Spot Diagnosis -VII

1. A patient has been brought in surgical emergency for compound fracture of his arm with pain, fever and vomiting.The  whole limb swollen, tense & khaki coloured .
2. A single sinus over the lower jaw with sprouting granulation tissue.
3. A patient with swelling and severe tenderness was diagnosed as Sarcoma , his regional lymph gland is enlarged and tender.
4. A patient has a stationary growth for long years, recently he had noticed that the growth is increasing abruptly and has become painful.
5.A patient had a growth for many years. recently it got ulcerated and fixed to the skin.
6. A patient of sixty has come with ulcer on the penis, the margin on the ulcer is everted.
7. A patient of 40 has come with ulcer penis, the margin of the ulcer is punched out.
8. A patient is extremely ill, has abrupt proptosis & there is a boil near the tip of  the nose.
9. A patient of head injury has developed temperature 108 F . Can u diagnose the case?
10. A patient comes with pinpoint pupil, hyperpyrexia and palsy.Pinpoint the disease.
11. In head injury patient, there is a difference of 1 or 2 degree of temperature between the two halves of the body being higher on the paralysed side.What is the sign known as?

Spot diagnosis -VI

1. A patient comes with a very hard and fixed mass in his right iliac fossa with multiple sinuses and yellowish discharge.
2. A patient has mucocutaneous hemorrhage with splenic enlargement.Other findings are low platelet count, prolonged bleeding time, normal clotting time and failure of the clot to retract.
3. A patient has moderate splenic enlargement, jaundice, absence of bile from urine and its presence in the stool.
4. A patient has rectal stricture which is hard , irregular and ulcerated.
5. Dependent oedema, enlarged liver with engorged neck vain.
6. Dependent oedema enlarged & firm lever, engorged neck vain plus palpable spleen.
7. A patient was on prolonged use of corticosteroid developed mooning of face.
8. A patient has huge soft and tender liver without palpable spleen.
9. A patient has huge enlarged hard irregular liver with deep jaundice.
10. Intermittent jaundice, intermittent colic and intermittent fever. What is this triad known as? Can u pin point the stone w/o any radiological help.
11. In which disease the elephantiasis graecorum is associated?

Spot Diagnosis - V

1. Huge enlargement of spleen with sternal tenderness.
2. Enlarged Liver with intercostal tenderness.
3. A febrile patient with Palpable spleen with relative bradycardia.
4. You are sent for to see a restless patient due to  severe abdominal pain.You gave him anticholinergic even pethidine but no relief.He is changing his posture every moment to get relief but no relief. What is your provisional diagnosis?
5. A patient gets throbbing pain in head, at times epileptic fits, there is reddish marks(port wine stain) on left side of her face.
6. A patient has an ulcer whose edge is thin, undermined & looks bluish.
7.A young-boy has a superficial ulcer of face which tends to heal at centre but active in periphery.On investigation any type of fungus was not found.
8. A patient has an ulcer margin punched out, lymph gland is enlarged , firm , discreet & painless.
9. A neonate has a naevus on the small of the back.What does it indicate?
10. A patient complaining of pain, swelling & slight restriction of his knee joint movement.X ray film shows a soft tissue shadows in which flex of calcification are seen scattered throughout the area of the tumour.There is no alteration of joint outline.X ray of the chest reveals pulmonary metastasis.
11. A  lady has a black tumour on her big toe that bleeds profusely and her liver is enlarged, hard & irregular.
12. A young patient has tumour in abdomen in umbilical region which has grown into a huge firm & nodulur mass & doesn't move with respiration.Later on, he has developed edema of both limbs.

Spot Diagnosis - IV

Recreate, revise & use your discretion, its a mental exercise & and learn how to diagnose clinically a case.Improve your clinical acumen.It is better for medical student, house surgeon, PG students & junior doctors.

1. A patient has been referred with abdominal board like rigidity with obliterated liver dullness.
2. A patient 60 yrs of age has many sebaceous cyst on his scalp one of which has become ulcerated,what is the name of the tumour?
3. A patient becomes extremely ill, there is abrupt proptosis, visual impairment & occulomotor paresis.
4. A patient with greatly enlarged hard liver, who wore a glass eye for many years.
5. what is that syndrome with hypertension diabetes mellitus, osteoporosis, moon faces.
6. What is that syndrome with ascitis, plural effusion & pericardial effusion in the case of female.
7. Haematuria during every mensturation is known as ........
8. Keratoconjunctivitis, sicca, xerostomia in rheumatoid arthritis.
 9. Symmetrical enlargement of all salivary gland with narrowing of the palpibral fissure & parchment dryness of mouth.
10. A known case of Hodgekins disease has developed, enlargement of lacrymal in salivary gland with narrowing of palpibral fissure and dryness of mouth.
11. Polyarticular rheumatoid arthritis in children associated with enlargement of spleen & lymph node.
12. A febrile patient with  palpable spleen & cardiac murmurs.

Spot Diagnosis -III

1. Slightly enlarged spleen with ascites.
2. A very hard and nodular liver.
3. A pulsatile liver with ascites.
4. A diffused abdominal swelling with loss of PSOAS margin.
5. An irregular and elevated right side of diaphragm with intercoaster tenderness.
6. In a febrile patient flaccid paraplegia rapidly developed. the symptoms are localized pain in the back of chest in the midline and with percussion and palpation often with radicular radiation.
7. the sudden appearance of obscure lumbar pain in patient receiving anticoagulant.

what is the nature of the growth?
1. A patient had a hard, irregular and fixed lump. Patient says, "it reduces in size at times.".
2. A patient had a static painless lump for long years but it has developed pain recently.
3. A patient had mixed perotid tumour for long years. Very recently he has developed facial palsy of that side.
4. A patient had hard small nodules on the lateral side of his nose which has become ulcerated with beaded margin but no lymphatic enlargement.

Spot Diagnosis - II

what is your clinical diagnosis when

1.  in a febrile patient there is throbbing pain in the perineum.
2.  on straining the flow of urine increases.
3.  on straining the flow of urine decreases or stops.
4.  the serum acid phosphotase rises.
5.  the serum alkaline phosphotase rises.
6.  in which carcinoma the secondary in the bone becomes osteosclerotic.
7.  when in an adult male urine is acidic in nature, contains pus cells & sterile on ordinary cultures.
8.  a known patient of hydroneprosis has developed fever with chill.
9.  a patient has a fistula over the ramus of mandible. he gives the history of watery discharge at the times of meals.
10. a patient has a painless whitlow.
11. neurolipomatosis is associated with which disease?