A 25-year-old man after road traffic accident with hypotension, tachycardia, flat neck veins. Diagnosis?

A. Hypovolemic shock | B. Cardiac tamponade | C. Tension pneumothorax | D. Septic shock

A trauma patient with hypotension, distended neck veins, muffled heart sounds. Diagnosis?

A. Cardiac tamponade | B. Tension pneumothorax | C. Hemothorax | D. PE

A 30-year-old man after chest trauma with absent breath sounds, hyperresonance, trachea deviated. Diagnosis?

A. Tension pneumothorax | B. Hemothorax | C. Flail chest | D. PE

A 35-year-old with blunt chest trauma, multiple rib fractures, paradoxical chest movement. Diagnosis?

A. Flail chest | B. Pneumothorax | C. Hemothorax | D. Contusion

A 28-year-old trauma patient with BP 80/40, HR 140, cool extremities. Class of shock?

A. Class I | B. Class II | C. Class III | D. Class IV

A trauma patient with airway obstruction and facial burns. Management?

A. Early intubation | B. Tracheostomy | C. Observe | D. Cricothyrotomy

A 35-year-old with abdominal trauma, free fluid on FAST. Next step?

A. Laparotomy | B. CT scan | C. Observation | D. Diagnostic peritoneal lavage

A 30-year-old with penetrating abdominal injury, hypotension, distended abdomen. Next step?

A. Exploratory laparotomy | B. CT scan | C. Ultrasound | D. Observe

A 25-year-old with blunt abdominal trauma, left shoulder pain, hypotension. Diagnosis?

A. Splenic rupture | B. Liver injury | C. Pancreatic injury | D. Kidney trauma

A 40-year-old with right upper quadrant injury, hypotension. Organ injured?

A. Liver | B. Spleen | C. Pancreas | D. Kidney

A 45-year-old man after RTA, blood at urethral meatus, high-riding prostate. Diagnosis?

A. Urethral injury | B. Bladder rupture | C. Renal trauma | D. Rectal tear

A 32-year-old with pelvic fracture, unable to pass urine. Next investigation?

A. Retrograde urethrogram | B. CT | C. Cystoscopy | D. USG

A 25-year-old with suspected bladder rupture. Best test?

A. Cystogram | B. IVP | C. USG | D. CT

A 35-year-old with penetrating neck wound, active bleeding. First step?

A. Secure airway | B. Direct pressure | C. CT angiography | D. Observe

A 40-year-old with peritonitis after trauma. Next step?

A. Laparotomy | B. CT scan | C. Observe | D. FAST

A 50-year-old with post-op fever on day 1. Most likely cause?

A. Atelectasis | B. Wound infection | C. UTI | D. DVT

A 50-year-old with fever on day 5 post-op. Likely cause?

A. Wound infection | B. Pneumonia | C. DVT | D. Sepsis

A 55-year-old with fever on day 7 post-op. Likely cause?

A. DVT | B. UTI | C. Pneumonia | D. Wound infection

A 45-year-old with sudden shortness of breath post-op, chest pain, tachycardia. Diagnosis?

A. PE | B. Pneumonia | C. MI | D. Pneumothorax

A 50-year-old post-surgery with abdominal distension, no bowel sounds. Diagnosis?

A. Ileus | B. Obstruction | C. Volvulus | D. Adhesion

A 40-year-old man with fever, RLQ pain, guarding. Diagnosis?

A. Appendicitis | B. Cholecystitis | C. Perforation | D. Renal colic

A 25-year-old woman with RLQ pain, tenderness, fever. Best initial test?

A. Ultrasound | B. CT | C. MRI | D. X-ray

A 50-year-old with fever, RUQ pain, Murphy’s sign. Diagnosis?

A. Acute cholecystitis | B. Cholangitis | C. Hepatitis | D. Peptic ulcer

A 60-year-old with fever, jaundice, RUQ pain. Diagnosis?

A. Ascending cholangitis | B. Cholecystitis | C. Hepatitis | D. Cirrhosis

A 45-year-old obese woman with postprandial pain, gallstones. Diagnosis?

A. Cholelithiasis | B. Cholecystitis | C. Choledocholithiasis | D. Pancreatitis

A 55-year-old alcoholic with epigastric pain radiating to back, ↑amylase/lipase. Diagnosis?

A. Acute pancreatitis | B. Cholecystitis | C. PUD | D. MI

A 45-year-old with history of gallstones, elevated bilirubin, dilated bile ducts. Diagnosis?

A. Choledocholithiasis | B. Cholangitis | C. Cholecystitis | D. Pancreatitis

A 50-year-old with severe epigastric pain, vomiting, free air under diaphragm. Diagnosis?

A. Perforated peptic ulcer | B. Pancreatitis | C. SBO | D. Gastritis

A 60-year-old with upper GI bleed, history of NSAID use. Cause?

A. Peptic ulcer | B. Gastritis | C. Varices | D. Mallory-Weiss

A 55-year-old with hematemesis and cirrhosis. Cause?

A. Esophageal varices | B. PUD | C. Mallory-Weiss | D. Gastritis

A 45-year-old alcoholic with vomiting, then hematemesis, tear at GE junction. Diagnosis?

A. Mallory-Weiss tear | B. PUD | C. Varices | D. Erosive gastritis

A 65-year-old with dysphagia to solids then liquids, weight loss. Diagnosis?

A. Esophageal cancer | B. Achalasia | C. Stricture | D. Plummer-Vinson

A 30-year-old woman with dysphagia to both solids and liquids, bird-beak on barium. Diagnosis?

A. Achalasia | B. Stricture | C. Cancer | D. Web

A 55-year-old with painful swallowing, mid-esophageal pouch. Diagnosis?

A. Diverticulum | B. Zenker | C. Stricture | D. Achalasia

A 70-year-old with epigastric pain relieved by food. Diagnosis?

A. Duodenal ulcer | B. Gastric ulcer | C. GERD | D. Gastritis

A 65-year-old with epigastric pain worsened by food, weight loss. Diagnosis?

A. Gastric ulcer | B. Duodenal | C. GERD | D. Pancreatitis

A 50-year-old with hematemesis, melena, cirrhosis. Initial management?

A. IV fluids + octreotide | B. Antibiotics | C. Endoscopy | D. Balloon tamponade

A 45-year-old with acute abdomen, rigid board-like, free air under diaphragm. Diagnosis?

A. Perforated ulcer | B. Pancreatitis | C. SBO | D. Appendicitis

A 50-year-old man with recurrent vomiting, visible peristalsis, succussion splash. Diagnosis?

A. Gastric outlet obstruction | B. Duodenal ulcer | C. Gastritis | D. Achalasia

A 65-year-old with painless hematochezia, anemia, change in bowel habits. Diagnosis?

A. Colon cancer | B. Diverticulosis | C. Hemorrhoids | D. UC

A 40-year-old with LLQ pain, fever, leukocytosis. Diagnosis?

A. Diverticulitis | B. UC | C. Crohn | D. IBS

A 45-year-old woman with painless breast lump, irregular hard, fixed to skin. Diagnosis?

A. Fibroadenoma | B. Breast carcinoma | C. Fibrocystic | D. Abscess

A 25-year-old woman with mobile, firm, non-tender breast lump. Diagnosis?

A. Fibroadenoma | B. Fibrocystic disease | C. Abscess | D. Carcinoma

A 35-year-old woman with cyclic mastalgia, nodular breast. Diagnosis?

A. Fibrocystic disease | B. Carcinoma | C. Abscess | D. Fibroadenoma

A 50-year-old woman with eczematous nipple changes and underlying lump. Diagnosis?

A. Paget disease | B. Fibrocystic | C. Mastitis | D. DCIS

A 60-year-old with peau d’orange breast and axillary nodes. Diagnosis?

A. Inflammatory carcinoma | B. Ductal carcinoma | C. Paget | D. Sarcoma

A 25-year-old lactating woman with fever, breast pain, tender swelling. Diagnosis?

A. Mastitis | B. Abscess | C. Carcinoma | D. Galactocele

A 30-year-old lactating woman with fluctuant breast swelling, fever. Diagnosis?

A. Abscess | B. Mastitis | C. Fibrocystic | D. Carcinoma

A 40-year-old woman post-breast surgery with arm swelling. Cause?

A. Lymphedema | B. Thrombosis | C. Infection | D. Cellulitis

A 55-year-old woman with breast cancer, bone metastasis. Common site?

A. Vertebrae | B. Lungs | C. Liver | D. Brain

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SMLE - Surgery


A 25-year-old man after road traffic accident with hypotension, tachycardia, flat neck veins. Diagnosis?	A. Hypovolemic shock \| B. Cardiac tamponade \| C. Tension pneumothorax \| D. Septic shock	A. Hypovolemic shock
A trauma patient with hypotension, distended neck veins, muffled heart sounds. Diagnosis?	A. Cardiac tamponade \| B. Tension pneumothorax \| C. Hemothorax \| D. PE	A. Cardiac tamponade
A 30-year-old man after chest trauma with absent breath sounds, hyperresonance, trachea deviated. Diagnosis?	A. Tension pneumothorax \| B. Hemothorax \| C. Flail chest \| D. PE	A. Tension pneumothorax
A 35-year-old with blunt chest trauma, multiple rib fractures, paradoxical chest movement. Diagnosis?	A. Flail chest \| B. Pneumothorax \| C. Hemothorax \| D. Contusion	A. Flail chest
A 28-year-old trauma patient with BP 80/40, HR 140, cool extremities. Class of shock?	A. Class I \| B. Class II \| C. Class III \| D. Class IV	C. Class III hemorrhagic shock
A trauma patient with airway obstruction and facial burns. Management?	A. Early intubation \| B. Tracheostomy \| C. Observe \| D. Cricothyrotomy	A. Early endotracheal intubation
A 35-year-old with abdominal trauma, free fluid on FAST. Next step?	A. Laparotomy \| B. CT scan \| C. Observation \| D. Diagnostic peritoneal lavage	A. Emergency laparotomy
A 30-year-old with penetrating abdominal injury, hypotension, distended abdomen. Next step?	A. Exploratory laparotomy \| B. CT scan \| C. Ultrasound \| D. Observe	A. Immediate laparotomy
A 25-year-old with blunt abdominal trauma, left shoulder pain, hypotension. Diagnosis?	A. Splenic rupture \| B. Liver injury \| C. Pancreatic injury \| D. Kidney trauma	A. Splenic rupture (Kehr’s sign)
A 40-year-old with right upper quadrant injury, hypotension. Organ injured?	A. Liver \| B. Spleen \| C. Pancreas \| D. Kidney	A. Liver laceration
A 45-year-old man after RTA, blood at urethral meatus, high-riding prostate. Diagnosis?	A. Urethral injury \| B. Bladder rupture \| C. Renal trauma \| D. Rectal tear	A. Posterior urethral injury
A 32-year-old with pelvic fracture, unable to pass urine. Next investigation?	A. Retrograde urethrogram \| B. CT \| C. Cystoscopy \| D. USG	A. Retrograde urethrogram before catheterization
A 25-year-old with suspected bladder rupture. Best test?	A. Cystogram \| B. IVP \| C. USG \| D. CT	A. Retrograde cystogram
A 35-year-old with penetrating neck wound, active bleeding. First step?	A. Secure airway \| B. Direct pressure \| C. CT angiography \| D. Observe	A. Secure airway and control bleeding
A 40-year-old with peritonitis after trauma. Next step?	A. Laparotomy \| B. CT scan \| C. Observe \| D. FAST	A. Exploratory laparotomy
A 50-year-old with post-op fever on day 1. Most likely cause?	A. Atelectasis \| B. Wound infection \| C. UTI \| D. DVT	A. Atelectasis (wind)
A 50-year-old with fever on day 5 post-op. Likely cause?	A. Wound infection \| B. Pneumonia \| C. DVT \| D. Sepsis	A. Wound infection
A 55-year-old with fever on day 7 post-op. Likely cause?	A. DVT \| B. UTI \| C. Pneumonia \| D. Wound infection	A. Deep vein thrombosis (walk)
A 45-year-old with sudden shortness of breath post-op, chest pain, tachycardia. Diagnosis?	A. PE \| B. Pneumonia \| C. MI \| D. Pneumothorax	A. Pulmonary embolism
A 50-year-old post-surgery with abdominal distension, no bowel sounds. Diagnosis?	A. Ileus \| B. Obstruction \| C. Volvulus \| D. Adhesion	A. Postoperative paralytic ileus
A 40-year-old man with fever, RLQ pain, guarding. Diagnosis?	A. Appendicitis \| B. Cholecystitis \| C. Perforation \| D. Renal colic	A. Acute appendicitis
A 25-year-old woman with RLQ pain, tenderness, fever. Best initial test?	A. Ultrasound \| B. CT \| C. MRI \| D. X-ray	A. Abdominal ultrasound
A 50-year-old with fever, RUQ pain, Murphy’s sign. Diagnosis?	A. Acute cholecystitis \| B. Cholangitis \| C. Hepatitis \| D. Peptic ulcer	A. Acute calculous cholecystitis
A 60-year-old with fever, jaundice, RUQ pain. Diagnosis?	A. Ascending cholangitis \| B. Cholecystitis \| C. Hepatitis \| D. Cirrhosis	A. Charcot’s triad – Ascending cholangitis
A 45-year-old obese woman with postprandial pain, gallstones. Diagnosis?	A. Cholelithiasis \| B. Cholecystitis \| C. Choledocholithiasis \| D. Pancreatitis	A. Symptomatic cholelithiasis
A 55-year-old alcoholic with epigastric pain radiating to back, ↑amylase/lipase. Diagnosis?	A. Acute pancreatitis \| B. Cholecystitis \| C. PUD \| D. MI	A. Acute pancreatitis
A 45-year-old with history of gallstones, elevated bilirubin, dilated bile ducts. Diagnosis?	A. Choledocholithiasis \| B. Cholangitis \| C. Cholecystitis \| D. Pancreatitis	A. Choledocholithiasis
A 50-year-old with severe epigastric pain, vomiting, free air under diaphragm. Diagnosis?	A. Perforated peptic ulcer \| B. Pancreatitis \| C. SBO \| D. Gastritis	A. Perforated peptic ulcer
A 60-year-old with upper GI bleed, history of NSAID use. Cause?	A. Peptic ulcer \| B. Gastritis \| C. Varices \| D. Mallory-Weiss	A. Peptic ulcer disease
A 55-year-old with hematemesis and cirrhosis. Cause?	A. Esophageal varices \| B. PUD \| C. Mallory-Weiss \| D. Gastritis	A. Bleeding esophageal varices
A 45-year-old alcoholic with vomiting, then hematemesis, tear at GE junction. Diagnosis?	A. Mallory-Weiss tear \| B. PUD \| C. Varices \| D. Erosive gastritis	A. Mallory-Weiss tear
A 65-year-old with dysphagia to solids then liquids, weight loss. Diagnosis?	A. Esophageal cancer \| B. Achalasia \| C. Stricture \| D. Plummer-Vinson	A. Esophageal carcinoma
A 30-year-old woman with dysphagia to both solids and liquids, bird-beak on barium. Diagnosis?	A. Achalasia \| B. Stricture \| C. Cancer \| D. Web	A. Achalasia cardia
A 55-year-old with painful swallowing, mid-esophageal pouch. Diagnosis?	A. Diverticulum \| B. Zenker \| C. Stricture \| D. Achalasia	A. Epiphrenic diverticulum
A 70-year-old with epigastric pain relieved by food. Diagnosis?	A. Duodenal ulcer \| B. Gastric ulcer \| C. GERD \| D. Gastritis	A. Duodenal ulcer
A 65-year-old with epigastric pain worsened by food, weight loss. Diagnosis?	A. Gastric ulcer \| B. Duodenal \| C. GERD \| D. Pancreatitis	A. Gastric ulcer
A 50-year-old with hematemesis, melena, cirrhosis. Initial management?	A. IV fluids + octreotide \| B. Antibiotics \| C. Endoscopy \| D. Balloon tamponade	A. Fluid resuscitation and octreotide
A 45-year-old with acute abdomen, rigid board-like, free air under diaphragm. Diagnosis?	A. Perforated ulcer \| B. Pancreatitis \| C. SBO \| D. Appendicitis	A. Perforated peptic ulcer
A 50-year-old man with recurrent vomiting, visible peristalsis, succussion splash. Diagnosis?	A. Gastric outlet obstruction \| B. Duodenal ulcer \| C. Gastritis \| D. Achalasia	A. Gastric outlet obstruction
A 65-year-old with painless hematochezia, anemia, change in bowel habits. Diagnosis?	A. Colon cancer \| B. Diverticulosis \| C. Hemorrhoids \| D. UC	A. Colorectal carcinoma
A 40-year-old with LLQ pain, fever, leukocytosis. Diagnosis?	A. Diverticulitis \| B. UC \| C. Crohn \| D. IBS	A. Acute diverticulitis
A 45-year-old woman with painless breast lump, irregular hard, fixed to skin. Diagnosis?	A. Fibroadenoma \| B. Breast carcinoma \| C. Fibrocystic \| D. Abscess	B. Invasive ductal carcinoma
A 25-year-old woman with mobile, firm, non-tender breast lump. Diagnosis?	A. Fibroadenoma \| B. Fibrocystic disease \| C. Abscess \| D. Carcinoma	A. Fibroadenoma
A 35-year-old woman with cyclic mastalgia, nodular breast. Diagnosis?	A. Fibrocystic disease \| B. Carcinoma \| C. Abscess \| D. Fibroadenoma	A. Fibrocystic change
A 50-year-old woman with eczematous nipple changes and underlying lump. Diagnosis?	A. Paget disease \| B. Fibrocystic \| C. Mastitis \| D. DCIS	A. Paget’s disease of the breast
A 60-year-old with peau d’orange breast and axillary nodes. Diagnosis?	A. Inflammatory carcinoma \| B. Ductal carcinoma \| C. Paget \| D. Sarcoma	A. Inflammatory breast carcinoma
A 25-year-old lactating woman with fever, breast pain, tender swelling. Diagnosis?	A. Mastitis \| B. Abscess \| C. Carcinoma \| D. Galactocele	A. Acute lactational mastitis
A 30-year-old lactating woman with fluctuant breast swelling, fever. Diagnosis?	A. Abscess \| B. Mastitis \| C. Fibrocystic \| D. Carcinoma	A. Breast abscess
A 40-year-old woman post-breast surgery with arm swelling. Cause?	A. Lymphedema \| B. Thrombosis \| C. Infection \| D. Cellulitis	A. Post-mastectomy lymphedema
A 55-year-old woman with breast cancer, bone metastasis. Common site?	A. Vertebrae \| B. Lungs \| C. Liver \| D. Brain	A. Vertebral metastasis
A 60-year-old woman with lump in breast, no nodes, <2 cm. Stage?	A. I \| B. II \| C. III \| D. IV	A. Stage I breast cancer
A 50-year-old man with nipple discharge, mass under areola. Diagnosis?	A. Male breast carcinoma \| B. Gynecomastia \| C. Fibroadenoma \| D. Abscess	A. Male breast carcinoma
A 60-year-old man with symmetric enlargement of both breasts. Diagnosis?	A. Gynecomastia \| B. Carcinoma \| C. Cyst \| D. Lipoma	A. Gynecomastia
A 45-year-old woman with solitary thyroid nodule, cold on scan. Next step?	A. FNAC \| B. Observe \| C. Surgery \| D. Suppression therapy	A. Fine-needle aspiration cytology
A 35-year-old woman with diffuse goiter, exophthalmos. Diagnosis?	A. Graves \| B. Hashimoto \| C. Toxic adenoma \| D. Multinodular goiter	A. Graves disease
A 40-year-old man with solitary thyroid nodule, solid, cold, male. Risk?	A. Malignancy \| B. Benign \| C. Thyroiditis \| D. Cyst	A. Malignancy risk
A 45-year-old woman with thyroid nodule, calcitonin elevated. Diagnosis?	A. Medullary carcinoma \| B. Papillary \| C. Follicular \| D. Anaplastic	A. Medullary thyroid carcinoma
A 55-year-old man with rapidly enlarging neck mass, hoarseness, dysphagia. Diagnosis?	A. Anaplastic thyroid carcinoma \| B. Medullary \| C. Lymphoma \| D. Papillary	A. Anaplastic carcinoma
A 40-year-old man with midline neck swelling moving with tongue protrusion. Diagnosis?	A. Thyroglossal cyst \| B. Dermoid \| C. Lymph node \| D. Goiter	A. Thyroglossal duct cyst
A 30-year-old man with lateral neck cyst, anterior to SCM. Diagnosis?	A. Branchial cyst \| B. Thyroglossal \| C. Dermoid \| D. Lipoma	A. Branchial cyst
A 25-year-old man with neck swelling after URTI, tender, fluctuant. Diagnosis?	A. Abscess \| B. Branchial cyst \| C. Lymphoma \| D. TB	A. Deep neck abscess
A 40-year-old man with epigastric swelling, increases on cough. Diagnosis?	A. Epigastric hernia \| B. Umbilical \| C. Incisional \| D. Inguinal	A. Epigastric hernia
A 30-year-old woman with swelling at umbilicus, reducible. Diagnosis?	A. Umbilical hernia \| B. Paraumbilical \| C. Incisional \| D. Spigelian	A. Umbilical hernia
A 50-year-old obese woman post-laparotomy with scar swelling. Diagnosis?	A. Incisional hernia \| B. Umbilical \| C. Paraumbilical \| D. Spigelian	A. Incisional hernia
A 25-year-old man with groin swelling above inguinal ligament, reducible. Diagnosis?	A. Indirect inguinal hernia \| B. Direct \| C. Femoral \| D. Hydrocele	A. Indirect inguinal hernia
A 60-year-old man with groin bulge medial to inferior epigastric vessels. Diagnosis?	A. Direct inguinal hernia \| B. Indirect \| C. Femoral \| D. Obturator	A. Direct inguinal hernia
A 55-year-old woman with swelling below inguinal ligament, tender, irreducible. Diagnosis?	A. Femoral hernia \| B. Direct \| C. Indirect \| D. Incisional	A. Femoral hernia
A 45-year-old man with irreducible hernia and obstruction. Management?	A. Emergency surgery \| B. Elective repair \| C. Truss \| D. Observe	A. Emergency hernia repair
A 40-year-old woman with right flank pain, hematuria, colicky pain. Diagnosis?	A. Renal stone \| B. Pyelonephritis \| C. Tumor \| D. Cyst	A. Ureteric calculus
A 55-year-old man with painless hematuria, smoker. Diagnosis?	A. Bladder cancer \| B. RCC \| C. Stone \| D. Cystitis	A. Transitional cell carcinoma
A 60-year-old man with painless scrotal swelling, transilluminates. Diagnosis?	A. Hydrocele \| B. Varicocele \| C. Hernia \| D. Epididymitis	A. Hydrocele
A 25-year-old man with scrotal pain, high-riding testis, absent cremasteric reflex. Diagnosis?	A. Torsion testis \| B. Epididymitis \| C. Hernia \| D. Hydrocele	A. Testicular torsion
A 30-year-old man with bag-of-worms feel, left side, infertility. Diagnosis?	A. Varicocele \| B. Hydrocele \| C. Hernia \| D. Epididymitis	A. Varicocele
A 65-year-old man with LUTS, enlarged firm prostate, PSA 12. Diagnosis?	A. BPH \| B. Prostate cancer \| C. Prostatitis \| D. Stone	B. Carcinoma prostate
A 60-year-old man with nocturia, hesitancy, weak stream, smooth prostate. Diagnosis?	A. BPH \| B. Carcinoma \| C. Prostatitis \| D. Urethral stricture	A. Benign prostatic hyperplasia
A 50-year-old man with acute retention. Initial management?	A. Catheterization \| B. Surgery \| C. Drugs \| D. Observe	A. Bladder catheterization
A 55-year-old man with perianal swelling, pain, fever. Diagnosis?	A. Perianal abscess \| B. Fistula \| C. Hemorrhoid \| D. Fissure	A. Perianal abscess
A 40-year-old man with chronic anal discharge, external opening near anus. Diagnosis?	A. Fistula-in-ano \| B. Fissure \| C. Abscess \| D. Hemorrhoid	A. Anal fistula
A 35-year-old woman with painful bleeding after defecation, tear in anoderm. Diagnosis?	A. Anal fissure \| B. Fistula \| C. Hemorrhoids \| D. Abscess	A. Anal fissure
A 45-year-old man with painless rectal bleeding, prolapse during defecation. Diagnosis?	A. Internal hemorrhoids \| B. Fissure \| C. Polyp \| D. Cancer	A. Internal hemorrhoids
A 50-year-old man with rectal bleeding, tenesmus, mass on DRE. Diagnosis?	A. Rectal cancer \| B. Hemorrhoid \| C. Fissure \| D. Fistula	A. Rectal carcinoma
A 25-year-old man fell on outstretched hand, pain over anatomic snuffbox. Diagnosis?	A. Scaphoid fracture \| B. Colles fracture \| C. Smith fracture \| D. Lunate dislocation	A. Scaphoid fracture
A 60-year-old woman fell on outstretched hand, dorsal angulation distal radius. Diagnosis?	A. Colles fracture \| B. Smith fracture \| C. Barton \| D. Monteggia	A. Colles fracture
A 45-year-old man with volar angulation distal radius. Diagnosis?	A. Smith fracture \| B. Colles \| C. Barton \| D. Galeazzi	A. Smith fracture
A 30-year-old man with ulnar fracture and radial head dislocation. Diagnosis?	A. Monteggia fracture \| B. Galeazzi \| C. Colles \| D. Smith	A. Monteggia fracture-dislocation
A 25-year-old with radial fracture and distal radioulnar dislocation. Diagnosis?	A. Galeazzi fracture \| B. Monteggia \| C. Colles \| D. Barton	A. Galeazzi fracture
A 40-year-old with shoulder pain after fall, arm externally rotated, abducted. Diagnosis?	A. Anterior shoulder dislocation \| B. Posterior \| C. Fracture clavicle \| D. Rotator cuff tear	A. Anterior shoulder dislocation
A 45-year-old with shoulder deformity, unable to abduct arm after dislocation. Nerve injured?	A. Axillary \| B. Radial \| C. Median \| D. Ulnar	A. Axillary nerve injury
A 30-year-old man with midshaft humerus fracture. Nerve injured?	A. Radial \| B. Ulnar \| C. Median \| D. Axillary	A. Radial nerve
A 60-year-old man with supracondylar humerus fracture, wrist drop. Nerve injured?	A. Radial \| B. Ulnar \| C. Median \| D. Axillary	A. Radial nerve
A 10-year-old with supracondylar fracture, loss of thumb opposition. Nerve?	A. Median \| B. Ulnar \| C. Radial \| D. Axillary	A. Median nerve
A 30-year-old with elbow injury, claw hand deformity. Nerve?	A. Ulnar \| B. Radial \| C. Median \| D. Axillary	A. Ulnar nerve injury
A 25-year-old with wrist laceration, cannot oppose thumb. Nerve?	A. Median \| B. Ulnar \| C. Radial \| D. Axillary	A. Median nerve injury
A 45-year-old with pelvic fracture, unable to dorsiflex foot. Nerve?	A. Common peroneal \| B. Femoral \| C. Sciatic \| D. Tibial	A. Common peroneal nerve injury
A 50-year-old with posterior hip dislocation. Nerve injured?	A. Sciatic \| B. Femoral \| C. Obturator \| D. Peroneal	A. Sciatic nerve
A 70-year-old woman with hip fracture, shortened externally rotated limb. Diagnosis?	A. Neck of femur fracture \| B. Intertrochanteric \| C. Shaft fracture \| D. Dislocation	A. Fracture neck of femur
A 65-year-old with subtrochanteric fracture after minor fall. Likely cause?	A. Osteoporosis \| B. Metastasis \| C. Paget \| D. OA	A. Osteoporotic fragility fracture
A 30-year-old with pain, swelling tibia, fever, high ESR. Diagnosis?	A. Osteomyelitis \| B. Osteosarcoma \| C. Ewing \| D. Cellulitis	A. Acute osteomyelitis
A 14-year-old boy with diaphyseal bone lesion, onion-skin periosteal reaction. Diagnosis?	A. Ewing sarcoma \| B. Osteosarcoma \| C. Osteomyelitis \| D. Chondrosarcoma	A. Ewing sarcoma
A 17-year-old boy with metaphyseal lesion around knee, sunburst pattern. Diagnosis?	A. Osteosarcoma \| B. Ewing \| C. Chondroblastoma \| D. Giant cell tumor	A. Osteosarcoma
A 25-year-old woman with epiphyseal lytic lesion, soap-bubble appearance. Diagnosis?	A. Giant cell tumor \| B. Chondroblastoma \| C. Ewing \| D. Osteosarcoma	A. Giant cell tumor (osteoclastoma)
A 35-year-old with chronic knee pain, morning stiffness <30 min. Diagnosis?	A. Osteoarthritis \| B. RA \| C. Gout \| D. Septic	A. Osteoarthritis
A 20-year-old athlete with knee pain after twist, positive Lachman test. Diagnosis?	A. ACL tear \| B. PCL \| C. Meniscus \| D. Collateral	A. ACL rupture
A 25-year-old athlete with knee locking, joint line tenderness. Diagnosis?	A. Meniscal tear \| B. ACL \| C. PCL \| D. OA	A. Meniscal tear
A 30-year-old man with posterior dislocation knee, weak dorsalis pedis. Vessel?	A. Popliteal artery \| B. Femoral \| C. Tibial \| D. Peroneal	A. Popliteal artery injury
A 60-year-old smoker with calf pain on walking, relieved by rest. Diagnosis?	A. Intermittent claudication \| B. DVT \| C. Varicose veins \| D. Cellulitis	A. Peripheral arterial disease
A 65-year-old man with rest pain, absent pulses, ulcer on toe. Diagnosis?	A. Critical limb ischemia \| B. DVT \| C. Varicose \| D. Cellulitis	A. Critical limb ischemia
A 40-year-old woman with dilated tortuous leg veins, aching pain. Diagnosis?	A. Varicose veins \| B. DVT \| C. Lymphedema \| D. Thrombophlebitis	A. Varicose veins
A 55-year-old with leg ulcer above medial malleolus, painless. Cause?	A. Venous ulcer \| B. Arterial \| C. Neuropathic \| D. Pressure	A. Venous ulcer
A 65-year-old diabetic with foot ulcer on sole, loss of sensation. Diagnosis?	A. Neuropathic ulcer \| B. Arterial \| C. Venous \| D. Pressure	A. Diabetic neuropathic ulcer
A 70-year-old with painful black toe, absent pulses. Diagnosis?	A. Arterial ulcer \| B. Venous \| C. Neuropathic \| D. Pressure	A. Arterial ischemic ulcer
A 25-year-old with deep laceration leg, absent distal pulses, cold limb. Management?	A. Vascular repair \| B. Fasciotomy \| C. Observe \| D. Amputation	A. Immediate vascular repair
A 35-year-old with crush injury, severe pain, paresthesia, pallor, tight limb. Diagnosis?	A. Compartment syndrome \| B. DVT \| C. Arterial occlusion \| D. Cellulitis	A. Acute compartment syndrome
A 40-year-old man with electric burn, myoglobinuria. Management?	A. IV fluids + alkalinization \| B. Antibiotics \| C. Observe \| D. Amputation	A. Aggressive IV fluids and urine alkalinization
A 30-year-old with circumferential full-thickness burn, distal pulses absent. Management?	A. Escharotomy \| B. Fasciotomy \| C. Grafting \| D. Amputation	A. Escharotomy
A 50-year-old with 40% flame burns, singed nasal hairs, hoarseness. Next step?	A. Intubate early \| B. Observe \| C. Oxygen only \| D. Fluids	A. Early airway intubation
A 25-year-old with 30% burns. Fluid requirement first 24h?	A. Parkland formula \| B. Holliday-Segar \| C. Maintenance \| D. Evans	A. Parkland formula (4 mL × %BSA × weight)
A 40-year-old with chemical burn. Immediate management?	A. Copious water irrigation \| B. Neutralize \| C. Cover \| D. Antibiotic	A. Copious irrigation with water
A 50-year-old with electrical burn and rhabdomyolysis. Best indicator renal failure?	A. Myoglobinuria \| B. Oliguria \| C. CK \| D. Hyperkalemia	A. Myoglobinuria
A 60-year-old with postoperative wound dehiscence, bowel visible. Management?	A. Cover with saline gauze + surgery \| B. Dress \| C. Observe \| D. Drain	A. Cover wound and urgent re-suturing
A 45-year-old post-op day 5, fever, erythema, pus discharge. Diagnosis?	A. Wound infection \| B. Seroma \| C. Hematoma \| D. Dehiscence	A. Surgical site infection
A 70-year-old diabetic with foul-smelling necrotic wound, crepitus. Diagnosis?	A. Gas gangrene \| B. Cellulitis \| C. Abscess \| D. Necrosis	A. Clostridial gas gangrene
A 50-year-old smoker with chronic nonhealing ulcer, rolled everted edges. Diagnosis?	A. SCC \| B. BCC \| C. Melanoma \| D. Keratoacanthoma	A. Marjolin’s ulcer (SCC)
A 60-year-old farmer with pearly nodular lesion, central ulceration. Diagnosis?	A. Basal cell carcinoma \| B. SCC \| C. Melanoma \| D. Keratoacanthoma	A. Basal cell carcinoma
A 55-year-old man with pigmented irregular lesion, changes in size and color. Diagnosis?	A. Melanoma \| B. BCC \| C. SCC \| D. Seborrheic keratosis	A. Malignant melanoma
A 25-year-old man after road traffic accident, hypotensive, flat neck veins. Diagnosis?	A. Hypovolemic shock \| B. Cardiac tamponade \| C. Tension pneumothorax \| D. Septic shock	A. Hypovolemic shock
A trauma patient with distended neck veins, muffled heart sounds, hypotension. Diagnosis?	A. Cardiac tamponade \| B. Tension pneumothorax \| C. Hemothorax \| D. PE	A. Cardiac tamponade
A 35-year-old man after chest trauma, absent breath sounds, trachea deviated. Diagnosis?	A. Tension pneumothorax \| B. Hemothorax \| C. Flail chest \| D. PE	A. Tension pneumothorax
A 40-year-old man with blunt chest trauma, paradoxical chest movement. Diagnosis?	A. Flail chest \| B. Pneumothorax \| C. Hemothorax \| D. Contusion	A. Flail chest
A 25-year-old trauma patient with hypotension, tachycardia, cool extremities. Type of shock?	A. Hypovolemic \| B. Septic \| C. Cardiogenic \| D. Neurogenic	A. Hypovolemic shock
A patient with spinal cord injury, hypotension, bradycardia, warm skin. Diagnosis?	A. Neurogenic shock \| B. Hypovolemic \| C. Septic \| D. Cardiogenic	A. Neurogenic shock
A 45-year-old with chest trauma, BP 70/40, JVP elevated, muffled heart sounds. Diagnosis?	A. Cardiac tamponade \| B. Tension pneumothorax \| C. Hemothorax \| D. PE	A. Cardiac tamponade
A 30-year-old man with blunt abdominal trauma, Kehr’s sign positive. Organ injured?	A. Spleen \| B. Liver \| C. Pancreas \| D. Kidney	A. Splenic rupture
A 50-year-old man after RTA, RUQ pain, hypotension. Organ injured?	A. Liver \| B. Spleen \| C. Pancreas \| D. Stomach	A. Liver laceration
A 45-year-old with pelvic fracture, blood at urethral meatus. Next step?	A. Retrograde urethrogram \| B. Catheterization \| C. Cystoscopy \| D. CT scan	A. Retrograde urethrogram before catheterization
A 25-year-old with lower abdominal pain, distension, no urine output. Diagnosis?	A. Bladder rupture \| B. Urethral injury \| C. Renal trauma \| D. Bowel injury	A. Bladder rupture
A 60-year-old with peritonitis after perforated ulcer. Management?	A. Exploratory laparotomy \| B. CT \| C. Observe \| D. Antibiotics only	A. Emergency laparotomy
A 35-year-old post-op day 5, fever, erythema, purulent wound. Diagnosis?	A. Wound infection \| B. Seroma \| C. Hematoma \| D. Dehiscence	A. Surgical site infection
A 60-year-old diabetic with foul-smelling necrotic tissue, crepitus. Diagnosis?	A. Gas gangrene \| B. Cellulitis \| C. Abscess \| D. Necrosis	A. Clostridial gas gangrene
A 70-year-old with black gangrene of toes, absent pulses. Diagnosis?	A. Arterial gangrene \| B. Venous \| C. Neuropathic \| D. Pressure	A. Arterial ischemic gangrene
A 55-year-old with chronic ulcer above medial malleolus. Cause?	A. Venous insufficiency \| B. Arterial \| C. Neuropathic \| D. Pressure	A. Venous ulcer
A 65-year-old diabetic with ulcer on sole, painless. Diagnosis?	A. Neuropathic ulcer \| B. Arterial \| C. Venous \| D. Pressure	A. Diabetic neuropathic ulcer
A 40-year-old man with severe leg pain, pallor, paresthesia, tense calf. Diagnosis?	A. Compartment syndrome \| B. DVT \| C. Arterial occlusion \| D. Cellulitis	A. Acute compartment syndrome
A 25-year-old with full-thickness circumferential burn, absent distal pulses. Management?	A. Escharotomy \| B. Fasciotomy \| C. Amputation \| D. Grafting	A. Escharotomy
A 50-year-old with flame burns 30% TBSA. Fluid calculation?	A. Parkland formula \| B. Maintenance \| C. Evans \| D. Holliday-Segar	A. Parkland formula (4 mL × %BSA × weight)
A 45-year-old with breast lump, hard, irregular, fixed. Diagnosis?	A. Carcinoma \| B. Fibroadenoma \| C. Fibrocystic \| D. Abscess	A. Invasive ductal carcinoma
A 25-year-old woman with mobile, firm breast lump. Diagnosis?	A. Fibroadenoma \| B. Fibrocystic \| C. Abscess \| D. Carcinoma	A. Fibroadenoma
A 30-year-old woman with cyclic breast pain, nodularity. Diagnosis?	A. Fibrocystic disease \| B. Carcinoma \| C. Fibroadenoma \| D. Mastitis	A. Fibrocystic disease
A 55-year-old woman with eczematous nipple lesion. Diagnosis?	A. Paget disease \| B. DCIS \| C. Fibrocystic \| D. Abscess	A. Paget’s disease of breast
A 60-year-old with peau d’orange breast and axillary nodes. Diagnosis?	A. Inflammatory carcinoma \| B. Ductal carcinoma \| C. Paget \| D. Fibrosis	A. Inflammatory breast carcinoma
A 35-year-old lactating woman with fever, painful breast swelling. Diagnosis?	A. Mastitis \| B. Abscess \| C. Carcinoma \| D. Galactocele	A. Acute mastitis
A 30-year-old with fluctuant tender breast lump, pus discharge. Diagnosis?	A. Breast abscess \| B. Mastitis \| C. Carcinoma \| D. Fibrocystic	A. Breast abscess
A 50-year-old man with nipple discharge, subareolar mass. Diagnosis?	A. Male breast carcinoma \| B. Gynecomastia \| C. Abscess \| D. Lipoma	A. Male breast carcinoma
A 60-year-old man with bilateral breast enlargement, non-tender. Diagnosis?	A. Gynecomastia \| B. Carcinoma \| C. Cyst \| D. Lipoma	A. Gynecomastia
A 40-year-old woman with solitary thyroid nodule, cold on scan. Next step?	A. FNAC \| B. Observe \| C. Surgery \| D. Suppression therapy	A. Fine-needle aspiration cytology
A 50-year-old with hard fixed thyroid mass, dysphagia. Diagnosis?	A. Anaplastic carcinoma \| B. Medullary \| C. Papillary \| D. Follicular	A. Anaplastic thyroid carcinoma
A 35-year-old woman with thyroid nodule, calcitonin high. Diagnosis?	A. Medullary carcinoma \| B. Papillary \| C. Follicular \| D. Anaplastic	A. Medullary thyroid carcinoma
A 45-year-old woman with papillary structures, psammoma bodies. Diagnosis?	A. Papillary thyroid carcinoma \| B. Follicular \| C. Medullary \| D. Anaplastic	A. Papillary thyroid carcinoma
A 55-year-old man with solitary nodule, capsular invasion, hematogenous spread. Diagnosis?	A. Follicular carcinoma \| B. Papillary \| C. Medullary \| D. Anaplastic	A. Follicular carcinoma
A 25-year-old man with groin swelling above inguinal ligament, reducible. Diagnosis?	A. Indirect inguinal hernia \| B. Direct inguinal hernia \| C. Femoral hernia \| D. Hydrocele	A. Indirect inguinal hernia
A 60-year-old man with groin swelling medial to inferior epigastric vessels. Diagnosis?	A. Direct inguinal hernia \| B. Indirect \| C. Femoral \| D. Spigelian	A. Direct inguinal hernia
A 55-year-old woman with swelling below inguinal ligament, irreducible. Diagnosis?	A. Femoral hernia \| B. Inguinal \| C. Incisional \| D. Umbilical	A. Femoral hernia
A 40-year-old woman with swelling at umbilicus, reducible. Diagnosis?	A. Umbilical hernia \| B. Paraumbilical \| C. Incisional \| D. Epigastric	A. Umbilical hernia
A 50-year-old woman post-laparotomy with bulge at scar. Diagnosis?	A. Incisional hernia \| B. Umbilical \| C. Paraumbilical \| D. Spigelian	A. Incisional hernia
A 35-year-old with swelling in epigastric region, increases on coughing. Diagnosis?	A. Epigastric hernia \| B. Umbilical \| C. Spigelian \| D. Paraumbilical	A. Epigastric hernia
A 45-year-old man with irreducible hernia, vomiting, distension. Diagnosis?	A. Obstructed hernia \| B. Strangulated \| C. Reducible \| D. Incisional	A. Obstructed hernia
A 40-year-old man with irreducible tender hernia, toxic, obstruction. Diagnosis?	A. Strangulated hernia \| B. Obstructed \| C. Incarcerated \| D. Reducible	A. Strangulated hernia
A 50-year-old man post-hernia repair with groin swelling again. Diagnosis?	A. Recurrent hernia \| B. Seroma \| C. Hematoma \| D. Infection	A. Recurrent hernia
A 25-year-old with right iliac fossa pain, fever, guarding. Diagnosis?	A. Acute appendicitis \| B. Cholecystitis \| C. Diverticulitis \| D. UTI	A. Acute appendicitis
A 30-year-old woman with RLQ pain, vomiting, tenderness at McBurney’s point. Next step?	A. Ultrasound \| B. CT \| C. Observe \| D. Laparotomy	A. Abdominal ultrasound
A 60-year-old man with fever, RUQ pain, Murphy’s sign. Diagnosis?	A. Acute cholecystitis \| B. Cholangitis \| C. Hepatitis \| D. Ulcer	A. Acute calculous cholecystitis
A 65-year-old with jaundice, fever, RUQ pain. Diagnosis?	A. Ascending cholangitis \| B. Cholecystitis \| C. Hepatitis \| D. Cirrhosis	A. Charcot’s triad → Ascending cholangitis
A 45-year-old woman with postprandial pain, gallstones. Diagnosis?	A. Symptomatic cholelithiasis \| B. Cholecystitis \| C. Choledocholithiasis \| D. Pancreatitis	A. Gallstones (chronic cholelithiasis)
A 55-year-old alcoholic with severe epigastric pain radiating to back. Diagnosis?	A. Acute pancreatitis \| B. Cholecystitis \| C. PUD \| D. MI	A. Acute pancreatitis
A 50-year-old with fever, jaundice, elevated ALP, dilated ducts. Diagnosis?	A. Choledocholithiasis \| B. PSC \| C. PBC \| D. Hepatitis	A. Common bile duct stones
A 60-year-old with sudden severe epigastric pain, free air under diaphragm. Diagnosis?	A. Perforated peptic ulcer \| B. Pancreatitis \| C. SBO \| D. Appendicitis	A. Perforated duodenal ulcer
A 55-year-old with hematemesis, history of NSAID use. Cause?	A. Peptic ulcer disease \| B. Mallory-Weiss \| C. Varices \| D. Gastritis	A. Peptic ulcer disease
A 50-year-old alcoholic with vomiting, then hematemesis. Diagnosis?	A. Mallory-Weiss tear \| B. Varices \| C. PUD \| D. Erosive gastritis	A. Mallory-Weiss tear
A 65-year-old with painless jaundice, palpable gallbladder. Diagnosis?	A. Carcinoma head of pancreas \| B. Cholangiocarcinoma \| C. Stones \| D. Cirrhosis	A. Pancreatic cancer (Courvoisier sign)
A 60-year-old man with dysphagia to solids then liquids, weight loss. Diagnosis?	A. Esophageal carcinoma \| B. Achalasia \| C. Web \| D. Stricture	A. Esophageal cancer
A 35-year-old woman with dysphagia to solids and liquids, bird-beak on barium. Diagnosis?	A. Achalasia \| B. Stricture \| C. Web \| D. Cancer	A. Achalasia cardia
A 50-year-old man with vomiting, visible peristalsis, succussion splash. Diagnosis?	A. Gastric outlet obstruction \| B. PUD \| C. GERD \| D. Cancer	A. Gastric outlet obstruction
A 70-year-old with epigastric pain relieved by food. Diagnosis?	A. Duodenal ulcer \| B. Gastric ulcer \| C. GERD \| D. Gallstones	A. Duodenal ulcer
A 65-year-old with pain worse after food, weight loss. Diagnosis?	A. Gastric ulcer \| B. Duodenal \| C. GERD \| D. PUD	A. Gastric ulcer
A 50-year-old with upper GI bleed, cirrhosis. Diagnosis?	A. Esophageal varices \| B. Mallory-Weiss \| C. PUD \| D. Gastritis	A. Bleeding esophageal varices
A 45-year-old with acute abdomen, rigid board-like, air under diaphragm. Diagnosis?	A. Perforated ulcer \| B. Pancreatitis \| C. SBO \| D. Appendicitis	A. Perforated peptic ulcer
A 60-year-old with recurrent vomiting, visible peristalsis. Diagnosis?	A. Gastric outlet obstruction \| B. PUD \| C. GERD \| D. IBS	A. Gastric outlet obstruction
A 55-year-old with lower GI bleed, painless hematochezia, anemia. Diagnosis?	A. Colon cancer \| B. Diverticulosis \| C. Hemorrhoid \| D. UC	A. Colorectal carcinoma
A 40-year-old with LLQ pain, fever, constipation. Diagnosis?	A. Diverticulitis \| B. Appendicitis \| C. UC \| D. IBS	A. Acute diverticulitis
A 45-year-old with perianal pain, fever, swelling. Diagnosis?	A. Perianal abscess \| B. Fistula \| C. Hemorrhoid \| D. Fissure	A. Perianal abscess
A 40-year-old man with chronic discharge, external opening near anus. Diagnosis?	A. Fistula-in-ano \| B. Abscess \| C. Fissure \| D. Hemorrhoid	A. Anal fistula
A 35-year-old with painful bleeding after defecation. Diagnosis?	A. Anal fissure \| B. Fistula \| C. Hemorrhoids \| D. Abscess	A. Anal fissure
A 50-year-old with painless rectal bleeding, prolapse on defecation. Diagnosis?	A. Internal hemorrhoids \| B. Fissure \| C. Cancer \| D. Polyp	A. Internal hemorrhoids
A 55-year-old with tenesmus, rectal mass, bleeding. Diagnosis?	A. Rectal carcinoma \| B. Hemorrhoids \| C. Fissure \| D. Fistula	A. Rectal cancer
A 40-year-old man with painful swelling in scrotum, high-riding testis, absent cremasteric reflex. Diagnosis?	A. Testicular torsion \| B. Epididymitis \| C. Hydrocele \| D. Hernia	A. Testicular torsion
A 25-year-old man with scrotal pain, fever, tender epididymis, normal cremasteric reflex. Diagnosis?	A. Epididymitis \| B. Torsion \| C. Varicocele \| D. Hydrocele	A. Epididymitis
A 30-year-old man with painless scrotal swelling that transilluminates. Diagnosis?	A. Hydrocele \| B. Varicocele \| C. Hernia \| D. Epididymitis	A. Hydrocele
A 35-year-old man with bag-of-worms feel in scrotum, infertility. Diagnosis?	A. Varicocele \| B. Hydrocele \| C. Hernia \| D. Epididymitis	A. Varicocele
A 65-year-old man with LUTS, enlarged firm prostate, PSA 12. Diagnosis?	A. Carcinoma prostate \| B. BPH \| C. Prostatitis \| D. Urethral stricture	A. Prostate carcinoma
A 60-year-old man with nocturia, hesitancy, smooth enlarged prostate. Diagnosis?	A. BPH \| B. Prostate cancer \| C. Prostatitis \| D. Cystitis	A. Benign prostatic hyperplasia
A 55-year-old man with acute urinary retention. Initial management?	A. Catheterization \| B. Surgery \| C. Observe \| D. Alpha-blocker	A. Urinary catheterization
A 50-year-old man with fever, dysuria, tender prostate. Diagnosis?	A. Acute prostatitis \| B. BPH \| C. Cancer \| D. Retention	A. Acute bacterial prostatitis
A 45-year-old with flank pain, hematuria, renal colic. Diagnosis?	A. Ureteric stone \| B. Pyelonephritis \| C. Cystitis \| D. Tumor	A. Ureteric calculus
A 60-year-old with painless gross hematuria, smoker. Diagnosis?	A. Bladder cancer \| B. RCC \| C. Stone \| D. Cystitis	A. Transitional cell carcinoma (bladder)
A 55-year-old man with right flank mass, hematuria, polycythemia. Diagnosis?	A. RCC \| B. PKD \| C. Stone \| D. Infection	A. Renal cell carcinoma
A 40-year-old woman with fever, flank pain, CVA tenderness. Diagnosis?	A. Pyelonephritis \| B. Cystitis \| C. Stone \| D. Tumor	A. Acute pyelonephritis
A 60-year-old woman with incontinence on coughing and sneezing. Diagnosis?	A. Stress incontinence \| B. Urge \| C. Overflow \| D. Functional	A. Stress urinary incontinence
A 70-year-old man with dribbling, distension, high residual urine. Diagnosis?	A. Overflow incontinence \| B. Urge \| C. Stress \| D. Functional	A. Overflow incontinence
A 45-year-old with sudden urge to void, frequent urination. Diagnosis?	A. Urge incontinence \| B. Stress \| C. Overflow \| D. Functional	A. Urge incontinence
A 25-year-old man with midshaft humerus fracture, wrist drop. Nerve injured?	A. Radial nerve \| B. Ulnar \| C. Median \| D. Axillary	A. Radial nerve injury
A 45-year-old with shoulder dislocation, unable to abduct arm. Nerve injured?	A. Axillary \| B. Radial \| C. Median \| D. Ulnar	A. Axillary nerve
A 30-year-old man with supracondylar fracture, loss of thumb opposition. Nerve injured?	A. Median \| B. Ulnar \| C. Radial \| D. Axillary	A. Median nerve
A 40-year-old with elbow injury, claw hand. Nerve injured?	A. Ulnar \| B. Radial \| C. Median \| D. Axillary	A. Ulnar nerve
A 25-year-old with pelvic fracture, foot drop. Nerve injured?	A. Common peroneal \| B. Femoral \| C. Tibial \| D. Sciatic	A. Common peroneal nerve
A 70-year-old woman with hip fracture, limb shortened and externally rotated. Diagnosis?	A. Neck of femur fracture \| B. Intertrochanteric \| C. Shaft fracture \| D. Dislocation	A. Fracture neck of femur
A 25-year-old with fracture tibia, severe pain, tense compartment. Diagnosis?	A. Compartment syndrome \| B. DVT \| C. Arterial occlusion \| D. Infection	A. Acute compartment syndrome
A 60-year-old man with chronic leg ulcer above medial malleolus. Cause?	A. Venous ulcer \| B. Arterial \| C. Diabetic \| D. Pressure	A. Venous ulcer
A 65-year-old diabetic with ulcer on sole, painless. Diagnosis?	A. Neuropathic ulcer \| B. Arterial \| C. Venous \| D. Pressure	A. Diabetic neuropathic ulcer
A 50-year-old smoker with black toe, absent pulses. Diagnosis?	A. Arterial gangrene \| B. Venous \| C. Neuropathic \| D. Pressure	A. Arterial ischemic gangrene
A 30-year-old woman with tortuous leg veins, aching after standing. Diagnosis?	A. Varicose veins \| B. DVT \| C. Lymphedema \| D. Cellulitis	A. Varicose veins
A 60-year-old man with rest pain, absent pulses, ulcer on toe. Diagnosis?	A. Critical limb ischemia \| B. DVT \| C. Venous ulcer \| D. Cellulitis	A. Critical limb ischemia
A 40-year-old man with crush injury, severe pain, paresthesia, pallor. Diagnosis?	A. Compartment syndrome \| B. DVT \| C. Arterial occlusion \| D. Cellulitis	A. Compartment syndrome
A 35-year-old with severe burns to 40% BSA. First step in management?	A. Airway + fluid resuscitation \| B. Antibiotics \| C. Dressing \| D. Surgery	A. Airway management and IV fluids
A 25-year-old with chemical burn. Immediate management?	A. Copious irrigation with water \| B. Neutralize \| C. Cover \| D. Ointment	A. Copious water irrigation
A 50-year-old with flame burn, hoarseness, singed nasal hairs. Management?	A. Early intubation \| B. Observe \| C. Oxygen only \| D. Fluid	A. Early intubation
A 60-year-old man with postoperative wound gaping, bowel visible. Management?	A. Cover with saline gauze + surgery \| B. Dress \| C. Observe \| D. Drain	A. Cover wound and urgent closure
A 55-year-old with chronic ulcer with rolled everted edges. Diagnosis?	A. SCC \| B. BCC \| C. Melanoma \| D. Keratoacanthoma	A. Squamous cell carcinoma
A 60-year-old man with pearly nodular lesion, central ulceration. Diagnosis?	A. BCC \| B. SCC \| C. Melanoma \| D. Keratoacanthoma	A. Basal cell carcinoma
A 50-year-old man with pigmented lesion, irregular borders, color change. Diagnosis?	A. Melanoma \| B. BCC \| C. SCC \| D. Keratoacanthoma	A. Malignant melanoma
A 40-year-old farmer with parotid swelling, facial nerve palsy. Diagnosis?	A. Parotid malignancy \| B. Pleomorphic adenoma \| C. Infection \| D. Cyst	A. Parotid carcinoma
A 35-year-old woman with firm, painless parotid mass, mobile, no nerve palsy. Diagnosis?	A. Pleomorphic adenoma \| B. Warthin tumor \| C. Mucoepidermoid \| D. Cyst	A. Pleomorphic adenoma
A 60-year-old man with recurrent parotid swelling, smoker. Diagnosis?	A. Warthin tumor \| B. Pleomorphic \| C. Mucoepidermoid \| D. Cyst	A. Warthin tumor (papillary cystadenoma lymphomatosum)
A 25-year-old man with midline neck swelling moving with tongue protrusion. Diagnosis?	A. Thyroglossal cyst \| B. Branchial cyst \| C. Dermoid \| D. Lymph node	A. Thyroglossal duct cyst
A 30-year-old man with cystic swelling anterior to sternocleidomastoid. Diagnosis?	A. Branchial cyst \| B. Thyroglossal \| C. Dermoid \| D. Lipoma	A. Branchial cyst
A 40-year-old man with soft fluctuant swelling at back of neck. Diagnosis?	A. Lipoma \| B. Sebaceous cyst \| C. Abscess \| D. Fibroma	A. Lipoma
A 35-year-old man with dome-shaped swelling with punctum, cheesy discharge. Diagnosis?	A. Sebaceous cyst \| B. Lipoma \| C. Abscess \| D. Lymph node	A. Sebaceous cyst
A 60-year-old man with lateral neck mass, firm, fixed, ulcerated. Diagnosis?	A. Metastatic lymph node \| B. Lymphoma \| C. TB \| D. Cyst	A. Metastatic lymph node
A 50-year-old with painless ulcer on lateral tongue, indurated edges. Diagnosis?	A. SCC of tongue \| B. Aphthous ulcer \| C. TB \| D. Cyst	A. Squamous cell carcinoma
A 45-year-old smoker with hoarseness, throat pain, weight loss. Diagnosis?	A. Laryngeal carcinoma \| B. Vocal cord polyp \| C. TB \| D. Pharyngitis	A. Carcinoma of larynx
A 60-year-old man with difficulty swallowing, regurgitation, neck swelling. Diagnosis?	A. Zenker diverticulum \| B. Achalasia \| C. Web \| D. Cancer	A. Pharyngoesophageal (Zenker) diverticulum
A 40-year-old with epigastric pain radiating to back, elevated amylase. Diagnosis?	A. Acute pancreatitis \| B. PUD \| C. Cholecystitis \| D. Gastritis	A. Acute pancreatitis
A 55-year-old man with chronic pancreatitis, steatorrhea, diabetes. Cause?	A. Alcohol \| B. Gallstones \| C. Trauma \| D. Viral	A. Alcohol abuse
A 45-year-old with painless jaundice, palpable gallbladder. Diagnosis?	A. Carcinoma head of pancreas \| B. Choledocholithiasis \| C. Cirrhosis \| D. Cholangiocarcinoma	A. Pancreatic head cancer
A 60-year-old woman with jaundice, palpable gallbladder, weight loss. Diagnosis?	A. Cholangiocarcinoma \| B. Pancreatic carcinoma \| C. Cirrhosis \| D. PSC	A. Carcinoma of biliary tract (cholangiocarcinoma)
A 50-year-old man with recurrent oral ulcers, genital ulcers, uveitis. Diagnosis?	A. Behçet disease \| B. SLE \| C. RA \| D. Vasculitis	A. Behçet syndrome
A 40-year-old with intermittent claudication, rest pain, absent pulses. Diagnosis?	A. Peripheral arterial disease \| B. DVT \| C. Varicose veins \| D. Lymphedema	A. Peripheral arterial occlusive disease
A 65-year-old smoker with pulsatile abdominal mass. Diagnosis?	A. Abdominal aortic aneurysm \| B. Renal cyst \| C. Lipoma \| D. Tumor	A. AAA
A 70-year-old with sudden back pain, hypotension, pulsatile mass. Diagnosis?	A. Ruptured AAA \| B. Renal colic \| C. MI \| D. Pancreatitis	A. Ruptured abdominal aortic aneurysm
A 40-year-old woman with recurrent varicose veins, ulcer over medial malleolus. Diagnosis?	A. Venous insufficiency \| B. Arterial \| C. Neuropathic \| D. Pressure	A. Chronic venous insufficiency
A 55-year-old diabetic with gangrene of toe, foul discharge. Diagnosis?	A. Wet gangrene \| B. Dry gangrene \| C. Gas gangrene \| D. Necrosis	A. Wet gangrene
A 60-year-old man with black mummified toe, clear line of demarcation. Diagnosis?	A. Dry gangrene \| B. Wet \| C. Gas \| D. Necrosis	A. Dry gangrene
A 45-year-old man with rapidly spreading infection, crepitus, foul smell. Diagnosis?	A. Gas gangrene \| B. Wet gangrene \| C. Cellulitis \| D. Abscess	A. Clostridial gas gangrene
A 30-year-old man with deep laceration, swelling, pain, paresthesia, tense compartment. Diagnosis?	A. Compartment syndrome \| B. DVT \| C. Arterial occlusion \| D. Infection	A. Acute compartment syndrome
A 50-year-old man with open fracture tibia, soft tissue loss. Management?	A. Debridement + external fixation \| B. Cast \| C. Internal fixation \| D. Observe	A. Surgical debridement and external fixation
A 70-year-old woman with wrist fracture, dorsal angulation. Diagnosis?	A. Colles fracture \| B. Smith \| C. Barton \| D. Monteggia	A. Colles fracture
A 45-year-old man with fracture radius and distal radioulnar dislocation. Diagnosis?	A. Galeazzi fracture \| B. Monteggia \| C. Smith \| D. Colles	A. Galeazzi fracture
A 30-year-old with ulnar fracture and radial head dislocation. Diagnosis?	A. Monteggia fracture \| B. Galeazzi \| C. Colles \| D. Smith	A. Monteggia fracture
A 40-year-old woman with shoulder dislocation, arm abducted and externally rotated. Diagnosis?	A. Anterior shoulder dislocation \| B. Posterior \| C. Fracture \| D. Subluxation	A. Anterior shoulder dislocation
A 50-year-old woman with breast cancer, lymphedema arm. Cause?	A. Lymphatic obstruction \| B. Venous thrombosis \| C. Infection \| D. Trauma	A. Post-mastectomy lymphatic obstruction
A 35-year-old man with chronic sinus discharge, foreign body in bone. Diagnosis?	A. Chronic osteomyelitis \| B. TB \| C. Sarcoma \| D. Abscess	A. Chronic osteomyelitis
A 15-year-old with diaphyseal lesion, onion-skin appearance. Diagnosis?	A. Ewing sarcoma \| B. Osteosarcoma \| C. Osteomyelitis \| D. Fibroma	A. Ewing’s sarcoma
A 17-year-old with metaphyseal lesion around knee, sunburst appearance. Diagnosis?	A. Osteosarcoma \| B. Ewing \| C. Chondroblastoma \| D. Giant cell tumor	A. Osteosarcoma
A 25-year-old woman with epiphyseal lytic lesion, soap-bubble appearance. Diagnosis?	A. Giant cell tumor \| B. Osteosarcoma \| C. Chondroblastoma \| D. Fibrous dysplasia	A. Giant cell tumor (osteoclastoma)
A 60-year-old man with bony pain, elevated ALP, normal calcium. Diagnosis?	A. Paget disease \| B. Osteoporosis \| C. Osteomalacia \| D. Metastasis	A. Paget’s disease of bone
A 40-year-old woman with loss of bone density, fragility fractures. Diagnosis?	A. Osteoporosis \| B. Osteomalacia \| C. Paget \| D. Myeloma	A. Osteoporosis
A 70-year-old man with spinal tenderness, anemia, lytic skull lesions. Diagnosis?	A. Multiple myeloma \| B. Metastasis \| C. Osteoporosis \| D. Paget	A. Multiple myeloma
A 30-year-old man with small bowel obstruction, previous surgery. Cause?	A. Adhesions \| B. Hernia \| C. Volvulus \| D. Intussusception	A. Post-operative adhesions
A 50-year-old man with sigmoid volvulus. X-ray finding?	A. Coffee-bean sign \| B. Air-fluid levels \| C. Free air \| D. String sign	A. Coffee-bean sign
A 65-year-old man with pain out of proportion, peritonitis, AF history. Diagnosis?	A. Mesenteric ischemia \| B. Perforation \| C. Obstruction \| D. Pancreatitis	A. Acute mesenteric ischemia
A 25-year-old man after a road traffic accident, BP 80/50, pulse 120, cold clammy skin. Diagnosis?	A. Hypovolemic shock \| B. Cardiogenic shock \| C. Septic shock \| D. Neurogenic shock	A. Hypovolemic shock
A trauma patient with distended neck veins, muffled heart sounds, hypotension. Diagnosis?	A. Cardiac tamponade \| B. Tension pneumothorax \| C. Hemothorax \| D. PE	A. Cardiac tamponade
A 30-year-old with chest trauma, trachea deviated away, absent breath sounds, hyperresonant chest. Diagnosis?	A. Tension pneumothorax \| B. Hemothorax \| C. Contusion \| D. Flail chest	A. Tension pneumothorax
A 40-year-old with blunt chest trauma, paradoxical movement of chest wall. Diagnosis?	A. Flail chest \| B. Pneumothorax \| C. Hemothorax \| D. Contusion	A. Flail chest
A 35-year-old trauma patient, absent pulses in leg, cold limb. Diagnosis?	A. Arterial injury \| B. Venous injury \| C. Compartment \| D. DVT	A. Arterial injury
A 25-year-old man with severe leg pain, pallor, paresthesia, and tense swelling. Diagnosis?	A. Compartment syndrome \| B. DVT \| C. Cellulitis \| D. Crush injury	A. Acute compartment syndrome
A 40-year-old man with upper GI bleed after vomiting, mucosal tear at GE junction. Diagnosis?	A. Mallory–Weiss tear \| B. Boerhaave \| C. Varices \| D. PUD	A. Mallory–Weiss syndrome
A 60-year-old alcoholic with severe epigastric pain radiating to back. Diagnosis?	A. Acute pancreatitis \| B. Perforated ulcer \| C. Gallstones \| D. PUD	A. Acute pancreatitis
A 55-year-old woman with right upper quadrant pain, fever, Murphy’s sign. Diagnosis?	A. Acute cholecystitis \| B. Cholangitis \| C. Pancreatitis \| D. Ulcer	A. Acute calculous cholecystitis
A 65-year-old with fever, jaundice, right upper quadrant pain. Diagnosis?	A. Ascending cholangitis \| B. Cholecystitis \| C. Hepatitis \| D. Cirrhosis	A. Charcot triad → Ascending cholangitis
A 45-year-old woman with postprandial RUQ pain, normal LFT. Diagnosis?	A. Chronic cholecystitis \| B. Acute \| C. Choledocholithiasis \| D. Pancreatitis	A. Symptomatic gallstones
A 60-year-old man with sudden severe epigastric pain, free air under diaphragm. Diagnosis?	A. Perforated peptic ulcer \| B. Pancreatitis \| C. SBO \| D. Appendicitis	A. Perforated peptic ulcer
A 55-year-old man with hematemesis and melena, history of NSAID use. Diagnosis?	A. Peptic ulcer disease \| B. Varices \| C. Mallory-Weiss \| D. Gastritis	A. Bleeding peptic ulcer
A 50-year-old alcoholic with vomiting then hematemesis. Diagnosis?	A. Mallory-Weiss tear \| B. Varices \| C. Gastritis \| D. Ulcer	A. Mallory–Weiss tear
A 60-year-old man with chronic liver disease and hematemesis. Diagnosis?	A. Esophageal varices \| B. Mallory-Weiss \| C. Ulcer \| D. Gastritis	A. Bleeding varices
A 45-year-old with acute abdomen, rigid board-like, air under diaphragm. Diagnosis?	A. Perforated duodenal ulcer \| B. Pancreatitis \| C. Appendicitis \| D. SBO	A. Perforated ulcer
A 40-year-old man with generalized peritonitis after trauma. Management?	A. Emergency laparotomy \| B. Observe \| C. CT scan \| D. Fluids only	A. Exploratory laparotomy
A 25-year-old man with periumbilical pain shifting to right lower quadrant, fever. Diagnosis?	A. Acute appendicitis \| B. Cholecystitis \| C. Diverticulitis \| D. UTI	A. Acute appendicitis
A 30-year-old woman with RLQ tenderness, guarding, rebound. Diagnosis?	A. Appendicitis \| B. PID \| C. Ovarian cyst \| D. UTI	A. Acute appendicitis
A 65-year-old man with abdominal distension, vomiting, air-fluid levels. Diagnosis?	A. Small bowel obstruction \| B. Large bowel \| C. Paralytic ileus \| D. Pseudo-obstruction	A. SBO (likely adhesions)
A 50-year-old with sigmoid volvulus. X-ray finding?	A. Coffee-bean sign \| B. Double bubble \| C. Air-fluid \| D. Free air	A. Coffee-bean sign
A 45-year-old man with LLQ pain, fever, constipation. Diagnosis?	A. Diverticulitis \| B. Appendicitis \| C. UC \| D. IBS	A. Acute diverticulitis
A 55-year-old with painless rectal bleeding, altered bowel habits, anemia. Diagnosis?	A. Colorectal cancer \| B. Hemorrhoid \| C. Polyp \| D. UC	A. Colorectal carcinoma
A 50-year-old man with acute anal pain and bleeding during defecation. Diagnosis?	A. Anal fissure \| B. Hemorrhoid \| C. Fistula \| D. Abscess	A. Anal fissure
A 45-year-old with perianal pain, swelling, fever. Diagnosis?	A. Perianal abscess \| B. Fistula \| C. Fissure \| D. Hemorrhoids	A. Perianal abscess
A 40-year-old with chronic perianal discharge and external opening. Diagnosis?	A. Fistula-in-ano \| B. Abscess \| C. Fissure \| D. Hemorrhoid	A. Anal fistula
A 50-year-old with painless rectal bleeding and prolapse during defecation. Diagnosis?	A. Internal hemorrhoids \| B. Fissure \| C. Cancer \| D. Polyp	A. Internal hemorrhoids
A 60-year-old man with jaundice, palpable gallbladder. Diagnosis?	A. Carcinoma head of pancreas \| B. Cirrhosis \| C. Stone \| D. Hepatitis	A. Pancreatic head carcinoma (Courvoisier’s sign)
A 40-year-old man with swelling in groin above inguinal ligament, reducible. Diagnosis?	A. Indirect inguinal hernia \| B. Direct \| C. Femoral \| D. Hydrocele	A. Indirect inguinal hernia
A 60-year-old man with groin bulge medial to epigastric vessels. Diagnosis?	A. Direct inguinal hernia \| B. Indirect \| C. Femoral \| D. Umbilical	A. Direct inguinal hernia
A 55-year-old woman with groin swelling below inguinal ligament. Diagnosis?	A. Femoral hernia \| B. Direct \| C. Indirect \| D. Umbilical	A. Femoral hernia
A 45-year-old woman with midline abdominal bulge after surgery. Diagnosis?	A. Incisional hernia \| B. Umbilical \| C. Epigastric \| D. Femoral	A. Incisional hernia
A 50-year-old with umbilical swelling, reducible. Diagnosis?	A. Umbilical hernia \| B. Paraumbilical \| C. Incisional \| D. Epigastric	A. Umbilical hernia
A 35-year-old with swelling above umbilicus, not reducible. Diagnosis?	A. Epigastric hernia \| B. Paraumbilical \| C. Umbilical \| D. Incisional	A. Epigastric hernia
A 25-year-old man with painful swelling in scrotum, absent cremasteric reflex. Diagnosis?	A. Testicular torsion \| B. Epididymitis \| C. Hydrocele \| D. Varicocele	A. Testicular torsion
A 30-year-old man with scrotal swelling, transillumination positive. Diagnosis?	A. Hydrocele \| B. Varicocele \| C. Hernia \| D. Epididymitis	A. Hydrocele
A 35-year-old man with bag-of-worms feel, infertility. Diagnosis?	A. Varicocele \| B. Hydrocele \| C. Torsion \| D. Epididymitis	A. Varicocele
A 60-year-old man with firm nodular prostate, PSA elevated. Diagnosis?	A. Prostate cancer \| B. BPH \| C. Prostatitis \| D. UTI	A. Adenocarcinoma prostate
A 55-year-old man with smooth enlarged prostate, no nodules. Diagnosis?	A. BPH \| B. Cancer \| C. Prostatitis \| D. Stricture	A. Benign prostatic hyperplasia
A 50-year-old man with fever, dysuria, tender prostate. Diagnosis?	A. Acute prostatitis \| B. BPH \| C. Cancer \| D. Retention	A. Acute bacterial prostatitis
A 40-year-old man with hematuria, flank pain, mass. Diagnosis?	A. RCC \| B. Stone \| C. Cystitis \| D. PKD	A. Renal cell carcinoma
A 45-year-old woman with flank pain, fever, CVA tenderness. Diagnosis?	A. Pyelonephritis \| B. Cystitis \| C. Stone \| D. Tumor	A. Acute pyelonephritis
A 60-year-old smoker with painless gross hematuria. Diagnosis?	A. Bladder cancer \| B. RCC \| C. Cystitis \| D. Stone	A. Transitional cell carcinoma
A 25-year-old man with fracture midshaft humerus, wrist drop. Nerve injured?	A. Radial nerve \| B. Ulnar \| C. Median \| D. Axillary	A. Radial nerve
A 40-year-old man with shoulder dislocation, loss of abduction. Nerve injured?	A. Axillary \| B. Radial \| C. Median \| D. Ulnar	A. Axillary nerve
A 30-year-old man with supracondylar humerus fracture, loss of thumb opposition. Nerve injured?	A. Median \| B. Ulnar \| C. Radial \| D. Axillary	A. Median nerve
A 40-year-old man with elbow injury, claw hand deformity. Nerve injured?	A. Ulnar \| B. Median \| C. Radial \| D. Axillary	A. Ulnar nerve
A 25-year-old with pelvic fracture and foot drop. Nerve injured?	A. Common peroneal \| B. Femoral \| C. Tibial \| D. Sciatic	A. Common peroneal nerve
A 70-year-old woman with hip fracture, leg shortened and externally rotated. Diagnosis?	A. Neck of femur fracture \| B. Intertrochanteric \| C. Shaft fracture \| D. Dislocation	A. Fracture neck of femur
A 25-year-old with tibial fracture and severe pain, tense compartment. Diagnosis?	A. Compartment syndrome \| B. DVT \| C. Arterial occlusion \| D. Infection	A. Acute compartment syndrome
A 40-year-old smoker with black toe, absent pulses. Diagnosis?	A. Arterial gangrene \| B. Venous \| C. Neuropathic \| D. Pressure	A. Arterial ischemic gangrene
A 65-year-old diabetic with painless plantar ulcer. Diagnosis?	A. Neuropathic ulcer \| B. Venous \| C. Arterial \| D. Pressure	A. Diabetic neuropathic ulcer
A 60-year-old with ulcer above medial malleolus, edema, pigmentation. Diagnosis?	A. Venous ulcer \| B. Arterial \| C. Pressure \| D. Neuropathic	A. Venous ulcer
A 30-year-old woman with tortuous leg veins, aching on standing. Diagnosis?	A. Varicose veins \| B. DVT \| C. Lymphedema \| D. Cellulitis	A. Primary varicose veins
A 65-year-old man with rest pain, absent pulses, nonhealing toe ulcer. Diagnosis?	A. Critical limb ischemia \| B. DVT \| C. Venous ulcer \| D. Cellulitis	A. Peripheral arterial disease (critical limb ischemia)
A 45-year-old with crush injury, severe pain, paresthesia, pallor. Diagnosis?	A. Compartment syndrome \| B. DVT \| C. Arterial occlusion \| D. Infection	A. Acute compartment syndrome
A 25-year-old man with 40% flame burns. Immediate management?	A. Airway + fluid resuscitation \| B. Antibiotic \| C. Dressing \| D. Surgery	A. Airway control and IV fluids
A 50-year-old with facial burns, hoarseness, singed nasal hairs. Management?	A. Early intubation \| B. Observe \| C. Oxygen only \| D. Fluids	A. Early airway intubation
A 30-year-old man with chemical burn to arm. Immediate management?	A. Copious irrigation with water \| B. Neutralize acid \| C. Ointment \| D. Dress	A. Irrigate thoroughly with water
A 40-year-old with circumferential full-thickness limb burn, absent pulse. Management?	A. Escharotomy \| B. Fasciotomy \| C. Amputation \| D. Grafting	A. Escharotomy
A 55-year-old with full-thickness burns over 30% body surface. Fluid therapy?	A. Parkland formula \| B. Maintenance \| C. Evans \| D. Holliday-Segar	A. Parkland formula (4 mL × %BSA × wt)
A 60-year-old with chronic ulcer with everted rolled edges. Diagnosis?	A. SCC \| B. BCC \| C. Melanoma \| D. Keratoacanthoma	A. Squamous cell carcinoma
A 55-year-old with pearly nodular lesion, central ulceration. Diagnosis?	A. Basal cell carcinoma \| B. SCC \| C. Melanoma \| D. Keratoacanthoma	A. Basal cell carcinoma
A 45-year-old with pigmented lesion, irregular border, color variation. Diagnosis?	A. Melanoma \| B. BCC \| C. SCC \| D. Keratoacanthoma	A. Malignant melanoma
A 40-year-old woman with firm, mobile, nontender breast lump. Diagnosis?	A. Fibroadenoma \| B. Fibrocystic \| C. Abscess \| D. Carcinoma	A. Fibroadenoma
A 35-year-old woman with cyclical mastalgia, nodularity. Diagnosis?	A. Fibrocystic disease \| B. Carcinoma \| C. Fibroadenoma \| D. Abscess	A. Fibrocystic change
A 55-year-old woman with hard irregular fixed breast lump. Diagnosis?	A. Carcinoma \| B. Fibroadenoma \| C. Abscess \| D. Fibrocystic	A. Invasive ductal carcinoma
A 50-year-old woman with eczematous nipple lesion, discharge. Diagnosis?	A. Paget disease \| B. DCIS \| C. Fibrocystic \| D. Abscess	A. Paget’s disease of breast
A 60-year-old woman with peau d’orange skin and axillary nodes. Diagnosis?	A. Inflammatory carcinoma \| B. Ductal \| C. Paget \| D. Fibrocystic	A. Inflammatory breast carcinoma
A 25-year-old lactating woman with fever, tender breast lump. Diagnosis?	A. Mastitis \| B. Abscess \| C. Galactocele \| D. Fibroadenoma	A. Acute mastitis
A 30-year-old with fluctuant breast lump, pus discharge. Diagnosis?	A. Breast abscess \| B. Mastitis \| C. Carcinoma \| D. Fibrocystic	A. Breast abscess
A 50-year-old man with subareolar mass, nipple retraction. Diagnosis?	A. Male breast carcinoma \| B. Gynecomastia \| C. Abscess \| D. Lipoma	A. Male breast cancer
A 60-year-old man with bilateral breast enlargement, soft. Diagnosis?	A. Gynecomastia \| B. Carcinoma \| C. Cyst \| D. Lipoma	A. Gynecomastia
A 35-year-old man with midline neck swelling moving with tongue. Diagnosis?	A. Thyroglossal cyst \| B. Branchial cyst \| C. Dermoid \| D. Lipoma	A. Thyroglossal duct cyst
A 30-year-old man with cystic swelling anterior to sternocleidomastoid. Diagnosis?	A. Branchial cyst \| B. Thyroglossal \| C. Lipoma \| D. Abscess	A. Branchial cyst
A 40-year-old man with soft, fluctuant swelling on back of neck. Diagnosis?	A. Lipoma \| B. Sebaceous cyst \| C. Abscess \| D. Lymph node	A. Lipoma
A 35-year-old with dome-shaped swelling with punctum and cheesy discharge. Diagnosis?	A. Sebaceous cyst \| B. Lipoma \| C. Abscess \| D. Lymph node	A. Sebaceous cyst
A 60-year-old with firm fixed neck mass, ulcerated skin. Diagnosis?	A. Metastatic lymph node \| B. Lymphoma \| C. TB \| D. Cyst	A. Secondary metastasis to cervical node
A 50-year-old with painless ulcer on lateral tongue, indurated edges. Diagnosis?	A. SCC \| B. Aphthous \| C. TB \| D. Syphilis	A. Squamous cell carcinoma of tongue
A 45-year-old smoker with hoarseness, throat pain, weight loss. Diagnosis?	A. Laryngeal carcinoma \| B. Vocal cord polyp \| C. Pharyngitis \| D. Laryngitis	A. Laryngeal carcinoma
A 60-year-old man with dysphagia, regurgitation, neck swelling. Diagnosis?	A. Zenker diverticulum \| B. Achalasia \| C. Web \| D. Cancer	A. Pharyngoesophageal (Zenker’s) diverticulum
A 40-year-old with pulsatile abdominal mass. Diagnosis?	A. Abdominal aortic aneurysm \| B. Lipoma \| C. Tumor \| D. Cyst	A. AAA
A 70-year-old with sudden back pain, hypotension, pulsatile mass. Diagnosis?	A. Ruptured AAA \| B. Renal colic \| C. MI \| D. Pancreatitis	A. Ruptured abdominal aortic aneurysm
A 60-year-old man with chronic venous insufficiency and ulcer. Location?	A. Medial malleolus \| B. Lateral malleolus \| C. Heel \| D. Sole	A. Over medial malleolus
A 55-year-old man with varicose veins, ulcer, pigmentation. Cause?	A. Venous hypertension \| B. Arterial \| C. Lymphatic \| D. Diabetic	A. Venous hypertension
A 60-year-old man with epigastric pain radiating to back, elevated amylase. Diagnosis?	A. Acute pancreatitis \| B. PUD \| C. Cholecystitis \| D. Gastritis	A. Acute pancreatitis
A 55-year-old with chronic pancreatitis, steatorrhea, diabetes. Cause?	A. Alcohol \| B. Gallstones \| C. Trauma \| D. Viral	A. Chronic alcohol use
A 50-year-old man with painless jaundice, palpable gallbladder. Diagnosis?	A. Pancreatic head carcinoma \| B. Cholangiocarcinoma \| C. PSC \| D. Cirrhosis	A. Carcinoma of pancreatic head (Courvoisier sign)
A 60-year-old woman with jaundice, weight loss, palpable GB. Diagnosis?	A. Cholangiocarcinoma \| B. Pancreatic CA \| C. PSC \| D. Gallstones	A. Cholangiocarcinoma
A 40-year-old woman with RUQ pain after fatty meal, US: stones. Diagnosis?	A. Cholelithiasis \| B. Cholecystitis \| C. Choledocholithiasis \| D. Cholangitis	A. Gallstones (chronic calculous cholecystitis)
A 65-year-old with fever, jaundice, hypotension. Diagnosis?	A. Ascending cholangitis \| B. Cholecystitis \| C. Pancreatitis \| D. Cirrhosis	A. Suppurative cholangitis (Charcot + Reynolds pentad)
A 70-year-old with dysphagia to solids then liquids, weight loss. Diagnosis?	A. Esophageal carcinoma \| B. Achalasia \| C. Web \| D. Stricture	A. Esophageal cancer
A 35-year-old woman with dysphagia to both solids and liquids, bird-beak sign. Diagnosis?	A. Achalasia cardia \| B. Stricture \| C. Web \| D. Cancer	A. Achalasia of esophagus
A 50-year-old man with vomiting, visible peristalsis, succussion splash. Diagnosis?	A. Gastric outlet obstruction \| B. PUD \| C. GERD \| D. Cancer	A. Gastric outlet obstruction
A 70-year-old man with epigastric pain relieved by food. Diagnosis?	A. Duodenal ulcer \| B. Gastric ulcer \| C. GERD \| D. Gallstones	A. Duodenal ulcer
A 60-year-old man with epigastric pain worse after food. Diagnosis?	A. Gastric ulcer \| B. Duodenal \| C. GERD \| D. PUD	A. Gastric ulcer
A 45-year-old with hematemesis and melena, cirrhosis. Diagnosis?	A. Esophageal varices \| B. Mallory-Weiss \| C. PUD \| D. Gastritis	A. Bleeding esophageal varices
A 50-year-old man with long-standing GERD, intestinal metaplasia. Diagnosis?	A. Barrett esophagus \| B. Stricture \| C. Ulcer \| D. Cancer	A. Barrett’s esophagus
A 45-year-old man with mass in parotid, no facial palsy. Diagnosis?	A. Pleomorphic adenoma \| B. Warthin tumor \| C. Mucoepidermoid \| D. Cyst	A. Pleomorphic adenoma
A 60-year-old man with parotid mass and facial nerve palsy. Diagnosis?	A. Parotid malignancy \| B. Pleomorphic \| C. Warthin \| D. Cyst	A. Malignant parotid tumor
A 65-year-old smoker with parotid cystic tumor, bilateral. Diagnosis?	A. Warthin tumor \| B. Pleomorphic \| C. Mucoepidermoid \| D. Cyst	A. Papillary cystadenoma lymphomatosum (Warthin tumor)
A 50-year-old woman with hard thyroid mass, compressive symptoms. Diagnosis?	A. Anaplastic carcinoma \| B. Medullary \| C. Papillary \| D. Follicular	A. Anaplastic thyroid cancer
A 35-year-old woman with thyroid nodule, psammoma bodies. Diagnosis?	A. Papillary carcinoma \| B. Follicular \| C. Medullary \| D. Anaplastic	A. Papillary thyroid carcinoma
A 45-year-old woman with thyroid nodule, calcitonin ↑. Diagnosis?	A. Medullary carcinoma \| B. Papillary \| C. Follicular \| D. Anaplastic	A. Medullary thyroid carcinoma
A 55-year-old with thyroid nodule and capsular invasion. Diagnosis?	A. Follicular carcinoma \| B. Papillary \| C. Medullary \| D. Anaplastic	A. Follicular thyroid carcinoma
A 40-year-old man with generalized weakness, Na ↓, K ↑, pigmentation. Diagnosis?	A. Addison \| B. Cushing \| C. Conn \| D. SIADH	A. Primary adrenal insufficiency (Addison)
A 50-year-old woman with moon face, central obesity, HTN. Diagnosis?	A. Cushing \| B. Conn \| C. Pheo \| D. Addison	A. Cushing syndrome
A 45-year-old man with episodic headache, palpitation, HTN. Diagnosis?	A. Pheochromocytoma \| B. Cushing \| C. Conn \| D. Addison	A. Pheochromocytoma
A 60-year-old man with truncal obesity, high glucose, purple striae. Diagnosis?	A. Cushing \| B. Metabolic syndrome \| C. Conn \| D. Addison	A. Cushing syndrome
A 30-year-old man with trauma, BP 70/40, muffled heart sounds, JVP ↑. Diagnosis?	A. Cardiac tamponade \| B. Tension pneumothorax \| C. Hemothorax \| D. Shock	A. Cardiac tamponade
A 25-year-old with Kehr’s sign after trauma. Organ injured?	A. Spleen \| B. Liver \| C. Pancreas \| D. Kidney	A. Splenic rupture
A 50-year-old man after RTA with RUQ pain and hypotension. Organ injured?	A. Liver \| B. Spleen \| C. Pancreas \| D. Stomach	A. Liver laceration

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