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A 19-year-old man is brought to A&E after a punch to the nose.
A 40-year-old woman with Crohn's disease has had two ileal resections. She now presents with macrocytic anaemia, glossitis, and paraesthesia. What is the most likely nutritional deficiency?
Terminal ileal resection causes vitamin B12 malabsorption and requires lifelong intramuscular hydroxocobalamin replacement.
A 13-year-old boy with a BMI on the 98th centile has 3 weeks of left knee pain and a limp. The knee is normal. The left leg rests in external rotation and internal rotation of the hip is lost. Which diagnosis is most likely?
Knee pain with a normal knee in an overweight adolescent is a slipped upper femoral epiphysis until the hips have been examined and X-rayed.
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Yes. Every question is mapped to the 2026 UKMLA content map, across all 24 areas, with more than 3,000 preclinical questions in anatomy, physiology, pathology and pharmacology.
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A 56-year-old woman with type 2 diabetes on dapagliflozin and metformin presents with 48 hours of vomiting and polyuria. Glucose is 9.8 mmol/L, ketones 4.2 mmol/L, pH 7.18, bicarbonate 12 mmol/L, anion gap 22. What is the most likely diagnosis?
This is euglycaemic DKA — anion-gap acidosis with ketosis in a patient on an SGLT2 inhibitor. SGLT2 inhibitors lower blood glucose by dumping it into the urine, masking the hyperglycaemia of DKA without preventing the underlying insulin deficiency that drives ketogenesis. HHS would show glucose >30 mmol/L with minimal ketones; metformin-induced lactic acidosis would have raised lactate rather than ketones as the gap-driver.
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A 70-year-old man collapses with syncope after climbing stairs. Examination reveals an ejection systolic murmur at the right sternal edge radiating to the carotids. What is the most likely diagnosis?
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A 62-year-old man attends his GP with a 3-month history of exertional chest pain relieved by rest. Resting ECG shows 1mm ST depression in V4–V6. He is started on aspirin. Which drug class should be added for symptom control?
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