Test your clinical acumen -12

(1) In a big hospital one laprotomy was done on a patient of obstruction by a reputed surgeon. When the stomach was opened the stomach was filled with a ball of hair which was causing obstruction . Can you say what is the name of this condition ?

(2) After some years in the same hospital one laprotomy was done by the same surgeon where after opening the stomach it was filled by fibres and skin of the vegetables and plants it was also a case of pyloric obstruction . Can you name this condition ?

Test your clinical acumen
(1) A patient has come with familial and congenital deformity of both the ears , micrognithia , high palate and his upper lip is enlarged. His palpebral fissures slope downwards and outwards and both his lower eyelids are devoid of eyelashes . What is this syndrome known as ?

Words of wisdom
(1) A defeated man should never feel dejected and dismayed because he has been occasioned to learn his defects and weaknesses , instead he should get an impetus to improve himself a lot . The next time he is bound to succeed like success

Words of wisdom

 Sorrow is the essential part of life like happiness .
It is bound to come and go . It must not affect your work because work is the only remedy of it .
It is the work alone which can digest every sorrow and depression.

Words of wisdom

(1) Opportunities do not always come to knock at your door but it is flying in the air . Keep on vigorous & round-the-clock vigil, be vigilant & vibrant and recognise them in time and then jump and fly to catch them . It comes only by your endeavours, efforts , fore-sightedness and  wisdom and never by your fate . There is nothing like fate for the brave , they make their own fate by themselves.

(2) Words of the patients are very very precious you should have only patience to listen to and to correlate them with your clinical findings . There is a seldom need for elaborate investigations .

Test your clinical acumen -11

(1) A lady patient of twenty years  came with the complaints of pain in her left breast she gives the history of ulcer breast that side which has healed completely . On examination of the breast everything is okay with the breast. On auscultation of her heart there is accentuation of first heart sound with mid diastolic murmur . On interrogation she gives the history of palpitation and repeated epistaxis .

(2) A lady of thirty has come S.O.P.D with punched out and painless ulcer on the upper lip .

(3) A young boy has come with an ulcer . The margin of the ulcer is undermined and the ulcer is painful .

(4) A lady patient of fifty has come with an ulcer just below the left maxillary prominence whose margin is raised and beaded

(5) A patient of sixty has come with an ulcer on the lower lip whose margin is raised and everted

(6) A lady patient has come with an ulcer on her burn scar which is Present for months together and seems to be static the margin  of the ulcer is raised and everted

Words of wisdom.

Even a lion gets tired.
Learn to take rest during your continued and prolonged work from your heart who works and works round the clock for the whole life but never feels tired because it takes rest only for a fraction -of -a-second during every cardiac cycle.

Words of wisdom

Opportunity knocks
 at every door
But only for once
Very seldom twice
But never thrice,
If it knocks thrice
Then it is no opportunity.

Test your clinical acumen -10

1)A patient of accident has just been brought in the emergency. He has tachycardia, pyrexia and neck rigidity.
2) A patient of accident has been brought in the emergency. He has tachycardia, neck rigidity but no pyrexia.
3) A patient is admitted in the ward.He has pyrexia headache, vomiting and neck rigidity.
4) A patient of severe headache, vomiting and pyrexia became unconscious but there is no neck rigidity.

Words of wisdom

Never indulge in bad company and never be tempted too much

To earn more and more money by bad and wrong means and deeds or your life span will be shortened like anything and you may suffer from thousand and one diseases arising due to tension. You may lose your peace of mind,sleep, appetite and satisfaction of life. You may forget all pleasures of life.
When it is more than certain that you have nothing to take with you when you leave this world.

Mind you greed has no end.

Better live like an ordinary man.

Be simple,sober, sincere and sympathetic to the poor.

Be kind, truthful, honest and economical and enjoy the pleasure of life around you till you are alive.

Words of Wisdom

(1) Many moments, Minor mistakes
      Make major misfortunes.                     

(2) Sometimes a fraction -of- a- second - delay in the beginning ends in a great defeat in life .
P.T Usha ( India) lost Olympic race only by a fraction -of -a -second .

(3) Bravo ,
run faster
to catch time
Only because
Time does not walk
But it runs .

(4) Think better for others and god is bound to do better for you .

Test your clinical acumen -9

(1) A patient has come with swelling and tenderness of the anatomical snuff box . What is your spot diagnosis .

(2) Sadle shaped area of hyperaesthecia and later anaesthecia of buttucks ,anus and perineum is the most definite sign of what tumour ?

(3) A patient has come in S.O.P.D
with painless whitlow . What do you think of ?

(4)Which radiological view is essential to visualise the fracture of scaphoid bone .

(5) A patient has come with loss of terminal portion of many fingers of both hands . What disease you think of ?

Test your Clinical Acumen -8

(1)A patient of hiccough is there in the medical ward he has smell of ammonia in his breath

(2) You have been shown an x-ray in which there is sunrays appearance and codman's triangle.

(3) You have been shown an x-ray chest P.A view of a patient of chronic bronchitis of an old man in which there is a coin like opacity in the left apex .

(4) There is a sinus on the tibia and the skin of the sinus is adhered to the bone

(5) You have been shown an x-ray. There is a cyst like cavity in the metaphysis of the bone the margin of the cavity is densely sclerosed .

Test your Clinical Acumen -7

1) You have been shown an X-ray of hip joint. There is haziness in the Babecocks triangle.what is your diagnosis?

2)You have been shown an X-ray of tibia of a boy of twelve years.There is rarefication of bone with subperiosteal deposits of bone longitudinally likened an onion.

3)what is the disease where there is neurolipomatosis?

4) what is proud flesh and what does it indicate?

5) A patient has  a swelling on the back likened an abscess but the swelling is not tender and the periphery feels wooden. Local temperature is doubtful.

Test your clinical acumen -6

1) A lady patient of  twenty seven came with complaints of pain in her left breast. She gives the history of ulcer breast some months ago.On examination of the breast every thing is okay. On auscultation of her heart accentuation of first heart sound with diastolic murmur. On enquiry she gives the history of palpitation and repeated epistaxis.
2) A lady patient of thirty has come with punched out and painless ulcer on the upper lip.
3) A child of fifteen has come with a painful ulcer margin of which is undermined.
4) A lady patient of fifty has an ulcer on lower lip whose margin is raised and everted.
5) A patient has ulcer on the left maxillary prominence whose margin is raised and beaded.

Test your clinical acumen-5

(1) A patient of forty has a lump in abdomen . The consistency of the lump is variable .
(2) A patient has a swelling which Pitts on pressure associated with brawny induration  .
(3) What is the test known as when a small, solid swelling feels firmer at the centre than the periphery and a small cystic swelling feels softer at the centre than in the periphery .
(4) A patient has multiple painful lipoma . What is this condition known as and which disease is associated with it ?
(5) A patient has multiple neurofibroma with patchy pigmentation of skin . What is this condition known as?

Test your clinical acumen -4

1) A patient has come with bagginess under eyes,dryness of skin and hoarseness of voice.
2) A patient has come with bagginess under eyes, frequency and disurea.
3) A patient has come with anasarca. He has raised blood pressure and microscopical haematuria.
4) In children cellulitis occurring near a joint signifies what disease?
5) A patient having cellulitis has developed throbbing pain. What does it indicate?
6) A patient has come with parotitis.,there is brawny  induration but no fluctuations.
7) A patient of pyemic abscess is having rigor and profound sweating. Now he has developed severe headache, vomiting and became comatosed.
8) A hard,painless lump  was present in the breast of a female aged forty years. Now pain has developed on the painless growth.

Test your clinical acumen-3

1) The tumour has become fixed and irregular involving the skin and neighbouring tissue.
2) A patient of old parotid tumour has come with facial nerve palsy.
3) A patient has come with a tumour with variable in consistency.
4) A patient has come with a tumour. He gives history that the size of the tumour reduces in size at times.
5) A patient has a swelling beside the sternum which is hard and yielding in nature.
6) A patient has come with a swelling in the breast . She has a stony hard gland in the axilla.
7) A patient has enlarged lymph gland in the neck. He has evening rise of temperature.
8) A patient has come with a bulldog jaw,heavy features and spade like fingers.

Test your clinical acumen -2

1) Pitting on pressure associated with browny induration.
2) which are the swellings which are translucent.
3) A patient was diagnosed sarcoma but his regional lymph nodes are enlarged and tender.
4) A patient was diagnosed sarcoma but he has hectic fever and leucocytosis.
5) A patient has come with a swelling with fixity, local heat, indefined margin and raised body temperature. His biopsy report goes in favour of malignancy. Do you think the report is correct?
6) A patient has come with a static and painless growth.Now pain has developed in the painless and static growth.
7) The size of the growth has increased very recently in a long static growth.
8) Local rise of temperature and presence of subcutaneous veins over the long static growth.