Spot the Diagnosis XIV

(1)Epigastric mass with pulsation from left to right .

 Ans. Pyloric stenosis.

(2)A hard enlarged and nodular liver .

Ans..secondary liver.

(3) A patient of chronic peptic ulcer has reported for severe pain but suddenly his pain vanished.on examination his liver dullness is gone.

Ans.perforation of peptic ulcer.

(4) A pulsatile liver with Ascites .

Ans. tricuspid. Incompetence.

(5) A firm liver with ascites.

And.portal hypertension.

(6) A soft liver with ascites.

Ans.extahepatic obstruction.

(7) Dilated loop  of intestine with fluid level in x-ray. Plate.

Ans. Intestinal obstruction .

(8) Diffuse abdominal hazziness and loss.of psoas margin.

Ans. Ascites.

(9) A patient with fever and chill with elevated and irregular diaphragm.

Ans. Liver abscess.

Spot the Diagnosis - XIII

(1) A patient developed agonising pain in left hand and the hand became white and blue ,there is no pulse but tenderness on the course of radial artery .on examination there is cardiac murmurs.

Ans- embolic gangrene

(2) One patient reported to a renowned clinician for hectic fever chill perspiration and tachycardia ,the clinician was sure that there is some abscess somewhere in his body but after a thorough search he failed to find any .

Ans sub - phrenic abscess

 (3) In elderly male aged about seventy had retension of urine now he developed fracture  of femoral neck .
Ans primary carcinoma prostate with secondary  in femoral neck .

(4) A chronic patient of amoebic liver abscess now developed severe headache , vomiting and went in coma

Ans metastatic amoebic abscess in the brain .

4..A child has reported for evening rise of temperature , night sweats and anorexia with a limping gait.

Ans T.B  hip joint .

(5)An x ray  plate was shown to you in which there is rarification in the babecock' s triangle . T.B hip joint

(6)  Veinous flow away from umbilicus .

Ans portal hypertension .

(7) epigastric mass with peristaltic movement left to right .

Ans pyloric obstruction

(8) An enlarged , hard , and nodular liver in right hypochondrium .

Ans secondary liver .

(9) A patient of chronic peptic ulcer has reported for severe and agonising pain but now his pain has vanished and  on examination his liver dullness is gone .

Ans perforation of peptic ulcer .

Spot the Diagnosis- XII

1)A young lady has come with the complaints of profuse sweating and triad of locals i.e. (a) local asphyxia ( b) local syncope (c) local gangrene of tips of all the fingers of her hands except both the thumbs,both the radial pulse is normal.

Ans Reynaud's  disease .

2) A patient has come  with generalised lymphadennopathy with splenic enlargment . The liver is not enlarged.

Ans lymphatic leukaemia.

(3)A lady has come with enlarged axillary lymph node which  is hard irregular and fixed .A hard lump is also found in  breast .

Ans carcinoma Brest with secondries   in the axillary lymph node.

 (4) What fracture  is there  when there is oedema and tenderness in the anatomical snuff box and what type of radiological view should be done to  visualise this fracture .

Ans fracture of scaphoid bone .oblique view is essential to visualise this fracture .

(5) A chain smoker has come with dry gangrene of his big toe .

Ans burger' s disease .

(6) An emaciated man has pain and tenderness over thoracic spine .

Ans- pott's disease .

(7) An old man has urinary retention with pain in the sacro- illiac spine

Ans carcinoma prostate .

(8) One patient has come in the emergency with injury near elbow he has shortening in length of the arm

.Ans supracondylar fracture .

(9) Another patient has come with injury near elbow he has shortening in length of his forearm .

Ans  posterior dislocation of elbow .

(10) A player has pain on the front of the lateral epicondyle of humerus bone.

Ans tenis elbow .

(11) A player complains of pain on the medial condyle of humerous bone .

Ans golfer' s elbow .

Spot The Diagnosis - XI

: 1) A patient complains of dyspnea on walking a very short distance . Spot the diagnosis -

Ans mitral stenosis

2) A patient with hectic fever ; chill and leucocytosis comes to a clinician and he thought there is pus somewhere but he failed to find pus anywhere . Spot the diagnosis ?

- Ans subphrenic abscess  (pus somewhere pus nowhere pus under diaphragm ).

3)A patient has mixed parotid tumour for long years . Now he has developed facial palsy . Spot the diagnosis ?

 Ans malignant transformation

4) A patient has a big lipoma on his back . Now he has develop pain in the tumour .

Ans sarcomatous  changes.

5)  A patient had a desmoid tumour,he was operated for this but. Tumour appeared after some months..

Ans malignant(recurrence is the rule in malignancy)

6) A lady complains of pain in the nail.on examination there is a small. Pin head  bluish spot beneath the nail local pressure gives excruciating pain.

Ans glomus tumour

7) A patient has swelling on the middle finger of his right hand .He had a history of pin prick .

Ans implantation dermoid cyst

8) A young lady has a port wine stain on her cheek & there is a history of fits.

Ans  sturge-weber syndrome

9)A young lady has an irregular ,firm elevation of the skin with finger like processes on the upper part of the sternum .

Ans keloid

10) A patient has a soft sponge swelling of his left arm with varicose veins and hemangiomas under the skin . Localised bruits are heard over the swelling .

Ans congenital arterio -venous fistulae

Spot the diagnosis -X

1)


2) A patient with hectic fever, chill and leucocytosis complains of pain and tenderness in right hypochondrium

 .-Ans- empyema gall bladder.

3) A patient has come with enlargered  soft and tender liver with inter costal tenderness .

- Ans - amoebic liver  abscess .

4) A patient of 30 has come with generalised lymph adenopathy with hepatosplenomegaly with pel- abstain fever .

- Ans hodgekin's disease

5) complete absence of protein in urine in cases of oedema points out to which organ to be looked for?

 - Ans liver

6) The presence of protein in the urine of  a pateint who has not a palpable liver in cases of oedema points out to which disease ?

- Ans nephrotic syndrome . 

7) A patient has come with red tip of his nose ; on auscultation there is mid - diastolic murmur .

- Ans -mitral stenosis .

8) A hypertensive person feels suffocated in cinema hall . Can you spot the diagnosis ?

Ans:-  acute left ventricular failure

9) A patient is found to sit near the open window most of the time in the night. Spot the diagnosis?

Ans- acute left ventricular failure.

Spot the diagnosis iX

1.)In a jaundice patient the gall bladder is palpably enlarged.
-Carcinoma head of panecreas.
2.)what are the exception of corvoisers law.
-Double impaction one stone in CBD and another stone in cystic duct.pancreatic canculi or chronic panecreatitis.
3.)In a patient with prolonged cough and dyspnoea the liver and cardiac dullness is obliterated.
-Emphysema
4.)A patient came in emergencie with fever,pain,vomiting and tenderness in left illiac fossa.on examination is his apex beat was found in the right of sternum.
-Appendicitis in dextro cardiac patient.
5.)An old case of peptic ulcer now feels pain in the back to the right side of spine.
-Extension of ulcer to the head of panecreas.
6.)An old case of peptic ulcer now feels pain in the back to the left side of spine.
- Extension of the ulcer to the body and tail of pancreas.
7.)A patient of 65 has been referred to you for enlarged prostate with pain in the lumbo-sacral vertebrae.
-Carcinoma of prostate.
8.)Which tuberculous arthritis finally ends with bony ankylosis.
-Pott's deaseas.
9.)A neonate has been born with a tuft of hair on lumbo -sacral region.
- spina bi fida occulta.
10.)A patient has come with a hard ovoid and lobulated swelling in the neck under the upper 3rd of sternomastroid muscle at the upper level of thyroid cartilage. movable laterally but not vertically.
-Potato tumour.

Spot the diagnosis VIII

1.) In which disease common carotid artery becomes pulsatile.
-arotic incompetence.
2.) In which disease the neck veins are engorged and full.
-Retro Sternal Goitre & Neoplasm of Media stinum
3.)In which disease there is pulsatile liver.
-Tricuspid regargitation.
4.)In which disease there is pulsatile superficial thyroid artery.
-Thyrotoxicosis.
5).Which solid  tumour of the neck becomes  pulsatile on  pressure.
-Potato tumour
6.)A patient on prolonged fluid transfusion has fullness of external jugular vein.
-Over hydration.
7.)A patient has superficial communication between vein of axilla and those of veins of femoral triangle on both sides of abdomen.
-Obstruction of inferior vena cava.
8.)When patient has superficial communication between axillary vein and those of vein of femoral triangle of only one side.
-Pressure over the common or  external illiac vein of that side
9.)A patient has come with uni lateral enlargement of external jugular vein.
-Pressure on the sub clavian vein or vein is partially occluded in supraclavicular fossa by enlarged lymph node,neoplasm and aneurysm.