A 50-year-old office worker presents with painful swollen big right toe for last 1 week. He is known hypertensive & is using Metformin, Atenolol, Hydrochlorothiazide, Omeprazole & Acetaminophen. Which of his medication may have contributed to development of his symptoms?

A 23-year-old woman comes to the clinic due to a bump on her vaginal introitus for the past three days. The bump causes discomfort when she walks. On examination, there is a 3-cm, mobile, soft, cystic mass on her vulva. What is the most likely diagnosis?

A 52-year-old woman is diagnosed with fatty liver following an ultrasound. What is the single most important step to help prevent the progression of her disease?

An 80-year-old patient of B.P.H. on Doxazocin 4 mg OD comes with hematuria. His post void residual urinary volume is 30 ml. What will be your next management plan?

A 60-year-old woman presents to the clinic with an episode of vaginal bleeding. She has not had a menstrual period since the age of 52. She has a BMI of 22 and has no significant past medical or family history. What is the next best step?

A 29-year-old medical student presents with redness and irritation of both eyes for two days. On examination both conjunctivae are red and congested and there are pre-auricular lymph nodes present. What is the single most appropriate preventive measure in this case?

A 19 yrs. male patient presents with spots on face. There are frequent papules, pustules, nodular abscesses and wide spread scarring. He applied topical treatment and took oral antibiotics for 8 weeks. Acne relapses after discontinuing treatment. What is single best treatment option?

A 4-week-old baby has weeping eyes, but these are not red. The discharge is mucoid and conjunctiva are white. The problem started two weeks after birth. What is the single most appropriate management step at this stage?

A 25-year-old man presents to you with a history of recurrent headaches at least four times a week for the last 4 months. He describes it as a tight band encircling his head. There is no history of nausea, vomiting & malaise. His sleep is disturbed due to workload & stress at his job place. His examination is unremarkable. What would be the most likely diagnosis of headache in this patient?

A 63-year-old man Ex-smoker comes to you for review with complaints of chest pain & breathlessness even when going out of the house. He is a known COPD patient & is on regular Formoterol, Tiotropium bromide & Beclomethasone therapy. You noticed some degree of cyanosis & peripheral oedema during his physical examination. Pulse oximetry shows oxygen saturation 92% & pulse 84 beats per minute. Which of the following features would you not consider for the need of oxygen therapy in this patient?

A 37-year-old woman comes to the clinic after discovering a lump in her left breast. She has no pain in the area. Her last menstrual period ended 4 days ago. Breast examination shows a 2-cm firm, round mass in the upper outer quadrant of the left breast. There is no axillary lymphadenopathy. Which of the following is the most appropriate next step in management of this patient? Which of the following is the most appropriate next step in management of this patient?

A 58-year-old man who is known diabetic and hypertensive presents with muscle aches and pains after his previous doctor changed his medications recently. He is currently taking the following medications: Enalapril, Metformin, Sitagliptin, Simvastatin, and Aspirin. Which of these medicines is mostly responsible for muscle aches and pains?

A 21-year-old woman comes to the office due to pelvic pain lasting 1-2 days every other month. The pain is unilateral, tolerable and occurs mid-cycle. Her menstrual cycles are regular, last 28 days, and have normal flow. Physical examination is normal. What is the best next step?

A 68-year-old man comes to you with complaints of sudden weakness in his right arm & leg since morning. He has been on treatment for diabetes & hypertension for the last 10 years. On examination power & tone is reduced on the right side of the body. Blood pressure is 170/105 mmHg. You also noticed drooping of his facial muscles on the right side but wrinkles on his forehead are produced bilaterally. Rest of examination is unremarkable. What would be the most likely diagnosis in this patient?

A 35-years-old man who is on anti-tuberculous therapy presents to you with difficulty to differentiate between different colours for the last 1 week. Which drug in his treatment is most likely responsible for this problem?

A school nurse called you to see a 6-year-old boy with school refusal. He cries and screams after his parents leave and refuses to stay in the classroom. The school nurse informed you that she tried her best during the last 4 weeks to help the child settle at school, and she met with the parents frequently. The parents have tried to calmly send the child to school and reward him for each completed day. Which of the following is the next best step in management?

A 7-year-old girl is brought by her mother after recovery from a recent sore throat for which she was given antibiotics for 1 week. She has missed school five times in the last three years. Her weight is 28 kg. Her tonsils are enlarged bilaterally. She is currently afebrile. What is the most appropriate next step in management of this patient?

A 20 years old boy presents with recurrent mild jaundice since his childhood usually after intercurrent infections and during fasting. His total bilirubin is 6 mg/ dl and unconjugated bilirubin is 5.1 mg/dl. All other liver function tests are normal. What is most appropriate diagnosis?

A 39-year-old woman comes to your clinic due to worsening pelvic pressure over the last three years. She has no abnormal uterine bleeding. On examination, there is an enlarged pelvic mass extending to the umbilicus. There is no tenderness to palpation. Urine pregnancy test is negative. Which of the following is the most likely diagnosis in this patient? Which of the following is the most likely diagnosis in this patient?

An 18-month-old girl has been having an intermittent sneezing and runny nose for the past 6 weeks. On physical examination, there is clear nasal discharge and nasal mucosa is mildly congested. The toddler appears healthy otherwise. What would be the most appropriate treatment option for her at this stage?