A 19-year-old woman presents with a painful left hip and groin and is unable to weight-bear. She completed therapy tor acute myeloblastic leukaemia some 6 months earlier. On examination, she walks with a limp and there is limitation of hip flexion, internal and external rotation. Investigations show: haemoglobin, 12.1 g/ dl, white cell count 6.1x 109/ 1, platelets 191 x 109/ 1, sodium 140 mmol/1, potassium 4.7 mmol/1, creatinine130 μmol/1, C-reactive protein (CRP) 12 mg/ I. The left hip X-ray shows joint sclerosis with collapse of the femoral head.



Which one of the following is the most likely diagnosis? 

47-year-old woman complains of exertional dyspnoea associated with a dry cough and bloody discharge from her nose. Her ankles, fingers and toes are swollen. Blood tests for antibodies are positive for cytoplasmic antineutrophil cyroplasmic antibodies (cANCA).



What is the most likely diagnosis? 

A 40-year-old woman who is a keen gardener presents to her GP complaining of pain in her right elbow. She is right-handed and has spent the past 2 weeks planting bulbs in the garden.



Which one of the following features would be rnost suggestive of a diagnosis of tennis elbow? 

A 27-year-old man known to be HIV-positive presents to clinic with xerophthalmia, xerostomia, abdominal pain, weakness and exertional dyspnoea. He is noted to have bilateral parotid gland enlargement, heparomegaly and a peripheral motor neuropathy. He is negative for rheumatoid factor and for antinuclear antibodies and SS-A and SS-B antibodies.



What is the most likely diagnosis? 

A 35-year-old man patient was referred from his GP because of recurrent genital ulcers and uveitis; he has had four recurrences in the last year. On examination the patient also has mouth ulcers.



What is the most likely diagnosis?