Spot the diagnosis 539-540

(539) A patient walks with high stepping gait and is unable to dorsiflex the ankle and evert the foot . Spot the diagnosis?

(540) A patient of compound fracture has come . On palpation around the wound there are crepitations . Spot the diagnosis?

Answers.
(539) Paralysis of lateral popliteal nerve .
(540) Gas gangrene .

Spot the diagnosis 537-538

537)A patient has come with severe and agonising pain in the abdomen when he lies on the back, but lessens when he sits up or lies on the abdomen..Spot the diagnosis.?

538)A lady patient of sixty has come with a thyroid swelling.The thyroid is  stony hard and fixed.When biopsy for carcinoma was done it was found to be negative.Spot the diagnosis.?

ANSWERS:-
537)Acute pancreatitis.
538)Riedel's  thyroiditis.

Spot the Diagnosis 535-536

535).A lady of fifty slipped in her bathroom and got fracture of neck of femur.On clinical examination everything is okay except the thyroid gland is enlarged,hard,irregular and fixed.Spot the diagnosis ?

536).A patient of upper abdominal injury has been admitted in the emergency ward.The patient complains of severe pain in the left shoulder girdle.The surgeon-on- call visited the case and put his finger above left clavicle between the sternomastroid and scalenus medius muscles which was excruciatingly painful.Spot the diagnosis

        ANSWER:-
535)primary carcinoma in the thyroid gland secondary in the bone ( Neck of femur..)
536) Splenic rupture.

Spot the diagnosis 531-534

(531) A patient has come with a hard, irregular and fixed swelling. He gives  the history of diminution in the size at times. Spit the diagnosis?

(532) A patient has come with multiple sebaceous cyst on the scalp. The upper one is ulcerated and looks like carcinoma.  spot the diagnosis?

(533) In a clinical class in S.O.P.D a student was given a case to examine. The student became happy to report,“ This is a clean cut case of fracture of sternum".  The teacher questioned him, “ when you find fracture of sternum which part of the skeleton must be examined only because they frequently Co-exist".

(534) A patient has come with a big, diffuse, browny indurated swelling. There is multiple vesicles over it. The patient is not a diabetic. Spot the diagnosis?

Answers.
(531) Inflamatory swelling.
(532) Cock's peculiar tumour.
(533) Spines.
(534) Carbuncle.

Spot the Diagnosis 518-530

Spot the diagnosis?
(518) A patient of cervical injury has come . He has paralysis of intrinsic muscles of hand with main -en-graffe deformity. At which level of spinal cord is injured ?
(519) A patient of spinal injury is already admitted in surgical ward for more than three weeks but still his reflexes did not return as yet . What do you suspect ?
(520) A patient of spinal cord injury has been admitted but his both the arms up to the fingertips are free . Point out the level below which the injury has occurred in the spinal cord ?
(521) A lady of fifty has come for sagging of the right shoulder girdle .
(522) You have been shown a barium meal x-ray of stomach in which there is an ulcer on the greater curvature . Spot the diagnosis?
(523) You have been shown a barium meal x-ray of stomach in which an ulcer is there on the lesser curvature, the size of which is more than one inch . Spot the diagnosis? (524) A lady of fifty has come with a small bluish spot beneath the nail which is painful. There is excruciating pain on pressure . Spot the diagnosis?
(525) A lady of forty has come with a cystic swelling of the breast . The cyst is translucent . Spot the diagnosis?
(526) A patient of fifty has come with a fungating ulcer with raised and rolled out margin with granular floor and indurated base .
(527) A patient of severe chest injury due to car accident has come . His face ,neck and upper part of the chest looks purple with peteche and conjunctival haemorrhage . What is this condition known as ?
(528) A patient of fifty five has come with ptosis ,myosis and enophthalmous . On clinical exam there is compression of lower brachial plexus . Spot the diagnosis?
(529) An x ray of chest was shown to you in which there is dense apical shadow and erosion of upper ribs .
(530) A lady of fifty has come with a lump in the right breast . On clinical examination the liver is enlarged ,hard,nodular and tender . Spot the diagnosis?

Answers.
(518)Eight cervical and first dorsal level.
(519) complete transverse section of the spinal cord.
(520) Below first dorsal level.
(521) Cervical rib.
(522) Malignant ulcer .
(523) Malignant ulcer.
(524) Glomus tumour.
(525) Cystic hygroma .(hydrocoele of the breast).
(526) Squamus- cell carcinoma .
(527) Traumatic asphaxia.
(528) Pancoast tumour(bronchogenic carcinoma).
(529) Bronchogenic carcinoma.
(530) Secondary carcinoma in the liver and primary in the breast.

Spot the Diagnosis 514-517

514) A known case of cirrhosis liver now complains of evening raise of tempreture..spot the diagnosis ?

515).A lady of forty-five has come with a lump in her left breast.Her nipple is raised above in comparison to the right nipple.spot the diagnosis??

516).A boy has come with a cyst in the neck.The cyst moves upward with the protrusion of the tongue.spot the diagnosis?

517).A boy has come with a fistula near the mid line of the front of the neck.The fistula is indrawn and there is a crescentic fold of skin.spot the diagnosis??

      ANSWER:-
514).Has developed pulmonary tuberculosis.

515).Carcinoma of the left breast.

516).Thyroglossal cyst.

517).Thyroglossal fistula.

Spot the Diagnosis510-513

510).A patient has come for lightening pain in the legs.He has a past history of syphilis.On examination there is sluggish pupillary reaction and loss of ankle jerks.spot the diagnosis.?

511).A patient has occipital headache which radiates down to the neck.Which tumour of the brain do u suspect.Spot the diagnosis ?

512).A patient of chest injury has come in the surgical emergency.On auscultation the heart is silent and On percussion his cardiac dulness is increased.spot the diagnosis ?.

513).A patient is already admitted in the surgical emergency whose apex beat is heard in the right side.spot the diagnosis ?

       ANSWERS:-
510)Tabes dorsalis.
511).Subtentorial growth.
512). Haemoparicardium.
513).Haemothorax.

Spot the diagnosis 506-509

506).A patient of fourty has come with a hard testis.His left supraclavicular gland is enlarged and firm.

507).A patient of fourty has come for upper abdominal pain.On clinical examination nothing abnormal was found except tenderness on the cartilage of 8th rib of the right side.
Spot the diagnosis ?

508).A patient of fifty-five has come with hard and nodular liver.
Spot the diagnosis ?

509).A patient of old peptic ulcer has come for a lump in the epigastrium.The mass is less mobile and more tender.
Spot the diagnosis ?.

    ANSWERS:-
506).Malignant testis with metastasis.
507).Cholecystitis.
508).Secondary carcinoma in the liver.
509).Leaking peptic ulcer.

Spot the diagnosis 501-505

501).A patient has come with a cystic swelling of parotid gland..
Spot the diagnosis ?

502).A patient has come with a hard parotid tumour for a long time.There is no recent growth.
Spot the diagnosis ?

503).A patient has a hard parotid tumour for a long time.Recently it is growing fast.
Spot the diagnosis ?

504).A patient has a hard parotid tumour for a long time.Now it has become painful and involved facial nerve.
Spot the diagnosis ?

505).A patient has come with a hard lump in the epigastrium.Previously his one testis was removed.
Spot the diagnosis.

        ANSWERS:-
501) Warthin's tumours.
502). Mixed parotid tumour.
503).Malignant parotid tumours.
504).Malignant parotid tumour involving facial nerve.
505).Secondary Deposit in gastric lymph node,Primary was in the testis.