A 74 year old man has a history of hypertension. He presents to AED with a sudden onset of palpitations. He is tachycardic with a rate of 140. an ECG was performed and revealed a narrow complex tachycardia with a rate of around 150 and a saw tooth pattern. The ECG showed which rhythm?

In hypothyroidism, which biochemical test is most useful in the diagnosis and monitoring of treatment?

Which biochemical test is most helpful in differentiating chronic from acute renal failure?

A 45 year old patient with a raised BMI presents with a hot, swollen, red very painful big toe. What is the most likely diagnosis?

PFTs reveal a reduced FEV1/FVC ratio, reduced gas transfer and increased total lung capacity. There is little improvement after salbutamol. What is the most likely diagnosis?

A 23 year old is brought to AED following an assault where he was stabbed in the chest. He was complaining of chest pain. His now tachycardic and hypotensive. He has muffled heart sounds, raised JVP and pulsus paradoxus. Respiratory examination is normal. What is the most likely diagnosis?

What A 52 year old patient who has recently been diagnosed with small cell lung cancer presents with weight gain (mainly around the face and trunk), bruising easily, striae, and his skin appears darker. On examination he has a moon face, buffalo hump and he is hypertensive. His bloods reveal hypokalaemia. What is the most likely diagnosis?

What is the most significant complication that can occur with metformin use in renal failure?

A 28 year old gentleman presents with severe low back pain. It has been present for several months and he is very stiff in the morning. He has been woken several times during the night with it. The pain is relieved by exercise. What is the most likely diagnosis?

A 45 year old gentleman who has COPD presents with SOB and pleuritic chest pain. he has aa cough and has has several episodes of haemoptysis. He has recently returned from visiting his family in Australia. On examination he is pyrexic, tachypnoeic with saturations of 90% and there is widespread wheeze throughout his chest. Bloods reveal an elevated CRP and WCC. A CXR reveals hyperinflation of the lungs and an ECG sinus tachycardia. Which investigation should be ordered to confirm the diagnosis?

A patient has just suffered a STEMI and is now found to be in complete heart block. Which vessel is likely to have been involved?

A 52 year old male of Asian descent is suffering from lethargy, bone pain and is complaint of weakness with difficulty getting up from chair and climbing chairs. Bloods reveal a low calcium and vitamin D level and an elevated ALP. What is the most likely diagnosis?

A 24 year old is found to have CKD. There is a history of numerous UTIs as a child. On USS there is evidence of renal scarring. She is hypertensive. What is the most likely diagnosis?

A 60 year old gentleman presents with proximal muscle weakness and has noticed a rash on his knuckles and a purplish rash around his eyes. His CK is elevated. He also admits to having significant weight loss, cough and hemoptysis. Which antibody would you expect to find?

A patient with asthma presents with a productive cough and breathlessness. A CXR reveals loss of volume in the left hemithorax and there appears to be an opacity behind the heart shadow and the left hemidiaphragm is obscured. What is the most likely cause?

A 72 year old gentleman with a history of ischaemic heart disease, has been unwell with diarrhoea and vomiting . He complains of intermittent palpatations and dizziness. He is brought to hospital and starts to complain of an episode and is found to have a broad complex tachycardia with the QRS complexes appearing to twist around the baseline. His blood pressure is 140/90 and GCS is 15. How would you manage this patient?

A 33 year old woman presents with amenorrhoea and has noticed reduced axially and pubic hair. She has also noticed a change in her vision. On examination she has a bitemporal hemianopia. Her prolactin levels are over 2000mg/L. What is the most likely diagnosis?

A 38 year old male presents with fatigue and weight loss. He has a long history of recurrent sinusitis, epistaxis and dry cough. He is found to have haematuria on urinalysis. He is cANCA positive.

A 65 year old presents with headache. He is also feeling feverish and generally unwell. He has also noticed his scalp is sensitive when he brushes his hair and is having pain when chewing. What test will make the definitive diagnosis?

A 37 year old presents with fatigue, weight loss and nausea. he decides episodes of haemoptysis and has noticed his urine being very dark. On examination he has bibasal crepitations. His bloods reveal an iron deficiency anaemia and renal impairment and urinalysis reveals proteinuria and microscopic haematuria. What is the most likely diagnosis?

Which antibodies present in the maternal circulation may lead to congenital heart block?

A 25 year old patient is suffering from hypertension which has been very difficult to control. Blood reveal metabolic acidosis, hyperkalaemia and low renin and aldosterone levels. What is the most likely diagnosis?

A 55 year old female presents to her GP after noticing blood in her urine. She is asymptomatic otherwise with no abdominal pain or other urinary symptoms. She is a heavy smoker and takes aspirin regularly. Her bloods reveal anaemia and urinalysis reveals haematuria. What is the most likely diagnosis?

A 23 year old presents with asthma and recurrent rhinitis develops purport, right foot and wrist drop and bloods reveal AKI, elevated eosinophils and pANCA positive. What is the most likely diagnosis?

A patient who was previously a coal miner is found on CXR to have numerous small round opacities with normal lung markings. What is the most likely diagnosis?