Oman Medical Specialty Board Examination (OMSB) · Clinical Medicine And Surgery

Clinical cases

99 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 99 questions

  1. Which investigation best confirms Inferior ST-elevation myocardial infarction?
  2. Which complication or association is classically linked with Inferior ST-elevation myocardial infarction?
  3. A 35-year-old woman taking the combined oral contraceptive has sudden pleuritic chest pain and breathlessness after a long flight, with a clear chest radiograph. What is the most likely diagnosis?
  4. Which is the most appropriate initial treatment for Pulmonary embolism?
  5. Which investigation best confirms Tension pneumothorax?
  6. Which complication or association is classically linked with Tension pneumothorax?
  7. A 19-year-old with type 1 diabetes has vomiting, deep sighing breathing, fruity breath and a blood glucose of 27 mmol/L. What is the most likely diagnosis?
  8. Which is the most appropriate initial treatment for Diabetic ketoacidosis?
  9. Which is the most appropriate initial treatment for Acute appendicitis?
  10. A 45-year-old woman has right upper quadrant pain after a fatty meal, fever and a positive Murphy sign. What is the most likely diagnosis?
  11. Which is the most appropriate initial treatment for Acute cholecystitis?
  12. Which investigation best confirms Acute pancreatitis?
  13. Which complication or association is classically linked with Acute pancreatitis?
  14. A woman with a previous laparotomy has colicky abdominal pain, vomiting, distension and absolute constipation. What is the most likely diagnosis?
  15. Which complication or association is classically linked with Small bowel obstruction?
  16. Which investigation best confirms Bleeding duodenal ulcer?
  17. Which complication or association is classically linked with Bleeding duodenal ulcer?
  18. A 70-year-old with atrial fibrillation develops sudden right arm weakness and slurred speech 90 minutes ago. What is the most likely diagnosis?
  19. Which is the most appropriate initial treatment for Acute ischaemic stroke?
  20. Which is the most appropriate initial treatment for Subarachnoid haemorrhage?
  21. A 19-year-old student has fever, headache, neck stiffness, photophobia and a non-blanching rash. What is the most likely diagnosis?
  22. Which is the most appropriate initial treatment for Bacterial meningitis?
  23. Which investigation best confirms Hypothyroidism?
  24. Which complication or association is classically linked with Hypothyroidism?
  25. A 30-year-old woman has weight loss, tremor, heat intolerance, exophthalmos and a diffuse goitre. What is the most likely diagnosis?
  26. Which is the most appropriate initial treatment for Graves disease?
  27. Which investigation best confirms Addison disease?
  28. Which complication or association is classically linked with Addison disease?
  29. A woman has central obesity, purple abdominal striae, proximal muscle weakness, hypertension and a rounded face. What is the most likely diagnosis?
  30. Which is the most appropriate initial treatment for Cushing syndrome?
  31. Which investigation best confirms Primary hyperparathyroidism?
  32. Which complication or association is classically linked with Primary hyperparathyroidism?
  33. A 30-year-old woman with heavy periods is tired and pale, with a low haemoglobin and microcytic hypochromic red cells. What is the most likely diagnosis?
  34. Which is the most appropriate initial treatment for Iron deficiency anaemia?
  35. Which investigation best confirms Pernicious anaemia?
  36. Which complication or association is classically linked with Pernicious anaemia?
  37. A 12-year-old with sickle cell disease has severe bone pain after dehydration. What is the most likely diagnosis?
  38. Which is the most appropriate initial treatment for Sickle cell painful crisis?
  39. Which investigation best confirms Chronic myeloid leukaemia?
  40. Which complication or association is classically linked with Chronic myeloid leukaemia?
  41. A 45-year-old woman has symmetrical swelling of the small joints of the hands with morning stiffness lasting over an hour. What is the most likely diagnosis?
  42. Which is the most appropriate initial treatment for Rheumatoid arthritis?
  43. Which investigation best confirms Acute gout?
  44. Which complication or association is classically linked with Acute gout?
  45. A 25-year-old woman has a malar rash, photosensitivity, joint pain and proteinuria. What is the most likely diagnosis?
  46. Which is the most appropriate initial treatment for Systemic lupus erythematosus?
  47. Which investigation best confirms Community-acquired pneumonia?
  48. Which complication or association is classically linked with Community-acquired pneumonia?
  49. A man has a three-week cough with night sweats, weight loss and haemoptysis, and an upper-lobe cavity on the chest film. What is the most likely diagnosis?
  50. Which is the most appropriate initial treatment for Pulmonary tuberculosis?
  51. Which investigation best confirms Acute severe asthma?
  52. A 65-year-old lifelong smoker has a chronic productive cough and exertional breathlessness with an FEV1/FVC of 0.55. What is the most likely diagnosis?
  53. Which is the most appropriate initial treatment for Chronic obstructive pulmonary disease?
  54. Which investigation best confirms Heart failure with reduced ejection fraction?
  55. Which complication or association is classically linked with Heart failure with reduced ejection fraction?
  56. A 72-year-old has palpitations and an irregularly irregular pulse. What is the most likely diagnosis?
  57. Which is the most appropriate initial treatment for Atrial fibrillation?
  58. Which investigation best confirms Infective endocarditis?
  59. Which complication or association is classically linked with Infective endocarditis?
  60. A 45-year-old has epigastric pain that is worse at night and a positive stool antigen test. What is the most likely diagnosis?
  61. Which is the most appropriate initial treatment for Helicobacter pylori duodenal ulcer?
  62. Which is the most appropriate initial treatment for Ulcerative colitis?
  63. A 22-year-old has chronic diarrhoea, weight loss and right iliac fossa pain, with skip lesions and non-caseating granulomas on biopsy. What is the most likely diagnosis?
  64. Which is the most appropriate initial treatment for Crohn disease?
  65. Which investigation best confirms Acute pyelonephritis?
  66. Which complication or association is classically linked with Acute pyelonephritis?
  67. A dialysis patient has weakness and peaked T waves, with a potassium of 7.2 mmol/L. What is the most likely diagnosis?
  68. Which is the most appropriate initial treatment for Hyperkalaemia with ECG changes?
  69. Which investigation best confirms Anaphylaxis?
  70. Which complication or association is classically linked with Anaphylaxis?
  71. A woman presents eight hours after taking 40 paracetamol tablets. What is the most likely diagnosis?
  72. Which is the most appropriate initial treatment for Paracetamol overdose?
  73. Which is the most appropriate initial treatment for Opioid overdose?
  74. A farmer has sweating, salivation, small pupils, a slow pulse and muscle fasciculations. What is the most likely diagnosis?
  75. Which is the most appropriate initial treatment for Organophosphate poisoning?
  76. Which investigation best confirms Acute limb ischaemia?
  77. Which complication or association is classically linked with Acute limb ischaemia?
  78. A 72-year-old smoker collapses with severe back pain, a pulsatile abdominal mass and low blood pressure. What is the most likely diagnosis?
  79. Which is the most appropriate initial treatment for Ruptured abdominal aortic aneurysm?
  80. Which investigation best confirms Testicular torsion?
  81. Which complication or association is classically linked with Testicular torsion?
  82. A man has severe loin-to-groin colicky pain and blood in the urine. What is the most likely diagnosis?
  83. Which complication or association is classically linked with Ureteric colic?
  84. Which investigation best confirms Breast carcinoma?
  85. Which complication or association is classically linked with Breast carcinoma?
  86. A 65-year-old has altered bowel habit, rectal bleeding and iron deficiency anaemia. What is the most likely diagnosis?
  87. Which is the most appropriate initial treatment for Colorectal carcinoma?
  88. Which investigation best confirms Hypoglycaemia in type 1 diabetes?
  89. Which complication or association is classically linked with Hypoglycaemia in type 1 diabetes?
  90. A man has fever, jaundice and right upper quadrant pain. What is the most likely diagnosis?
  91. Which is the most appropriate initial treatment for Acute cholangitis?
  92. Which investigation best confirms Giant cell arteritis?
  93. Which complication or association is classically linked with Giant cell arteritis?
  94. A 30-year-old woman has ptosis and double vision that get worse towards the evening. What is the most likely diagnosis?
  95. Which is the most appropriate initial treatment for Myasthenia gravis?
  96. Which investigation best confirms Guillain-Barre syndrome?
  97. Which complication or association is classically linked with Guillain-Barre syndrome?
  98. A 68-year-old has a resting tremor, slow movements and cogwheel rigidity. What is the most likely diagnosis?
  99. Which complication or association is classically linked with Parkinson disease?

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