Words of wisdom

 A good clinician should better listen patiently to the presenting complaints and history of the patients and then go for thorough clinical examination and  should make first a clinical and provisional diagnosis than giving him  a list of unnecessary test which at times may deviate his diagnosis and bring unnecessary financial and physical troubles to the poor patients .
                                                                                                              The patient who soever he may be are the poorest and helpless creatures and for then the treating doctor is the only help and a real  god on earth .
                 A good doctor should prescribe only the desired test only to confirm his provisional diagnosis and prescribe only the desired drugs which must be affective ,safe and economical too .
                  

Everybody is born on earth with only one motive to earn more and more money even by wrong and illegal means . It is only a real doctor who are born only to serve his patients.
 

Please don't be a commoner , a professional. Be a real doctor ,a real god on earth . It is certain that you will not be given another chance to be a doctor in your next birth,and it is more than certain that you will take nothing with you when your heart stops for ever then why to cry after excess money .

Words of wisdom.

(1) A brainy surgeon operates more by his brain than  by his hands and surgical knives .

(2) A seasoned physician treats his patients more by his words than by medicine if he has a grip not only over his diagnosis but also over the  psychology of his patients .

Spot the diagnosis

 (1)A huge and hard enlargement of  liver and spleen without sternal tenderness .
Ans Post Kalazar  syndrome .

(2) A patient with palsatile liver with ascites .
Ans Tricuspid regurgitation

(3) A firm liver suggests .
Ans Cirrhosis of liver .

(4) Hard and nodular liver suggest .
Ans Secondary carcinoma

Spot the diagnosis- 79

(1) Which tuberculous arthritis finally ends in bony- ankylosis unlike other tuberculous arthritis?
 Ans Pott's disease.

(2) Abdominal pain which radiates to the sacral region ,flank or genitalia is a signal of the possibility  of which condition ?
Ans Rupturing of abdominal aorotic aneurysm
 ( lower portion)

(3) A patient has come with a fixed mass in abdomen not descending with respiration .
Ans Retroperitonel tumour.

Spot the diagnosis -78

(1) A young lady has come with the complaints of occasional   tremors and  twitching in the right forearm muscles and in all the  fingers of right hand .          On clinical exam nothing abnormal was  detected except an irregular protuberance on right side at the junction of parietal and occipital region due to very old fracture of skull .
Ans Jacksonian epilepsy due to previous head injury.

(2) A patient has come with palpably enlarged spleen with ascites  .
Ans Cirrhosis liver

(3) A patient has come with throbbing pain in the pelvis .
Ans Pelvic abscess

Spot the diagnosis

(1) A young lady of twenty three has come for occasional shooting pain, burning sensation, pallor , blanching and numbness in both arms and fingers ( Both the thumbs are escaping). Nothing abnormal  detected in x ray of the cervical region .
Ans: Reynaud's disease

(2) Huge and soft enlargement of liver with intercostal tenderness .
Ans :Amoebic liver abscess

(3) Huge and hard liver without splenic enlargement.
Ans :Metastatic cancer of liver .

(4) Huge and hard enlargement of spleen with sternal tenderness
Ans Chronic myeloid leukemia .

(5)  Posterior vertebral protusion (Gibbus ) with local bony tenderness .
Ans: Pott's disease .

Spot the diagnosis.

(1) Froth coming out of the mouth of a young -adult- male- patient was rushed to the hospital . The patient had died before he reached the hospital. Immediately,post mortem was done and nothing abnormal was detected except his heart was found to be enlarged .
Ans - It may be a case of acute left ventricular failure

Test your clinical acumen

(1) What does it suggest - pitting oedema on pressure with brawny induration .
(2) What is the difference between phlegmasia alba dolens and phlegmasia cerulia  dolens .
(3) In which disease the epitrochlear and occipital lymph nodes are involved and palpably enlarged
(4) What are the drainage areas of Virchow's gland (left  supraclavicular lymph gland)
(5) What comes first in your mind when a lymph gland is found to be hard ,irregular and fixed to the skin