Spot the Diagnosis- XXIX

(1) A young patient has come for frequency of micturation with sterile,acidic urine with pus cells.
Ans renal tuberculosis .

(2) A case of anasarca has come with hypertension and microscopic haematuria .
Ans Sub acute glomerulonephritic.

(3) What is that disease in which mortality rate is still 100%.
Ans Hydrophobea .

(4) A patient of rheumatoid arthritis has developed extreme leucopaenia .
Ans felty syndrome .

(5) A child has come he has wasting of his body muscles in spite of voracious appetite , has chronic cough , passes bulky and most offensive smelling stool .
Ans Fibrocystic disease of pancreas .

(6) A lady patient of thirty complains of a growth from umbilicus which bleeds at each menstrual cycle .
Ans endometrioma of the umbilicus .

(7) A patient has come with oral black pigmentation of lips with intestinal polyposis .
Ans peutz zigger syndrome .

(8) A patient has come for treatment of bogginess under his eyes and urine is loaded with albumin  without  pus cell .
Ans nephritis .

(9) A patient has come with a pale and puffy face , bogginess under his eyes and dryness of skin .
Ans myxoedema .

(10) A patient has come with complete ptosis .There is no history of trauma and his W.R is positive .
Ans Cerebro- spinal syphilis .

Spot the Diagnosis - XXVIII

(1) A boy has a swelling near the knee joint in tibia. All signs of inflammation are there except ingguinal lymph adeniitis ,hectic fever and chill .
Ans.Osteogenic sarcoma.

(2) A jaundiced patient has has no bile in his stool but present in the urine
Ans.Obstructive jaundice.

(3) A patient has jaundice but no bile in the urine but present in the stool .
Ans. Hemolytic jaundic.

(4)A jaundiced patient has palpable gall bladder.
Ans.Carcinoma head of pancreas.

(5) What are the other causes of palpable gall bladder with jaundice.
Ans.Double impaction ,one in the cystic duct another  in common bile duct ,chronic pancreatitis and pancreatic stone.

(6)A patient has nausea ,vomiting ,fever ,jaundice and palpable liver.
Ans.Infective hepatitis.

(7) A patient has come for huge enlargement and firm spleen upto the umbilicus with sternal tenderness.
Ans.Myeloid leukaemia.

(8) A patient of spinal injury has palsy of intrinsic muscle of his hands.
Ans.Injury  of segment eight and T1.

Spot the Diagnosis - XXVII

(1) A case of mitral stenosis has come  with unilateral gangrene of fingers in his left hand .
Ans Embolic gangrene .

(2) An emaciated lady was operated on both the breast for discharge of pus but did not heal. The discharge was watery , the sinuses were undermined with bluish margin .
Ans tubercular sinuses .

(3) A child has been brought for headache and vomiting which usually happens before breakfast.
Ans medulloblastoma of cerebellum .

(4) A patient has come with occipital headache with a tendency to radiation down the neck and dimness  of vision .
Ans. subtentorial growth.

(5) A patient has come with epileptic fits preceded by an aura.
Ans cerebral lobe tumour .

Spot the Diagnosis - XXVI

(1)..An x-ray of an oldman shows metastasis in bones .His acid phosphatase in serum is raised .
Ans .Carcinoma prostate .

(2) Presence of soft tissue shadow
in bones is a definite sign of what
disease ?
Ans.Bone sarcoma

(3) Soft tissue shadow with flecks of calcification is found in which disease ?
Ans.Malignant synovioma .

(4).In a patient after removal
of plaster in colles fracture joints stiffness , pain and vasomotor changes are seen.X-ray shows
Spotty osteoporosis affecting all bones in the region of the fracture.
Ans. Sudek osteodystrophy.

(5) In a patient of injury the flattening of the shoulder is obvious with undue prominence of acromion and there is a buldge in the deltopectoral groove.
Ans:Subcoracoid dislocation.

(6).In a case of pain abdomen the positive findings are loss of ankle jerk,sluggish pupillary reaction to light and presence of lightening pain in the legs.
Ans: Syringomyelia.

(6a) A patient has come with a rash in the body his epitrochlear and occipital group of lymph nodes are enlarge.
Ans: Secondary syphilis.

(7)A boy of 7 yrs has been brought with superficial ulcer of the face that heals in the centre but remains active in the periphery.The ulcer is spreading in nature.
Ans: Lupus vulgaris.

(8) A young and emaciated lady has come with a sinus in the neck with wide mouth like an ulcer with a thin,blue and undermined edge.
Ans: Tuberculous sinus.

(9)A neonate has been brought with a naevus in the midline on the small of back.
Ans: Spina bifida oculta.

(10) A boy has been brought with dilated, tortuous and arteriovenous anastmosing vessels on the scalp that feels like pulsating earthworms.
Ans: Cirsoid aneurysmal haemangioma.

Spot the diagnosis- XXV

(1)A patient has  come with embarrassed breathing with cynosis  .
Ans heart failure .

(2) An emaciated patient has swollen , white and tender ankle joint .He has a scar in the neck .
Ans tubercular arthritis .

(3) Prolonged fever , cardiac murmurs and clubbing of nails are present .
Ans sub acute bacterial endocarditis  .

(4) A patient of fever has  come he has angry looking margin with coated tongue .
Ans Enteric  fever .

(5) A patient of fever with relative bradycardia .
Ans Enteric fever .

(6) A patient has come with magenta coloured and slightly swollen tongue .
Ans Riboflavin defficiency .

(7) A patient has a dry brown tongue with persistent hiccough .
Ans Uraemia.

(8) A patient has come with a swelling .The swelling has pitting oedema and brawny  endurance .
Ans suppuration

(9) A patient has come with hard , red nodules present around the umbilicus .
Ans sister Joseph' s nodule .

(10) A patient of forty five has come with retention of urine with over flow his eye examination revealed Argyll Robertson pupil .
Ans Tabes dorsalis .

Spot the Diagnosis- XXIV

(1) Prolonged fever , heart murmur and splenic enlargement .
Ans sub acute bacterial endocarditis.

(2) A patient suffers from hectic fever and chill .On examination fullness , tenderness and rigidity are found on the renal angle with scoliosis .
Ans perinephric abscess .

(3) One patient of fever and chill is admitted, his one thigh is flexed .
Ans IIiac abscess .

(4) You have been sent for to attend one patient who is tossing about in bed and tries one position after another in futile search for a posture free from pain.
Ans renal stone .

(5) A patient has a peculiar aspect of helplessness , the limb lies motionless , joint being swollen , stiff and painful .
Ans acute rheumatism.

(6) A patient of severe vomiting is admitted , his neck is bent backward so that the head seems to bore with the pillow .
Ans meningitis .

(7) A patient looks in the erect posture , foreword stoop, the stiff neck, tremors and fingers flexed at the metacarpophalangeal joint .
Ans paralysis agitans

(8) A child of ten has come with cough , fever and dyspnea.There is herpes labilis on his upper lip .
Ans pneumonia .

(9) A patient has coloured cheeks which has a bluish tinge .
Ans Conjestive heart failure .

(10) One patient has come his one side of the face is wrinkled another side is smooth .
Ans unilateral facial palsy .

Spot the diagnosis - XXIII

(1) A lady with pain vomiting and fever has come with tenderness on the
eighth right costal cartilage.
Ans.cholecystitis.

 ( 2) What are the causes of wasting in surgical cases.
Ans .obstruction in C.B.D.,pyloric obstruction and carcinoma.

(3)What are the organs of which carcinoma,weight loss is a very late feature ?
Ans ca stomach,colon,and penis.

(3a) A patient of fifty years has come with the complaint of alternate constipation and diarrhoea.
Ans. ca. colon.

(4)Eccymosis appearing a few days after an injury.
 Ans.Fracture or dislocation .

(5) What are the conditions in injury where crepitus is found besides fracture .
Ans Hematoma, Gas gangrene , Tenosynobitis , Osteoarthaitis and Charcot's joint .

(6) What are the carcinoma which metastise in bones .
Ans Carcinoma thyroid , Bronchus , Breast , Kidney and Prostate .

(7) In painless progressive jaundice discomfort is felt sometimes in recumbency and relieved in upright posture .
Ans Pain due to distension of pancreatic duct .

(8) Absence of tenderness and rigidity in presence of continuous diffuse abdominal pain in presence of valvular heart disease .
Ans Mesentric thrombosis .

(9) A fat female of forty , a case of cholelithiasis  has come in the emergency with small intestinal obstruction .
Ans Gall stone ileus .

(10) Abdominal pain radiation to the sacral region , flank and genitalia .
Ans possibility of rupturing aortic aneurysm .

Spot the Diagnosis - XXII

(1) A patient has come with profuse , painless and paroxysmal haematuria .On pyelography there is filling defect on renal pelvis .
Ans. papilloma of renal pelvis .

(2) A patient has dull ache pain in renal angle with haematuria .
Ans renal calculi.

(3) A young and emaciated man complains of vague pain with frequency day and night .On cystoscopy red , swollen and ulcerated uretric orifice is seen with a few tubercles .
Ans tuberculosis of kidney .

(4) Sister Joseph ' s nodules are found in what  disease ? .
Ans carcinoma stomach and breast .

(5) A patient has come with severe suprapubic and flank pain which radiates to penis , scrotum and inner aspect of upper thigh .Where is the stone ?
Ans intravesicular portion of  ureter .

(6) A patient has come with pain in the costovertbral angle .Where is the stone ?
Ans uretropelvic junction .

(7) A patient has come with flank pain which radiates to the corresponding side of abdomen.Where is the stone ?
Ans In the middle portion of ureter.

(8) A patient has come with dull suprapubic pain associated with distended urinary bladder .
Ans stone in urinary bladder .

(9) Where is the stone in a patient having intermittent colic, intermittent fever , intermittent jaundice .
Ans stone in common bile duct .

(10) What is your diagnosis in a patient having painless , progressive and deepening jaundice .
Ans carcinoma head of pancreas or pancreatic calculus .

Spot the Diagnosis - XXI

(1) In an x-ray the end of the bone is expanded into a cavity lined by a thin shell of bone traversed by bony trabeculae giving a soap bubble appearance .
Ans.Osteoclastoma.

(2)A patient has come with an x- ray of his joint with soft tissue shadow.
Ans.sarcoma of bone

(3)In an x- ray multiple punched out areas of destruction of pea size are there .
Ans.Multiple myloma.

(4) A patient  has come with secondaries in bones which are sclerosed.
Ans .primary carcinoma prostate.

(5) An old lady of seventy five who as a result of very trivial injury falls on the ground and cannot get up .
Ans  Fracture femoral neck .

(6) In an emaciated patient the abdomen is doughy with fluctuating abdominal pain.
Ans kock ' s abdomen .

(7) A young lady has come for a swelling under tongue which is bluish to look at and brilliantly translucent .
Ans Ranula

(8) One patient has come with a cyctic swelling in floor of the mouth which is central and opaque .
Ans sub lingual dermoid cyst .

(9) A patient has come with a swelling which is brilliantly translucent there is a another swelling in the neck and there is a cross fluctuation between the two swelling .
Ans deep plunging ranula .

(10) An adult male comes with a lump in abdomen which is painless and there is painless haematuria .On x ray chest there is canon ball appearance .
Ans hypernephroma .

Spot the Diagnosis -XX

(1)A man has a swelling on his back .The swelling is variable in consistency somewhere hard somewhere soft .
Ans .Malignant .

(2) A man of sixty has urinary retention on pressure the flow  urine decreases or stops and sometimes he defaecates .
Ans enlarged prostate

(3) A man of forty five has urinary trouble. On pressure the flow of urine is slightly improved . On ultrasound his prostate , kidney urieter and urinary bladder are normal .
Ans stricture of ureathra .

(4) A child of ten has lower abdominal pain of spasmodic nature .during micturation his flow of urine suddenly stops but with change of posture his flow improves again .
Ans bladder stone .

(5) A boy of five has come with painless and gross enlargement of kidney without haematuria.
Ans wilms tumour .

(6) A man of forty has reported for by bi-lateral renal swelling but the affection of left kidney is more advanced .
Ans polycystic kidney .

(7) A patient has come with swelling in the Ioin .he gives the history that immediately after passing a large amount of urine the swelling diminishes .
Ans intermittent hydronephrosis .

(8) A child has been brought for screaming pain during micturation and pulling by prepuce during micturation .
Ans stone in urinary bladder .

(9) What is the segment of cervical spinal cord above which any injury becomes fatal .
Ans Fifth cervical .

(10) A patient of injury lies helplessly with arm abducted , forearm flexed and hand supinated .
Ans fifth cervical spine .

Spot the diagnosis - XIX

(1) A patient with chest injury has  unduly resonant chest  .
Ans pneumothorax

(2) A patient of road accident has reported with silent heart .
Ans Haemopericardium .

(3) A patient of injury was admitted his apex beat is displaced to the right .
Ans Haemothorax .

(4) A patient has obliterated cardiac dullness and liver dullness he gives the history of chronic bronchitis .
Ans Emphysema .

(5) A patient has obliterated liver dullness with board like abdominal rigidity .
Ans Gastric perforation .

(6) A patient has fever and chill on examination there is enlarged and smooth liver with inter costal tenderness .
Ans amoebic liver abscess .

(7) A patient has been admitted with a hard lump in right illiac  fossa .He gives the history that about a month ago he had hectic fever , chill and severe pain in right illiac fossa for which he was treated with strong antibiotics .
Ans antibioma .

(8) A hypertensive patient has reported for nocturnal dyspnea with basal crepts both side of his lung .
Ans acute left ventricular failure .

(9) In an x ray there is a cyst in the metaphysis of the bone the cyst wall is sclerosed .
Ans Brodie's abscess.

(10) In another x ray there is a cyst but the wall of the cyst is not sclerosed .
Ans bone cyst .

Spot the Diagnosis- XVIII

(1) A. .Shepherd has reported in O.P.D. for urticaria and eosinophilia .
On  examination there is a spherical cystic swelling is found
on the lower part of his liver.
Ans.Hydatid cyst.

(2) A patient has come with a hard and irregular liver .He is wearing a glass eye.
Ans..Malignant melanoma.

(3)Special axial view of x-ray is taken
In fracture of which bone ?
Ans.Oscalcis.

(4) Oblique view is taken in fracture of which bone ?
Which bones are there in which fracture lines are located by stereoscopic view.
Ans..skull and pelvis.

(5) In an x-ray a bone cyst like appearance is present  with the
only difference that the cystic wall is sclerosed .
Ans. Brodie's abscess.
                          

Spot the Diagnosis- XVII

(1) A lady gives the history of missed periods .She is in Profound shock,pallor and lower abdominal pain.
Ans.RupturedEctopic gestation .

(2) An adult male was admitted
With pallor tachycardia land sock .On examination there was a soft and pulsatile lump above the umbilicus.The patient died at night.
Ans.Leaking abdominal aneurysm.

(3) A man of forty was. brought to emergency for acute agonising pain abdomen at epigastrium with shock and vomiting.There is a black hue around his umbilicus and ecchymosis in his loin
Ans acute pancreatitis

(4) A patient of motorcycle accident has been brought to emergency .He is unable to raise his one leg but can move his foot .
Ans fracture neck of femur .

(5) Another patient of accident was brought to emergency . He is unable to raise his both legs .
Ans spinal injury .

(6) One patient of severe injury was brought with palsy of both the arms and both the feet .
Ans Cervical injury .

(7) A known case of valvular heart disease is seized with acute abdominal pain copious vomiting
 , haemetemesis associated with tender and rigid abdomen .
Ans mesentric vascular thrombosis .

(8) Two days after an abdominal operation the gas did not pass and the abdomen is silent .
Ans paralytic illeus .

(9)  A lady of forty is seized with sudden and severe pain in lower abdomen with vomiting and collapse and at the same time a tense , tender and cystic swelling is discovered moving in the lower part of the abdomen .
Ans twisted ovarian cyst .

(10) Oedema without proteinuria with palpable liver .
Ans liver disease.                      

 (11) Slight to moderate proteinuria is the rule in patient of which disease ? .
Ans heart failure

Spot the Diagnosis -XVI

(1)A lady has reported for severe burning pain , pins and needles in the hand on fingers with wasting of thenar eminence.
Ans carpal tunnel syndrome .

(2) A patient has deformity of wrist drop .He is  unable to extend the wrist ,thumb and metacarpophalangeal joint of fingers .Some days ago the patient had gone for cholecystectomy operation under G.A
Ans radial nerve palsy

(3) A man has come with gangrene of fingers .His heart is normal .
Ans cervical rib .

(4) A lady has come with superficial gangrene of her fingers' tips of all the fingers of both the hands excluding both the thumbs .
Ans Reynaud' s disease .

(5) A lady has come with gangrene of fingers of her left hand only .She is a chronic case of valvular heart disease .
Ans embolic gangrene .

(6) A male patient of forty has an ulcer on the tibia bone , the margin is punched out, the lymph node are not involved .
Ans syphilitic ulcer .

(7) An emaciated and ill patient
complains of ulcers on his tongue , the margin is thin , undermined and looks bluish .
Ans tuberculous ulcer .

Spot the Diagnosis- XV

(1)Silent abdomen with gas under. Diaphragm

 Ans.perforation.

(2) Palpable  and tender liver with tender left illiac fossa

Ans.Amoebic hepatitis and colitis.

(3)Sudden increase in size associated with pain in the goiter.

Ans..Haemorrage in the goiter.

(4) What is the cyst known as when small swelling near the hyoid bone lying exactly on the midline and moves upwards with the protrusion of the tounge .

Ans.Thyroglosssl cyst.

(5) A fistula is present on the midline just below the hyoid bone.The opening of the fistula is
indrown and overlaid by a crecentric fold of skin.

Ans. Thyroglossal fistula.

(6) what is that syndrome when there is pseuptosis, enopthalamous, and myosis.

Ans. Horner's syndrome.

(7) A lady has come with a fracture in the upper part of humerus bone her thyroid gland feels stone hard

 Ans pathological fracture due to carcinoma thyroid.

(8) A lady of fifty has reported for thyroid swelling which is rubbery
To feel and there is  hepatosplenomegaly.

Ans..  Hashmoto's disease.

(9) A lady patient complains of dyspnea on lying on left side only .On inspection on
the upper part of her chest  there Is engorged veins.

Ans - Retrosternal goitre

Spot the Diagnosis XIV

(1)Epigastric mass with pulsation from left to right .

 Ans. Pyloric stenosis.

(2)A hard enlarged and nodular liver .

Ans..secondary liver.

(3) A patient of chronic peptic ulcer has reported for severe pain but suddenly his pain vanished.on examination his liver dullness is gone.

Ans.perforation of peptic ulcer.

(4) A pulsatile liver with Ascites .

Ans. tricuspid. Incompetence.

(5) A firm liver with ascites.

And.portal hypertension.

(6) A soft liver with ascites.

Ans.extahepatic obstruction.

(7) Dilated loop  of intestine with fluid level in x-ray. Plate.

Ans. Intestinal obstruction .

(8) Diffuse abdominal hazziness and loss.of psoas margin.

Ans. Ascites.

(9) A patient with fever and chill with elevated and irregular diaphragm.

Ans. Liver abscess.

Spot the Diagnosis - XIII

(1) A patient developed agonising pain in left hand and the hand became white and blue ,there is no pulse but tenderness on the course of radial artery .on examination there is cardiac murmurs.

Ans- embolic gangrene

(2) One patient reported to a renowned clinician for hectic fever chill perspiration and tachycardia ,the clinician was sure that there is some abscess somewhere in his body but after a thorough search he failed to find any .

Ans sub - phrenic abscess

 (3) In elderly male aged about seventy had retension of urine now he developed fracture  of femoral neck .
Ans primary carcinoma prostate with secondary  in femoral neck .

(4) A chronic patient of amoebic liver abscess now developed severe headache , vomiting and went in coma

Ans metastatic amoebic abscess in the brain .

4..A child has reported for evening rise of temperature , night sweats and anorexia with a limping gait.

Ans T.B  hip joint .

(5)An x ray  plate was shown to you in which there is rarification in the babecock' s triangle . T.B hip joint

(6)  Veinous flow away from umbilicus .

Ans portal hypertension .

(7) epigastric mass with peristaltic movement left to right .

Ans pyloric obstruction

(8) An enlarged , hard , and nodular liver in right hypochondrium .

Ans secondary liver .

(9) A patient of chronic peptic ulcer has reported for severe and agonising pain but now his pain has vanished and  on examination his liver dullness is gone .

Ans perforation of peptic ulcer .

Spot the Diagnosis- XII

1)A young lady has come with the complaints of profuse sweating and triad of locals i.e. (a) local asphyxia ( b) local syncope (c) local gangrene of tips of all the fingers of her hands except both the thumbs,both the radial pulse is normal.

Ans Reynaud's  disease .

2) A patient has come  with generalised lymphadennopathy with splenic enlargment . The liver is not enlarged.

Ans lymphatic leukaemia.

(3)A lady has come with enlarged axillary lymph node which  is hard irregular and fixed .A hard lump is also found in  breast .

Ans carcinoma Brest with secondries   in the axillary lymph node.

 (4) What fracture  is there  when there is oedema and tenderness in the anatomical snuff box and what type of radiological view should be done to  visualise this fracture .

Ans fracture of scaphoid bone .oblique view is essential to visualise this fracture .

(5) A chain smoker has come with dry gangrene of his big toe .

Ans burger' s disease .

(6) An emaciated man has pain and tenderness over thoracic spine .

Ans- pott's disease .

(7) An old man has urinary retention with pain in the sacro- illiac spine

Ans carcinoma prostate .

(8) One patient has come in the emergency with injury near elbow he has shortening in length of the arm

.Ans supracondylar fracture .

(9) Another patient has come with injury near elbow he has shortening in length of his forearm .

Ans  posterior dislocation of elbow .

(10) A player has pain on the front of the lateral epicondyle of humerus bone.

Ans tenis elbow .

(11) A player complains of pain on the medial condyle of humerous bone .

Ans golfer' s elbow .

Spot The Diagnosis - XI

: 1) A patient complains of dyspnea on walking a very short distance . Spot the diagnosis -

Ans mitral stenosis

2) A patient with hectic fever ; chill and leucocytosis comes to a clinician and he thought there is pus somewhere but he failed to find pus anywhere . Spot the diagnosis ?

- Ans subphrenic abscess  (pus somewhere pus nowhere pus under diaphragm ).

3)A patient has mixed parotid tumour for long years . Now he has developed facial palsy . Spot the diagnosis ?

 Ans malignant transformation

4) A patient has a big lipoma on his back . Now he has develop pain in the tumour .

Ans sarcomatous  changes.

5)  A patient had a desmoid tumour,he was operated for this but. Tumour appeared after some months..

Ans malignant(recurrence is the rule in malignancy)

6) A lady complains of pain in the nail.on examination there is a small. Pin head  bluish spot beneath the nail local pressure gives excruciating pain.

Ans glomus tumour

7) A patient has swelling on the middle finger of his right hand .He had a history of pin prick .

Ans implantation dermoid cyst

8) A young lady has a port wine stain on her cheek & there is a history of fits.

Ans  sturge-weber syndrome

9)A young lady has an irregular ,firm elevation of the skin with finger like processes on the upper part of the sternum .

Ans keloid

10) A patient has a soft sponge swelling of his left arm with varicose veins and hemangiomas under the skin . Localised bruits are heard over the swelling .

Ans congenital arterio -venous fistulae

Spot the diagnosis -X

1)


2) A patient with hectic fever, chill and leucocytosis complains of pain and tenderness in right hypochondrium

 .-Ans- empyema gall bladder.

3) A patient has come with enlargered  soft and tender liver with inter costal tenderness .

- Ans - amoebic liver  abscess .

4) A patient of 30 has come with generalised lymph adenopathy with hepatosplenomegaly with pel- abstain fever .

- Ans hodgekin's disease

5) complete absence of protein in urine in cases of oedema points out to which organ to be looked for?

 - Ans liver

6) The presence of protein in the urine of  a pateint who has not a palpable liver in cases of oedema points out to which disease ?

- Ans nephrotic syndrome . 

7) A patient has come with red tip of his nose ; on auscultation there is mid - diastolic murmur .

- Ans -mitral stenosis .

8) A hypertensive person feels suffocated in cinema hall . Can you spot the diagnosis ?

Ans:-  acute left ventricular failure

9) A patient is found to sit near the open window most of the time in the night. Spot the diagnosis?

Ans- acute left ventricular failure.