1.A68 year old man with poorly controlled diabetes presents with severe otalgia and headaches. On examination, there is granulation tissue within the external auditory meatus. What is the most likely underlying infective agent?

2.A 68 year old women with previous rheumatic fever is admitted with pyrexia of unknown origin. Her blood cultures are unhelpful but transoesophageal echocardiography reveals vegetations on Catalase negative the mitral valve. Infection with which of the following organisms is most likely?

3.A 50-year-old female with a history of rheumatoid presents with a suspected septic knee joint. A diagnostic aspiration is performed and sent to microbiology. Which of the organisms below is most likely to be responsible?

4.A young woman is admitted to hospital with E-coli 0157 after visiting Germany during an outbreak. Which of the following is not true of the condition?

5.A 32 year old woman undergoes mastectomy and latissimus dorsi flap reconstruction for breast cancer, to provide optimal cosmesis a McGhan implant is placed under the myocutaneous flap. Three weeks post operatively the patient continues to suffer from recurrent wound infections that have proved resistant to multiple courses of antibiotics. Which of the organisms listed below is most likely to be responsible?

6.A 4year old child presents with a4-5 day history of feeling generally unwell and also of having a sore throat. On examination, there is marked cervical lymphadenopathy, the oropharynx is covered with a thick grey membrane which bleeds following attempted removal. What is the most likely diagnosis?

7.A34-year-old man from Zimbabwe is admitted with abdominal pain to the Emergency Department. An abdominal x-ray reveals urinary bladder calcification. What is the most likely cause?

8.A23 year old man is admitted to hospital with diarrhoea and severe abdominal pain. He was previously well and his illness has lasted 18 hours. What is the likely cause?

9.A 28 year old man undergoes a laparotomy for perforated duodenal ulcer and broad spectrum antibiotics are administered. Post operatively he has hearing impairment. Which of the following agents is the most likely underlying culprit?

10.A25 year old man returns from a backpacking holiday in India. He presents with symptoms of coughing and also of episodic abdominal discomfort. Peri anal examination is normal. Stool microscopy demonstrates both worms and eggs within the faeces. What is the most likely infective organism?

11.What is the mechanism of action of ciprofloxacin?

12.A 14 year old boy presents with enlarged tonsils that meet in the midline. Oropharyngeal examination confirms this finding and you also notice petechial haemorrhages affecting the oropharynx. On systemic examination he is noted to have splenomegaly. What si the most likely cause?

13.IN a 72 year old man undergoing a sigmoid colectomy for diverticular disease, which of the following interventions is most likely to reduce his risk of developing a post operative wound infection?

14.A 54-year-old female is admitted one week following a cholecystectomy with profuse diarrhoea. Apart from a minor intra-operative bile spillage incurred during removal of the gallbladder, the procedure was uncomplicated. What is the most likely diagnosis?

15. A 22 year old Chef presents with abdominal pain in the right iliac fossa. There is an associated
temperature and diarrhoea. The CT1 takes the patient to theatre for an appendicectomy, but the appendix appears normal. The terminal ileum appears thickened and engorged. Infection with which of the following is most likely?

16.A 65 year old man presents with a 5cm ulcerated area over his medial malleolus. It has been
present for many years and the nurses have complained that it is not healing with simple bandages. What is the best course of action?

17.A2 year old woman presents with a newly pigmented lesion on her right shin, it has regular borders and normal appearing dermal appendages. However, she reports a recent increase in size. What is the best course of action?

18.Which of the following statements relating to sebaceous cysts is false?

19.An 8 year old boy presented with a painless swelling on the superotemporal aspect of his orbit. It was smooth on examination, produced no visual disturbances. Following excision it was found to be lined by squamous epithelium and hair follicles. Which of the following lesions most closely matches these findings?

20. 68 year old farmer presents with a skin lesion on his forehead. It has been present for the past 6 months and has grown slightly in size during that time. On examination, he has an ulcerated lesion with pearly white raised edges that measures 2cm ni diameter. What is the most likely diagnosis?

21.A29 year old man presents with a lump in his scalp. It is located approximately 4cm superior to the external occipital protuberance. It feels smooth and slightly fluctuant and has a centrally located small epithelial defect. What is the most likely underlying diagnosis?

22.A 72 year old man presents with a large nodule on his face. It is friable. There is no regional lymphadenopathy. He is lost to follow up and re-attends several months later. On this occasion
the lesion has been noted to resolve with scarring. What is the most likely lesion?

23.A28 year old man undergoes an ileocaecal resection and end ileostomy for Crohn’s disease. One year later he presents with adeep painful ulcer at his stoma site. What is the most likely diagnosis?

24.A2 year old man presents with an infected sebaceous cyst. The cyst itself si swollen, discharging pus and has some surrounding erythema. What is the most appropriate treatment?

25.A 73 year old man presents with a 1.5cm ulcerated basal cell carcinoma on his back. What is the best course of action?