Spot the Diagnosis 851-860

(851)  An already diagnosed case of carcinoma has come . Now he complains of pain . What does it indicate?

(852)  A young boy of 12 has come with a swelling on the upper portion of tibia . He says that previously only pain was there ,now swelling has developed . Spot the diagnosis?

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

(854) A patient has come with a swelling on the posterior side of the neck which has browny induration and multiple sieve like openings . Spot the diagnosis?

(855) A patient has come with a swelling. The swelling pits on pressure and there is browny induration. Spot the diagnosis?

(856) A lady has come with a black and bleeding ulcer of the big toe . When examined her liver is enlarged ,tender,hard and nodular. Spot the diagnosis?

(857) A patient has come with a swelling. There is history of reduction of the swelling at one time . The diagnosis of the swelling is thought to be malignant . Spot the diagnosis?

(858) A patient has come with a swelling . He was diagnosed as a case of sarcoma . There is a history of hectic type of temperature with rigor and sweating . Spot the diagnosis?

(859) A patient has come with a swelling . The regional lymph glands are enlarged and tender . Spot the diagnosis?

(860) A patient has come with a swelling with fixicity , local heat and ill defined margin  . Two surgeons have  difference of opinion . One says it is a case of carcinoma and the other day chronic inflammation. What is your opinion?

Answers.

(851)  Ulceration,deep infiltration and involvement of nerves .

(852) Osteogenic sarcoma .

(853) Post auricular Dermoid cyst .

(854) Carbuncle .

(855) There is suppuration .

(856) Malignant melanoma .

(857) Inflammatory swelling.

(858) The swelling contains puse .

(859) Inflammatory swelling.

(860) Chronic inflammation.

Spot the Diagnosis 841-850

(841)  A lady patient has come with neurofibromatosis of the whole body . Her one breast was removed earlier . Spot the diagnosis why her breast was removed?

(842) A patient of epilepsy has come who has neurofibromatosis . Spot the diagnosis?

(843) A patient has come with heart murmur  and fever . He has developed epilepsy . Spot the diagnosis?

(844) A patient has come with epilepsy he has vascular naevi on the face . Spot the diagnosis?

(845)  A patient has come who has epilytic fits . On examination there are white spots on the trunks and limbs and sebaceous oedema on the face. Spot the diagnosis ?

(846) A patient has come with recurrent attacks of fits . He has sixth crenial nerve palsy .

(847) A patient of epilepsy has come. On clinical examination there is nothing abnormal only the intracranial pressure is raised . Spot the diagnosis?

(848) A patient of epilepsy has come his cell - count of CSF is very high . Spot the diagnosis?

(849) The total protein of CSF of a patient of epilepsy is greater than 100mg per 100ml of CSF . Spot the diagnosis?

(850) A patient has come with facial palsy with herpes zoaster of external auditary canal . Spot the diagnosis?

Answers 

(841) Her breast was removed wrongly for carcinoma breast but it was a case of neurofibroma of the breast .

(842) Neurofibroma of the brain .

(843) Embolism .

(844) Sturge-weber syndrome.

(845) Tuberous sclerosis.

(846) Epilepsy is due to raised intracranial pressure.

(847)Expanding intracranial lesion . what

(848) An infective process in the brain .

(849) Intracranial tumour.

(850) Ramsay hunt syndrome.

Spot the diagnosis 811-830

(811) An old man has come with multiple sebaceous cyst on the scalp . The prominent cyst is ulcerated and fungated . Spot the diagnosis?

(812) An infant has been brought with cellulitis near the  knee joint . Spot the diagnosis?

(813) An adult patient has been brought with cellulitis of scrotum . Spot the diagnosis?

(814) A cystic swelling was removed from a patient and dissected which contained hair in pultaceous mass . Spot the diagnosis?

(815) A patient has come with a cyst which has a punctum . Spot the diagnosis?

(816) A patient has come with a cyst which is fixed to the pericranium with erosion of the bone . Spot the diagnosis?

(817) A patient has come with a cyst in the finger . He gives the history of pin-prick . Spot the diagnosis ?

(818) A patient has come with a firm and irregular elevation from the skin . The margin is pink and tender . He gives the history of burn scar . Spot the diagnosis?

(819) A lady patient has come with a rounded ,firm and elastic swelling on the dorsum of wrist joint of the size of a nut . Spot the diagnosis ?

(820) A lady has come with a swelling of nut - size on the Palmar side of wrist joint which is firm, rounded and elastic .

(821) A lady of 40 has come with a palpable pea- size swelling on the radial styloid process which is painful on passive aduction and ulner deviation . Spot the diagnosis ?

(822)  A patient has come with a cystic swelling in the palm which extends in to the forearm which is above the wrist joint . There is cross fluctuation . Spot the diagnosis?

(823) A patient has come with a thick scar which gives rise to itching . Which is  vascular and tendancy to spread . Spot the diagnosis?

(824) A baby was born. There is a naevus in the midline over the small of the back . Spot the diagnosis ?

(825) A young lady of 25 has come for the repeated attack of faintness . She has portwine stain on her chicks right side . Spot the diagnosis?

(826) A patient has come with a horn like structure from the scalp . Spot the diagnosis?

(827) A patient of head injury has come. He has palsy ,hyperpyrexia and pin - point and fixed pupil. Spot the diagnosis?

(828) A lady of 40 has come for epilepsy which start in the finger and unilateral . Spot the diagnosis ?

(829) A lady has come for locking of joints and effusion in the joint . Spot the diagnosis?

(830) A patient has come with epistaxis . There is a spider naevi on the chest and abdomen and his spleen is palpable . Spot the diagnosis?

Answers.
(811) Cock's piculiar tumour .
(812) Acute osteomyelitis.
(813)Extra vasation of urine .
(814) Dermoid cyst .
(815) Sebaceous cyst.
(816) Dermoid cyst.
(817) Implantation Dermoid .
(818) Keloid .
(819) Dorsal gangliom.
(820) Palmar gangliom .
(821) De quervan's disease.
(822) Compound Palmar gangliom ( tuberculous affection of ulner barsa ).
(823) Keloid .
(824) Spina bifida ossulta .
(825) Sturge-weber syndrome .
(826) Sebaceous horn.
(827) Pontine haemorrhage .
(828)  Jacksonian epilepsy.
(829) loose body in the joints.
(830) Cirrhosis of liver .

Spot the Diagnosis 801-810

(801) A patient has come with superficial gangrene of fingers . On clinical examination everything is normal. The surgeon prescribed X  ray neck. Spot the diagnosis? 

(802) A patient of 65 has come with dry gangrene of finger of foot which was caused paring nails. On X ray there is calcification of arterial wall. Spot the diagnosis? 

(803) A patient has come with all the features of cervical rib but on X ray there is no cervical rib seen. Spot the diagnosis? 

(804) A patient has come with an ulcer on the old burn scar, the margin is raised and everted but the progress of spreading is very slow. Spot the diagnosis? 

(805) A patient has come with an ulcer on the face just by the side of nose. The edge of the ulcer is raised and beaded. Spot the diagnosis? 

(806) A patient has come with an ulcer and the lymph node in the drainage area are stony hard and fixed to the surrounding structure. Spot the diagnosis? 

(807) A patient has come with an ulcer on Penis and his inguinal glands are firm discrete and shotty. Spot the diagnosis? 

(808) A patient has come with a sinus which is at the end of tibia. Spot the diagnosis? 

(809) A patient has come with a Deepening groove around the root of little finger of foot. Spot the diagnosis? 

(810) A patient has come with a swelling which has arousen from a lymph node. The skin over the swelling is tense and glossy with dilated cutaneous veins over it. 

Answers. 

(801) Cervical rib.

(802) Senile gangrene. 

(803) Scalenus anticus syndrome. 

(804) Marjolin's ulcer.

(805) Rodent ulcer. 

(806) Secondary deposite in the lymph gland. 

(807) Hunterian chancre. 

(808) Osteomylitis. 

(809) Ainhum. 

(810) Lymphosarcoma.

Spot the Diagnosis 791-800

(791) A patient has come with a single sinus over the ramus of lower jaw. Spot the diagnosis? 

(792) A patient has come with multiple indurated sinuses in the neck. Spot the diagnosis? 

(793) A patient has come with a sinus in the neck which looks like an ulcer and the margin is thin and undermined. Spot the diagnosis? 

(794) An adult male has come with painless paronychia. Spot the diagnosis? 

(795) An adult male has come with an ulcer on the tibia. The edge of the ulcer is punched out. Spot the diagnosis? 

(796) An adult male of 40 has come with dry gangrene of right big toe. The patient is a heavy smoker. Spot the diagnosis? 

(797) A known patient of mitral stenosis has come with gangrene of ring finger of his left hand. Spot the diagnosis? 

(798) A young female has come with ulceration of tips of fingers with severe sweating. The pulse is unaffected. Spot the diagnosis? 

(799) A patient has come with wet gangrene. He has a long history of diabetes mellitus. Spot the diagnosis? 

(800) A patient has multiple fistula on the scrotum has come. Which part should be examined throughly. Spot the diagnosis? 

Answers 

(791) Osteomylitis. 

(792) Actinomycosis.

(793) Tuberculous sinus.

(794) Morvan's disease.

(795) Syphilitic ulcer. 

(796)Burger's disease. 

(797) Embolic gangrene. 

(798)Reynaud's disease.

(799) Diabetic gangrene. 

(800) lower urinary tract.

Spot the Diagnosis 781-790

(781) A patient has severe rigors followed by severe sweating.  What is this clinical condition? 

(782) A patient has come with pain and swelling of the knee joint. On X ray of this joint, there are flex of calcification and soft tissue shadows. Spot the diagnosis? 

(783) A lady patient has come with a pinhead, small bluish point below the nail with pain. The pain is excruciating when the nail is pressed. Spot the diagnosis? 

(784) A young patient has come with a fast growing tumour. Veins over the swelling is engorged and on auscultation gives murmur like sound.

 Spot the diagnosis? 

(785) A young patient has come with an ulcer. The margin of the ulcer is undermined, thin and bluish. Spot the diagnosis? 

(786) An adult patient has come with an ulcer. The margin of the ulcer is thick perpendicular and punched out. Spot the diagnosis? 

(787) A patient  60 has come with an ulcer with raised and rolled out margin and gives the look of a cauliflower. Spot the diagnosis? 

(788) A patient has come with an ulcer on the face. The margin is raised and beaded, not everted. Spot the diagnosis? 

(789) A patient has come with greenish discharge from an ulcer with peculiar smell. Spot the diagnosis? 

(790) A young boy of 12 has come with a superficial ulcer of the skin of the face. It heals at the centre and spreads in the  periphery. Spot the diagnosis? the 

Answers 

(781) Pyemia.

(782) Malignant Synovioma. 

(783) Glomus tumour.

(784) Sarcoma.

(785) Tuberculous  ulcer. 

(786) Syphilitic ulcer. 

(787) Squamous- cell carcinoma. 

(788) Rodent ulcer.

(789) Infection by B.pyocyaneus.

(790) Lupus vulgaris.

Words of wisdom

Words of wisdom. 

(1) It is good to be ambitious but it is too bad to be too ambitious. You may have acute myocardial infaction and cerebral haemorrhage. 

(2) If you earn slightly less you will flourish in your business.

 If you eat slightly less you will remain healthy and disease- free for whole of your life.

 If you spend slightly more on others you will be the most popular and tension-free person and can enjoy the true pleasure of life.

Spot the Diagnosis 741-750

(741) What disease is associated with Neurolipomatosis?

(742) A patient has come with multiple nodules, firm in nature all over the body with patchy pigmentation of skin. Spot the diagnosis? 

(743) A patient has come with a lipoma. There is many capillaries over it and there is sign of compressibility. Spot the diagnosis? 

(744) A patient has come for generalised enlargement of lymph glands. The glands are rubbery in feel. On examination his spleen is also enlarged. Spot the diagnosis? 

(745) A patient has come with severe pain and sudden increase in the size of an old goitre. Spot the diagnosis? 

(746) A patient has come with dry gangrene of his big toe. He is a heavy smoker. Spot the diagnosis? 

(747) A patient has come with wet gangrene. His urine is loaded with sugar. Spot the diagnosis? 

(748) A patient has come with a cystic swelling in the midline near the hyoid bone and on Protrusion of the tongue it moves upward. Spot the diagnosis? 

(749) A patient has come with a fistula in the midline of the neck below hyoid bone. There is a crescentric fold of skin hanging from the wall of fistula and the mouth is indrawn. Spot the diagnosis? 

(750) A patient has come. There is dilated subcutaneous veins at the inlet of thorax. When the patient was told to raise his both hands above. When the hands is raised above the ears and kept for a while his face becomes congested with cynosis. Spot the diagnosis? 

Answers 

(741) It is associated with Dercum's disease. 

(742) Neurofibromatosis. 

(743) Naevolipoma.

(744) Hodgekin's disease. 

(745) Haemorrhage in the goitre. 

(746) Burger's disease.

(747) Diabetic gangrene. 

(748) Thyroglossal cyst.

(749) Thyroglossal fistula. 

(750) Retrosternal goitre.

Spot the Diagnosis 731-740

(731) A patient has an ulcer tongue. On X -ray chest his right apex is hazzy. Spot the diagnosis? 

(732) A patient has come who has pin-point and fixed pupil with paralysis . Spot the diagnosis? 

(733) A patient of head injury is admitted in the ward. He has palsy and pyrexia . Spot the diagnosis? 

(734) A patient has come with rigor and fever. He has swelling and tenderness of his scrotum. Spot the diagnosis? 

(735) A patient has come. He complains of bleeding per rectum specially when he passes hard stool and spatters the whole basin. Spot the diagnosis? 

(736) A patient of dactylitis has come. The affected bone is enlarged, spindle shaped and extremely painful. Spot the diagnosis? 

(737) Another patient of dactylitis has come. Every finding is the same as in (736) except it is painless. Spot the diagnosis? 

(738) A known hypertensive patient has come. Now he complains of complete deafness of only one ear. Spot the diagnosis? 

(739) A known hypertensive patient now complains of breathlessness on slight exersion. Spot the diagnosis? 

(740) A patient has come with multiple, painful lipomas all over the body. Spot the diagnosis? 

Answers 

(731) Tubercular ulcer. 

(732) Pontine haemorrhage. 

(733) Pontine haemorrhage. 

(734) Filerial fever.

(735) Internal piles.

(736) Tubercular Dactylitis. 

(737) Syphilitic Dactylitis. 

(738) He has developed hemiplegia due to cerebral thrombosis.

(739) He has developed acute left ventricular failure.

(740) Neurolipomatosis.

Spot the Diagnosis 721-730

(721) A fatty lady of 45 has come. There is severe pain in the right shoulder. Spot the diagnosis? 

(722) A male patient with abdominal injury has been admitted with severe pain on the left shoulder. Spot the diagnosis? 

(723) A patient has come. He is restless with pain at suprapubic region. Spot the diagnosis? 

(724) A patient has come with severe suprapubic and flank pain which radiates to the Penis, scrotum and upper portion of the thigh. Spot the diagnosis? 

(725) A patient has come with pain in the costovertebral region. Spot the diagnosis? 

(726) A patient has come with flank pain which extends to the corresponding side of abdomen. Spot the diagnosis? 

(727) A case of acute intestinal obstruction has come. There is early appearance of abdominal rigidity. Spot the diagnosis? 

(728) A patient has come with a lump in right iliac fossa the lump is tender, fixed and ill defined. Spot the diagnosis?

(729) A patient has come with a fistula in the midline, a little below the hyoid bone. The opening of the fistula is indrawn and overlaid by crescentric fold of skin . Spot the diagnosis? 

(730) A patient was diagnosed by a senior surgeon as a case of carcinoma tongue. In pathological examination his W.R was found to be positive. Spot the diagnosis? 

Answers.

(721) Cholecystitis.

(722) Splenic rapture. 

(723)Obstruction of the urinary bladder. 

(724) Obstruction of the intravesical portion of the ureter.

(725) Obstruction of uretro-pelvic junction.

(726) Obstruction of the ureter. 

(727) There is internal strangulation. 

(728) Appendicular lump.

(729) Thyroglossal fistula.

(730) Positive W.R will not exclude carcinoma.it p

Spot the Diagnosis 711-720

(711) A patient of 50 has come. His liver is rock -like hard. Spot the diagnosis? 

(712) A patient has come his spleen is enlarged up to the umbilicus and hard to feel. Spot the diagnosis? 

(713) A patient has hepatic enlargement. there is cardiac murmur. Spot the diagnosis? 

(714) A patient has rigor,fever and sweating for long. On examination his spleen is palpable, clubbing of fingers and cardiac murmur.Spot the diagnosis? 

(715) A patient has arterial bruit over the liver. Spot the diagnosis? 

(716) A female patient has come. She has cutaneous and mucus haemorrhage. (a)Her bleeding time is prolonged. 

(b) Low platelet count. 

(c) Normal clotting time. 

( d) Failure of the clot to retract. 

(717) A patient has come with jaundice, splenic enlargement, absence of bile in the urine and presence of bile in the stool. Reticulocyte count has increased. Spot the diagnosis? 

(718) A deep- jaundice patient has come. Bile is present in the urine but not in the stool. Spot the diagnosis? 

(719) A patient with dyspnoea, engorged neck vein and enlarged liver has come. Spot the diagnosis? 

(720) A patient with moon - face, hypertension, diabetes and osteoporosis has come. Spot the diagnosis? 

Answers 

(711) Secondary carcinoma.

(712) Chronic myeloid leukemia. 

(713) Congestive heart failure.

(714) Subacute bacterial endocarditis. 

(715) Hepatoma.

(716) Essential thrombocytopenic purpura haemorrhagica.

(717) Haemolytic jaundice. 

(718) Obstructive jaundice. 

(719) Congestive heart failure.

(720) Cushing syndrome.

Spot the Diagnosis 701-710

(701) A patient has come. He has palmar  erythema, spider naevi and palpable spleen. Spot the diagnosis? 

(702) An emaciated patient of 50 has come. He has been suffering from gastro-intestinal disorder for long. On examination his left supraclavicular gland is enlarged. Spot the diagnosis? 

(703) A patient has come. He has dilated veins on the abdomen. The flow of blood is  downwards. Spot the diagnosis?  

(704) A patient has come with ascites and palpable spleen. Spot the diagnosis? 

(705) A patient has come with pulsatile liver with ascites. Spot the diagnosis? 

(706) A patient has come with severe epistaxis. His liver is firm. Spot the diagnosis? 

(707) An old patient of pulmonary tuberculosis has come with a lump and pain in the right iliac fossa. Spot the diagnosis? 

(708) A patient has come with irregular bowel. On examination his liver is enlarged, soft and tender. Spot the diagnosis? 

(709) A diagnosed patient of acute appendicitis now complains of pain in the left iliac fossa. Spot the diagnosis? 

(710) An old malerial patient was hurt in his abdomen by a fist. He became pale with severe pain and hypersthecia on the left shoulder. Spot the diagnosis? 

Answers.

(701) Cirrhosis of liver. 

(702) carcinoma of gastro-intestinal tract. 

(703) Superior venacava obstruction.

(704) Cirrhosis of liver.

(705) Tricuspid regurgitation. 

(706) Cirrhosis of liver.

(707) Ileocaecal tuberculosis. 

(708) Amoebic hepatitis and colitis. 

(709) Peritonitis has set in.

(710) Splenic rapture.

Spot the Diagnosis 691-700

(691) A fatty lady patient has come with the pain in the right hypochondrium and vomiting. On examination her cartilage of the right eighth rib is tender. Spot the diagnosis? 

(692) A boy of twelve years has come with a hard ovoid swelling on the upper third of sternomastoid muscles. The swelling moves laterally but not vertically. The swelling when pressed causes slowing of the pulse- rate and  feeling of faintness. Spot the diagnosis? 

(693) A patient has come. He has pin-point,  fixed pupil, pyrexia and paralysis. Spot the diagnosis? 

(694) A patient of head injury is admitted in the surgical ward. After three days there appears echhymosis over the mastoid process. 

(a) What does it indicate?

(b) What is name of this sign? 

(695) A patient aged about 60 has come with an ulcer in the umbilicus. His lymph glands are enlarged both axillary and both groins. Spot the diagnosis? 

(696) An elderly patient has come with dysphagia and foul smelling from his mouth. On examination there is a fungating and endurated mass in the posterior half of his tongue.  Spot the diagnosis? 

(697) A lady patient of 50 has come. She has a hard and irregular lump in the breast and pain in the shoulder. Spot the diagnosis? 

(698) A lady patient of 30 complains of pain at menstrual period. Spot the diagnosis? 

(699) A lady patient of 30 has come. She has come for ammenorrhea, decreased toleration to cold,hypoglycemic episode and hypotension. Spot the diagnosis? 

(700) A patient having bone pain polyurea and renal calculia has come. Spot the diagnosis? 

Answers

(691)Cholecystitis. 

(692)Carotid body tumour (potato tumour) 

(693)Pontine haemorrhage. 

(694)(a)There is a fracture in the posterior cranial fossa.

(b) This sign is known as Battle's sign. 

(695) Primary carcinoma of the umbilicus. 

(696) Carcinoma of the tongue. 

(697) Carcinoma of breast with metastasis in the shoulder.

(698) Fibro-adenosis.

(699) Hypopituitarism. 

(700) Hypoparathyrodism.

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.

Spot the diagnosis 637-641

(637) A patient has come with tenderness over the metaphysis of tibia. Spot the diagnosis?

(638) You have been shown an X-ray plate in which there is a cavity in the metaphysis of the bone surrounded by sclerosed margin.

(639) You have been shown an X-ray plate in which there is pedunculated bony out growth from the metaphysis.

(640) You have been shown an X-ray plate in which the end of a bone is seen like a cavity. The cavity is soap bubble appearance and enlarged transversely.

(641) You have been shown an X-ray plate of humorous bone in which there is a cyst but the margin of the cyst is not sclerosed and expansion occurring along the long axis of the bone.
Answers.
(637) Acute osteomylitis.
(638) Brodie's abscess.
(639) Osteoma (exostosis)
(640) Osteoclastoma.
(641) Bone cyst.