APRIL 2026 Recalls Compilation
46M w/ 3mo constant nocturnal epigastric pain, early satiety & 7kg wt loss. Noted dark urine & pale stools last 2wks. Hx chronic Hep B, no tx. Mild jaundice, mod epigastric tenderness. Diagnosis?
a/ Peptic ulcer disease
b/ Cholangiocarcinoma
23M presented w/ severe HA, unsteadiness, & intractable V/D for 2 days. Appeared pale, dehydrated, tachycardic & hypotensive. Temp 38.6. Mild abd tenderness, no guarding. Dx?
a/ Ondansetron IV + 1L NaCl IV
b/ Stool sample for viral ag
45F w/ fatigue, low mood, concentration issues. Smoking 10-15 cigs/day, BMI 34. No fam hx kidney disease. Only abnormal labs were elevated LDL & urine albumin:creatinine ratio. next?
a/ Initiate perindopril 5mg daily.
b/ Re-eval urine albumin:creatinine ratio x 2 in 3 mos.
c/ Commence atorvastatin 20mg daily.
2yo M presents w/ barking cough, noisy breathing last 2 nights, now irritable & lethargic. On exam, audible inspiratory/expiratory stridor at rest, significant retractions, tracheal tug. Cause?
a/ Neb nebulised adrenaline.
b/ PO prednisolone.
87M w/ FTD + recent behavioral changes,↓ PO intake, infrequent BMs. Urine dip + for leukocytes. No fever. immediate intervention?
a/ Mirogalol 500 oral powder 2 tabs stat, then titrate.
b/ Citalopram 10 mg PO AM.
59M w/ 6wk progressive dyspnea on exertion & dry cough. Hx of 25 yrs stonemason. CXR shows bilateral basal reticular opacities. Crackles bilat bases on exam. O2 sat 95%. Next step?
a/ HRCT thorax
b/ Autoimmune serology
64F presented w/ palpitations, ECG showed AFib, rate 96. Spontaneously reverted to SR w/in 12 hrs, asymptomatic. Hx HTN on candesartan. CHADS2 score 1. No stroke/HF.
a/ No antithrombotic therapy warranted.
b/ Apixaban 5mg BID.
7yo G presented by father re: leg length discrepancy concern. Asymptomatic, normal dev milestones, no gait issues noted. Father esp. due to fam hx. What is initial inv management?
a/ Clinical ASIS to medial malleolus meas.
b/ CT scan of lower limbs.
6yoM w/ new rash on palms/soles, preceded by fever/sore throat 3 days ago. erythematous macules & vesicles on hands/feet, w/ shallow ulcerative lesions on buccal mucosa/tongue.
a/ HFMD
b/ EM
c/ HSP
59M w/ 4mo hx of thickened skin on both palms, progressively worsening. Plaques are hyperkeratotic, scaly, w/ fissuring bilat., centrally. No response to OTC hydrocortisone. cause?
a/ Clobetasol ointment w/ occlusion
b/ Tacrolimus ointment
53M presents w/ firm, irregular, non-tender 1.5cm lesion on L lateral tongue, ~6wk hx, incr size. Smoker, EtOH use hx. No cervical LAD.
a/ Biopsy ASAP
b/ Nystatin suspension
27F presented w/ acute painful L ant. cervical lymph node, tender & mobile, ~2cm. Pt had recent URTI symptoms & hx of thyroid nodule excision yrs ago. Denies fever/weight loss. next step?
a/ NSAIDs & review in 2 wks
b/ Expedited neck US
72M w/ progressive gait disturbance, unsteady, near-falls x 8mos. Spouse notes smaller handwriting, slower movements. Exam shows cogwheel rigidity UEs, decr arm swing. Romberg neg.
a/ Drug-induced parkinsonism
b/ Parkinson disease
66M w/ metastatic prostate ca, bone mets, home palliative care. Pt developed inc agitation, confusion. Abdo mildly distended, palpable faecal loading. Drowsy but rousable, disoriented.
a/ Haloperidol 0.5mg PO BID
b/ Midazolam 2.5mg SC PRN
16F w/ social anxiety on fluoxetine 20mg for 6 wks after CBT. C/o jitteriness, N/V, restlessness, ↑ anxiety, poor sleep x 5d. Denies SI/HI/hallucinations. PE shows anxious pt, HR 96.
a/ Maintain fluoxetine 20mg.
b/ Decrease fluoxetine to 10mg.
20yo M goin 8wk cycling trip thru MX, eating street food. Had Hep A x2, up-to-date childhood vax, recent Fiji trip w/ recommended vax. No current medical conditions or meds. What vax next?
a/ Typhoid vaccine
b/ Hepatitis B vaccine
c/ Rabies pre-exposure immunisation
29F w/ 5mo secondary amenorrhea after OCP cessation 9mo ago. Increased stress & intense exercise for half-marathon prep. Wt loss 6kg/6mo. BMI 19. Denies hirsutism, galactorrhea. Cause?
a/ Urine hCG assay
b/ Progesterone challenge test
c/ Serum prolactin level
23F, migrant from ME, presents w/ 4mo hx profuse, malodorous vag discharge + post-coital spotting. Exam reveals frothy yellow-green d/c, erythematous cervix w/ punctate bleeding. Dx confirmed. next?
a/ Tinidazole 2g PO single dose
b/ Metronidazole 2g PO single dose
63M w/ T2DM & HTN, on metformin & perindopril. Rec HbA1c 7.6%, LDL 3.0, but eGFR 76 & ACR 2.2. Asks re: CV prevention. Next step?
a/ Incr perindopril
b/ Start gliclazide MR
c/ Start atorvastatin 20mg
59M had sudden transient R visual obscuration lasting ~10 min, no HA, no focal neuro sx. Hx HTN, hypercholesterolemia, ex-smoker, etoh daily. BP 142/86, LDL 2.1. Recovered fully.
a/ Urgent ED referral
b/ Carotid duplex US
c/ MRI brain w/ DWI
33F w/ 6wk watery diarrhoea, abd cramping, urgency, & 3kg wt loss. She has oral ulcers & R knee pain. Recent travel hx. Hb 108, MCV 74, Ferritin 8, CRP 18, Fcal protectin 620. Mild RIF tenderness
a/ Coeliac serology & GFD trial
b/ Colonoscopy w/ ileoscopy & biopsies
c/ Cipro 500mg BID x5
45M w/ sudden severe R pleuritic chest pain & dyspnoea post long flight. 92% on RA, HR 112, positive D-dimer. Mild R calf tenderness noted, no swelling. Obesity hx.
a/ Rivaroxaban + CTPA today
b/ Enoxaparin + immediate CTPA
23F presents 10 days postpartum w/ worsening dyspnea, orthopnea, palpitations, chest tightness. Exam shows tachycardic irregular rhythm. JVP elevated 4cm, bilateral ankle edema.
a/ Peripartum cardiomyopathy
b/ Pulmonary embolism
c/ Anxiety or panic attack
37F w/ 3 mo fatigue, h/a, pruritus post hot showers. Plethoric appear, BP 146/88, Spleen palpable 2cm below LCM. Labs: Hb 19.6, Hct 0.58, WCC 13.2, Plts 620, EPO low. O2 sat 98%. Cause?
a/ Therapeutic venesection
b/ Ferrous fumarate
c/ Aspirin 100 mg daily
63M w/ 6wk proximal muscle weakness, difficulty rising/climbing stairs, heliotrope/chest rash, mild dysphagia, high CK, high ESR, high ALT. Pt on atorvastatin/ramipril. Cause?
a/ Discontinue atorvastatin.
b/ Initiate prednisolone 60mg daily.
32F, 10 wks pp, breastfeeding, menses R. Hx migraine w/ aura (visual disturbances). Wants effective, reversible contraception, concerned w/ wt gain/mood changes. No estro.
a/ Combined OCP w/ 20mcg EE
b/ DMPA IM q12wk
73M w/ PD x 6yr presented w/ 3d AMS, visual hallucinations, sleep-wake cycle reversal. started oxybutynin 5mg BID 5d ago. U/A trace leukocytes, neg nitrites. No focal neuro deficits. Diagnosis?
a/ Haloperidol
b/ Quetiapine
43F w/ 14mo hx heavy menses & clots, now fatigued. Has IDA, on Fe. US shows normal uterus, ET 8mm, no fibroids. Pt wants definitive tx, no surgery preferred.
a/ Tranexamic acid
b/ Norethisterone
c/ LNG-IUS
58M presented w/ acutely painful, swollen R knee. Hx of gout x 10 yrs, T2DM. Current allopurinol, metformin. R knee hot, tense effusion, severe pain. Labs inc. high CRP, high WBC, low serum urate.
a/ Initiate colchicine.
b/ Perform joint aspiration.
c/ Start indomethacin.
53M w/ 6d hx fever, prod cough w/ purulent sputum, pleuritic CP, incr dyspnea. T 38.6C, tachycardic, R basilar crackles. T2DM, HTN. PNC allergy (diarrhea).
a/ Oral amox 1g TID x 5d
b/ Oral doxy 100mg BID x 7d