He complains that he has lost his taste for food. He also has increased
hair loss and a new perioral pustular rash. Which of the following deficien-
cies does he most likely have?
a. Zinc
b. Selenium
c. Molybdenum
d. Chromium
e. Thiamine
10. A 32-year-old male with third-degree internal hemorrhoids
underwent an operative hemorrhoidectomy in the surgical
center and was discharged home. What is the most common
early postoperative complication after hemorrhoidectomy?
A. Urinary retention
B. Bleeding
C. Fecal Incontinence
D. Perirectal abscess
E. Anal fissure
underwent an operative hemorrhoidectomy in the surgical
center and was discharged home. What is the most common
early postoperative complication after hemorrhoidectomy?
A. Urinary retention
B. Bleeding
C. Fecal Incontinence
D. Perirectal abscess
E. Anal fissure
A7-month-old โpresents with intermittent episodes of severe crying and drawing up of the legs with vomiting and a red, jelly-like stool. On exam,a sausage-shaped mass is felt in the right upper quadrant,and the right lower quadrant is empty.Dx is?
Anonymous Quiz
6%
A) Infantile hypertrophic pyloric stenosis
81%
B) Intussusception
6%
C) Volvulus
6%
D) Hirschsprungโs disease
0%
E) Necrotizing enterocolitis
A 62-year-old man presents with iron deficiency anaemia. Colonoscopy reveals a non-obstructing carcinoma in the ascending colon. CT staging shows no metastases. What is the most appropriate next step?
Anonymous Quiz
61%
A) Right hemicolectomy
6%
B) Left hemicolectomy
11%
C) Total colectomy
22%
D) Adjuvant chemotherapy
0%
E) Palliative stenting
A 68-yearold presents with abdominal distension and absolute constipation. Plain abdominal X-ray shows a massively dilated loop of large bowel with an appearance resembling acoffee bean.most likely Dx
Anonymous Quiz
0%
A. Cecal volvulus
93%
B. Sigmoid volvulus
7%
C. Large bowel carcinoma
0%
D. Toxic megacolon
0%
E. Paralytic ileus
A 45-year-old presents with colicky abdominal pain,vomiting,and abdominal distension. Erect abdominal X-ray shows multiple air-fluid levels arranged in a step-ladder pattern.What is the most likely Dx
Anonymous Quiz
0%
A) paralytic ileus
75%
B) Small bowel obstruction
13%
C) Large bowel obstruction
0%
D) Sigmoid volvulus
13%
E) toxic mega colon
A stable adult patient presents with atypical symptoms of appendicitis. Which investigation is the best next step to confirm the diagnosis?
Anonymous Quiz
5%
A) abdominal X- ray
43%
B) Ultrasound
48%
C) CT abdomen with contrast
0%
D) MRI abdomen
5%
E) Diagnostic laparoscopy