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Question 1
Correct
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A 7-month-old baby girl is admitted with poor feeding and irritability for 2 days. She is lethargic and persistently crying. Urine dipstick showed leukocytes. What is the single most important investigation to arrive at a diagnosis?
Your Answer: Urine for C&S
Explanation:The clinical presentation and leucocytes on the urine dipstick is suggestive of a urinary tract infection. To confirm the diagnosis, urine should be sent for culture and sensitivity.
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This question is part of the following fields:
- Emergency & Critical Care
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Question 2
Correct
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A 72-year-old female patient with a history of atrial fibrillation was admitted with recurrent episodes of syncopal attacks. Her ECG showed torsade de pointes. What is the drug which does not cause the above presentation?
Your Answer: Omeprazole
Explanation:Drugs causing torsades de pointes are Amiodarone, Chlorpromazine, Clarithromycin, Disopyramide, Dofetilide, Erythromycin, Haloperidol, Methadone, Procainamide, Quinidine, Sotalol, Levofloxacin, Moxifloxacin, Nilotinib, Ondansetron, Ranolazine, Sunitinib, Ziprasidone, Amitriptyline, Ciprofloxacin, Imipramine, Chlorthalidone, Dasatinib, Hydrochlorothiazide, Furosemide.
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This question is part of the following fields:
- Cardiovascular System
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Question 3
Correct
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A 60-year-old male smoker presented in the emergency room with a history of chest pain and a cough for the last few days. He is now complaining of increasing dyspnoea and sharp pains around the 4th and 5th ribs. On CXR, there is right sided hilar enlargement. Which of the following is the most likely diagnosis?
Your Answer: Bronchogenic carcinoma
Explanation:The history of smoking with a cough and bone pain is suggestive of bronchogenic carcinoma. CXR findings are also supportive of this diagnosis. In COPD, a cough with dyspnoea and wheezing is prominent.
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This question is part of the following fields:
- Respiratory System
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Question 4
Correct
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A 1-day-old baby started having pallor and jaundice. The mother's first child did not have jaundice at birth. On clinical investigations, direct Coombs test is positive. Mother's blood group is A negative. Baby's blood group is O positive. What is the most probable cause of the condition of this new-born?
Your Answer: Rhesus incompatibility
Explanation:Jaundice in a new-born on the day of delivery is most likely due to Rh incompatibility. This occurs when the mother is Rh-negative and the baby is Rh-positive. Antibodies in the mother against the Rh factor in the baby will destroy the red blood cells in the baby, increasing the bilirubin in the blood. Breast milk jaundice and Galactosemia do not occur immediately after birth, and congenital rubella syndrome and formula feeding does not cause jaundice in babies.
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This question is part of the following fields:
- Immune System
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Question 5
Incorrect
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A child with jaundice and pale stools would most likely be evaluated by which of the following tests?
Your Answer: LFT
Correct Answer: US
Explanation:Blood tests do not help in the diagnosis of jaundice except of course by telling the level of jaundice (bilirubin) and providing some corroborative evidence such as autoantibodies, tumour markers or viral titres in the case of hepatitis. Classifying causes of jaundice on the basis of ultrasound provides a quick and easy schema for diagnosing jaundice which is applicable in primary care as well as hospital based practice.
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This question is part of the following fields:
- Hepatobiliary System
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Question 6
Incorrect
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Which of the following statements regarding the clinical effects of long-term oxygen therapy (LTOT) is the most accurate?
Your Answer: No effect on cardiac arrhythmias
Correct Answer: Reduced sympathetic outflow
Explanation:Studies have shown that benefits of Long-tern oxygen therapy (LTOT) include improved exercise tolerance, with improved walking distance, and ability to perform daily activities, reduction of secondary polycythaemia, improved sleep quality and reduced sympathetic outflow, with increased sodium and water excretion, leading to improvement in renal function.
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This question is part of the following fields:
- Respiratory System
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Question 7
Correct
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A 22-year-old man is being evaluated for chronic lower backache. Which of the following would most strongly point towards the diagnosis of ankylosing spondylitis?
Your Answer: Reduced lateral flexion of the lumbar spine
Explanation:Ankylosing spondylitis (spondylarthritis) is a chronic inflammatory disease of the axial skeleton that leads to partial or even complete fusion and rigidity of the spine. Males are disproportionately affected and upwards of 90% of patients are positive for the HLA-B27 genotype, which predisposes to the disease. The most characteristic early finding is pain and stiffness in the neck and lower back, caused by inflammation of the vertebral column and the sacroiliac joints. The pain typically improves with activity and is especially prominent at night. Other articular findings include tenderness to percussion and displacement of the sacroiliac joints (Mennell’s sign), as well as limited spine mobility, which can progress to restrictive pulmonary disease.
The most common extra-articular manifestation is acute, unilateral anterior uveitis. Diagnosis is primarily based on symptoms and x-ray of the sacroiliac joints, with HLA-B27 testing and MRI reserved for inconclusive cases. There is no curative treatment, but regular physiotherapy can slow progression of the disease. Additionally, NSAIDs and/or tumour necrosis factor-? inhibitors may improve symptoms. In severe cases, surgery may be considered to improve quality of life. The spine adopts a bamboo shape, not lordosis. The pain usually improves as the day progresses. leg raise test causes pain in cases of meningitis etc not in this case. -
This question is part of the following fields:
- Musculoskeletal System
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Question 8
Correct
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A 55-year-old female, on warfarin for mitral valve replacement and atrial fibrillation (AF), is due for extensive abdominal surgery.
What is the most appropriate step in regards to her anticoagulation therapy?Your Answer: Stop warfarin five days pre-operatively, bridge with LMWH and give vitamin K if INR is still above 3.0 on the evening of operation
Explanation:Patients with a VTE within the previous three months, patients with AF and previous stroke or TIA or multiple other risk factors, and patients with a mitral valve replacement should be considered for bridging therapy.
The most appropriate bridging therapy in this case would be low-molecular-weight heparin (LMWH), with the last dose given not less than 24 hours prior to the procedure. Warfarin should be discontinued 5 days prior to the procedure. If the INR is still above 3 on the day prior to the procedure, vitamin K should be administered.
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This question is part of the following fields:
- Haematology & Oncology
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Question 9
Incorrect
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Regarding bupropion (Zyban), all of the following statements are true except?
Your Answer: It is an amphetamine derivative
Correct Answer: It is associated with an idiosyncratic risk of seizure
Explanation:Bupropion (Zyban) is an amphetamine derivative which is used primarily as an anti depressant and for smoking cessation. It acts by increasing dopamine levels in the CNS. It has fewer withdrawal symptoms compared to other drugs. It is associated with dose associated risk of epileptic seizures in 1: 1000 patients and is contraindicated in a patient already suffering from epilepsy. Chief side effects include tremors, anxiety, insomnia, depression and a hypersensitivity urticarial rash. It inhibits the cytochrome p450 enzyme system in the liver and greater precaution is required when it is to be administered with other drugs like paroxetine, risperidone, beta blockers, propafenone and flecainide.
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This question is part of the following fields:
- Pharmacology
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Question 10
Correct
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A 25-year-old male presented in the emergency room with a history of loose stools which were bloody and mucoid for the last 2 to 3 months. The stools were also associated with abdominal cramps. He undergoes a colonoscopy after which he will start treatment. What is the most suitable drug in this case?
Your Answer: Mesalazine
Explanation:Symptoms are suggestive of inflammatory bowel disease. In this disease mesalazine is very effective as an anti-inflammatory drug.
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This question is part of the following fields:
- Emergency & Critical Care
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Question 11
Correct
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A 38-year-old alcoholic presented with an ataxic gait, nystagmus and confusion. What is the most likely clinical diagnosis?
Your Answer: Wernicke's encephalopathy
Explanation:Wernicke’s encephalopathy is a clinical triad of encephalopathy, gait ataxia and nystagmus.
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This question is part of the following fields:
- Nervous System
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Question 12
Incorrect
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An 8-year-old boy is admitted to the ward with renal colic. Family history is significant for similar renal calculi in his mother. Which of the following is the most likely explanation for this recurrent colic in both mother and child?
Your Answer: Cystinuria
Correct Answer: Idiopathic hypercalciuria
Explanation:Idiopathic hypercalciuria (IH) is the commonest metabolic abnormality in patients with calcium kidney stones. It is characterized by normocalcemia, absence of diseases that cause increased urine calcium, and calcium excretion that is above 250 mg/day in women and 300 mg/day in men. Subjects with IH have a generalized increase in calcium turnover, which includes increased gut calcium absorption, decreased renal calcium reabsorption, and a tendency to lose calcium from bone. Despite the increase in intestinal calcium absorption, negative calcium balance is commonly seen in balance studies, especially on a low calcium diet. The mediator of decreased renal calcium reabsorption is not clear; it is not associated with either an increase in filtered load of calcium or altered PTH levels. There is an increased incidence of hypercalciuria in first-degree relatives of those with IH, but IH appears to be a complex polygenic trait with a large contribution from diet to expression of increased calcium excretion. Increased tissue vitamin D response may be responsible for the manifestations of IH in at least some patients.
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This question is part of the following fields:
- Renal System
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Question 13
Incorrect
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A 56-year-old male presents to the emergency department with confusion and agitation for the past four hours. He is a known alcoholic who has abstained from drinking for the past three days.
On examination, he is sweating, agitated and disoriented. His temperature is 37.7°C, pulse 112 bpm regular and blood pressure is 150/76 mmHg.
Blood investigations performed in the emergency department reveal:
FBC: Normal
U&E: Normal
Plasma glucose: 4.6 mmol/l (3.6-6)
Which of the following medications would be the most appropriate treatment for this man?Your Answer: Oral diazepam
Correct Answer: Oral lorazepam
Explanation:The most probable diagnosis for this patient is delirium tremens due to alcohol withdrawal, which should be treated as a medical emergency.Â
Delirium tremens is a hyperadrenergic state and is often associated with tachycardia, hyperthermia, hypertension, tachypnoea, tremor, and mydriasis.
Treatment:
– The most common and validated treatment for alcohol withdrawal is benzodiazepine: first-line treatment includes oral lorazepam.
– If the symptoms persist, or the medication is refused, parenteral lorazepam, haloperidol or olanzapine should be given.
– Central-acting, alpha-2 agonists such as clonidine and dexmedetomidine should not be used alone for the treatment of alcohol withdrawal.
– It is also recommended to avoid using alcohol, antipsychotics, anticonvulsants, beta-adrenergic receptor blockers, and baclofen for the treatment of alcohol withdrawal as there are not enough studies to support the safety of these. -
This question is part of the following fields:
- Pharmacology
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Question 14
Incorrect
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A 60-year old male presented to the OPD with a complaint of a rusty-coloured sputum along with a cough for 3 days. His has a history of smoking for 40 years, and a history of significant weight loss. His chest X-ray revealed solid nodules in both lungs and bilateral hilar lymphadenopathy. Out of the following, which one is the most appropriate investigation?
Your Answer: CT
Correct Answer: LN biopsy
Explanation:The patient’s age, a history of long-term smoking, and bilateral hilar lymphadenopathy are strong indications of malignancy. Lymph node biopsy would be essential in order to check the degree of metastasis in the mediastinal lymph nodes.
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This question is part of the following fields:
- Respiratory System
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Question 15
Correct
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A 32-year-old complains of pain in her hands bilaterally. Which of the following symptoms would point towards an inflammatory joint disease such as rheumatoid arthritis?
Your Answer: Marked stiffness for more than an hour in the mornings
Explanation:In rheumatoid arthritis (RA), clinical symptoms of joint stiffness, pain, and functional disability are commonly most severe in the early morning. These symptoms closely follow the circadian rhythm of the pro-inflammatory cytokine, interleukin (IL)-6. In RA, the increase in nocturnal anti-inflammatory cortisol secretion is insufficient to suppress ongoing inflammation, resulting in the morning symptoms characteristic of RA. Established diagnostic criteria for RA include prolonged morning stiffness that could last up to an hour. Loss of joint mobility, pain, malaise and swelling of finger joints are features that are not specific to rheumatoid arthritis, and are found in many other conditions.
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This question is part of the following fields:
- Musculoskeletal System
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Question 16
Correct
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A 39-year-old female had surgery for the removal of thyroid carcinoma. One week later, she presented in the OPD with complaints of numbness, tingling, involuntary spasm of the upper extremities, paraesthesia and respiratory stridor. Which of the following is the most likely cause?
Your Answer: Hypocalcaemia
Explanation:Hypocalcaemia presents with such symptoms. It probably happened due to accidental removal of a parathyroid gland during the thyroid surgery. Hypocalcaemia causes laryngospasm which produces stridor.
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This question is part of the following fields:
- Endocrine System & Metabolism
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Question 17
Incorrect
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A defect in DNA gyrase can lead to which of the following cancerous conditions?
Your Answer: von Hippel-Lindau
Correct Answer: Xeroderma pigmentosum
Explanation:Xeroderma pigmentosum is an X-linked recessive condition, which is caused by mutations in DNA gyrase which further encodes the XP gene. The defect may lead to skin cancer at an early stage of life, especially at photo exposed sites.
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This question is part of the following fields:
- The Skin
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Question 18
Incorrect
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A 13-year-old girl is brought by her mother to the A&E with breathlessness, fatigue and palpitations. Anamnesis does not reveal any syncope or chest pain in the past. on the other hand, these symptoms were present intermittently for a year. Clinical examination reveals a pan-systolic murmur associated with giant V waves in the jugular venous pulse. Chest auscultation and resting ECG are normal. 24 hour ECG tape shows a short burst of supraventricular tachycardia. What is the most probable diagnosis?
Your Answer: Arrhythmogenic right ventricular cardiomyopathy
Correct Answer: Ebstein's anomaly
Explanation:Ebstein’s anomaly is characterised by apical displacement and adherence of the septal and posterior leaflets of the tricuspid valve to the underlying myocardium, thereby displacing the functional tricuspid orifice apically and dividing the right ventricle into two portions. The main haemodynamic abnormality leading to symptoms is tricuspid valve incompetence. The clinical spectrum is broad; patients may be asymptomatic or experience right-sided heart failure, cyanosis, arrhythmias and sudden cardiac death (SCD). Many Ebstein’s anomaly patients have an interatrial communication (secundum atrial septal defect (ASD II) or patent foramen ovale). Other structural anomalies may also be present, including a bicuspid aortic valve (BAV), ventricular septal defect (VSD), and pulmonary stenosis. The morphology of the tricuspid valve in Ebstein anomaly, and consequently the clinical presentation, is highly variable. The tricuspid valve leaflets demonstrate variable degrees of failed delamination (separation of the valve tissue from the myocardium) with fibrous attachments to the right ventricular endocardium.
The displacement of annular attachments of septal and posterior (inferior) leaflets into the right ventricle toward the apex and right ventricular outflow tract is the hallmark finding of Ebstein anomaly. -
This question is part of the following fields:
- Cardiovascular System
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Question 19
Incorrect
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A 44-year-old woman is investigated for hot flushes and night sweats. Her blood tests show a significantly raised FSH level and her symptoms are attributed to menopause. Following discussions with the patient, she elects to have hormone replacement treatment. What is the most significant risk of prescribing an oestrogen-only preparation rather than a combined oestrogen-progestogen preparation?
Your Answer: Increased risk of venous thromboembolism
Correct Answer: Increased risk of endometrial cancer
Explanation:The use of hormone replacement therapy (HRT) based on unopposed oestrogen increases the risk of endometrial cancer, and uterine hyperplasia or cancer.
Evidence from randomized controlled studies showed a definite association between HRT and uterine hyperplasia and cancer. HRT based on unopposed oestrogen is associated with this observed risk, which is unlike the increased risk of breast cancer linked with combined rather than unopposed HRT. -
This question is part of the following fields:
- Endocrine System & Metabolism
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Question 20
Correct
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A 4-year-old baby was brought in by her mother with complaints of generalized pallor, loss of weight and loose stools. The baby's stools were frothy in nature and difficult to flush. Which investigation can help in diagnosing this patient?
Your Answer: Anti-endomysial antibodies
Explanation:The presence of anti-endomysial antibodies confirms the diagnosis of Celiac disease, which is the primary cause of illness in this patient. The sweat chloride test is performed with cystic fibrosis.
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This question is part of the following fields:
- Gastrointestinal System
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Question 21
Correct
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A 58-year-old lady was admitted to hospital with increasing thirst and generalised abdominal pain. She was diagnosed with breast carcinoma three years previously and treated with a radical mastectomy.
Â
Investigations showed:
Serum corrected calcium 3.5 mmol/L (NR 2.2-2.6)
Serum alkaline phosphatase 1100 IU/L
Â
Her serum calcium was still elevated following 4 litres of 0.9% saline intravenous infusion.
Â
Which of the following is the most appropriate next step?Your Answer: Pamidronate 60 mg intravenously
Explanation:This case has hypercalcaemia most likely associated with the bony metastases from her pre-existing breast carcinoma. The most appropriate next step is to give Pamidronate 60mg intravenously, a bisphosphonate, to immediately inhibit bone resorption and formation.
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This question is part of the following fields:
- Renal System
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Question 22
Incorrect
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A 41-year-old woman who has a history of SLE presents with a dry cough, dyspnoea and fever. She is being treated with a monthly dose of IV cyclophosphamide for Grade IV nephropathy. The last cyclophosphamide dose was 10 years ago. Lab investigations are as follows:
WCC: 2.3 (lymphocyte count 0.7)
Platelets: 81
Hb: 10.5
ESR: 56
CRP: 43
PO2: 7.2 kPa, PCO2: 3.6 kPa after walking out to the toilet.
Chest X ray was unremarkable apart from some patchy pulmonary infiltration.
What is the likely diagnosis?Your Answer: TB
Correct Answer: Pneumocystis carinii pneumonia (PCP)
Explanation:Pneumocystis carinii pneumonia, is an opportunistic fungal lung infection occurring almost exclusively in immunocompromised individuals. In 50% of cases, PCP is the first manifestation of AIDS (acquired immune deficiency syndrome), but it may be caused by other immunodeficiency disorders. PCP should be suspected in patients with a history of progressive dyspnoea and a dry cough with resistance to standard antibiotic treatment. Signs that support this diagnosis include a CD4 count < 200/μL, an increased beta-D-glucan level, and diffuse bilateral infiltrates on chest x-ray. Management of PCP includes high-dose trimethoprim/sulfamethoxazole (TMP/SMX), treatment of the underlying immunodeficiency disorder, and steroids in the case of severe respiratory insufficiency. TB is less likely to be present in this case as ESR is relatively low and chest x-ray appeared normal.
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This question is part of the following fields:
- Musculoskeletal System
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Question 23
Incorrect
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A 34-year-old woman is admitted to the hospital with a one-week history of dark urine and fatigue. One day before admission, she developed severe abdominal pain and abdominal distension.
On examination, she has pallor, jaundice, an enlarged tender liver, and ascites. Her investigations show:
Hb: 7.9 g/dL
WCC: 3.2 x 10^9/L
Plts: 89 x 10^9/L
MCV: 101 fL
Peripheral smear: Mild polychromasia
AST: 144 U/L
ALT: 130 U/L
Bilirubin: 54 μmol/L
Urine hemosiderin: ++
Urine urobilinogen +
Abdominal ultrasound reveals an enlarged liver, ascites, and absent flow in the hepatic veins.
Which single test would you request to confirm the underlying diagnosis?Your Answer: Viral hepatitis serology
Correct Answer: Flow cytometry for CD55 and CD59 expression
Explanation:The patient has paroxysmal nocturnal haemoglobinuria (PNH) complicated by acute hepatic vein thrombosis (Budd-Chiari syndrome).
PNH is an acquired clonal disorder of haematopoietic stem cells, characterised by variable combination of intravascular haemolysis, thrombosis, and bone marrow failure. Diagnosis is made by flow cytometric evaluation of blood, which confirms the CD55 and CD59 deficiencies and deficiency of expression of other GPI-linked proteins. This test is replacing older complement-based assays such as the Ham test and sucrose lysis test.
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This question is part of the following fields:
- Haematology & Oncology
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Question 24
Correct
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A 40-year-old male was diagnosed with HIV. He had had multiple sexual partners. He was not willing to change his lifestyle, nor was he willing to inform any of his former partners. What is the most suitable next step for the doctor?
Your Answer: Give general advice
Explanation:General advice should be given to the patient as HIV is not a notifiable disease. Informing someone about the disease without the patient’s consent will breach the confidentiality.
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This question is part of the following fields:
- Ethical & Legal
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Question 25
Incorrect
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An elderly man presents with fever of 38°C and a very severe headache. His BP is 85/50 mm Hg. He has neck stiffness and photophobia. What is the most appropriate management?
Your Answer: CT head and Lumbar puncture
Correct Answer: CT head
Explanation:In elderly patients, symptoms suggestive of meningitis could be due to an intracranial mass lesion (such as abscess, tumour or an intracerebral haematoma). Therefore elderly patients are increased risk of cerebral herniation from an LP. A CT head should be done before an LP to exclude a mass lesion.
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This question is part of the following fields:
- Geriatric Medicine
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Question 26
Correct
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A 40-year-old man complains of impotence and reduced libido for 4 months. He has been married for 15 years and has two children. He smokes five cigarettes per day and drinks approximately 12 units of alcohol weekly.
Examination reveals an obese man who is phenotypically normal with normal secondary sexual characteristics.
Investigations are as follows:
Hb 13.4 g/dl (13.0-18.0)
WCC 6 x 109/l (4-11)
Platelets 210 x 109/l (150-400)
Electrolytes Normal
Fasting glucose 5.6 mmol/l (3.0-6.0)
LFTs Normal
T4 12.7 pmol/l (10-22)
TSH 2.1 mU/l (0.4-5)
Prolactin 259 mU/l (<450)
Testosterone 6.6 nmol/l (9-30)
LH 23.7 mU/l (4-8)
FSH 18.1 mU/l (4-10)
What is the next investigation needed for this patient?Your Answer: Ultrasound examination of the testes
Explanation:The patient has primary Hypogonadism.
Since he already had two children, Klinefelter syndrome is excluded and the patient does not need karyotyping.
His lab results are normal indicating normal pituitary gland functions.
So the next step is testicular ultrasound as testicular tumour, infiltration or idiopathic failure is suspected. -
This question is part of the following fields:
- Endocrine System & Metabolism
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Question 27
Correct
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A 26-year-old male presents with right sided elbow and wrist pain and left sided knee and ankle pain that has persisted for about two weeks. He recently returned from a trip to Thailand that last for two weeks. The patient admits to having unprotected sex while on holiday. Examination reveals swelling and tenderness of tendons around joints but no inflammation of the joints. A vesiculopustular skin rash is also observed. What is the most likely cause?
Your Answer: Gonococcal arthritis
Explanation:Patients with disseminated gonococcal arthritis may present with dermatitis-arthritis syndrome (60%) of with localized septic arthritis. (40%). Arthritis-dermatitis syndrome includes the classic triad of dermatitis, tenosynovitis, and migratory polyarthritis. Gout usually involves a singe joint and does not cause vesicopustular skin rash. Reactive arthritis has ocular symptoms (conjunctivitis), urethritis, and arthritis. Fungal arthritis occurs rarely and it may occur after a surgical infection or fungal spread hematogenously. it presents with tender, red, hot and swollen joint with loss of range of motion.
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This question is part of the following fields:
- Musculoskeletal System
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Question 28
Correct
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A 50-year-old man presented with polyuria and orthostatic hypotension. Which of the following medications is the most likely to be associated with this condition?
Your Answer: Bendroflumethiazide
Explanation:Bendroflumethiazide is known to cause photosensitive rash as part of an allergic reaction during which the person might also have wheezing, chest tightness or dyspnoea. The rash typically occurs on the areas of body exposed to the sun, like the back, hands, arms and legs.
Comparatively, digoxin produces a rash that comprises of nearly the whole body.
Atenolol may also cause skin rash but that is not photosensitive.
Clopidogrel might produce an non-photosensitive urticarial rash.
Ezetimibe causes a severe allergic reaction but only rarely. This rash is also non-photosensitive and is in the form of blisters, associated with itching. -
This question is part of the following fields:
- Pharmacology
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Question 29
Correct
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A 22-year-old nulliparous female presents with shortness of breath. She has a history of recurrent deep vein thrombosis. Complete blood count and clotting screen reveals the following results:
Hb: 12.4 g/dl
Plt: 137
WBC: 7.5*109/l
PT: 14 secs
APTT: 46 secs
Which of the following would be the most likely diagnosis?Your Answer: Antiphospholipid syndrome
Explanation:The combination of APTT and low platelets with recurrent DVTs make antiphospholipid syndrome the most likely diagnosis.
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This question is part of the following fields:
- Musculoskeletal System
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Question 30
Incorrect
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A 75-year-old male patient with a three weeks history of recurrent epistaxis and haemoptysis presents with acute kidney injury. Which antibody would you expect positive?
Your Answer: P ANCA
Correct Answer: C ANCA
Explanation:Pulmonary renal syndrome is most commonly due to an ANCA positive vasculitis. The history of recurrent epistaxis makes Wegener’s granulomatosis the most probable diagnosis. It presents with pulmonary haemorrhage producing haemoptysis, rapidly progressive glomerulonephritis and anti-glomerular basement membrane antibodies. Recurrent epistaxis favours the diagnosis. In this patient we suspect C ANCA to be positive.
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This question is part of the following fields:
- Musculoskeletal System
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SESSION STATS - PERFORMANCE PER SPECIALTY
