Middle twist

A 54-year-old man with no family history of prostate cancer attends his GP for a routine check-up. He is asymptomatic and has no significant past medical histor…

Year 4 · Clinical rotations · middle twist

A 58-year-old man with no symptoms attends your clinic for a general health check. He is concerned because his uncle and cousin both died of pancreatic cancer.…

Year 4 · Clinical rotations · middle twist

A 60-year-old man with a history of chronic diarrhea presents with muscle weakness and lethargy. Laboratory tests show: potassium 3.1 mmol/L (3.5-5.0 mmol/L), b…

Year 4 · Clinical rotations · middle twist

A 64-year-old man presents with a right-sided groin bulge that becomes more prominent on coughing. He reports no pain and has no difficulty with daily activitie…

Year 4 · Clinical rotations · middle twist

A 62-year-old man presents with a bulge in his right groin that becomes more prominent when he coughs and reduces spontaneously when lying down. On examination,…

Year 4 · Foundations · middle twist

A 54-year-old man presents with persistent heartburn and regurgitation despite six weeks of once-daily omeprazole. He has no dysphagia, weight loss, or anemia.…

Year 4 · Clinical rotations · middle twist

A 72-year-old woman is undergoing evaluation for persistent postprandial fullness and intermittent epigastric discomfort. She has no history of reflux or dyspha…

Year 4 · Clinical rotations · middle twist

A 58-year-old man with a 3-year history of gastroesophageal reflux disease (GERD) undergoes an upper endoscopy for ongoing reflux symptoms. Endoscopy reveals a…

Year 4 · Clinical rotations · middle twist

A 68-year-old man presents to his general practitioner for a routine review of his medications. He has a history of osteoarthritis, for which he takes naproxen…

Year 4 · Clinical rotations · middle twist

A 76-year-old man presents to the emergency department with a 6-hour history of passing large volumes of bright red blood per rectum. He feels lightheaded and f…

Year 4 · Clinical rotations · middle twist

A 68-year-old man presents to the emergency department with a 24-hour history of worsening abdominal pain, nausea, and vomiting. He has a history of open sigmoi…

Year 4 · Clinical rotations · middle twist

A 67-year-old man presents to the emergency department with a 2-day history of severe diarrhea, abdominal cramping, and fever (38.5°C). His symptoms began appro…

Year 1 · Foundations · middle twist

A 45-year-old woman with diabetes mellitus presents with a painful, rapidly expanding area of redness on her thigh. She has a fever of 39°C (102.2°F) and hypote…

Year 1 · Mechanisms of disease · middle twist

A 65-year-old man presents with purple spots on his forearms and hands that appeared over the past few days. He denies pain, itching, or trauma. His medical his…

Year 1 · Mechanisms of disease · middle twist

A histological sample from a region with high mechanical stress shows stratified squamous epithelium. Which of the following characteristics would distinguish w…

Year 1 · Foundations · middle twist

A 72-year-old man with a history of hypertension and heart failure with reduced ejection fraction (HFrEF) presents the emergency department due to sudden onset…

Year 4 · Clinical rotations · middle twist

A 5-day-old newborn presents with purulent conjunctivitis, eyelid swelling, and significant eye discharge. What is the most appropriate initial treatment?

Year 4 · Clinical rotations · middle twist

A 45-year-old woman is brought to the emergency room after developing diffuse skin tenderness and blistering. Her symptoms initially started with fever and mala…

Year 4 · Pre-internship · middle twist

A 72-year-old man with Alzheimer’s disease is brought to the emergency room by his daughter due to confusion and lethargy over the past few days. His daughter s…

Year 4 · Pre-internship · middle twist

A 24-year-old woman presents with right knee pain, swelling, and difficulty walking for the past 2 days. She also reports multiple joint pains and swelling. The…

Year 4 · Clinical rotations · middle twist