Spot the Diagnosis -82

(1) One patient has come with enlarged and soft liver . There is intercostal tenderness . Spot the diagnosis ?
Ans Amoebic liver abscess .

(2) A diagnosed patient of acute appendicitis has developed pain in the left iliac fossa .
Ans He has developed peritonitis.

(3) A patient has pain in the left iliac fossa at manson bar's amoebic point (same point like macburny's point  in the left side)
Ans chronic amoebic colitis

(4) A lady of fifty has pain on the tip of right shoulder and there is hyperesthecia below right scapula on the back .
Ans Cholecystitis .

(5) A patient of abdominal injury has pain on the  tip of the left shoulder and rigidity in the left side of the epigastrium .
Ans Spleenic rupture

Spot the diagnosis -81

 (1)A patient of acute abdomen has come in the emergency in which nothing abnormal was detected except on per rectal exam there is bulging of anterior rectal wall with tenderness. Can you spot the diagnosis ?
Ans Pelvic abscess .

(2) What dermoid cyst is the commonest ?
Ans External angular dermoid cyst .

(3) Earlier appearance of rigidity in the cases of acute intestinal obstruction indicates what condition?
Ans Internal strangulation.

(4) Late peritonitis with the features of toxaemia without muscular rigidity name the conditions .
Ans Typhoid perforation and post operative peritonitis.

(5) A patient was seized with sudden and severe pain in the epigastrium  after some times the pain has subsided automatically and there is slight  rigidity in the epigastrium and on P.R exam there  is tenderness in the rectovesical pouch .
Ans Perforation of peptic ulcer.

Words of wisdom

 A good clinician should better listen patiently to the presenting complaints and history of the patients and then go for thorough clinical examination and  should make first a clinical and provisional diagnosis than giving him  a list of unnecessary test which at times may deviate his diagnosis and bring unnecessary financial and physical troubles to the poor patients .
                                                                                                              The patient who soever he may be are the poorest and helpless creatures and for then the treating doctor is the only help and a real  god on earth .
                 A good doctor should prescribe only the desired test only to confirm his provisional diagnosis and prescribe only the desired drugs which must be affective ,safe and economical too .
                  

Everybody is born on earth with only one motive to earn more and more money even by wrong and illegal means . It is only a real doctor who are born only to serve his patients.
 

Please don't be a commoner , a professional. Be a real doctor ,a real god on earth . It is certain that you will not be given another chance to be a doctor in your next birth,and it is more than certain that you will take nothing with you when your heart stops for ever then why to cry after excess money .

Words of wisdom.

(1) A brainy surgeon operates more by his brain than  by his hands and surgical knives .

(2) A seasoned physician treats his patients more by his words than by medicine if he has a grip not only over his diagnosis but also over the  psychology of his patients .

Spot the diagnosis

 (1)A huge and hard enlargement of  liver and spleen without sternal tenderness .
Ans Post Kalazar  syndrome .

(2) A patient with palsatile liver with ascites .
Ans Tricuspid regurgitation

(3) A firm liver suggests .
Ans Cirrhosis of liver .

(4) Hard and nodular liver suggest .
Ans Secondary carcinoma

Spot the diagnosis- 79

(1) Which tuberculous arthritis finally ends in bony- ankylosis unlike other tuberculous arthritis?
 Ans Pott's disease.

(2) Abdominal pain which radiates to the sacral region ,flank or genitalia is a signal of the possibility  of which condition ?
Ans Rupturing of abdominal aorotic aneurysm
 ( lower portion)

(3) A patient has come with a fixed mass in abdomen not descending with respiration .
Ans Retroperitonel tumour.

Spot the diagnosis -78

(1) A young lady has come with the complaints of occasional   tremors and  twitching in the right forearm muscles and in all the  fingers of right hand .          On clinical exam nothing abnormal was  detected except an irregular protuberance on right side at the junction of parietal and occipital region due to very old fracture of skull .
Ans Jacksonian epilepsy due to previous head injury.

(2) A patient has come with palpably enlarged spleen with ascites  .
Ans Cirrhosis liver

(3) A patient has come with throbbing pain in the pelvis .
Ans Pelvic abscess