A 25-year-old man presents to his doctor with a complaint of a lump in his testicle. During the examination, the lump disappears when he lies down. The scrotum shows dilated veins, while the abdominal examination is unremarkable. He expresses concern about his inability to conceive despite trying. What is the most probable diagnosis?
A 12-year-old boy presents acutely with petechiae on his legs, severe abdominal pain, bloody faeces, haematuria and painful joint swelling. The haematology laboratory results are normal.
Which of the following is the most likely diagnosis?
A 25-year-old man visited his GP after he discovered a solid lump in his left testis.
What is the most probable diagnosis?
A 78-year-old man with known metastatic prostate cancer presents to his General Practitioner with generalised pain. He states that he has always had aches and pains from old age, but that this is different: he can feel the pain particularly in his back at night.
What is the most likely site to be involved in bone metastasis in this patient?
A 30-year-old man presents approximately 2 weeks after a viral illness with petechiae, easy bruising, gum bleeding and lesions of the oral mucosa and tongue. He has no personal or family history of note and is not taking any medication. Physical examination is normal, except for petechiae, bruising and oral lesions. An image of the patient’s tongue is shown below. What is the most appropriate initial investigation/management option for this clinical scenario and image?
A 49-year-old school teacher presents with abdominal fullness and weight loss over the last six months. On examination, he is pale.
Investigations reveal the following:
Investigation Result Normal range
Haemoglobin (Hb) 102 g/l 135–175 g/l
White cell count (WCC) 68.2 × 109/l 4.0–11.0 × 109/l
Neutrophil count 39.1 × 109/l 2.2–8.6 ×109/l
Lymphocyte count 4.8 × 109/l 0.8–3.5 × 109/l
Platelets (PLT) 505 × 109/l 150–400 × 109/l
Erythrocyte sedimentation rate (ESR) 56 mm/hour 1–20 mm/hour
His peripheral blood picture is shown here:
Picture courtesy: Dr R Paul, MCH, Kolkata
What is the next most definitive step in diagnosis?
A 28-year-old man presents to his General Practitioner with pallor, fatigue, weakness, palpitations and dyspnoea on exertion. His symptoms have come on quickly over the last three weeks. A full blood count is ordered and is suggestive of acute lymphoblastic myeloid leukaemia (AML).
What Is the next most appropriate investigation for this patient?
A 4-year-old girl presents to the Emergency Department with haemarthrosis in the knee and elbow after a trivial injury. She is otherwise fit and well. The patient’s mother suffers from Christmas disease.
What investigation should be organised to confirm this diagnosis in this patient?
A 32-year-old man presents to his General Practitioner having been feeling unwell for a few days with a persistent cough.
Investigations:
Investigation Result Normal value
Haemoglobin (Hb) 130 g/l 120–160 g/l
White cell count (WCC) 18 × 109/l 4.5–11.0 × 109/l
Neutrophils 12 × 109/l 2.0–7.5 × 109/l
Platelets (PLT) 450 × 109/l 150–400 × 109/l
A blood film shows atypical lymphocytes.
What is the most likely diagnosis?
A 16-year-old girl comes to the clinic with a palpable purpuric rash on her lower limbs and polyarthralgia after experiencing a recent sore throat. What is the probable diagnosis?