Spot the diagnosis 361- 364

(361) A patient of twenty has come with dyspnoea . He has a spleenohepatomagly with generalised lymph-adenopathy .

(362) A patient of forty five has come . His left supraclavicular (virchow's) lymph node is enlarged which is hard and irregular . On examination nothing abnormal was detected except one testes was found to be enlarged and hard.

(363) A patient of eighteen has reported in the emergency for dysphagia . On examination there is spleenohepatomagly and generalised lymphadenopathy . Spot the diagnosis?

(364) A patient of twenty with a big and firm mass fixed to the deeper structure . The skin over the lump is tensed ,glossy and dilated veins under the skin . Spot the diagnosis?

Answers
(361) Hodgekin's disease . The dyspnoea is due to pressure over the bronchus by the enlarged lymph nodes.
(362) Carcinoma testes .
(363) Hodgekin's disease dysphagia is due pressure over the oesophagus by the enlarged lymph node.
(364) Lymphosarcoma .

Spot the Diagnosis 357-360

(357) A patient previously diagnosed as cirrhosis liver has come with neuropyschiatric symptoms . On examination of the eyes there is Keyser fleischure brown ring in the periphery of cornea . Spot the diagnosis?

(358) A patient of forty has come. He has bilateral epiprochlear lymph -gland enlargement and an enlargement of the lymph- gland in the occipital triangle.

(359) A patient of forty has come with a lymph node enlargement . The gland is tensed ,glossy and there is dilated veins over the gland .  Spot the diagnosis?
(360) A patient has come with a hard ,irregular and fixed lymph node in the neck when he is told to protude tongue ,the tip of the tongue points toward the affected side .

Answers.
(357) Wilson's disease (heptolenticular degeneration )
(358) Syphilitic glands .
(359) Lymphosarcoma.
(360)Carcinoma nasopharynx .

Spot the diagnosis 353 - 356

(353) A patient has come with a pinhead bluish spot beneath the nail of the right big toe . It is very painful and local pressure gives excruciating pain . Spot the diagnosis?

(354)  A male patient has come with a cystic swelling of the right breast which is brilliantly translucent . Spot the diagnosis?

(355) A man of thirty has come with a deep ulcer which has eroded all the tissue even the bones . He gives the history of a brown and firm  nodule previously near the outer canthus of the  left eye. Then the ulcer began . Spot the diagnosis?

(356) An alcoholic patient has come  with spider naevi on the chest and abdomen and his spleen is palpable . Spot the diagnosis?

Answers.
(353) Glomus tumour . It consists of thickened arterio -venous communication associated with large epitheloid cells known as glomus cell.
(354) Hydrocoele of the breast.
(355) Rodent ulcer.
(356) Cirrhosis of liver.

Spot the Diagnosis 349- 352

(349) A patient of rheumatoid arthritis has come . He has leucopaenia ,palpable spleen and ulcer of the leg . Spot the diagnosis?

(350) A cynosed infant was born. When he cries the cynosis deepens .

(351) An infant of seven years squats on heels  ,there is clubbing of fingers and toes and there is breathlessness on exertion has come . Spot the diagnosis?

(352) A neomate has been born . There is constant frothy saliva coming out of his nose and mouth. Spot the diagnosis?

Answers.
O(349) Felty's syndrome.
(350) Fallot's tetralogy .
(351) Fallot's tetralogy .
(352) Congenital atresia of oesophagus .

Spot the Diagnosis 345- 348

(345) A patient has come with a non-pulsating cyst in the burn space of neck . Spot the diagnosis?

(346) A baby was brought with a swelling in the neck with a faint bluish hue . The cyst is not translucent and there is a sign of emptying . Spot the diagnosis?

(347) A boy of six has been brought by his parents . The boy has a unilateral purulent discharge . Spot the diagnosis?
(348) A man of sixty has come . He has thickening and irregularity of nasal skin of about two third of nasal skin.

Answers.
(345) Dermoid cyst .
(346) Cavernous haemangioma of the neck.
(347) Foreign body in the nasal discharge.
(348) Rhinophyma .

Spot the Diagnosis 341- 344

(341) A patient of pale and puffy face has come . He has worn woolen clothes in the month of summer and his voice is hoarse . Spot the diagnosis?

(342) A lady has come to a gynaecologist with a cystic swelling on the right lower portion of vagina . The gynaecologist operated on the patient taking to be a case of bartholin cyst . The cyst contains pultaceous  cheesy material. Spot the diagnosis?

(343) A patient of anasarca has come. He has raised blood pressure and microscopic haematuria  . Spot the diagnosis?

(344) A patient has come with splenic enlargement to the umbilicus and hard to feel . There is sternal tenderness . Spot the diagnosis?

Answers.
(341) Myxoedema .
(342) Sebaceous cyst.
(343) Subacute glomerulo-nephritis.
(344) Chronic myeloid leukaemia .

Spot the Diagnosis 337 -340

(337) A patient has come with exuberant granulation tissue (proud flesh) around a sinus near the lower end of tibia . Spot the diagnosis?

(338) A patient of sixty has come. He has bagginess under the eyes and complains of frequency of urine and dysuria .

(339) A lady of fifty has come with bagginess under the eyes,dryness of skin and hoarseness of voice . Spot the diagnosis?

(340) A patient has come . He has plumb - colour skin and same coloration of tongue and mucus membrane of mouth .

Answers.
(337) Osteomylitis of tibia or foreign body inside.
(338) Nephritis .
(339) Myxoedema.
(340) Polycythemia rubra vera .

Spot the Diagnosis 334-336

(334)  One lady patient of thirty five has come . She has Jacksonians type of fits in her right upper extremity only . Spot the diagnosis?

(335) A patient came he had Jacksonians types of fits. The fits were bilateral . Spot the diagnosis?

(336) A patient of fifty was admitted in the ward with very severe pain in the epigastrium with shock and cynosis morphine was given but no relief. Spot the diagnosis?

Answers
(334) Middle meningeal haemorrhage .
(335) Haemorrhage in superior longitudinal sinus  .
(336) Acute pancreatitis.

Spot the Diagnosis 330- 333

(330) A lady of fair skin ,warm and moist hand has come . She complains of loss of weight and lassitude . On examination of her pulse,the pulse rate is found to be high . Spot the diagnosis?

(331) A patient if prolonged fever has come . He has spleenomegaly and valvular heart disease . Spot the diagnosis?

(332) An unconscious patient of .accident was seen . There  was pyrexia ,neck rigidity and rapid pulse . Spot the diagnosis?

(333) A patient of accident was seen . He has rigidity of neck and fast pulse but no pyrexia . Spot the diagnosis?

Answers.
(330) Hyperthyroidism .
(331) Subacute bacterial endocarditis .
(332) Sub arachnoid hemorrhage.
(333) Fracture dislocation of cervical vertebra .

Spot the Diagnosis 326-329

(326) A patient of sixty has come. He has a big, hard swelling of the right palate and  right side nasal block . Spot the diagnosis?

(327) A lady patient of thirty five has come with a cystic swelling in the upper neck between the upper third of sternomastoid muscle and ramus of mandible . Spot the diagnosis?

(328) A patient of fifty has come. He has a hard lump in the neck and a cotton pad in the ear . Spot the diagnosis?

(329) A patient of sixty five has come with hard and irregular lymph node in the neck with the involvement of third,fourth,ophthalmic division of fifth and sixth cranial nerves . Spot the diagnosis?

Answers.
(326) Carcinoma arising from the right maxillary antrum which is lined by epithelial cells .
(327) Branchial cyst .
(328) Carcinoma of the deep pharynx .
(329) Advance carcinoma of the nasopharynx .

Spot the Diagnosis 322-325

(322) A patient complains of pain , profuse perspiration and hypersthesia in one side of face , When he eats lemon, spicy curry even chocolates . Spot the diagnosis?

(323) A boy has come in S.O.P.D with a big cystic swelling in the neck . On examination it is brilliantly translucent . Spot the diagnosis?

(324) A child has been brought ,he has cellular cellulitis . There is no abraison in the vicinity ,there is no edge , no fluctuation and no puss . Spot the diagnosis?

(325) A patient has come with cellulitis over the bursa of the hallux vulgus . There is small ulcer in the middle of the inflamed  skin.

Answers.
(322) Frey's syndrome (auricular temporal syndrome).
(323) Cystic hygroma.
(324) Osteomylitics .
(325) Bunion .

Spot the Diagnosis 318-321

(318) A patient has a cyst in the floor of mouth which is opaque in nature. Spot the diagnosis?

(319) Which dermoid cyst in the body contains no hair . Spot the diagnosis?

(320) Which cystic swelling in the mid-line of the floor of mouth is brilliantly translucent .

(321) A lady patient has come with a discharging sinus exactly on the mid-line  of the mandible . Spot the diagnosis?

Answers.
(318) Dermoid cyst.
(319) Sublingual dermoid cyst.
(320) Ranula .
(321) Medial mental sinus due to periodontal abscess ,wrongly diagnosed as a infected sebaceous cyst.

spot the diagnosis 314-317

(314) A patient has come with swelling and tenderness in the anatomical snuff - box . You want to prescribe an x-ray to see the fracture of scaphoid bone ,which view of x-ray you think to visualise  the fracture of scaphoid .

(315) A patient has come with wadling gait . Spot the diagnosis?

(316) A patient has come with fullness in the hallow of the palm extending to the forearm . On examination there is cross fluctuation . Spot the diagnosis?

(317) An adult male has come in the S.O.P.D for the gangrene of his little toe of one feet . The patient gives the history that it started as linear groove in the skin at the root of the little toe . Spot the diagnosis?

Answers.
(314) Oblique view .
(315) Bilateral congenital dislocation and bilateral coxa vara.
(316) Compound palmer ganglion. It is tuberculous in nature  . It contains glairy fluid in which melon seed bodies are found .
(317)Ainhum .

Spot the diagnosis 310-313

(310) A patient of forty has come with left supraclavicular enlarged and firm lymph node. Spot the diagnosis?

(311) An adult male has a chronic ulcer on the old burn scar . The margin of the ulcer is raised and everted .

(312) A patient of compound fracture has come with x-ray plate (negative film). There are dark round spots in the x-ray . Spot the diagnosis?

(313) A patient of suspected fracture of os calcis has come. Which x-ray view is essential to detect the line of fracture .

Answers.
(310) Carcinoma stomach. The gland is known as virchow's gland .
(311) Marjolin ulcer .(it is just like epithelioma only the spread or metastasis is very late due to fibrosis all around )
(312) Gas gangrene .
(313) Special axial radiograph.

Spot the Diagnosis 306-309

(306) A patient of fifty has come with stony hard and nodular liver. Spot the diagnosis?

(307) A lady patient of thirty has come with a lump on the epigastrium . The lump is less mobile and more tender . spot the diagnosis?

(308) An adult male has come with a lump in the epigastrium. The lump is firm ,irregular and tender . Spot the diagnosis?

(309) A patient of forty five has come with lightning pain in the limbs . On examination there is loss of ankle jerk and sluggish pupillary reaction to light . Spot the diagnosis?

Answers.
(306) Secondary carcinoma liver.
(307) Leaking peptic ulcer.
(308) Carcinoma stomach.
(309) Tabes dorsalis .

Spot the diagnosis 302- 305

(302) A boy of three years has been brought with bloody diarrhoea with acute abdomen and distension. On examination of his abdomen there is a saugage shaped lump in the line of colon convexity towards the umbilicus.

(303) A female patient of fifty has come with the features of intestinal obstruction . She gives the history of cholelithiasis for long .

(304)  A patient of recurrent renal calculi has come . His urine contains large amount of calcium. Spot the diagnosis?

(305) A patient of forty has come with hard subcutaneous nodules near the umbilicus . Spot the diagnosis?

Answers.
(302) Acute Intussusception .
(303) Gall stone illeus .
(304) Hyperparathyroidism .
(305) It is most likely a case of intra-abdominal carcinoma , Most likely carcinoma stomach.

Spot the diagnosis 298-301

(298) A patient has come with frequency of urine . He gives the history of a fall from the roof of his house . On examination nothing abnormal was found . Spot the diagnosis?

(299) A patient of severe motorcycle accident has been brought  .He has
(a) Blood per urethrum .
(b) Perineal haematoma.and
(c) Distended bladder. Spot the diagnosis?

(300) A patient of severe accident has been brought . He has severe tenderness and a tumour like mass in the suprapubic region with strangury. Spot the diagnosis?

(301) A patient has come with distended,tender and rigid abdomen with vomiting and malaema . On examination of her heart there is valvular disease . Spot the diagnosis?

Answers.
(298) Spinal injury.
(299) Urethral damage .
(300) Injury to the urinary bladder.
(301) Masentric thrombosis.

Spot the diagnosis 293-297

(293) A patient of sixty has come with chronic retention of urine . Spot the diagnosis?

(294) A patient of seventy has come with chronic retention of urine and pain on the back in lumbosacral area . Spot the diagnosis?

(295) A patient of fifty says that straining at micturation hinders the flow . Spot the diagnosis?

(296) A patient of forty says that straining at micturation enhances the flow . Spot the diagnosis?

(297) A patient of twenty one has come with frequency of urine . His urine is sterile on ordinary culture,contains pus cells and acidic in nature. Spot the diagnosis?

Answers.
(293) Benign hypertrophy of prostate .
(294) Carcinoma prostate .
(295) Senile hypertrophy of prostate .
(296) Stricture of urethra .
(297) Renal tuberculosis.

Spot the diagnosis 287-292

(287) A boy of four has been brought with a huge enlargement of one kidney without haematuria . Spot the diagnosis?

(288) A patient of forty has come with a lump in renal area which has grown painlessly . Spot the diagnosis?

(289) A patient of fifty has come with bilateral renal swelling. Spot the diagnosis?

(290) A recurrent case of urinary calculi has come. Which organ should he examined?

(291) A patient of thirty has come with acute retention of urine. Spot the diagnosis?

(292) A patient of seventy five who is a hemiplegic has come with  tenderness of knee joint. He has a history of minor trauma . On x-ray exam there is fracture which is semilunar in shape at the lateral aspect of medial condyle . Spot the diagnosis?
Answers.
(287) Wilms tumour.
(288) Hypernephroma.
(289) Polycystic kidney.
(290) Neck should he examined for parathyroid tumour.
(291) Stricture of urethra.
(292) Osteochondritis dissecans (Paget's quiet necrosis)

spot the diagnosis 282-286

(282) A female patient of thirty five has come . She has pyrexia ,bilateral lower abdominal pain and tenderness. Scalding pain during micturation and vaginal discharge . The urine contains gonococi . Spot the diagnosis?

(283) A male of fifty has come . His nail of big toe is like a  twisted  horn . Spot the diagnosis?

(284) A lady of thirty five has  come with diminished size of areola of her breast with retracted nipple . Spot the diagnosis?

(285) A patient of fifty five has come with pyrexia
 (hyperpyrexia),pin -point- pupil and palsy . The diagnosis also starts with the letter "P" . Spot the diagnosis?

(286) A lady patient of twenty five has come with red ,destroyed and weeping areola and  of her one breast . Spot the diagnosis?
Answers.
(282) Acute salpingitis .
(283) Onichographosis.
(284) Carcinoma breast.
(285) Pontine haemorrhage .
(286) Paget's disease of breast.