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

Spot the Diagnosis 921-933

921: Which view of radiography is essential to locate the fracture of scaphoid bone?

Ans: oblique view

922: Special axial radiography is needed in fracture of which bone

And: os calcis

923: Stereoscopic picture is needed in the diagnosis of fracture of which bone?

Ans: Skull andPelvis

924: A patient has come with ecchymosis of arm. He has history of injury in the arm from two days ago?

Ans: fracture of humerous

925: A child of 8 has been brought with injury to the arm .there is formation of callous on the arm.Can you find the age of injury?

Arm: more than 10 days

926: A patient of severe injury has been brought in the emergency.He has a blood per urethral , perineal haematoma and distended urinary bladder.

Ans: urethral damage

927: A patient of bus accident has been brought. He has a tumour like mass in the suprapubic region associated with strangury when catheterised. Blood stained scanty urine comes.

Ans: injury to the urinary bladder.

928: A patient of injury has come with oedema and tenderness of  the anatomical snuff box.

Ans:  Fracture of the scaphoid bone

929 : A child of 10 has come with superficial ulceration of cheek which heals  at centre and active at the periphery.

Ans: lupus vulgaris

930: A baby was born with a naevus in the mid line of the small of the back

Ans: Spina bifida occulta

931: An adult male has come with many spider-naevi on the chest and the abdomen. His spleen is palpable and not the liver

Ans : cirrhosis of the liver

932: A lady of 60  has come with nodules of the maxxilary area of her face. It is hard to feel, there is no pain and  many capullaries on the nodules are seen.

Ans: rodent ulcer.

933: A patient has been admitted for pain and swelling in the knee joint.On X-ray ther is soft tissue sshadows and flex of calcification are seen.

And Malignant csynovioma

Spot the diagnosis : 911-920

911: A young male child of 10 has come with cervical lymphoadenopathy. The glands are enlarged and feels rubbery. There is splenic enlargement.

Ans: hodgekins disease

912: A patient of 50 has come with a hard irregular and fixed lump in the right iliac fossa. On examination his right side of testis in scrotum is missing.

Ans malignancy of retained testis.

913: A patient of60 has come with stricture of rectum. On examination the stricture feels hards, irregular and fixed.

Ans Malignant stricture of rectum.

914: A lady of 40 has come with stricture rectum. She gives the history of vaginal sore and inginal bobo.

Ans: lymphogranuloma inginal

915:  A boy of 50 has come with 2 cystic swelling one above the inguinal ligament and another just below it. There is cross-fluctuation. On examination the fifth thorasic vertebra is very tender on palpation.

Ans : Cold abcess due to Potts Disease.

916: A patient has come with multiple sinuses on mandible with discharging pus sulphur granules.

Ans: Actinomycosis

917: A Patient has come. He complains of deep aching pain in the metaphysis of lower end and of tibia aggravated by warmth. The bone is thickened, irregular and tender.

Ans: Brodies abcess.

918: A patient has come with localised pitting oedema of the scalp.He has a history of scalp-injury.

Ans: Potts puffy tumour.

919: In a suspected case of malignancy, the lymph gland of the drainage area is not hard and fixed to the surrounding structure.

Ans: Enlargement is due to infection

920: A person has come with an ulcer. The ulcer looks completely black.

Ans :  Malignant Melaloma

Spot the Diagnosis 901-910

901. A patient has come for flatulence and nausea and vomiting. On examination his 8^th rib on the right side is tender.

Ans: -Cholecystitis.

902: A patient of 50 has come. He has lightening pain in the leg. On examination loss of ankle jerk sluggish pupilliary reaction to light.

Ans: tabes dorsalis.

903: An X-ray plate of abdomen was shown to you in which there is gas under the diaphragm.

Spot the diagnosis??

Ans: perforation of peptic ulcer.

904: A young patient of 15 has come with oedma legs. On examination there is a huge, firm and nodular mass in the abdomen which does not move with respiration.

Ans: Retro-peritoneal  sarcoma giving pressure on the interior vena cava.

905: A female of 25 has come with a firm and rounded tumour arising from the rectus abdominius below the umblicus.

Ans: desmoid tumour

906: A patient has come with spleenic enlargement upto umbilicus and there is sternal tenderness on pressure by fingers.

Ans: Myloid leukaemia.

907: A patient has come with generalised enlargement of lymph node with enlargement of spleen,He has lymphocytosis and their pre-cursors.

Ans: lymphatic leukamia

908: A lady was operated for laparotomy. Her stomach was full of hair.

Ans: Tricho bezoar

909: A laprotomy was done on a lady of fourty. Her stomach was full of plant skin.

Ans: Phytobezoar.

910: A patient has come with an ulcer There is a  greenish discharge with a peculiar smell.

Ans: The ulcer is infected with B.Pyocanacus