Spot the Diagnosis 1026-1034

 1026) A lady patient has come in the  emergency  and complaints that there is sudden increase in the size of her goitre with pain.spot the diagnosis ? 

1027) A young boy has come with a cystic swelling in the neck . When asked to swallow the swallowing moves upward with protrusion of tongue.  Spot the diagnosis?

1028) A young boy has come with a small ulcer  near the mid line of the neck below hyoid bone with a crecentric fold of skin , spot the diagnosis ?

1029) A patient of injury has come with oedema of anatomical smull box,spot the diagnosis ? 

1030) A patient of accident has come in the emergency ,he has three things a) blood per urethrun b) perineal haematoma c) and

 distended bladder 

1031) A patient of injury has come with tumor like mass in the supra pubic region with strangury when catheter is passed the catheter goes easily but blood stained urine  comes . Spot the diagnosis ?

1032) A patient has come whose urine is acidic in nature contains pus cells and on ordinary culture ,it is sterile. What do you suspect and what more test you will do to confirm ? 

1033) Urine of a patient contains large amount of calcium and on plane x - ray abdomen there is renal stone.what is the cause of renal stone ?

1034) A fat patient of forty has come in the emergency for acute abdomen and  he has brusing in the loin and red area around the umbilicus. Spot the diagnosis ? 

Answers -

1026 ) Haemorrhage in the thyroid

1027) Thyroglossal cyst

1028) Thyroglossal fistula

1029) Fracture of scaphoid bone 

1030) Urethral damage 

1031) Injury to the bladder 

1032) Renal tuberculosis and to detect the special  culture of urine or animal inoculation test

1033)  Hyperparathyroidisn

1034) Acute pancreatitis

Spot the Diagnosis 1013-1020

(1013) You have been shown an X-ray plate in which there is bilateral effusion at the base of the lungs and prominent aorotic knucle . Spot the diagnosis?

(1014) A patient has been admitted in the emergency with silent heart , increased area of cardiac dullness and steady fall in arterial pressure and with gradual rise in the venous pressure . What is the urgent treatment . Spot the diagnosis?

(1015) A patient has a cystic swelling on the outer canthus of the eye which is free from the skin but fixed to the underlying skull in which there is saucer - shaped depression with a peripheral ridge . Spot the diagnosis?

(1016) A patient has come with a parotid temour and his facial nerve is affected . Spot the diagnosis?

(1017) A patient has come in the outdoor . He has a submandibular swelling which becomes tense and tender during meals . Spot the diagnosis?

(1018) A patient has come with swelling of all salivary glands including lacrimals . Spot the diagnosis?

(1019) A patient complains of hypersthecia during shaving on one side of check . The check and parotid area that side is red, hot and tender . He has a history of operation for suppurative parotiditis . Spot the diagnosis?

(1020) A known case of mixed parotid tumour has come and complains that it has become painful now, growing rapidly and feels hard . On examination it is found to be fixed to the masseter and mandible . Spot the diagnosis?

  Answers.

(1013) Acute left ventricular failure .

(1014) Hemopericardium . Aspiration of the pericardium through left costoxiphoid angle.

(1015) External angular dermoid cyst.

(1016) Malignant transformation in parotid gland .

(1017) Sub mandibular salivary stone .

(1018) Muculics's disease.

(1019) Frey's syndrome.

(1020) Malignant transformation in mixed parotid tumour .

Spot the Diagnosis qllllllllllll) llll) llllll

(1005) A patient has come with injury . He is unable to raise his one leg but can move his foot . Spot the diagnosis?

(1006) A patient has come with injury . He is unable to raise his both limbs . After X ray there is no fracture in both the limbs . Spot the diagnosis?

(1007) A patient above 40 has come with bilateral renal swelling . Spot the diagnosis?

(1008) A patient has come with pain referred to the tip of penis and haematuria at the end of micturation . Spot the diagnosis?

(1009) A patient has come with throbbing pain in the perineum . Spot the diagnosis? 

(1010) A child of 7 has come with his parents who complain that his child screams during micturation and pulls at the prepuce . Spot the diagnosis?

(1011) An adult feels scalding pain during micturation . Spot the diagnosis?

(1012) A boy of four has come with painless gross enlargement of kidney with haematuria . Spot the diagnosis? 

Answers.

(1005) Fracture of femur .

(1006) Injury to the cord.

(1007) Polycystic kidney.

(1008) Bladder stone.

(1009) Prostatic abscess .

(1010) Stone in the bladder .

(1011) Acute urethristis .

(1012) Wilms's tumour .

Spot the Diagnosis 998-1003

(998) A patient of injury has been admitted .He is unable to raise one leg but can move his foot . Spot the diagnosis?

(999) A lady of 65 with injury has been  brought on a strature . Her left leg is externally rotated . Spot the diagnosis?

(1000) An X ray of the hip joint has been shown to you in which there is rarification in the babecock's triangle. Spot the diagnosis?

(1001) A baby has been brought. He has a big mass attached to the sacral area there is rudimentary hand and finger . Spot the diagnosis?



(1002) A patient has a swelling for long years with no complain . Spot the diagnosis?


(1003) A patient has swelling . He give the history of reduction in size in the past . Spot the diagnosis?

(1004) A patient has come with a browny induration which pits on pressure by the finger . Spot the diagnosis?

Answers.
(998) Fracture of femur .
(999)  Fracture neck of femur  .
(1000) Tuberculosis hip joint .
(1001) Sacrococcygeal teratoma.
(1002) Benign growth.
(1003) Inflamatory or super imposed infection in a malignant growth.
(1004) Suppuration.

Spot the Diagnosis 988-997

(988) A patient has come with a sinus on the ramus of the mandible with a history of watery discharge at the time of meals . Spot the diagnosis?

(989) A lady patient complains of sudden increase in the size of thyroid      associated with pain . Spot the diagnosis? 

(990) A patient has come with a big cystic swelling of the temporal region of scalp with complete baldness over the cyst . Spot the diagnosis?

(991) A patient has come with a cystic swelling on the finger with a history of pin- prick . Spot the diagnosis?

(992) A lady of 45 got vertigo and fell on the ground . There was bleeding from her ear and she died within few hours . Spot the diagnosis?

(993) You have been shown an ulcer . The margin of which is raised and everted . Spot the diagnosis?

(994) You have been shown an ulcer . The margin of which is thin bluish and undermined . Spot the diagnosis?

(995) You have been shown an ulcer . Which is raised and beaded . Spot the diagnosis?

(996) A patient of 20 has come with painful lymphadenitis . Spot the diagnosis?

(997) A patient has come with enlarged sub- occipital and epitrochlear glands . Spot the diagnosis?

 Answers

(988) Parotid fistula .

(989) Haemorrhage in the thyroid .

(990) Sebaceous cyst.

(991) Implantation dermoid .

(992) Haemorrhage in the middle cranial fossa. She might have severe hypertension.

(993) Carcinoma.

(994) Tubercular ulcer .

(995) Basal cell carcinoma.

(996) Septic lymphadenitis.

(997) Syphilitic gland.

Spot the Diagnosis 934-987

934: A patient of dyspnea and dysphagia has been admitted.He has spleno-hepatomegaly and generalise lymph-adenopathy

Ans: Hodgekin's disease

935: An unmarried girl of 24 has been brought by the parents for a thickened overgrowth of fibrous tissue over the manubrium sterni which is vascular,bluish and has finger  like processes.

Ans:keloid

936: A  patient has come with the superficial gangrene of hands.His W.R is positive.

Ans: Shringomylia

937:A patient of gangrene of index finger of left hand has come.On auscultation there is mid diastolic murmur.

Ans: Embolic gangrene

938: A patient of severe car accident has come.He has diminshed cardio-sound,increased cardiac dullness and low b.p.

Ans: Haemo-pericardium.

939: A patient has come in the emergency. On rectal examination his anterior rectal wall is bulging with tenderness.

ans: Pelvic abcess

940: A severely ill patient of pain abdomen has come in the emergency.On rectal examination there is tendernessin the recto-vasical pouch.

Ans: perforated peptic ulcer.

941: A patient of pain in lower abdominal rt side has come. on the P.R Pain in the right wall of rectum.

Ans:Acute appendicitis

942: A patient has come with many cysts on the scalp.One of the cyst is ulcerated and looks like epithelioma.

Ans: Cock's peculiar tumour.

943: A patient has come with a unilateral, purulent nasal discharge and there is tenderness on the maxilliary prominenece.

Ans:empyema of maxilliary prominence.

944:A child has come with bluish swelling on the side of midline of the floor of the mouth.the warton's duct is visible.

Ans: Ranula

945: An opaque cyst in the middle of the floor of the mouth found in a child.

Ans: dermoid cysts

946: A Patient has come.His urine is acidic,contains pus cells and on ordinary culture there is no growth.

Ans: Renal tuberculosis

947: An old man has come with gynocomasia.He was taking some drug for months alltogather for suspected case of carcinoma prostate.which drug it may be?

Ans: Stillbostrom

948: A patient of severe abdominal pain has been admitted.He feels more
agonising pain when he lies on his back and lessens when he sits up.

Ans: Acute Pancreatitis

949: A patient of acute appendititis has been admitted.Now he says that his pain is lessened too much.

Ans:Perforation of appendics has occured.

950:A patient of colicky pain now complains that the colicky pain has now turned into burning pain.Spot the Diagnosis

Ans : Peritonitis has set-in

951: A retired doctor has come.He complains of persistent flexion of his terminal phalanx of his left index finger.

Ans: Mallet fingers (due to rupture of extensior tendons)

952: A patient has come with a boney swelling under the flexor retinaculur.

Ans: dislocation of lunate bone.

953: A lady has come with oedema  and tenderness of her rt.anatomical snuff box

Ans: Fracture of the scaphoid

954: A lady has come with a haematoma on the thenarspace. When asked to touch the littlefinger of the injured hand by the thumb of the same hand but he fails to do this.

Ans: bennett's fracture

955: A child of 10 has come with superficial ulceration of the arm. The ulcer heals at the centre and active at the periphery.

Ans: lupus vulgaris

956: A patient has come with multiple sinuses in the perinium discharging sulphur granules

Ans: actinomycosis

957: A patient of 25 has come with raised and hypertrophied epithelium around the anus and his epitrochlear and sub occipital lymph nodes are enlarged

Ans: Syphilis in the secondary stage

958: A patient has come with multiple acute ulcers on his genitals with copius purulent secretions with acute lymphoplasia.

Ans: ducreyi ulcer

959: An adult male has come with enlarged epitroclear and sub occipat group of lymph nodes enlargement.

Ans: Syphilis in the secondary stage.

960: A patient of hand injury has come. His middle metacarpel is depressed on examination as compared with the sound side when he makes a fist.On x-ray examination his middle metacarpel is not fractured

Ans: Dislocation of the Semi-lunar

961: A patient of hands injury has come.His middle metacarpel on one hand is depressed when he makes a fist as compared to the sound side

Ans :fracture of the middle metacarpel

962: A febrile patient aged 12 yrs was admitted in surgical ward.He is having pain abdomen and vomiting.The site of the pain was around the umbilicus.There is increse in the neutrophil count and on the ultrasound of the abdomen it is all okay. There is a history of pain in the right illiac fosa.

Ans : Appendicitis

963: A lady of 45 has come with a hard lump in her breast and pain & tenderness in the spine

Ans: carcinoma breast and metastitis in the spine

964: A lady patient has come. She has a lump in the breast which becomes painfull at the time of mensturation.

Ans: fibroedinosis

965: A lady has come,she complains of dark green discharge from the nipple.

Ans: fibroadenosis

966: A patient has come with painfull intermittent jaundice.

Ans : Stone in the CBD

967: A patient has come with painless and progressive jaundice

Ans : Carcinoma head of pancreas



969:A patient of 37yrs has come with a lump in the epigastrium.The lump is less mobile and more tender.

Ans: Perforating peptic ulcer

970: A patient of recurring pain abdomen has come .All the test prescribed was done but no positive finding.He complains of ligtening pain in the legs,loss of ankle joint,sluggishness in the papillary reaction and history of syphilis the long back.

Ans:Tabes dorsialis

971: A patient of severe chest pain has come.On palpatation you have detected a fracture in the sternum.What is that bone that is fractured simultaneously very frequently.

Ans: Spine 

972: A patient has come with a x-ray plate of his chest.In his X-ray there is a cannon-ball appearance.

Ans: hypernephroma

973: A patient of chest injury has come with emphysema of neck,face and chest and then abdomen.what is that emphysema and where is the rupture

Ans: Midiastinal emphysema due to rupture of the bronchus

974: A patient of chest injury has been admitted.His Chest X-ray Shows horizontal line of the haemorraghe in the plural cavity.

Ans : Haemo pnemo thorax

975: A patient of fifty has come with huge enlargement of the spleen.The spleen is enlarged beyond the umblicus. There is sternal tenderness on pressure by the fingers.

Ans: Chronic myeloid leukemia

976:A patient of 50 has come with a enlarged lyphatic gland in the occipital triangle and enlarged lymph node in the epitrochlear area.

Ans : secondary syphilis

977: A patient has come with the pigmentation of the skin. On examination there is pigmentation of the buccal mucosa.

Ans: Addison's disease

978: A male patient of 50 complains of throbbing pain in the perinium.

Ans: prostatic abcess

979: A patient of 15 has come with a firm, irregular, fixed and tender lump.The patient has given history of diminishing of swelling sometime back. Two surgeons have difference in opinion.One says that the malignancy and the other says its inflammatory.What is your opinion??

Ans:Inflammatory swelling

980: A patient has come with a long standing parotind tumour. Now there is facial nerve involvement.

Ans:Malignancy has developed in the parotid tumour.

981: A newborn was brought.It has a naevus in the small of the back.            
Ans: Spina bifida occulta

982: A patient has come.He has swelling in the scalp which looks like a bag full of pulsating earthworms.

Ans: Cirdoid ananeursymal haemangiona

983: A patient has come with a brownish-red-nodule with shining surface showing fine cappillaries over it.It lies on the cheek by the side of the nose.

Ans:rodent ulcer

984: An X-ray plate of the knee-joint was shown to you in which there are soft tissues shadows seen with flecks of calcification.

Ans: Malignant synovioma 

985: A patient of 60 has come. He cannot raise his right leg but can move the right foot.

Ans: fracture of the femoral neck

986:A patient has come with huge enlargement of spleen upto the umblicus and the surface of the spleen is very hard.There is sternal tenderness

And: Myloid leukemia

987: A patient has come with huge enlargement of spleen up to the umblicus.The spleen is soft and the platlets count is very low.

Ans : essential thrombo cyto paenic pupurra haemorragica   

Spot the diagnosis 934-950

934:A patient of dyspnoe and dysphagia has been admitted in the ward. He has spleeno-hepatomegaly and generalised lymphoadenopathy.

Ans: Hodegekins Dideases

935: An unmarried girl has a thickened overgrowth on manibrium sterni which is bluish and has finger like processes.

Ans: Keloid

936: A patient has come with superficial gangrene of hand.His WR ispositive.

Ans: Sryngomylia

937: A patient of gangrene of index finger of left hand come. On auscultation there is mid-diaostolic murmur.

Ans: Embolic gangrene

938: A patient of severe car accident has come. He has diminished cardiac sound. Increased cardiac dullness and low BP.

Ans: Haemopericardium

939: A patient has come in the emergency. On rectal examination his interior rectal wall is bulging with tenderness.

Ans: pelvic abcess

940: Seriously ill lady patient of pain abdomen has come in the emergency.On rectal examination there is tenderness in the recto-vesical pouch.

Ans: Perforated peptic ulcer.

941: A patient of pain in lower abdomen right side has come.On P.R there is pain on the right wall of the rectum is present.

Ans: Acute appendicitis

942: A patient has come with many cysts on the scalp.One of the cyst is ulcerated and looks like epithelioma

Ans: Cock’s peculiar tumour

943: A patient has come with unilateral purulent nasal discharge and there is tenderness in maxillary prominence.

Ans: empyema of maxillary antrum.

944: A child has come with a bluish swelling on the side of midline on the floor of the mouth.The Warton’s duct is visible

Ans :Ramula

945: An opaque cyst in the midline of the floor of the mouth is found in a  child

And: Dermoid cyst

946: A patient has come.His Urine is acidic in nature and contains pus cells. And on ordinary culture there is no growth.

Ans: Renal tuberculosis

947: An old man has come with gyenocomasia. He was taking some drugs for months together for suspected case of carcinoma prostate. Which drug it may be?

Ans: Stillboestroll.

948: A patient of severe abdominal pain has been admitted. He feels more agonising pain when he lies on his back and lessened when he lies on his abdomen or sits up.

Ans: acute pancreatitis

949: A patient of acute appendititis has been admitted.Now he says that his pain has reduced a lot.

Ans: Perforation of appendix has occurred.

950: A patient of colicky pain now complains that his colicky pain has now changed into burning pain.

Ans: peritonitis has set in