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.

Spot the Diagnosis 632-636

(632) Which tumour grows from the epiphysis of bone?

(633) Which malignant tumour grows from the metaphysis?

(634) A patient has come with a malignant tumour grown from the the diaphysis of tibia but he has no primary growth anywhere in the body.

(635) A patient has come with a malignant tumour which has arisen from the metaphysis of tibia. Pain preceded the growth for a month.

(636) A patient has come with a sinus. He gives the history of extrusion of the bone chip.

Answers.
(632) Osteoclastoma.
(633) Osteogenic sarcoma.
(634) Ewing's tumour.
(635) Osteogenic sarcoma.
(636) Chronic osteomylitis.

Spot the Diagnosis 627-631

(627) A patient has come who is suspected to be a  case of osteogenic sarcoma. The symptoms started fifteen days back. Spot the diagnosis?

(628) A patient has come with a depressed scar in his right thigh.

(629) A skiagram of a bone tumour was shown to you in which a soft tissue shadow was seen. Spot the diagnosis?

(630) An X-ray plate was shown to you. In which bone destruction was shown without bone formation.

(631) An X-ray plate of bone was shown to you in which bone destruction was shown with sclerosis.

Answers.
(627) It is not a case of osteogenic sarcoma.
(628) Fibrosis due to previous suppuration.
(629) Bone sarcoma,the soft tissue shadow is due to increased vascularity.
(630) Secondary carcinoma.
(631) Secondary prostatic carcinoma.

Spot the Diagnosis 621-626

(621) A patient has come with a bony swelling. The swelling has a variant feel at different parts. Spot the diagnosis?

(622) A patient has come with a sinus. The sinus is adherent to the bone.

(623) A child of ten has come with a swelling of bone and high rise of temperature.

(624) A child patient has come with pain and swelling. The pain and swelling has started at the same time.

(625) A patient has come with a swelling of bone. He is having chronic otitis media.

(626) A patient has come who is suspected to be a case of osteogenic sarcoma. The  symptoms started twelve months back.

Answers.
(621) Oesteogenic sarcoma.
(622) Osteomylitis.
(623) Acute Osteomylitis.
(624) Inflammation.
(625) Osteomylitis.
(626) It is not a case of osteogenic sarcoma.

Spot the Diagnosis 611-620

(611) A patient has come with a sinus with sprouting granulation tissue over a bone. Spot the diagnosis?

(612) A robust man of forty has come with acute agonising pain and fullness in the epigastrium. The pain pierces to the back. On examination there is a bruise in the loin and around the umbilicus.

(613) A patient of fifty five is admitted in the medical ward. He is having abdominal distention, hiccup, vomiting. His blood urea is raised. Spot the diagnosis?

(614) A lady of forty has come with gripping pain abdomen. Spot the diagnosis?

(615) An adult male has come with engorged superficial veins around the umbilicus. Spot  the diagnosis?

(616) A patient has come with superficial veins engorged and dilated on the side of abdomen. Spot the diagnosis?

(617) A patient has come with hard subcutaneous nodules around the umbilicus. Spot the diagnosis?

(618) A patient of car accident has been brought in the emergency. On auscultation his heart seems to be silent.

(619) A patient of chest injury has been brought in the emergency. His heart beat is displaced to the other side.

(620) A patient of chest injury has been brought. There is absence of breath sound and vocal- resonance at the base of the lungs.

Answers.
(611) Sequestration of bone or Foreign body inside and granulation tissue is known as proud flesh.
(612) Acute pancreatitis.
(613) Uraemic distention.
(614) Biliary colic.
(615) Portal obstruction.
(616) Obstruction of the inferior vena cava.
(617) Carcinoma of stomach or intraabdominal carcinoma.
(618) Haemopericardium.
(619) Haemothorax.
(620) Haemo-and Pneumothorax.