Spot the Diagnosis 632-636

(632) Which tumour grows from the epiphysis of bone?

(633) Which malignant tumour grows from the metaphysis?

(634) A patient has come with a malignant tumour grown from the the diaphysis of tibia but he has no primary growth anywhere in the body.

(635) A patient has come with a malignant tumour which has arisen from the metaphysis of tibia. Pain preceded the growth for a month.

(636) A patient has come with a sinus. He gives the history of extrusion of the bone chip.

Answers.
(632) Osteoclastoma.
(633) Osteogenic sarcoma.
(634) Ewing's tumour.
(635) Osteogenic sarcoma.
(636) Chronic osteomylitis.

Spot the Diagnosis 627-631

(627) A patient has come who is suspected to be a  case of osteogenic sarcoma. The symptoms started fifteen days back. Spot the diagnosis?

(628) A patient has come with a depressed scar in his right thigh.

(629) A skiagram of a bone tumour was shown to you in which a soft tissue shadow was seen. Spot the diagnosis?

(630) An X-ray plate was shown to you. In which bone destruction was shown without bone formation.

(631) An X-ray plate of bone was shown to you in which bone destruction was shown with sclerosis.

Answers.
(627) It is not a case of osteogenic sarcoma.
(628) Fibrosis due to previous suppuration.
(629) Bone sarcoma,the soft tissue shadow is due to increased vascularity.
(630) Secondary carcinoma.
(631) Secondary prostatic carcinoma.

Spot the Diagnosis 621-626

(621) A patient has come with a bony swelling. The swelling has a variant feel at different parts. Spot the diagnosis?

(622) A patient has come with a sinus. The sinus is adherent to the bone.

(623) A child of ten has come with a swelling of bone and high rise of temperature.

(624) A child patient has come with pain and swelling. The pain and swelling has started at the same time.

(625) A patient has come with a swelling of bone. He is having chronic otitis media.

(626) A patient has come who is suspected to be a case of osteogenic sarcoma. The  symptoms started twelve months back.

Answers.
(621) Oesteogenic sarcoma.
(622) Osteomylitis.
(623) Acute Osteomylitis.
(624) Inflammation.
(625) Osteomylitis.
(626) It is not a case of osteogenic sarcoma.

Spot the Diagnosis 611-620

(611) A patient has come with a sinus with sprouting granulation tissue over a bone. Spot the diagnosis?

(612) A robust man of forty has come with acute agonising pain and fullness in the epigastrium. The pain pierces to the back. On examination there is a bruise in the loin and around the umbilicus.

(613) A patient of fifty five is admitted in the medical ward. He is having abdominal distention, hiccup, vomiting. His blood urea is raised. Spot the diagnosis?

(614) A lady of forty has come with gripping pain abdomen. Spot the diagnosis?

(615) An adult male has come with engorged superficial veins around the umbilicus. Spot  the diagnosis?

(616) A patient has come with superficial veins engorged and dilated on the side of abdomen. Spot the diagnosis?

(617) A patient has come with hard subcutaneous nodules around the umbilicus. Spot the diagnosis?

(618) A patient of car accident has been brought in the emergency. On auscultation his heart seems to be silent.

(619) A patient of chest injury has been brought in the emergency. His heart beat is displaced to the other side.

(620) A patient of chest injury has been brought. There is absence of breath sound and vocal- resonance at the base of the lungs.

Answers.
(611) Sequestration of bone or Foreign body inside and granulation tissue is known as proud flesh.
(612) Acute pancreatitis.
(613) Uraemic distention.
(614) Biliary colic.
(615) Portal obstruction.
(616) Obstruction of the inferior vena cava.
(617) Carcinoma of stomach or intraabdominal carcinoma.
(618) Haemopericardium.
(619) Haemothorax.
(620) Haemo-and Pneumothorax.

Spot the Diagnosis 608-610

608).A patient has come with rounded swelling of shoulder joint but there is no effusion in the joint.Spot the diagnosis?

609).A known patient of senile  hypertrophy of prostate has come. Now he complains of pain in the perineum. Spot the diagnosis?

610).A Rickshaw pullar has come. His tibia is thickned with multiple sinuses attached to the bone.Spot the diagnosis?

Answers :-
608)Subdeltoid bursitis.
609)Malignancy has developed in prostate.
610).Osteomyelitis.

Spot the diagnosis 601-607

601).A patient of sixty-five has come for frequently of urine.Spot the diagnosis ?

602).A patient of thirty complains of frequency of urine.His urine is acidic and contains pus cells and sterile on ordinary culture.Spot the diagnosis ?

603).A man of fifty has come with polyurea,polydypsia and polyphagia.Spot the diagnosis?

604).An X-ray picture was shown in which there is soft tissue shadow.Spot the diagnosis?

605).An X-ray film of tibia was shown in which there are multiple punched out shadows like peas.Spot the diagnosis?

606).A lady of fifty has come with a bony swelling and a lump in the breast.X-ray of the bone shows destructive features only.Spot the diagnosis?

607).A patient of sixty has come.In his X-ray of bone there is sclerosis of bone and his alkaline phosphates is raised.Spot the diagnosis?

ANSWERS:-
601)Senile hypertrophy of prostate.
602).Tuberculosis of kidney.
603).Diabetes mellitus.
604).Osteosarcoma.
605).Multiple myeloma.
606).Secondary carcinoma in the bone and primary in the breast.
607).primary carcinoma of prostate and secondary in the bone.

Spot the Diagnosis 598-600

(598) A patient of forty has come. He has lightening pain in the legs. On.examination there is an old ulcer scar on his glans penis and sluggish pupillary reaction. Spot the diagnosis?

(599)A patient has come. He has oedema of both lower limbs. On examination there is a huge firm and nodular mass in the umbilical area of abdomen.

(600) A patient has come with multiple, yellowish discharging sinuses on right iliac fossa. He gives the history of previous operation. On examination there is a very hard and fixed lump in the right iliac fossa. Spot the diagnosis?

Answers.
(598) Tabes dorsalis.
(599) Retroperitoneal sarcoma.
(600) Actinomicosis of caecum.

Spot the diagnosis 593-597

593).A child has been admitted in surgical ward with generalised lymph adenopathy.The child is anemic with cynosis and respiratory trouble.There is splenoheptomegaly also.Spot the diagnosis?

594).A patient has come with red and oedematous swelling.Spot the diagnosis?

595).A young patient of forty has come.He has painless enlargement of epitrochlear and occipital lymph node.Spot the diagnosis?

596).A lady of sixty has come with a swelling of breast.The skin of the breast gives the appearance of orange skin.Spot the diagnosis?

597).A patient of fifty has come.He has enlargement of deep cervical lymph nodes.When he protudes his tongue ,the tip of the tongue points towards the lesion .He has paralysis of hypoglossal nerve.Spot the diagnosis?

          ANSWERS:-
593).Hodgekin's disease.
594)Suppuration .
595)Syphilitic glands.
596).Carcinoma of breast..
597).Secondary carcinoma of lymph gland.

Spot the diagnosis 581-592

581)A patient has come.He says that his pain in epigastrium is more or less constant between meals but the pain is increased just after meals.After examination it is found that there is no pyloric stenosis and gastric carcinoma.Spot the diagnosis?

582).A lady of fifty has come with grippping pain in right hypocondrium which rediates to the back.Spot the diagnosis ?

583).A patient says that when I feel pain in the epigastrium I Induce vomitting and get relief.Spot the diagnosis.

584).A fatty lady of forty-five complains that she offen gets vomiting.

585).A known drunkard has come with severe haemetemesis.Spot the diagnosis ?

586).A patient of fifty has come.He complains of alternate constipation and diarrhoea for a long time.Spot the diagnosis ?

587).A lady of sixty has come with a thyroid swelling.On examination of thyroid swelling carotid pulse is not felt.Spot the diagnosis ?

588).A patient has come with enlargement of a lymph gland in the neck.There is subcutaneous dilated veins over it.Spot the diagnosis ?

589)A patient of fifty has come with a swelling.The skin at one point is stuck down at one place causing a fold of skin to stand out below it.Spot the diagnosis?

590).A patient has come with a transverse scar looking like an incisinal scar on the neck.Spot the diagnosis ?

591).A patient has come with a sinus just below the angle of mandible.Spot the diagnosis ?

592).A patient has come with an indurated mass on which there is multiple discharging sinuses .The discharge is yellowish.Spot the diagnosis ?


           ANSWERS:-
581).Gastric ulcer penetrating into the panecreas .
582).Cholescystitis.
583).Gastric ulcer.
584).Cholescystitis.
585)Cirrhosis of liver.
586)carcinoma of colon
587).Malignant thyroid.
588).Lymphosarcoma.
589).Secondary carcinoma of lymph gland.
590).Healed tuberculous ulcer  and multiple healed sinuses.
591).Osteomylitis of mandible.
592).Actynomycosis.

Spot the diagnosis 575-580

575).A child has been brought in S.O.P.D. for an abscess just medial to the mid ingunial region.Spot the diagnosis ?

576).A patient has come for one cold abscess in the gluetial region.Spot the diagnosis ?

577).A patient has come.He has fallen from a tree.Everything is okay except he has a swelling in dorsal vertebral region.The swelling is fluctuant .Spot the diagnosis ?

578).A patient has come.He has fallen from the roof of his house but still he can walk.Spot the diagnosis.

579).A patient has come.He is having painful and intermittent jaundice.Spot the diagnosis?

580).A patient has come with painless and progressive jaundice.Spot the diagnosis ?

         ANSWERS:-
575).Suppurative arthritis of hip joint.
576).Tubuerculor effusion of hip joint.
577).Haematoma.
578).No injury to the cord or lower extremities.
579).Stone in the common bile duct.
580).Carcinoma head of pancreas.

Spot the diagnosis 570-574

570).P.R Examination of a patient of forty was done.There was a gritting sound.Spot the diagnosis ?

571).A patient has come.He has multiple whitish nodules all over the scrotun.Spot the diagnosis ?

572).A child of six has been brought.He has polyarticular Rumatoid arthritis with lymph nodes inlargememt and spleenomegaly.Spot the diagnosis ?

573).A patient has come with   pain and swelling .There is a browny induration that pits on pressure by fingure tip.Spot the diagnosis ?

574).A young boy of five has been brought for pain in right hip joint.There are wasting of muscles,flatting of buttucks and loss of gluteal  folds.Spot the diagnosis ?


             ANSWERS:-
570) Prostatic calculi.
571).Multiple seabaceous cyst.
572).Still's disease.
573).Deep seated abscess.
574).Tuberculosis of hip joint.

Spot the diagnosis 565-569

565).A patient has come in surgical emergency with intestinal obstruction.The abdomen is tender and regid.On auscultation he is having vulvular heart disease.Spot the diagnosis ?

566).A fat lady of forty-five has been admitted in the surgical ward for intestinal obstruction.She gives the history of cholelithiasis .Spot the diagnosis ?

567).A patient of intestinal obstruction was admitted in the surgical ward.He gives the history of tabes mesentrica .Spot the diagnosis.?

568).A know case of senile hypertrophy of prostate has come.Now he complains of pain in perineum .Spot the diagnosis ?

569).A house surgeon does per rectal examination of a patient.He reports that the prostate is hard and irregular in feel and there is obliteration of median and lateral grooves.Spot the diagnosis.

     ANSWERS:-
565)Masentric vascular occlusion.
566)Gall stones in ileus.
567) Bands and adhesion.
568)Malignant transformation in prostate.
569)Carcinoma prostate.

Spot the diagnosis 561-564

 (561) A patient has come with spasmodic pain abdomen. The pain radiates from loin down to the groin, testis and inner side of the thigh. Spot the diagnosis?

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

(563) A patient has come with a tumour in the neck. He has a history of recurrent renal calculi. Spot the diagnosis?

(564) Urine of a patient of renal calculi contains large amount of calcium. Spot the diagnosis?

Answers.
(561) Stone in the ureter.
(562)Hypernephroma
(563) Parathyroid tumour.
(564) Hyperparathyroidism.

spot the diagnosis 557-560

(557) A patient of 60 has come with the complain of throbbing pain in the perineum. Spot the diagnosis?

(558) A child of 6 has been brought by his parents. They complain that at the time of micturation the child screams with pain and pulls at the prepuce. Spot the diagnosis?

(559) A patient of 55has come. He complains that straining during micturation hinders the flow. Spot the diagnosis?
(560) A patient of 40 has come. He complains that straining during micturation increases the flow of urine. Spot the diagnosis?
Answers.
(557) Prostatic abscess.
(558) Stone in the bladder.
(559) Prostatic hypertrophy.
(560) Urethral stricture.

Spot the diagnosis 551-556

551).A patient has a parotid swelling for a long time.Now there is involvement of facial nerve.Spot the diagnosis?

552).A patient had a mixed parotid tumour for a long time.Now it has started to grow fast.Spot the diagnosis ?

553).An old man of known prostatic enlargement has come.Now he complains of pain in the back in lumbosacral region.Spot the diagnosis ?

554).A patient of sixty has come with stricture rectum.On examination the stricture is ulcerated,hard and irregular in feel.Spot the diagnosis ?

555).A lady of forty has come with stricture rectum.She gives the history of genital sorses and inguinal bubo.Spot the diagnosis ?

556).A lady has come in S.O.P.D.She complains that when she passes hard stool there is bright red bleeding which spatters the whole basin.Spot the diagnosis ?

         ANSWERS:-
551)Malignant transformation in parotid gland.
552).Malignant transformation in mixed parotid tumour.
553).Malignancy has developed in prostate.554).Malignant stricture.
555).Lymphogranuloma inguinale .
556).Internal piles.

Spot the Diagnosis 541-550

541).A patient of fifty has come with pain and swelling in the scrotum.On examination his spermatic cord is thickend and epididymus is enlarged,hard and nodular.Spot the diagnosis?

542).A patient has come with a lump in the epigastrium.His one testis was removed previously.On examination his left supraclavicular lymph node was enlarged and firm.Spot the diagnosis?

543).A patient has come with a cystic swelling near the outer canthus of his left eye.The cyst is translucent,free from skin and attached to the pericranium with saucer-shaped erosion in the bone.Spot the diagnosis?

544)A patient has come with a cystic swelling just behind the ear.Spot the diagnosis ?

545).A boy of six has come with a cystic swelling at the root of the nose.There is an impulse when the child coughs.Spot the diagnosis?

546)A patient has come with a cystic swelling on the temporal region of a scalp with baldness over the cyst.Spot the diagnosis?

547).A patient of fifty-five has come with chest pain and profused sweating.Spot the diagnosis?

548).A patient gets breathlessness on walking even for a very short distance.On auscultation there is a mid diastolic murmur.Spot the diagnosis ?

549).A patient narrates that during meals the parotid area and cheek of left side of the face becomes red,hot,painfull and beads of perspiration appear on the cheek.During saving the area becomes hypersthetic.He gives the history of parotid abscess which was incised and drained previously.Spot the diagnosis?

550).A patient complains that during meal he gets a tough,tense and tender swelling in the submandibular area.Spot the diagnosis.

             ANSWERS:-
541) Tuberculous epididymus.
542) Secondary deposit in pre and para arotic lyumh nodes and virchow's gland and primary in the testis.
543)External angular dermoid cyst.
544)Posterior auricular dermoid cyst.
545)Meningocoele.
546)Sebaceous cyst.
547)Acute Myocardial infaction.
548)Mitral stenosis.
549)Frey's syndrome.(Auricular temporal syndrome).
550)Salivary calculus in the duct.

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.

Spot the diagnosis 496-500

496) A lady of fourty has come with a brownish- red,hard and painless nodule and on the Left side of her nose. There are capillaries on the nodule . Spot the diagnosis?

497) A patient complains of bitemporal headache. The neurologist diagnoses as a case of brain tumour.Which tumour of the brain do you suspect.Spot the Diagnosis?

498)A patient has been admitted for pain and swelling of right knee joint. On x-ray examination there are soft tissue shadow with flecks of calcification scattered all over the swelling. Spot the Diagnosis?

 499) A patient has come with dialated ,tortuous and arteriovenus anastmosing vessels on the scalp.This feels like earthworms moving in a bag .Spot the Diagnosis?

 500) A child was bought in the S.O.P.D .The child has a cystic swelling in the neck. The swelling is brilliantly translucent and becomes turgid when the child cries.

 ANSWERS:-

496) Rodent ulcer.
497) Pituitary tumour.
498)Malignant synovioma.
499) Circoid aneurysm.
500) Cystic hygroma.

Spot the diagnosis 489-493

489) A patient has come with a cystic swelling behind the right ear.Spot the diagnosis ?

490)A lady of twenty-five has come with blueish,slightly raised area on the upper portion of sternum which is butterfly shaped.Spot the diagnosis ?

491) A patient of generalized oedema has come.He has diabetes and nephritis.Spot the diagnosis?

492)A patient of generalized oedema has come.He has raised blood pressure and microscopical haemaeturia.Spot the diagnosis ?

493) A patient has come with generalized oedema with heavy protenuria and raised choelostrol level.Spot the diagnosis ?

494) A patient was admitted for hectic fever,rigor and profuse sweating.On examination there are two findings, spleen is palpable and there is  cardiac murmur.Spot the diagnosis.

495)A patient walks with high -stepping gait.Spot the diagnosis.

Answers:-
489) Posterior auricular dermoid cyst.
490)Butterfly keloid.
491)K.W.Syndrome.
492)Sub acute glomerulonephritis.
493) Nephrotic syndrome.
494)Sub acute bacterial endocarditis.
495)Paralysis of lateral popliteal nerve.

Spot the diagnosis 485-488

(485) You have been shown an ulcer . The lymph glands of the drainage area are firm ,discrete and shotty .
(486) A patient has come with a cystic swelling on the outer canthus of left eye .
(487) A patient of sixty has come with a tumour . The tumour is variable in consistency .
(488) A lady of sixty was having a thyroid swelling for long years. Now she has come with a fracture of vertebra .

Answers.
(485) Hunterian chancre .
(486) External angular dermoid cyst .
(487) Malignant tumour.
(488) Secondary carcinoma of vertebra with primary in the thyroid .

Spot the diagnosis 482-485

 (482) A patient of injury has come with loss of all forms of sensation below a certain level.  What does it indicate?
(483) A lady has come with enlarged,firm and irregular liver. Her one eye has been previously removed. Spot the diagnosis?
(484) A patient has come with an ulcer on the old burn scar.  The margin of the ulcer is raised and everted. Spot the diagnosis?

Answers.
(482) This indicates  complete contusion of the spinal cord.
(483) Malignant melanoma.
(484) Marjolin's ulcer.

Spot the diagnosis 478-481

(478) An adult male has come with multiple and painful lipomas.  
(a) What is the name of this condition?
(b) What disease is associated with this condition?

(479) A patient has come with patchy pigmentation of skin and multiple small nodules varying from the size of a pea to a cricket ball.

(480) A child of ten was brought to the S.O.P.D. He complains of headache and vomiting before breakfast.  What tumour of the brain do you suspect.

(481) A lady of fifty has come with an ulcer near the left side of her nose. The margin of the ulcer is raised and beaded.

Answers.
(478a) Neurolipomatosis.
(b) Dercumb's disease.
(479)Neurofibromatosis.
(480) Medulloblastoma of cerebellum.
(481) Rodent ulcer.

Spot the diagnosis 473-477

473).In the surgical emergency one patient lies helplessly on the back with his arm abducted and externally rotated and forearm flexed and supinated.spot the segment which has been envolved.

474) A boy of thirteen was diagnosed as a case of brain tumor by a great neurologist.Can you spot which tumour of the brain it was ?

475)A young patient has come with an ulcer.The margin of the ulcer is thin,blue and undermined.Spot the diagnosis.

476)A patient of fifty has come with an ulcer.The ulcer is having punched out margin with wash-leather slough.Spot the diagnosis.

477)A patient has come with an ulcer with greenish discharge and peculiar smell.Spot the diagnosis.

Answer:-
473) 6th cervical.
474) Medulloblastoma.
475) Tuberculous ulcer.
476) Syphilitic ulcer.
477) Infected by B.pyocyaneous.

Spot the Diagnosis (Answers 461-468)

Answers :-
461) Carcinoma breast.
462).Gas gangrene.
463).Deep seated abscess.
464).8th cervical and 1st dorsal.
465).No cord injury.
466).The lesion is below the 1st dorsal segment of spinal segment.
467).Cervical region.
468).Sebaceous cyst...

Spot the Diagnosis 469-472

469) An adult lady has come with bilateral renal swelling with occasional haematuria.Spot the diagnosis.

470)A pyelogram was shown to you in which calyces are attenuated and alongated with terminal clubbing.Spot the diagnosis.

471)A patient has come with pain in the renal angle and hematuria.The pain is aggrevated during exercise and gone after rest.Spot the diagnosis ?

472)A case of long standing mixed parotid tumour has now involved the facial nerve has now become painful.Spot the diagnosis.

ANSWER:-
469)polycystic kidney.
470)Polycystic kidney.
471)Renal stone.
472)Malignant transformation in mixed parotid tumour

Spot the diagnosis 461-468

461) A lady of forty-five has come with a lump in her left breast.The consistency of the lump is variable.spot the diagnosis ?

462)A case of supra condylar fracture has come creptus are felt on palpation.spot the diagnosis ?

463)A boy has come with brawny induration which pitts on pressure.spot the diagnosis ?

464)A patient has come with paralysis of intrinsic muscles of hands with main-en-griffe deformities.He gives the history of spinal injury.spot the segment which are involve.

465)A patient has come.He  has  a serious car-accident but he can walk.
Is there any cord injury ?

466) A patient was diagnosed as a case of spinal injury but his forearm upto fingur- tips is free.spot the level below which the cord injury has taken place.

467) A patient was brought from  a village .He has quadriplegia.Spot the region of the cord which is involved.Spot the diagnosis.

468)A patient has come with a big cyst in the scalp in temporal region.There is complete baldness over the cyst.Spot the diagnosis.

Spot the diagnosis 456-460

(456) A patient of fever has come with generalised lymph-adeno-pathy and spleno-hepato-megaly . His eosinophil count is raised .
(457) A patient of thirteen has been admitted for paraplegia, generalised lymph node enlargement and spleno -hepato-megaly . The feel of the gland is rubbery .
(458) A patient of generalised lymph- node enlargement has come . He has splenic enlargement and lymphocytosis .
(459) A patient of thirty has come with urinary retention with over flow . He has a gibbus on the thoracic vertebra .
(460) A patient has come with the swelling of right humerus bone . The temperature of the swelling is raised and there is wrist drop .
Answers
(456) Hodgekins disease .
(457) Hodgekins disease.
(458) Lymphatic leukaemia.
(459) Caries spine .
(460)Sarcoma of the right humerus with involvement of right radial nerve.

Spot the diagnosis 453-455

(453) A baby has come with naevus on the small of the back . Spot the diagnosis?
(454) A young lady has port- wine -stain on the right side of her cheek . She gives the history of fits . Spot the diagnosis?
(455) A young boy has come in S.O.P.D .He complains that he feels pain in the hypogastrium which is referred to the tip of penis and at the end of micturation there is haematuria .

Answers.
(453) Spina bifida occulta .
(454) Sturg -weber-syndrome
(455) Stone in the urinary bladder .

Spot the diagnosis 446-452

446).A patient of high fever with ten days duration has relative bradycardia.spot the diagnosis...???

447).A patient of fever of more than three weeks duration has total WBC Count only two thousand.spot the diagnosis..?

448).A patient of fever has cardiac murmurs and splenic enlargement.spot the diagnosis?.

449).A patient has come with a fistula on the ramus of mandible.He has a history of watery discharge at the time of meals.spot the diagnosis?.

450).An old lady of seventy is lying in the surgical emergency with her right lower extremities everted.spot the diagnosis?.

451).An X-ray plate of pelvis was shown to you in which the head of the femur lies medial to the pelvic brim.spot the diagnosis...?

452).A negative film of a compound fracture was shown to you.There are dark round spots in the X-ray plates.spot the diagnosis.?

ANSWERS: 446)Typhoid.
447).Kala-zar.
448).Sub acute bacterial endocarditis.
449).Parotid fistula.
450).Fracture of the neck of femur.
451).Central dislocation of femoral head.
452).Gas gangrene.

Spot the Diagnosis 443-445

 443).A patient has come with hepatic enlargement.There is intercostal tenderness.spot the diagnosis....???

444).A patient has come with enlarged and soft liver with tenderness in the left iliac fossa at Manson's bar  amoebic point.spot the diagnosis?

445).A patient of sixty-five has come with enlarged prostate .He complains of pain in the back.spot the diagnosis..?                      

 Answer:-
443) Amoebic liver abscess.
444).Amoebic colitis with hepatitis.
445).Carcinoma prostate.

Spot the Diagnosis 440-442

1).A patient has come in the SOPD .He has fallen from a tree.Everything is okay except he can't raise his right lower extremity but can only move his right foot..spot the diagnosis..
2).A patient has come in the SOPD.His splenic enlargement is up to the umbilicus and the feel is firm and hard.There is also sternal tenderness.spot the diagnosis?
3).A patient has come with severe cervical injury.Please tell me the level of cervical segment above which severe injury causes death.spot the diagnosis.?.

Answer:-1).Fracture neck of right femur..2).Chronic myeloid leukemia.
3).Above Fifth cervical segment.

Spot the Diagnosis 435-439

1).A child has come in the SOPD for rigor,fever,leucocytosis and cellulitis in the metaphyseal region of tibia....spot the diagnosis..

2).A patient has come with a sinus with sprouting granulation tissue..

3).A patient has come with painless,serous effusion in the both knee joint with symmetrical affection with free movement...spot the diagnosis..

4).A patient came in the SOPD .His face was pale and puffy and was wearing wollen shirt in the days of summer when asked his name to test his voice it was husky.spot the diagnosis..

5).A lady of sixty has come for enlarged liver with chronic black ulcer under the nail of big toe which often bleeds...spot the diagnosis..


Answers
(1)Acute osteomylitis
(2)chronic osteomylitis.
(3)syphilis of joint.
(4) Myxoedema.
(5)malignant melanoma.

Spot the Diagnosis 432-434

432)A Patient has come with hard and fixed lump in right illiac fossa with multiple sinus discharging yellowish fluid.Previously He was operated for appendicectomy.

433)A Patient of 55 has come with hard lump in right illiac fossa.He has a history of alternate constipation and diarrhoea.

434)A lady patient of 30 has come with hard and fixed lump in right illiac fossa.Previously, she suffered from rigor, fever, leucocytosis and acute tenderness in right illiac fossa.She consulted with a senior physician who treated her with higher antibiotics...


Answer:-432)Actinomicosis...
433)Carcinoma caecum.
434)Antibioma...

Spot the diagnosis 429-431

(1) A patient has come in the
 S.O.P.D for haematoma of the thinner eminence . He can't approximate the tip of the thumb with tip of the ring finger of the same hand. Spot the diagnosis?

(2) A patient has come with excruciatingly tender ,red coloured ,small localised area beneath the nail .

(3) A lady of seventy slips and falls  in her bathroom . Now she is quite unable to stand up by her self .

Answers
(1) Benette's fracture.
(2) Glomus tumour .
(3) Fracture of neck of femur.

Spot the diagnosis 427-428

(1) A patient comes with twisted big toe -nail like ram's horn . Spot the diagnosis?
Ans Onychographosia.

(2) A lady of fifty five seats on the ground and stands by taking the help of ground by putting her both the palms placing on the ground . Spot the diagnosis?
Ans Menopausal osteoprosis of lumbar vertebrae.

Single Son Syndrome -II

Single son syndrome occurs most commonly with parents having only one son but this may happen also with the persons who have many sons . 

This  happens with the youngest son or a handicapped and weak sons or who has suffered long for any disease or has gone under major operation in the childhood . In this syndrome the sufferers is the mother if father is too busy in his daily business . 

The most common feature the child becomes a malingerer or always possess a weak and ill health in his childhood .

 In recent years doctors in many countries have visualised that mothers have a special centre in their brain which looks after and cares for only for the babies . This centre is called baby's brain in single son syndrome. This centre in the brain of mother is much developed and hypertrophied . 

This has also been seen in tortoise . In tortoise this baby centre of the mother tortoises are also very much developed so the mother tortoise plays and hunt in the distant water but cares and maintains the eggs lying on the ground elsewhere . The constant breast feeding nourishes baby's brain in the mother . The mother's breast may also be connected with this baby's brain in the mother because some mother complain whose baby working outside that they feel some abnormal sensation or itching in the breast . When their child is not okay .

Single Son Syndrome

   
    A child was consulted with many doctors many times at Saharsa for some or other reasons but no relief . His parents thought of consulting doctors at Patna the parents lived at near by village named Chainpur . When they reached Saharsa platform the boy started crying for abdominal pain. As my clinic was near the platform so they brought the boy to my clinic .

 I examined the boy thoroughly but could find no disease . Then again I pulpated his abdomen three times after some interval engaging him in different talks and told him to point out the area of maximum tenderness . He marked three different points of tenderness at different palpation . My junior doctor insisted me on doing emergency laparotomy . I told him to wait and watch.

I asked his father who was a school teacher, “How many child you have ?".
 The teacher replied ,  “ Sir, I have only one son. kindly do something ,I can spend anything". 
I asked him,“ Did you visit any shop in the way to the station ". 
The gentleman replied “yes sir ,I visited one shop in the way to the station ". I asked him “Did this child insist on purchasing something for him .   Yes sir, he was bent upon purchasing one toy -car which I could not give him . I thought it was completely a wastage of money ."

  I ordered the gentleman to bring the toy-car immediately . The gentleman ran to the shop and brought the toy car and gave that to me . I just rolled the car on the floor toward the ailing child . The ailing child jumped out of his bed and caught the car and became very happy. His abdominal pain was gone to the winds .