Spot the Diagnosis 681-690

(681) A lady of 50 has come. She feels dyspoenic when walking for a long distance. On auscultation there is mid diastolic murmur and on inquiry gives the history of epistaxis. Spot the diagnosis?

(682) A patient has come with a sinus which looks like an ulcer due to wide mouth, thin blue, an undermine edge. Spot the diagnosis?

(683) A male patient has come in the emergency for severe agonising pain. The pain is lessened when he sits up or lies down on abdomen. Spot the diagnosis?

(684) A patient of road accident has come in the emergency. He has severe abdominal pain in the left hypochondrium. He is pallor and has running pulse and pain and hypersthesia in the right shoulder. Spot the diagnosis?

(685) A patient has come with large liver without palpable spleen and there is no finding what so ever except leucocytosis. Spot the diagnosis?

(686) A patient has been admitted in medical ward. He has fever, arthralgia, plural pericardial rub and unexplained heart murmur.the patient responded well to aspirin. Spot the diagnosis?

(687) A nurse is addicted to taking drugs for years together now has grown abnormally fatty,developed hypertension and diabetes. Spot the diagnosis?

(688) A patient was admitted in the medical ward for fever,rigor and sweating. On examination there are clubbing of fingers, on palpation spleen is palpable and on auscultation there are cardiac murmur. Spot the diagnosis?

(689) An elderly person has been admitted in the medical ward for hemiplegia. He gives the history of fever, rigor and sweating. On auscultation there is cardiac murmur and arrhythmias. Spot the diagnosis?

(690) A patient has come with dilation of superficial veins on the side of abdomen. The flow of the blood is from lower to upper side. Spot the diagnosis?

Answers
(681) Miteral stenosis.
(682) Tuberculous sinus.
(683) Acute pancreatitis.
(684) Splenic rupture.
(685) Liver abscess.
(686)Rheumatic fever.
(687) Iatrogenic cushing syndrome.
(688) Subacute bacterial endocarditis.
(689) The cause of hemiplegia is subacute bacterial endocarditis.
(690) Obstruction of inferior venacava.

Spot the Diagnosis 671-680

(671) You have been shown a Barium -meal X-ray of abdomen in which there is a spasm of the terminal part of the ileum and elevated portion of the caecum. Spot the diagnosis?

(672) A patient has come with oedema of both lower limbs. On examination there is a huge,firm and nodular tumour in the abdomen which doesn't move with respiration. Spot the diagnosis? 

(673) A patient has come who has a hard and irregular lump in the right iliac fossa. On examination the right side testis is unfounded. Spot the diagnosis?

(674) A lady of 32 came in the surgerical emergency with severe pain in the lower abdomen,  vaginal bleeding and shock like features. She gives the history of ammenorrhea for two months. She was operated for tubectomy two years back. Spot the diagnosis?

(675) A patient of injury has come. He has rigidity of the neck but no fever. Spot the diagnosis?

(676) A patient of head injury has come. He has rigidity of the neck with fever. Spot the diagnosis?

(677) A patient of head injury is admitted. His temperature of body is above 101 degree. Spot the diagnosis?

(678) A male patient of 45 has come with stricture of rectum. The stricture is hard, irregular and ulcerated. Spot the diagnosis?

(679) A young lady of 30 has come in the S.O.P.D. She has stricture of rectum. On inquiry she gives the history of previous vaginal sores and inguinal bubo. Spot the diagnosis?

(680) A child of 10 has come. He feels pain in the hypogastrium. Pain is referred to the tip of penis and haematuria at the end of micturation. Spot the diagnosis?

Answers.
(671) Hypertrophic ileocaecal tuberculosis.
(672)Retroperitoneal sarcoma.
(673)Malignant undecended testis.
(674)Ruptured ectopic gestation.
(675) Fracture- dislocation of cervical spine.
(676) Subarachnoid haemorrhage.
(677) Intracranial haemorrhage.
(678)Carcinoma rectum.
(679) Lymphogranuloma inguinale.
(680)Stone in urinary bladder.

Spot the Diagnosis 661-670

(661) A patient has come his liver is enlarged, hard and irregular. His one eye has been removed earlier. Spot the diagnosis?

(662) A patient has come with splenic enlargement,haemetemesis and caput meducae. Spot the diagnosis?

(663) A patient was admitted in the surgical ward for hectic rise of temperature,tachycardia, rigor. His X-ray shows gas under dyphram. He was a known case of PU syndrome.

(664) A patient has come with a well defined intraabdominal cyst. The cyst moves freely at right angle to the line mesentry.

(665) A lady has come with a firm and rounded mass below the umbilicus. The mass is arising from the deeper part of rectus abdominis muscle.

(666) A fatty lady aged about 50 complains of pain in the right shoulder and right side of back.

(667) A patient has an ulcer. The edge of the ulcer is thin, undermined and bluish. Spot the diagnosis?

(668) A fatty lady patient of 50 has come with right upper abdominal pain and pain in the right  shoulder. Spot the diagnosis?

(669) A fatty male patient of 60 has come with pain in the upper epigastrium and pain in the left arm. Spot the diagnosis?

(670) A child of 10 has come with intestinal obstruction and was diagnosed as a case of intussception but he gives the history of vomiting round worm. Spot the diagnosis?

Answers.
(661) Melanotic sarcoma of the liver.
(662) Cirrhosis of liver.
(663) Subphrenic abscess due to subacute perforation of peptic ulcer.
(664) Cyst of the mesentry.
(665) Desmoid tumour.
(666) Cholecystitis.
(667) Tuberculous ulcer.
(668) Acute Cholecystitis.
(669) Ischaemic heart disease.
(670) intestinal obstruction due to impaction of round worms.

Spot the Diagnosis 651-660

(651) You get a telephonic call  that your sister aged about 50 at home got abdominal pain with vomiting. Spot the diagnosis?

(652) A lady of 45 got abdominal pain at epigastrium to the right  side of rectus abdominis. Spot the diagnosis?

(653) A lady got pain at right  hypochondrium which is referred to the shoulder.

(654) A lady of 50 got pain in the epigastrium penetrating through to the back. Previously she was suffering from peptic ulcer.

(655) A patient has come with pain at right hypochondrium. He gives the history of irregular bowel for months together. There is intercostal tenderness. Spot the diagnosis?

(656) A patient has come with a fluctuant swelling with no sign of inflammation in the right hypochondrium. Spot the diagnosis?

(657) A patient with inflamed piles now complains of high fever with rigor. Spot the diagnosis?

(658) A medical student  has diagnosed a case as carcinoma of liver but on his pathological exam his W.R is positive. Spot the diagnosis?

(659) A patient has come with a hard, irregular and nodular liver with umbilication . Spot the diagnosis?

(660) A patient has come with a cystic and fluctuant swelling on the lower part of liver. He gives the history of urticaria and the eosinophilia. Spot the diagnosis?

Answers
(651) Cholecystitis.
(652) Gall -bladder disease.
(653) Gall -bladder disease.
(654) Peptic ulcer penetrating to the pancreas.
(655) Amoebic hepatitis.
(656) Cold abscess due to tuberculous ribs or spine.
(657)Suppurative pylephlebitis.
(658) Gumma of the liver.
(659) Carcinoma of liver.
(660) Hydatid cyst.

Spot the Diagnosis 642-650

(642) You have been shown an X-ray plate of tibia. There is wide spread rarifaction with subperiosteal deposition of bone longitudinally.

(643) You have been shown an X-ray of a bone in which there is a soft tissue shadow. Spot the diagnosis?

(644) A lady of 60 has come with fracture of humerus. Her right breast was removed earlier. Spot the diagnosis?

(645)  A patient has come in the emergency for abdominal pain with vomiting. There is visible peristalsis which moves from left to the right. Spot the diagnosis?

(646) A patient of 50 has come in the S.O.P.D. He has enlarged left supraclavicular lymph gland.
(a) Spot the diagnosis?
(b) What is the name of the gland?

(647) A patient has come. When his loin just outside of erector spinae was percussed it is found to be dull. Spot the diagnosis?

(648) A patient of 50 has come with pain in the epigastrium which passes through to the back. The pain is aggrevated when he lies down and lessens when he sits up.  Spot the diagnosis?

(649) A lady have been admitted in the surgical ward for a lump in the epigastrium. The mass is less mobile and more tender. Spot the diagnosis?

(650) A patient of 55 has been admitted for a lump in the epigastrium. The lump is farm, irregular and tender. Spot the diagnosis?

Answers.
(642) Ewing's tumour.
(643) sarcoma.
(644) Secondary carcinoma of humerus primary was in the breast.
(645) Pyloric stenosis.
(646) (a) Carcinoma of stomach.
(b) Troisier's sign.
(647) Renal tumour.
(648) Carcinoma of the body and tail of pancreas.
(649) Leaking perforation of peptic ulcer.
(650) Carcinoma stomach.