id stringlengths 36 36 | text stringlengths 202 1.34k | case_prompt stringlengths 71 1.3k ⌀ | diagnostic_reasoning stringlengths 1 5.96k ⌀ | final_diagnosis stringlengths 2 76 |
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cbd91783-e901-4672-9ec1-7f58bce041da | A 74-year-old woman develops occipital headache, vomiting, and dizziness. She looks unwell, her blood pressure is 180/100 mm Hg, pulse is 70/min, and respirations are 30/min. She is unable to sit or walk because of unsteadiness. Over the next few hours, she develops a decline in her level of consciousness.For the above... | A 74-year-old woman develops occipital headache, vomiting, and dizziness. She looks unwell, her blood pressure is 180/100 mm Hg, pulse is 70/min, and respirations are 30/min. She is unable to sit or walk because of unsteadiness. Over the next few hours, she develops a decline in her level of consciousness. | Cerebellar hemorrhage, when mild, may present with only headache, vomiting, and ataxia of gait. Patients may complain of dizziness or vertigo. The eyes may be deviated to the side opposite the hemorrhage. Nystagmus is not common, but an ipsilateral sixth nerve palsy can occur. This is the only type of intracerebral hem... | cerebellar hemorrhage |
17a37bf5-e78b-48f2-be15-16c1049d1427 | A 40-year-old man presents with a 2-week history of recur- rent oral ulcers, genital ulcers, intermittent arthritic pain of the knees, and abdominal pain. Physical examination reveals shallow ulcerations of the mucosa of the glans penis, as well as oral aphthous ulcers and conjunctivitis. Which of the following is the ... | A 40-year-old man presents with a 2-week history of recur- rent oral ulcers, genital ulcers, intermittent arthritic pain of the knees, and abdominal pain. Physical examination reveals shallow ulcerations of the mucosa of the glans penis, as well as oral aphthous ulcers and conjunctivitis. | Behget disease is a systemic vasculitis characterized by oral aphthous ulcers, genital ulceration, and ocular inflammation, with occasional involvement of the nervous, gastrointestinal, and cardiovascular systems. The mucocutaneous lesions show a non-specific vasculitis of arterioles, capillaries, and venules. The caus... | Behyet disease |
f68d215d-20f5-4c82-a386-02445dc44ebc | A 50 years old lady presented with lump in the left breast, which has developed suddenly in weeks. Perimenstrual symptoms are present. No associated family history. On examination, the lump is well circumscribed, fluctuant, 1.5 cm oval in shape. Most likely diagnosis: | A 50 years old lady presented with lump in the left breast, which has developed suddenly in weeks. Perimenstrual symptoms are present. No associated family history. On examination, the lump is well circumscribed, fluctuant, 1.5 cm oval in shape. | Fibroadenoma - it occurs in 2nd to 3rd decade of life Galactocele - it occurs in 3rd to 4th decade of life. Breast cancer - there is no associated family history and lump has developed suddenly hence breast cancer is ruled out. Breast cyst - it occurs in 5th to 6th decade of life. Examination revealed fluctuant lesion ... | Breast cyst |
fc4ad074-28fe-4b8f-bde1-79c50dadad98 | A 1 year old child is brought to you with delayed milestones. On examination you note that the child is very fair with hypopigmented hair and blue eye. He has also got eczemas. The child was also very irritable. What is your diagnosis? | A 1 year old child is brought to you with delayed milestones. On examination you note that the child is very fair with hypopigmented hair and blue eye. He has also got eczemas. The child was also very irritable. | This child is suffering from Phenylketonuria. Here there is inability to conve phenylalanine to tyrosine due to phenylalanine hydroxylase deficiency. The decreased pigmentation in this condition is due to reduced melanin formation. The treatment is a diet low in phenylalanine with tyrosine supplementation. Delay in ini... | Phenylketonuria |
43746273-1b76-4c58-97ac-7de0af6fdab0 | A 1-year-old boy presents with a delay in motor development. Progressive muscle weakness and blindness ensue, and the patient dies within a year. The brain at autopsy shows swollen neurons that contain numerous lysosomes filled with lipid. Which of the following is the most likely diagnosis? | A 1-year-old boy presents with a delay in motor development. Progressive muscle weakness and blindness ensue, and the patient dies within a year. The brain at autopsy shows swollen neurons that contain numerous lysosomes filled with lipid. | Tay-Sachs disease is a lethal, autosomal recessive disorder caused by an inborn deficiency of hexosaminidase A, which permits the accumulation of ganglioside GM1 in CNS neurons. The disease is fatal in infancy and early childhood. Retinal involvement increases macular transparency and is responsible for a cherry-red sp... | Tay-Sachs disease |
aaa09f14-d097-401e-a543-a9a9e4fa9a7d | A patient was diagnosed with schizophrenia and was staed on haloperidol 5mg. On 3rd day he presented with uprolling of eyes. A complete neurological examination revealed no spasticity or any other abnormalities except uprolling of eyeballs. Visual acuity was found to be normal. What is your likely diagnosis? | A patient was diagnosed with schizophrenia and was staed on haloperidol 5mg. On 3rd day he presented with uprolling of eyes. A complete neurological examination revealed no spasticity or any other abnormalities except uprolling of eyeballs. Visual acuity was found to be normal. | * <48 hours of staing antipsychotics * M.C in======Younger black males * If a patient develops dystonia he is more prone for eps Patient considers this as an Allergic reaction , thereby may stop drugs Layryngeal dystonia is a Psychiatric emergency, should be treated with IV lorazepam TREATMENT * Diphenhydramine * Benzt... | Acute dystonia |
92f241b1-5dd7-4309-be7d-575987eb3c07 | A young male presents with ear discharge since three years; recently developed swelling in the neck below and behind the angle of mandible, toicollis; on the examination, the external auditory canal was filled with granulation tissue. What is the diagnosis? | A young male presents with ear discharge since three years; recently developed swelling in the neck below and behind the angle of mandible, toicollis; on the examination, the external auditory canal was filled with granulation tissue. | Bezold's abscess It can occur following acute coalescent mastoiditis when pus breaks through the thin medial side of the tip of the mastoid and presents as a swelling in the upper pa of the neck. The abscess may Lie deep to sternocleidomastoid, pushing the muscle outwards. Follow the posterior belly of digastric and pr... | Bezold's abscess |
2c676972-bd4f-4a3c-b082-2af34b86c74c | A 30 year old female patient complains of painless hard anterior neck mass. FNAC was inconclusive. Open thyroid biopsy was performed which revealed the fibrous nature of the mass, woody, non tender thyroid, mimicking carcinoma is observed. The diagnosis points towards | A 30 year old female patient complains of painless hard anterior neck mass. FNAC was inconclusive. Open thyroid biopsy was performed which revealed the fibrous nature of the mass, woody, non tender thyroid, mimicking carcinoma is observed. | null | Riedel's thyroiditis |
e08a75ac-3fb1-4ca9-a24c-d6798f56a3f0 | A 20 year female presents with a ovarian mass 6x 6 x 6cm in size. Ultrasonography reveals solid structures in the mass. Her serum biomarkers such as AFP. fO-hCG and CA 125 are normal, however, her serum alkaline phosphatase was found to be elevated. The most likely diagnosis is | A 20 year female presents with a ovarian mass 6x 6 x 6cm in size. Ultrasonography reveals solid structures in the mass. Her serum biomarkers such as AFP. fO-hCG and CA 125 are normal, however, her serum alkaline phosphatase was found to be elevated. | null | Dysgerminoma |
c2c522e9-595e-4327-a763-7eb93c7fcb88 | A 68-year-old male is brought to the outpatient by his wife due to increasing forgetfulness. On taking history in details, wife repoed that for around 6 months patient is having trouble in organising the finances and paying bills, something he has done all his life. He has also become withdrawn and has decreased meetin... | A 68-year-old male is brought to the outpatient by his wife due to increasing forgetfulness. On taking history in details, wife repoed that for around 6 months patient is having trouble in organising the finances and paying bills, something he has done all his life. He has also become withdrawn and has decreased meetin... | The history is suggestive of executive dysfunction (trouble in organising the finances and paying bills), apathy and disinhibition (decreased socialisation and inappropriate behaviour with women), lack of insight (denies having any problem) and memory disturbances. This is suggestive of frontotemporal dementia, in whic... | Frontotemporal dementia |
974166b0-214b-4d84-8785-3a6ad189abd0 | An alcoholic is brought to the casualty, 3 days after he quit alcohol, with the complaints of irrelevant talking. On examination, he is found to be disoriented to time, place and person. He also has visual illusions and hallucinations. There is no history of head injury. The most probable diagnosis is: | An alcoholic is brought to the casualty, 3 days after he quit alcohol, with the complaints of irrelevant talking. On examination, he is found to be disoriented to time, place and person. He also has visual illusions and hallucinations. There is no history of head injury. | This patient in the question who is a chronic alcoholic is showing features of delirium tremens, which typically appears after 3-4 days of abstinence from alcohol (24 hours to 7 days). Ref: CURRENT Diagnosis and Treatment: Emergency Medicine, 7th Edition, Chapter 37 ; CURRENT Diagnosis and Treatment: Psychiatry, 2nd Ed... | Delirium tremens |
5aa04ff1-94e0-42c0-b4d6-5f8b444cbb2e | A 33-yr old man presented with a slowly progressive swelling in the middle 113d of his right tibia. X-rays examination revealed multiple sharply demarcated radiolucent lesions separated by areas of dense and sclerotic bone. Microscopic examination of a biopsy specimen revealed island of epithelial cells in a fibrous st... | A 33-yr old man presented with a slowly progressive swelling in the middle 113d of his right tibia. X-rays examination revealed multiple sharply demarcated radiolucent lesions separated by areas of dense and sclerotic bone. Microscopic examination of a biopsy specimen revealed island of epithelial cells in a fibrous st... | Adamantinoma of long bone Introduction: Unusual neoplasm, almost always located in tibial shaft. Clinical features: Localized swelling and pain for several years. Age: Between 15-55 yrs. Radiological features: * An eccentric well demarcated area of destruction usually involving the anterior poion of the tibial shaft. *... | Adamantinoma |
f8d1aab7-88d9-4a6a-982d-8f8ad20ddd8a | A 33-year-old male immigrant from Taiwan presents with increasing right upper quadrant (RUQ) pain. The pain is dull, and it does not radiate or change with eating. On examination the abdomen is soft, there is a mass in the RUQ, and no ascites is clinically detected. He has a prior history of hepatitis B. His laboratory... | A 33-year-old male immigrant from Taiwan presents with increasing right upper quadrant (RUQ) pain. The pain is dull, and it does not radiate or change with eating. On examination the abdomen is soft, there is a mass in the RUQ, and no ascites is clinically detected. He has a prior history of hepatitis B. His laboratory... | (b) Source: (Devita, pp. 533-534) Only the chronic carrier state increases HCC risk, not previous infection. The majority, but not all, of HCC associated with HBV occurs in the setting of cirrhosis (60-90%). Because the latency period of HBV infection is 35 years, before HCC supervenes, early-life infection is strongly... | hepatocellular carcinoma (HCC) |
bdcb31fe-c6de-4120-ae58-4eecc6e8888c | A 5-year-old girl is brought to the physician after her parents noticed red blood in her stool. Physical examination reveals mucocutaneous pigmentation. Small bowel radiography discloses multiple, small- to medium-sized polyps that are diagnosed pathologically as hamartomas. Which of the following is the most likely di... | A 5-year-old girl is brought to the physician after her parents noticed red blood in her stool. Physical examination reveals mucocutaneous pigmentation. Small bowel radiography discloses multiple, small- to medium-sized polyps that are diagnosed pathologically as hamartomas. | Peutz-Jeghers syndrome is an autosomal dominant, hereditary disorder characterized by intestinal hamartomatous polyps and mucocutaneous melanin pigmentation, which is particularly evident on the face, buccal mucosa, hands, feet, and perianal and genital regions. The polyps seen in Peutz-Jeghers syndrome are hamartomato... | Peutz-Jeghers polyp |
c3073526-26e4-4552-9050-a08cfd2af1d4 | A 30-year-old woman sustained a traumatic blow to her right breast. Initially, there was a 3-cm contusion beneath the skin that resolved within 3 weeks, but she then felt a firm, painless lump that persisted below the site of the bruise 1 month later. What is the most likely diagnosis for this lump? | A 30-year-old woman sustained a traumatic blow to her right breast. Initially, there was a 3-cm contusion beneath the skin that resolved within 3 weeks, but she then felt a firm, painless lump that persisted below the site of the bruise 1 month later. | Fat necrosis is typically caused by trauma to the breast. The damaged, necrotic fat is phagocytosed by macrophages, which become lipid-laden. The lesion resolves as a collagenous scar within weeks to months. The firm scar can mammographically and grossly resemble a carcinoma. An abscess may form a palpable but painful ... | Fat necrosis |
1dbdf7c2-95d8-41a0-9d5d-641e2666be8e | A 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they says that he has been muttering to self and gesticulating. There is no h/o of psychiatric illness. Likely diagnosis is | A 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they says that he has been muttering to self and gesticulating. There is no h/o of psychiatric illness. | Acute psychosis ??? [Ref: Kaplan and Saddock synopsis of Psychiatry 10/e p 516-5171We are unable to reach a conclusive diagnosis with the information provided in the question.Acute onset, presence of fever, no history of psychiatric illness suggests delirium.But, the diagnosis of delirium cannot be made definitively in... | Acute psychosis |
9dbfe50d-9f1b-40f7-9d22-086482e85b07 | A child is taken to a pediatrician because his mother notices that his eyes appear very puffy. The mother said that the boy's eyes appeared normal two days ago, and pa of what caused her concern was that her child seemed to be rapidly becoming ill. On physical examination, the boy is noted to have generalized edema. No... | A child is taken to a pediatrician because his mother notices that his eyes appear very puffy. The mother said that the boy's eyes appeared normal two days ago, and pa of what caused her concern was that her child seemed to be rapidly becoming ill. On physical examination, the boy is noted to have generalized edema. No... | Proteinuria greater than 40 mg/h/m2 in a child or 3.5 g/d/1.73 m2 in an adult produces nephrotic syndrome, which is characterized by generalized edema, often most noticeable in the face. The condition develops when large amounts of protein are spilled through the glomeruli into the duct system of the kidneys. In contra... | Nephrotic syndrome |
f8ba7301-121a-479d-9340-514301b354d5 | A 40 year old female reports of sudden bouts of anxiety which would occur anytime and associated with sweating, palpitation, derealization, and feeling of going crazy. These episodes would last for 20 -25 minutes. So much so that she fears of having these episodes in future. All routine investigations are normal. What ... | A 40 year old female reports of sudden bouts of anxiety which would occur anytime and associated with sweating, palpitation, derealization, and feeling of going crazy. These episodes would last for 20 -25 minutes. So much so that she fears of having these episodes in future. All routine investigations are normal. | Ans. C. Panic disorderPanic attack: acute intense attack of anxiety accompanied by feelings of impending doom.Symptoms during panic attack usually involve* Sudden onset of palpitations, Sweating, Trembling or shaking,* Shortness of breath, Feelings of choking, Chest pain,* Nausea/abdominal distress, Feeling dizzy, unst... | Panic disorder |
fce59ebf-c07e-4ffc-9c94-c93da3164977 | Vasanti, a 25-year-old-girl, presents with complaints of fever and weakness. On examination there is splenomegaly of 3 cm below the costal margin.Hb is 8 gm/dL, TLC is 3,000/mm3 , platelet count is 80,000 mm3. Which of the following is the least likely diagnosis - | Vasanti, a 25-year-old-girl, presents with complaints of fever and weakness. On examination there is splenomegaly of 3 cm below the costal margin.Hb is 8 gm/dL, TLC is 3,000/mm3 , platelet count is 80,000 mm3. | null | Aplastic anemia |
68ff9908-2480-44a0-b76d-a50dd05032f9 | A 60-year-old man with diabetes acutely develops double vision and discomfort in his left eye. On examination, there is ptosis of the left eyelid, the eye is rotated down and out, and the pupil is 3 mm and reactive to light. The right eye is normal. Which of the following is the most likely diagnosis? | A 60-year-old man with diabetes acutely develops double vision and discomfort in his left eye. On examination, there is ptosis of the left eyelid, the eye is rotated down and out, and the pupil is 3 mm and reactive to light. The right eye is normal. | Third nerve palsy can result in ptosis of the eyelid. There is also loss of the ability to open the eye, and the eyeball is deviated outward and slightly downward. With complete lesions, the pupil is dilated, does not react to light, and loses the power of accommodation. In diabetes, the pupil is often spared. The sixt... | third nerve palsy |
f360e887-b066-4a7d-9231-c516a7ed6532 | 48 year old male reported with the chief complaint of ulcer on the gums and on general examination headache, fever and malaise was observed. On oral examination, sharply punched out crater-like erosions of the interdental papillae of sudden onset were noted. The patient also complained of bad breath.
Diagnosis is | 48 year old male reported with the chief complaint of ulcer on the gums and on general examination headache, fever and malaise was observed. On oral examination, sharply punched out crater-like erosions of the interdental papillae of sudden onset were noted. The patient also complained of bad breath.
| null | ANUG |
f0e1adc0-eeb7-43ed-b013-27f0a855961f | A 23-year-old woman is noticed to have irregular pupils on routine examination. She has 1 large pupil, which has minimal response to light stimulation, but it does respond to accommodation. The eye movements are normal and she experiences no double vision.For the above patient with a pupillary abnormality, select the m... | A 23-year-old woman is noticed to have irregular pupils on routine examination. She has 1 large pupil, which has minimal response to light stimulation, but it does respond to accommodation. The eye movements are normal and she experiences no double vision. | The tonic pupil (Holmes-Adie syndrome) is caused by a parasympathetic lesion at or distal to the ciliary ganglion. The pupil is large and usually unilateral, with absent response to light. A bright room, by causing constriction of the normal pupil, accentuates the anisocoria. The tonic pupil can be associated with Shy-... | tonic pupils (Holmes-Adie syndrome) |
7c2228ca-b770-4cd6-b018-66056347cfb9 | A 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they say that he has been muttering to self and gesticulating. There is no of psychiatric illness. Likely diagnosis is: | A 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they say that he has been muttering to self and gesticulating. There is no of psychiatric illness. | B i.e. Acute psychosis- Delusions or hallucinations (suchas hearing voices in this case) with grossly disorganized speech and behavior (such as muttering to self, gesticulation, aggressiveness in this case) of acute onset with normal cognition & consciousness indicate the diagnosis of acute psychosis (i.e. psychosis of... | Acute psychosis |
a29bb139-1b53-463c-b01d-8c6404f7f06d | 30 year old patient with pain in right hypochondrium for 5 days with soft and tender liver and intercostal tenderness. He complains of catch in breath on inspiration and has a non productive cough. On examination the lung fields are clear, patient looks pale and emaciated. Probable diagnosis is | 30 year old patient with pain in right hypochondrium for 5 days with soft and tender liver and intercostal tenderness. He complains of catch in breath on inspiration and has a non productive cough. On examination the lung fields are clear, patient looks pale and emaciated. | Ans. (a) Ameobic liver abscessRef:Manipal Manual of surgery, 4th ed./521Refer to the above explanationHydatid cystUsually clinically silentEnlarged liver with smooth surface and is non tender.Pyogenic liver abscessMultiple abscess leading to spiky fever and enlarged liver.Hepatic adenomaPresents in young women on OCP a... | Amoebic liver abscess |
ea5f1823-e6eb-443b-a8ba-fd006d951f58 | A 38-year-old gentleman repos of decreased hearing in the right ear for the last two years. On testing with a 512 Hz tuning fork, the Rinne&;s test without masking is negative in the right ear and positive on the left ear. With Weber&;s test, the tone is perceived as louder in the right ear. The most likely diagnosis i... | A 38-year-old gentleman repos of decreased hearing in the right ear for the last two years. On testing with a 512 Hz tuning fork, the Rinne&;s test without masking is negative in the right ear and positive on the left ear. With Weber&;s test, the tone is perceived as louder in the right ear. | The characteristics of conductive hearing loss are: 1. Negative Rinne test, i.e. BC > AC. 2. Weber lateralized to poorer ear. 3. Normal absolute bone conduction. 4. Low frequencies affected more. 5. Audiometry shows bone conduction better than air conduction with air-bone gap. Greater the air-bone gap, more is the cond... | Right conductive hearing loss |
5def7c8a-7647-4298-8a56-63a1be239920 | Ramkali bai, a 35-year-old female presented with a one-year history of menstrual irregularity and galactorrhoea. She also had off and on headache, her examination revealed bitemporal superior quadrantanopia. Her fundus examination showed primary optic atrophy. Which of the following is a most likely diagnosis in this c... | Ramkali bai, a 35-year-old female presented with a one-year history of menstrual irregularity and galactorrhoea. She also had off and on headache, her examination revealed bitemporal superior quadrantanopia. Her fundus examination showed primary optic atrophy. | A 35 year old woman complaining of amenorrhoea — galactorrhoea syndrome along with visual field defects confirms the diagnosis of pituitary macrodenoma (prolactinoma)
Amenorrhoea and galactorrhoea results due to increased secretion of prolactin.
Headache and visual field defects are seen due to mass effect of the tumou... | Pituitary macroadenoma |
ddb2fe1c-105e-4ccf-a740-fe383571d102 | A 30 year old male was brought for evaluation. The history revealed that the patients 3 year old son died, 5 months back after being hit by a car. At the time of accident, patient was standing nearby and witnessed the accident. For last 5 months, he has been having symptoms of sadness of mood, crying spells, feelings o... | A 30 year old male was brought for evaluation. The history revealed that the patients 3 year old son died, 5 months back after being hit by a car. At the time of accident, patient was standing nearby and witnessed the accident. For last 5 months, he has been having symptoms of sadness of mood, crying spells, feelings o... | Depression: A major depressive disorder occurs without a history of a manic, mixed, or hypomanic episode. A major depressive episode must last at least 2 weeks DIAGNOSIS: Major Depressive Disorder The DSM-5 diagnostic criteria for major depression Sadness of mood Diminished interest in pleasure Significant weight loss ... | Major depression |
e4ba25b1-2be8-4d30-b095-c3ddc931cc4c | A 26 year old third_gravida mother delivered a male baby weighing 4-2 kg at 37 weeks of gestation through an emergency caesarean section, for obstructed labour. The child developed respiratory distress one hour after bih. He was kept nil per orally (NPO) and given intravenous fluids. He maintained oxygen saturation on ... | A 26 year old third_gravida mother delivered a male baby weighing 4-2 kg at 37 weeks of gestation through an emergency caesarean section, for obstructed labour. The child developed respiratory distress one hour after bih. He was kept nil per orally (NPO) and given intravenous fluids. He maintained oxygen saturation on ... | Ans. is 'a' i.e., Transient tachypnea of newborn o Respiratory distress, which resolves within 24 hours without any respiratory suppo and fluid in interlobar fissure on chest X-ray suggest the diagnosis of TTN. | Transient tachypnea of the newborn |
ec6babf8-6e3e-49af-aa46-c746a914850b | An 8 years old child has left sided flank pain and mental retardation. On ultrasound, a hyperechoic lesion in the right kidney and multiple lesions in the liver are noted. CT examination of the abdomen revealed -50 to -80 HU density of these lesions. The most probable diagnosis is: | An 8 years old child has left sided flank pain and mental retardation. On ultrasound, a hyperechoic lesion in the right kidney and multiple lesions in the liver are noted. CT examination of the abdomen revealed -50 to -80 HU density of these lesions. | Answer- A (Tuberous sclerosis)AML is a benign clonal neoplasm consisting of varying amounts of mature adipose tissue, smooth muscle and thick-walled vessels. | Tuberous sclerosis |
3dc7cfae-f1fa-4b38-9b68-c95eebbad9ff | An 8 year old child has shown of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches as anexcuse to avoid school. What would be the most appropriate clinical diagnosis in this patient? | An 8 year old child has shown of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches as anexcuse to avoid school. | Since the person in the question is showing a hostile behavior which is impairing his academic activities for the last 6 months, the most appropriate next step would be to rule out Oppositional defiant disorder.Oppositional defiant disorder is a recurrent pattern of negativistic, hostile or defiant behavior that lasts ... | Rule out an oppositional defiant disorder |
2a8e61f3-085c-4603-b331-de0078d6e5f9 | A 12-year-old boy had a gradually progressive plaque on a buttock for the last 3 years. The plaque was 15 cm in diameter, annular in shape, with crusting and induration at the periphery and scarring at the centre. The most likely diagnosis – | A 12-year-old boy had a gradually progressive plaque on a buttock for the last 3 years. The plaque was 15 cm in diameter, annular in shape, with crusting and induration at the periphery and scarring at the centre. | This boy has
Annular plaque
On buttock
Crusting at periphery
Scarring at centre
These suggest the diagnosis of lupus vulgaris.
Annular lesions
When the lesions of a skin disease are arranged in ring shape, they are called annular lesions. | Lupus vulgaris |
31117f1b-6870-4655-bd34-9f166f70b54f | A 52-year-old alcoholic notices a skin rash on his chest, and also has symptoms of diarrhea and abdominal pain. On examination, he has a scaly and pigmented rash on the sun-exposed areas of his skin, the abdomen is soft, and his short-term memory is impaired. He has dermatitis, diarrhea, and dementia syndrome.For the p... | A 52-year-old alcoholic notices a skin rash on his chest, and also has symptoms of diarrhea and abdominal pain. On examination, he has a scaly and pigmented rash on the sun-exposed areas of his skin, the abdomen is soft, and his short-term memory is impaired. He has dermatitis, diarrhea, and dementia syndrome. | Diarrhea, dementia, and dermatitis are the classic triad for pellagra (niacin deficiency). The diagnosis is based on clinical suspicion and response to therapy, and can be confirmed by demonstrating low levels of the urinary metabolites 2-methylnicotinamide and 2-pyridone. Small doses of niacin (10 mg/day) with adequat... | niacin |
d93522e3-8ae1-451e-a688-daec2e5dfe08 | A 19-year-old man presents to the clinic complaining of early fatigue and muscle cramps while playing sports. He is fine when walking or doing less intense levels of work. On physical examination, he appears well and the vital signs are normal. Muscle bulk, tone and strength in the proximal muscles are normal. There is... | A 19-year-old man presents to the clinic complaining of early fatigue and muscle cramps while playing sports. He is fine when walking or doing less intense levels of work. On physical examination, he appears well and the vital signs are normal. Muscle bulk, tone and strength in the proximal muscles are normal. There is... | There are many types of glycogen storage diseases, each caused by a different enzymatic abnormality. The best-known types of glycogen storage disease are those that have hepatic hypoglycemic pathophysiology (eg, von Gierke disease) or those that have muscle energy pathophysiology (McArdle disease). InMcArdle' symptoms ... | McArdle disease (glycogen storage disease) |
25f981b1-3ecc-43c0-a40e-89937631579b | A 50 years old patient presented to the skin OPD with erythematous scaly plaques over trunk and extremities for last l0 years. Lesions are occasionally itchy. There is history of remission and relapse with exacerbation during winters. Most likely diagnosis is? | A 50 years old patient presented to the skin OPD with erythematous scaly plaques over trunk and extremities for last l0 years. Lesions are occasionally itchy. There is history of remission and relapse with exacerbation during winters. | Ans: B. Psoriasis vulgaris(Ref: Neena Khanna 4'h/e p. 40-48; Roxburg lVh/e p. 128-42; Venkataram 1"'/e p. 491)Psoriasis (psoriasis vulgaris):Psoriasis is chronic dermatosis characterized by unpredictable course of remission and relapse and presence of well defined silvery white scaly papules and plaques on erythematous... | Psoriasis vulgaris |
a157f6a4-4f0b-4c11-82a9-effbebbba58d | 1729. A 28 yr old female presented with malaise and generalised weakness since 6 month. Her appetite Is reduced and she has giddiness and palpitations on and off. There was no organomegaly. Laboratory Study showed normochromic to hypochromic anaemia and MCV-80. What Is the diagnosis | 1729. A 28 yr old female presented with malaise and generalised weakness since 6 month. Her appetite Is reduced and she has giddiness and palpitations on and off. There was no organomegaly. Laboratory Study showed normochromic to hypochromic anaemia and MCV-80. | <p> Iron deficiency anemia is much more common in women between the age of 20 & 45 yrs than in men.The onset of this anemia is generally slow .The usual symptoms are weakness ,fatigue ,palpitations ,dyspnoea on exeion & pallor of skin, sclera & mucous membrane.</p><p>Also MCV will be less than 80fl in iron deficiency a... | Iron deficiency anaemia |
de231299-c4b5-4980-88ca-3dd828085789 | A patient with primary Sjogren syndrome treated with tear replacement for symptomatic relief notes continued parotid swelling for the last 3 months. She also has enlarged posterior cervical lymph nodes. Evaluation shows leukopenia and low C4 complement levels. What is the most likely diagnosis? | A patient with primary Sjogren syndrome treated with tear replacement for symptomatic relief notes continued parotid swelling for the last 3 months. She also has enlarged posterior cervical lymph nodes. Evaluation shows leukopenia and low C4 complement levels. | Lymphoma is well known to develop specifically in the late stage of Sjogren syndrome. Common manifestations include: Persistent parotid gland enlargement Purpura Leukopenia Cryoglobulinemia Low C4 complement levels. - Most of the lymphomas are extranodal, marginal zone B cell, and low grade. Low-grade lymphomas may be ... | Lymphoma |
93871c68-7564-4ba5-aa49-a23221c122c9 | A 10 year old boy has a fracture of femur. biochemical evaluation revealed Hb 11.5 gm/dl and ESR 18 mm 1st hour. Serum calcium 12.8 mg/dL, serum phosphorus 2.3 mg/dL, alkaline phosphate 28 KA units and blood urea 32 mg/dl. Which of the following is the most probable diagnosis in his case – | A 10 year old boy has a fracture of femur. biochemical evaluation revealed Hb 11.5 gm/dl and ESR 18 mm 1st hour. Serum calcium 12.8 mg/dL, serum phosphorus 2.3 mg/dL, alkaline phosphate 28 KA units and blood urea 32 mg/dl. | You can solve the question just looking at calcium value. Amongst the given options only hyperparathyroidism causes hypercalcemia.
The patient in question has an increased serum Ca', decreased serum phosphorus and increased values of alkaline phosphatase, all of which characterize hyperparathyroidism. | Hyperparathyroidism |
50f67ace-0c4b-435b-89bc-e827d452a3d2 | A 6 year old boy has been complaining of headache, ignoring to see the objects on the side for 4 months. On Examination, he is not mentally retarded, his grades at school are good & visual acuity is diminished in both the eyes, visual chaing showed significant field defect. CT scan of the head showed suprasellar mass w... | A 6 year old boy has been complaining of headache, ignoring to see the objects on the side for 4 months. On Examination, he is not mentally retarded, his grades at school are good & visual acuity is diminished in both the eyes, visual chaing showed significant field defect. CT scan of the head showed suprasellar mass w... | B i.e. Craniopharyngioma | Craniopharyngioma |
b3b8f17f-25ac-4f83-9434-0efb1f1621b8 | An 11-year-old boy was brought to the pediatric OPD with multiple abscesses over his face, chest, and back. The child has a history of recurrentrespiratory infections. On examination, he has atopic excoriating skin and multiple cold abscesses on his back. What is the most probable diagnosis? | An 11-year-old boy was brought to the pediatric OPD with multiple abscesses over his face, chest, and back. The child has a history of recurrentrespiratory infections. On examination, he has atopic excoriating skin and multiple cold abscesses on his back. | From the above clinical history and examination, the most probable diagnosis is Hyper IgE syndrome (Job's syndrome). It is an autosomal dominant primary immunodeficiency disease caused by a mutation of STAT3 gene. Neutrophils do not generate an immune response, probably due to a defect in chemotaxis. Patients present w... | Hyper IgE syndrome |
37e100e7-52d2-4744-aa7a-daa3992d56e0 | A 19 year old young girl with previous history of repeated pain over medial canthus and chronic use of nasal decongestants, presented with abrupt onset of fever with chills & rigor, diplopia on lateral gaze, moderate proptosis & chemosis. On examination optic disc is congested. Most likely diagnosis is: | A 19 year old young girl with previous history of repeated pain over medial canthus and chronic use of nasal decongestants, presented with abrupt onset of fever with chills & rigor, diplopia on lateral gaze, moderate proptosis & chemosis. On examination optic disc is congested. | Patient is suffering from cavernous venous thrombosis, as a complication of chronic ethmoidal sinusitis. The facial veins make clinically impoant connections with the cavernous sinus through the superior ophthalmic veins. Cavernous sinus thrombosis usually results from infections in the orbit, nasal sinuses, and superi... | Cavernous sinus thrombosis |
fa39bc4c-eb92-4bd1-9331-02c0440326ce | A 70-years-old retired military person with good previous medical record complains of bi-temporal headache which is decreased in lying down position. He states that he gets relief by giving pressure over bilateral temples. The patient also complains of loss of appetite with feeling feverish. Diagnosis is: | A 70-years-old retired military person with good previous medical record complains of bi-temporal headache which is decreased in lying down position. He states that he gets relief by giving pressure over bilateral temples. The patient also complains of loss of appetite with feeling feverish. | Ans. a. Chronic tension headache (Ref: Harrison 19/e p107t, p2587t, 2593-2594, 18/e p122, 2849)Tension-type Headache:Tension-type headache (TTH) is commonly used to describe a chronic head-pain syndrome characterized by bilateral tight, bandlike discomfortQ.Pain typically builds slowly, fluctuates in severity, and may ... | Chronic tension headache |
fbe5853c-1451-4c8b-a6ab-f5b573f17e50 | A 35 yr old male female singer presents with complains of hoarseness, vocal fatigue & pain in neck on prolonged phonation. Direct laryngoscopy shows bilateral pin head size swelling on Ant.1/3 & post 2/3 junction of vocal cord. What could be the probable diagnosis ? | A 35 yr old male female singer presents with complains of hoarseness, vocal fatigue & pain in neck on prolonged phonation. Direct laryngoscopy shows bilateral pin head size swelling on Ant.1/3 & post 2/3 junction of vocal cord. | Vocal nodule (singer's or screamer's node) Seen symmetrically on the free edge of vocal cord, at the junction of anterior one third, with the posterior two thirds (i.e. area of maximum vibration of cord). Vocal nodules are bilateral. Mostly seen in teachers, vendors, actors or pop singers as they speak in unnatural low... | Vocal nodule |
a006d753-e819-4876-8108-217d0450d732 | A 4-year-old male child presents with muscles weakness. His mother tells that her child has difficulty in climbing stairs and getting up from the floor. On muscle biopsy, small muscle fibrils and absent of dystrophic was found. What is the diagnosis out of given option? | A 4-year-old male child presents with muscles weakness. His mother tells that her child has difficulty in climbing stairs and getting up from the floor. On muscle biopsy, small muscle fibrils and absent of dystrophic was found. | Duchenne Muscular Dystrophy Progressive weakness Calf muscle involvement Pseudo hyperophy Difficulty in climbing stairs Gowersign present (+) Wheel chair bound Patient Death - CHF/ Pneumonia CPK MM: Increased IOC: - PCR for dystrophin gene (Dystrophin gene absent) Rx: - Chest Physiotherapy NOTE:Immunohistochemical stud... | Duchenne muscular dystrophy |
d5dff6dd-595e-4e6e-93cf-ff6c3b3d673f | A four year old boy Tinu has normal developmental milestones except delayed speech. He is interested to watch spinning objects like fan and the washing machine. His parents struggle to get him interested in other children at home. People often comment that he is disinterested and self centred. What will be your thought... | A four year old boy Tinu has normal developmental milestones except delayed speech. He is interested to watch spinning objects like fan and the washing machine. His parents struggle to get him interested in other children at home. People often comment that he is disinterested and self centred. | Tinu's presentation is that of poor 'theory of mind' or lack of perspective taking, poor communication and social skills and obsessive interests in spinning objects, which is common in ASD (autism spectrum disorder). Autism is characterized by triad of impaired social development, disturbed communication and language a... | Autism Spectrum Disorder |
16d42a46-f79f-43dd-8b96-0c262d911885 | A 5-year-old child presents with a history of fever off–and–on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 ems below the costal margin. The most likely diagnosis is – | A 5-year-old child presents with a history of fever off–and–on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 ems below the costal margin. | Pallor (anemia), petechial spot (thrombocytopenia), fever (infection due to neutropenia) with splenomegaly suggest the diagnosis of acute leukemia.
Further, the presence of splenomegaly eliminates aplastic anaemia and ITP as the possibilities
"Splenomegaly and lymphadenopathy are extremely uncommon in ITP and their pr... | Acute leukemia |
371ac31c-1a40-4504-9606-186ebb9e2820 | A 56 year old man has been having bloody bowel movements on and off for the past several weeks. He repos that the blood is bright red, it coats the outside of the stools, and he can see it in the toilet bowl even before he wipes himself. When he does so, there is also blood on the toilet paper. After fuher questioning,... | A 56 year old man has been having bloody bowel movements on and off for the past several weeks. He repos that the blood is bright red, it coats the outside of the stools, and he can see it in the toilet bowl even before he wipes himself. When he does so, there is also blood on the toilet paper. After fuher questioning,... | The combination of red blood coating the stools and a change in bowel habit and stool caliber spells out cancer of the rectum in someone in this age group. Anal fissure is typically seen in young women who have very painful bowel movements with streaks of blood. Pain is the dominant symptom in this condition. Cancer of... | Cancer of the rectum |
9b67ab79-55ec-4005-91e0-9874ad934308 | A 60-year-old male, chronic smoker, presented with fatigue and chest pain. On examination, there was inset left eyeball with drooping upper left eyelid and reduced left pupil size. Which of the following is the most likely diagnosis in this condition? | A 60-year-old male, chronic smoker, presented with fatigue and chest pain. On examination, there was inset left eyeball with drooping upper left eyelid and reduced left pupil size. | Most tumors of the apex of the lung are adenocarcinomas Pancoast tumors - apical lung tumors in the superior pulmonary sulcus tend to invade the neural structures around the trachea, including the cervical sympathetic plexus. Involvement of sympathetic fibers gives rise to severe pain in the distribution of the ulnar n... | Squamous cell carcinoma involving the apex of his left lung |
f4386929-0d3a-42af-9769-20d7b370c1b2 | A 20-year-old woman has an ovarian tumor removed. The surgical specimen is 10 cm in diameter and cystic. The cystic cavity is found to contain black hair and sebaceous material. Histologic examination of the cyst wall reveals a variety of benign differentiated tissues, including skin, cailage, brain, and mucinous gland... | A 20-year-old woman has an ovarian tumor removed. The surgical specimen is 10 cm in diameter and cystic. The cystic cavity is found to contain black hair and sebaceous material. Histologic examination of the cyst wall reveals a variety of benign differentiated tissues, including skin, cailage, brain, and mucinous gland... | Teratomas are benign tumors composed of tissues derived from all three primary germ layers: ectoderm, mesoderm, and endoderm. They are most common in the ovary but also occur in the testis and extragonadal sites. Adenoma (choice A) is a benign tumor of epithelial origin. Chondroma (choice B) is a benign cailaginous tum... | Teratoma |
66eb15d8-7c27-4164-9062-61154ce1358d | A 23-year-old female presents with pelvic pain and is found to have an ovarian mass of the left ovary that measures 3 cm in diameter. Grossly, the mass consists of multiple cystic spaces. Histologically, these cysts are lined by tall columnar epithelium, with some of the cells being ciliated. What is your diagnosis of ... | A 23-year-old female presents with pelvic pain and is found to have an ovarian mass of the left ovary that measures 3 cm in diameter. Grossly, the mass consists of multiple cystic spaces. Histologically, these cysts are lined by tall columnar epithelium, with some of the cells being ciliated. | The surface epithelial tumors of the ovary are derived from the surface celomic epithelium, which embryonically gives rise to the Mullerian epithelium. Therefore these ovarian epithelial tumors may recapitulate the histology of organs derived from the Mullerian epithelium. For example, serous ovarian tumors are compose... | Serous tumor |
5d4c0357-a1d0-4e16-a8e7-bebbc006aca9 | A 58-year-old woman presents with an irregular nodularity that has developed in her right breast over the past 3 months. Mammography demonstrates irregular densities in both breasts. A needle biopsy of one breast lesion is shown. An excisional biopsy of the contralateral breast shows similar histology. Which of the fol... | A 58-year-old woman presents with an irregular nodularity that has developed in her right breast over the past 3 months. Mammography demonstrates irregular densities in both breasts. A needle biopsy of one breast lesion is shown. An excisional biopsy of the contralateral breast shows similar histology. | Lobular carcinoma in situ arises in the terminal duct lobular unit. Malignant cells appear as solid clusters that pack and distend the terminal ducts but not to the extent of ductal carcinoma in situ. The lesion does not usually incite the dense fibrosis and chronic inflammation so characteristic of intraductal carcino... | Lobular carcinoma in situ |
59101bd7-d67f-485f-8e90-6477f59694b9 | A 50-year-old woman presents with lower back pain of 3 weeks in duration. Radiologic studies reveal several discrete lytic lesions in the lumbar back and pelvis. Laboratory studies show elevated serum levels of alkaline phosphatase. Serum calcium, serum protein, and peripheral blood smears are normal. Aspiration biopsy... | A 50-year-old woman presents with lower back pain of 3 weeks in duration. Radiologic studies reveal several discrete lytic lesions in the lumbar back and pelvis. Laboratory studies show elevated serum levels of alkaline phosphatase. Serum calcium, serum protein, and peripheral blood smears are normal. Aspiration biopsy... | Multiple lytic lesions associated with keratin-positive cells strongly suggest metastatic bone cancer. Metastatic carcinoma is the most common tumor of bone, and skeletal metastases are found in at least 85% of cancer cases that have run their full clinical course. The vertebral column is the most commonly affected bon... | Metastatic carcinoma |
20d211b9-a4b1-4b39-8fc4-163bb59cccd6 | An 18-year-old presents with a well- circumscribed 2 cm mass in her right breast. The mass is painless and has a rubbery consistency and discrete borders. It appears to move freely through the breast tissue. What is the likeliest diagnosis? | An 18-year-old presents with a well- circumscribed 2 cm mass in her right breast. The mass is painless and has a rubbery consistency and discrete borders. It appears to move freely through the breast tissue. | Fibroadenomas are most often found in teenage girls. They are firm in consistency, clearly defined, and very mobile. The typical feature on palpation is that they appear to move freely through the breast tissue ("breast mouse"). | Fibroadenoma |
3a6b4569-defb-49b4-8430-ff9ea210a929 | A 69 year old male presents with an episode of slurring of speech which lasted for 12 hours and then resolved.He is heavy smoker having smoked 60 cigarettes per day for 40 years. He had a single episode of haemoptysis 4 weeks previously and has underlying lung cancer with brain metastases and is referred for an urgent ... | A 69 year old male presents with an episode of slurring of speech which lasted for 12 hours and then resolved.He is heavy smoker having smoked 60 cigarettes per day for 40 years. He had a single episode of haemoptysis 4 weeks previously and has underlying lung cancer with brain metastases and is referred for an urgent ... | The axial image from a contrast enhanced CT scan, in aerial phase, shows a filling defect in the left atrial appendage layered along the anterior wall. Given the clinical history and the CT appearance, the most likely diagnosis is of thrombus in the LA as a consequence of AF. Myxomas generally arise from interatrial se... | Left atrial thrombus |
e441837c-07d0-4eb3-946f-23cbfad66f59 | A 6 year old boy has been complaining of a headache, ignoring to see the objects on the sides for four months. On examination he is not mentally retarded, his grades at school are good, and visual acuity is diminished in both the eyes. Visual charting showed significant field defect. CT scan of the head showed suprasel... | A 6 year old boy has been complaining of a headache, ignoring to see the objects on the sides for four months. On examination he is not mentally retarded, his grades at school are good, and visual acuity is diminished in both the eyes. Visual charting showed significant field defect. CT scan of the head showed suprasel... | Suprasellar calcification along with the presence of visual field defects and headache suggests the diagnosis of craniopharyngioma. | Craniopharyngioma |
1a8810bc-b2de-4926-bbda-a81733e983c1 | A 5-year-old child presents with history of fever off- and-on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 cm below costal margin. The most likely diagnosis is: | A 5-year-old child presents with history of fever off- and-on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 cm below costal margin. | - Pallor (anemia), petechial spot (thrombocytopenia), fever (infection due to neutropenia) with splenomegaly suggest the diagnosis of acute leukemia. - Splenomegaly eliminates aplastic anemia - Presence of anemia and recurrent infections, go against ITP | Acute leukemia |
09ea0c6f-f9a6-4f8f-ba26-ada2bf04f236 | A patient presents with mental confusion, visual and auditory hallucinations, perceived changes of body shape, swelling of the tongue and a fear of impending death after he was treated for primary chancre of syphilis with an intramuscular injection. What is the likely diagnosis? | A patient presents with mental confusion, visual and auditory hallucinations, perceived changes of body shape, swelling of the tongue and a fear of impending death after he was treated for primary chancre of syphilis with an intramuscular injection. | -Hoigne's syndrome is a pseudoanaphylactic or pseudoallergic reaction that occurs after the intramuscular administration of Penicillin G procaine or benzathine. These are usually embolic toxic reactions possibly due to vascular occlusion by large crystals of the Penicillin salts. It is not due to Penicillin allergy-Acu... | Hoigne Syndrome |
c07322bc-4b43-4c1a-839e-154aefcc3aa5 | A 25-year-old woman rushes to an emergency depament because she is afraid she is dying. She is experiencing chest pain, a sensation of choking, nausea, and tingling sensations up and down her arms. When the screening nurse examines the patient, her face is flushed and sweating. Her pulse is 140/min and respirations are... | A 25-year-old woman rushes to an emergency depament because she is afraid she is dying. She is experiencing chest pain, a sensation of choking, nausea, and tingling sensations up and down her arms. When the screening nurse examines the patient, her face is flushed and sweating. Her pulse is 140/min and respirations are... | This woman had a panic attack. These are common, affecting more than one third of the general population each year. The etiology appears to be a combination of both biological and psychological dysfunction. The sensations and physiologic changes can be very dramatic and, in addition to the features cited in the questio... | Panic attack |
def5bcbb-25e9-4c20-bccd-72f6180d84ab | A 35-year-old woman develops an itchy rash over her back, legs, and trunk several hours after swimming in a lake. Erythematous, edematous papules are noted. The wheals vary in size. There are no mucosal lesions and no swelling of the lips. The most likely diagnosis is | A 35-year-old woman develops an itchy rash over her back, legs, and trunk several hours after swimming in a lake. Erythematous, edematous papules are noted. The wheals vary in size. There are no mucosal lesions and no swelling of the lips. | (a) Source: (Braunwald, 15/e, pp 318, 323, 822, 1061, 1917-1918.) Urticaria, or hives, is a common dermatologic problem characterized by pruritic, edematous papules and plaques that vary in size and come and go, often within hours. Mast cells may be stimulated by heat, cold, pressure, water, or exercise. Immunologic me... | Urticaria |
43647b60-760f-4f7a-bbef-9c3fb997e9b6 | A 27-yrs-old woman has been feeling low for the past 2 weeks. She has little energy and has trouble concentrating. She states that 6 weeks ago she had been feeling very good, with lots of energy and no need for sleep. She states this pattern has been occurring for at least the past 3 years, though the episodes have nev... | A 27-yrs-old woman has been feeling low for the past 2 weeks. She has little energy and has trouble concentrating. She states that 6 weeks ago she had been feeling very good, with lots of energy and no need for sleep. She states this pattern has been occurring for at least the past 3 years, though the episodes have nev... | Cyclothymic disorder *Cyclothymic disorder is characterized by recurrent periods of mild depression alternating with periods of hypomania. *This pattern must be present for at least 2 years (1 year for children and adolescents) before the diagnosis can be made. *During these 2 years, the symptom-free intervals should n... | Cyclothymic disorder |
7efc8789-126c-487d-abe8-7a5e172213c6 | A 22-year-old primigravida at 11 weeks of gestational age has a blood pressure reading of 150/100 mm Hg obtained during a routine visit. . The patient denies any headache, visual changes, nausea, vomiting, or abdominal pain. Her repeat BP is 160/90 mm Hg, and urinalysis is negative for protein. Which of the following i... | A 22-year-old primigravida at 11 weeks of gestational age has a blood pressure reading of 150/100 mm Hg obtained during a routine visit. . The patient denies any headache, visual changes, nausea, vomiting, or abdominal pain. Her repeat BP is 160/90 mm Hg, and urinalysis is negative for protein. | Chronic hypeension is defined as BP >140/90 mmHg before pregnancy or diagnosed before 20 weeks of gestation, or hypeension first diagnosed after 20 weeks of gestation and persistent after 12 weeks postpaum. The average prevalence of hypeension in women aged 18 to 39 years is approximately 5-7 percent. | Chronic hypeension |
5f114658-03b5-4e65-8899-536cf718b503 | A 43-year-old man is hit in the face with a baseball bat and presents to the emergency department with massive facial swelling, ecchymosis, and an elongated face. There is mobility of the middle third of the face on digital manipulation of the maxilla. What is the likely diagnosis? | A 43-year-old man is hit in the face with a baseball bat and presents to the emergency department with massive facial swelling, ecchymosis, and an elongated face. There is mobility of the middle third of the face on digital manipulation of the maxilla. | The physical findings are characteristics of a Le Fort III fracture (Figure below). In this injury, the fracture passes through maxilla and nasal bones and above the zygomatic bone.Classic Le Fort fracture patterns | LeFort III fracture |
cd88e21a-473a-4182-a3e4-c2d1f0fc7cd1 | A 63-year-old bartender presents at his physician's office complaining of a painful sore on his tongue. On examination, it is found that he has an ulcerated lesion on his tongue and a mass in the submandibular gland triangle. What is the most likely diagnosis? SELECT ONE. | A 63-year-old bartender presents at his physician's office complaining of a painful sore on his tongue. On examination, it is found that he has an ulcerated lesion on his tongue and a mass in the submandibular gland triangle. | The tip of the tongue drains into the submental lymph nodes, whereas, the side of the tongue drains into the submandibular lymph nodes. | Squamous cell carcinoma |
a0c65ec6-228b-46a8-b3fb-e40662190620 | A 43-year-old woman with chronic alcoholism presents with shortness of breath and edema. On examination, her blood pressure is 100/60 mm Hg, pulse 110/min, JVP is 8 cm, the cardiac apex is displaced and enlarged, there are bilateral inspiratory crackles, and there is pedal edema.For the patient with vitamin deficiency ... | A 43-year-old woman with chronic alcoholism presents with shortness of breath and edema. On examination, her blood pressure is 100/60 mm Hg, pulse 110/min, JVP is 8 cm, the cardiac apex is displaced and enlarged, there are bilateral inspiratory crackles, and there is pedal edema. | Thiamine deficiency can cause high-output cardiac failure (wet beriberi) or neurologic symptoms (dry beriberi). In North America, thiamine deficiency occurs in alcoholics or those with chronic disease. In alcoholics, deficiency is secondary to low intake, impaired absorption and storage, and accelerated destruction. Ge... | thiamine |
e87dcbbc-8435-454a-9146-7fdf8e7e071e | A 68-year-old male musician presents to the emergency department with a sudden onset of colicky abdominal pain and massive vomiting of 4-hour duration. Examination shows an elevated WBC of 13,200 with a HCT of 45%. Electrolytes and blood urea nitrogen (BUN) are normal. An erect film of the abdomen reveals dilatation of... | A 68-year-old male musician presents to the emergency department with a sudden onset of colicky abdominal pain and massive vomiting of 4-hour duration. Examination shows an elevated WBC of 13,200 with a HCT of 45%. Electrolytes and blood urea nitrogen (BUN) are normal. An erect film of the abdomen reveals dilatation of... | Mechanical obstruction implies a barrier that impedes progress of intestinal contents. Complete mid or distal small-bowel obstruction presents with colicky abdominal pain, more marked abdominal distention but with vomiting that is less frequent and occurs at a later stage than that of proximal jejunal obstruction. | Complete proximal intestinal obstruction |
11782a0a-44e3-4ac1-bf84-ec304a63094a | A 9 year old girl is presenting with non productive cough and mild stridor for 2.5 months duration. Patient is improving but suddenly developed wheeze, productive cough, mild fever and on X-ray hyperlucency is seen and PFT shows obstructive curve. The MOST probable diagnosis is? | A 9 year old girl is presenting with non productive cough and mild stridor for 2.5 months duration. Patient is improving but suddenly developed wheeze, productive cough, mild fever and on X-ray hyperlucency is seen and PFT shows obstructive curve. | Bronchiolitis obliterans is a rare chronic obstructive lung disease characterized by complete obliteration of the small airways following a severe insult. The most common form in children is postinfectious, following a lower airway tract infection with adenovirus, although influenza, rubeola, Bordetella, and Mycoplasma... | Bronchiolitis obliterans |
874e45c8-1b40-41c2-9fe5-3e9329a84653 | Many rashes and skin lesions can be found first in the newborn period. For each of the descriptions listed below, select the most likely diagnosis. Each lettered option may be used once, more than once, or not at all. An adolescent boy complains of a splotchy red rash on the nape of his neck, discovered when he had his... | Many rashes and skin lesions can be found first in the newborn period. | Salmon patches (aka nevus simplex or nevus flammeus) are flat vascular lesions that occur in the listed regions and appear more prominent during crying. The lesions on the face fade over the first few years of life. Lesions found over the nuchal and occipital areas often persist. No therapy is indicated. | Salmon patch |
d12e78d3-6249-49de-8d70-680af7a2e738 | A 42-year old female presents with the complaint of bleeding gums for the past 20 days. Intra-oral examination shows thickened and friable gums. Also, she has hepatosplenomegaly with generalized non tender lymphadenopathy. The blood count reveals: Hemoglobin 11.4 g/dl, Platelet count 90,000/mm3, WBC count 4600/mm3. Th... | A 42-year old female presents with the complaint of bleeding gums for the past 20 days. Intra-oral examination shows thickened and friable gums. Also, she has hepatosplenomegaly with generalized non tender lymphadenopathy. The blood count reveals: Hemoglobin 11.4 g/dl, Platelet count 90,000/mm3, WBC count 4600/mm3. Th... | Patient has an “aleukemic” leukemia in which leukemic blasts fill the marrow, but the peripheral blood count of leukocytes is not high. The staining of the blasts suggests the presence of monoblasts (peroxidase negative and nonspecific esterase positive). So, the likely diagnosis for her is M5 leukemia, which is characte... | Acute monocytic leukemia |
0a22bdab-b65a-48b8-bde8-e73a0ecf5d0b | A 69-year-old man has had mild arthritis involving many joints for several years. Over 1 or 2 days, he develops severe pain and swelling of his knee. His x-ray reveals calcifications in his articular cartilage. Which of the following is the most likely diagnosis? | A 69-year-old man has had mild arthritis involving many joints for several years. Over 1 or 2 days, he develops severe pain and swelling of his knee. His x-ray reveals calcifications in his articular cartilage. | The articular calcification chondrocalcinosis is typical for pseudogout or calcium pyrophosphate disease (CPPD). The most common joint involved is the knee, but the wrist, shoulder, ankle, elbow, and hand are also frequently involved. Definitive diagnosis depends on finding typical rhomboid-shaped crystals with weak-po... | pseudogout |
dd8b1ce8-3494-4843-9808-25eaedce1e46 | A 22-year-old man has symptoms of low back pain and stiffness. After several months of mild symptoms, he notes more severe stiffness at night and hip pain. On physical examination, there is paravertebral muscle tenderness and limited flexion of the lumbar spine. Figure shows an x-ray of the lumbar spine. Which of the f... | A 22-year-old man has symptoms of low back pain and stiffness. After several months of mild symptoms, he notes more severe stiffness at night and hip pain. On physical examination, there is paravertebral muscle tenderness and limited flexion of the lumbar spine. Figure shows an x-ray of the lumbar spine. | (c) Source: (Kasper, p. 1993) AS occurs in 1-6% of adults inheriting human lymphocyte antigen B27 (HLA-B27). However, the prevalence in B27-positive relatives of patients with AS is up to 30%. Men are three times more likely to be affected. | ankylosing spondylitis (AS) |
5930efe0-aabd-4031-add7-926dca85292b | A 27-year-old woman comes to psychiatrist complaining of sleep difficulty since her breakup a month ago. On exploring fuher she repos difficulty in work, decision making, socializing without his help. Since early age she has struggled with low self-confidence and fears of rejection and abandonment. She appears anxious ... | A 27-year-old woman comes to psychiatrist complaining of sleep difficulty since her breakup a month ago. On exploring fuher she repos difficulty in work, decision making, socializing without his help. Since early age she has struggled with low self-confidence and fears of rejection and abandonment. She appears anxious ... | Patient's excessive dependency on her boyfriend,indecisiveness, and fear of being alone are suggestive of dependent personality disorder. It is a cluster C PD .Additionally in this patient is uncomfoable when alone. | Dependent personality disorder |
10572939-fdef-490b-89f1-88597f5c4c2d | A 10 year old boy has a fracture of femur. Biochemical evaluation revealed Hb 11.5 gm/dl and ESR 18 mm 1st hr. Serum calcium 12.8 mg/dL, serum phosphorus 2.3 mg/dL, alkaline phosphate 28 KA units and blood urea 32 mg/dL. Which of the following is the most probable diagnosis in his case- | A 10 year old boy has a fracture of femur. Biochemical evaluation revealed Hb 11.5 gm/dl and ESR 18 mm 1st hr. Serum calcium 12.8 mg/dL, serum phosphorus 2.3 mg/dL, alkaline phosphate 28 KA units and blood urea 32 mg/dL. | Ans. is 'c' i.e., Hyperparathyroidism o You can solve the question just looking at calcium value. Amongst the given options only hyperparathyroidism causes hypercalcemia. The patient in question has an increased serum Ca', decreased serum phosphorus and increased values of alkaline phosphatase, all of which characteriz... | Hyperparathyroidism |
defafb75-e1d8-454c-84fe-a326151e3cba | Shailza, a 40-year-old female is having headache for the past 6 months. All her investigations were normal. She had several consultations and she had no relief of her symptoms. She still believes that she has some problem in her brain. Likely diagnosis could be: September 2010 | Shailza, a 40-year-old female is having headache for the past 6 months. All her investigations were normal. She had several consultations and she had no relief of her symptoms. She still believes that she has some problem in her brain. | Ans. D: Hypochondriasis Hypochondriasis, hypochondria refers to excessive preoccupation or worry about having a serious illness. An individual suffering from hypochondriasis is known as a hypochondriac. Often, hypochondria persists even after a physician has evaluated a person and reassured them that their concerns abo... | Hypochondriasis |
a942906f-ed09-4b02-a88e-d246f207d122 | 29 year old female with history of Sjogren's syndrome presents with a 2 day episode of watery diarrhea 2 days ago. Physical examination is unremarkable. Because of her history, the physician decides to check her urine electrolytes. Urine chemistry: K = 31, Na = 100, Cl = 105. Her current diagnosis is? | 29 year old female with history of Sjogren's syndrome presents with a 2 day episode of watery diarrhea 2 days ago. Physical examination is unremarkable. Because of her history, the physician decides to check her urine electrolytes. Urine chemistry: K = 31, Na = 100, Cl = 105. | * The urine electrolytes are used to distinguish between A and diarrhea * UAG is an indirect measure of ammonium excretion * UAG = (Na + K) - Cl * UAG = ( 100 + 31 ) - 105 = 26 * A positive UAG suggest A because in the setting of diarrhea, ammonium chloride concentration in the urine would be high and the UAG would be ... | Renal tubular acidosis |
f9fbafd4-304c-48a8-a0d1-2b099186c022 | A 23 year old male who is otherwise normal complains of mild pain in his right iliac fossa in a waveform pattern which increases during the night and he becomes exhausted and is admitted in the hospital. On examination there is mild hematuria. Urine examination reveals plenty of RBCs, 50WBCs/hpf. Urine pH is 5.5. Most ... | A 23 year old male who is otherwise normal complains of mild pain in his right iliac fossa in a waveform pattern which increases during the night and he becomes exhausted and is admitted in the hospital. On examination there is mild hematuria. Urine examination reveals plenty of RBCs, 50WBCs/hpf. Urine pH is 5.5. | Ans. is 'c' ie. Ureteral calculus The patient's clinical picture is typical of ureteric calculus.Colicky renal pain associated with hematuria is suggestive of ureteric stone although a clot from a bleeding renal tumor can cause the same type of pain.A ureteric calculus pain is almost invariably associated with hematuri... | Ureteral calculus |
720afc18-c097-4084-8974-4e948c9a4462 | A 5 year old male child has multiple hyperprigmented macules over the trunk. On rubbing the lesion with the rounded end of a pen, he developed uicarial wheal, confined to the border of the lesion. The most likely diagnosis is | A 5 year old male child has multiple hyperprigmented macules over the trunk. On rubbing the lesion with the rounded end of a pen, he developed uicarial wheal, confined to the border of the lesion. | Darriers sign : uicarial wheal produced in a lesion after it is firmly rubbed with a finger or rounded end of a pen, the wheal is strictly confined to the borders of the lesion. Seen in uicarial pigmentosa, and rarely with cutaneous lymphoma or histiocytosiS FITZPATRICK TEXTBOOK OF DERMATOLOGY , PAGE 12. | Uicaria pigmentosa |
cb4b13c8-4fd2-4ec1-9a77-0ccdff88ca5b | A 3 month old child has moderate fever and non productive cough and mild dyspnea. After course of mild antibiotic the condition of the child improved transiently but he again develops high fever, productive cough and increased respiratory distress. Chest X ray shows hyperluscency and PFT shows obstructive pattern. Most... | A 3 month old child has moderate fever and non productive cough and mild dyspnea. After course of mild antibiotic the condition of the child improved transiently but he again develops high fever, productive cough and increased respiratory distress. Chest X ray shows hyperluscency and PFT shows obstructive pattern. | Bronchiolitis obliterans Repeat from Nov 08 Q no.130 | >Bronchiolitis obliterans |
00dd6465-084b-44fd-b64f-dbb33bbde0e0 | A 7 year old child presents with non productive cough, mild stridor since 6 months. On oral antibiotics, patient is improving but suddenly develops wheezing, productive cough, mild fever. X-ray shows hyperlucency and PFT shows obstructive curve. Most probable diagnosis is - | A 7 year old child presents with non productive cough, mild stridor since 6 months. On oral antibiotics, patient is improving but suddenly develops wheezing, productive cough, mild fever. X-ray shows hyperlucency and PFT shows obstructive curve. | Ans. is 'b' i.e., Bronchiolitis obliterance | Bronchiolitis obliterans |
9294dd10-66b0-499a-8c5c-b1aa175dc434 | An eight year old boy presents with back pain and mild fever. His plain X-ray of the dorsolumbar spine reveals a solitary collapsed dorsal vertebra with preserved disc spaces. There was no associated soft tissue shadow. The most likely diagnosis is - | An eight year old boy presents with back pain and mild fever. His plain X-ray of the dorsolumbar spine reveals a solitary collapsed dorsal vertebra with preserved disc spaces. There was no associated soft tissue shadow. | Solitary collapsed vertebra (vertebra plana) with preserved disc spaces in a child suggests the diagnosis of Eosinophilic granuloma (a type of Histiocytosis). | Histiocytosis |
06a059e8-ce09-46d0-81ba-2bf989c7f059 | A 16-year-old boy arrives to your office soon after beginning basketball season. He states that he has had progressive pain in his knees. A physical examination reveals, in addition to tenderness, a swollen and prominent tibial tubercle. Radiographs of the area are unremarkable. Which of the following is the most likel... | A 16-year-old boy arrives to your office soon after beginning basketball season. He states that he has had progressive pain in his knees. A physical examination reveals, in addition to tenderness, a swollen and prominent tibial tubercle. Radiographs of the area are unremarkable. | This history is typical of Osgood-Schlatter disease. Microfractures in the area of the insertion of the patellar tendon into the tibial tubercle are common in athletic adolescents. Swelling, tenderness, and an increase in size of the tibial tuberosity are found. Radiographs can be used to rule out other conditions. Tre... | Osgood-Schlatter disease |
80743579-7b0b-4df2-a10a-04e4f2311aa7 | A thirty year man presented with nausea, fever and jaundice of 5 days duration. The biochemical tests revealed a bilirubin of 6.7 mg/dl (conjugated 5.0 mg/dl) with SGOT/SGPT (AST/ALT) of 1230/ 900 IU/ml. The serological tests showed presence of HBsAg, IgM anti HBc and HBe Ag. The most likely diagnosis - | A thirty year man presented with nausea, fever and jaundice of 5 days duration. The biochemical tests revealed a bilirubin of 6.7 mg/dl (conjugated 5.0 mg/dl) with SGOT/SGPT (AST/ALT) of 1230/ 900 IU/ml. The serological tests showed presence of HBsAg, IgM anti HBc and HBe Ag. | null | Acute hepatitis B infection with high infectivity |
512ce60e-6c09-417d-91b3-e1d2f0d539b6 | A patient presents in the causality with history of abdominal pain. On examination the person is in shock, with severe abdominal tenderness and guarding. There was also one episode of bloody diarrhoea. He gives a history of recurrent abdominal pain soon after taking food which persists for about 3 hours after food. He ... | A patient presents in the causality with history of abdominal pain. On examination the person is in shock, with severe abdominal tenderness and guarding. There was also one episode of bloody diarrhoea. He gives a history of recurrent abdominal pain soon after taking food which persists for about 3 hours after food. He ... | The person has had recurrent episodes of abdominal angina as shown by the pain after food intake. He also has a history of MI which also suggests that he has atherosclerosis. The bloody diarrhoea is again suggestive of mesenteric vascular occlusion in this patient. Ref: Manipal Millennium Edition, Page 429; S.Das, Edit... | Acute thrombotic mesenteric vascular occlusion |
68c63050-83c0-4669-8c29-9637d4061726 | 40 years old male patient came with complaint of dry cough and dyspnoea. On lung function tests, restrictive pattern of decreases lung function is seen. Chest x-ray showed few reticular opacities in bilateral lung. HRCT of lung was performed which shows GGO in bilateral lung fields sparing sub-pleural region. Most prob... | 40 years old male patient came with complaint of dry cough and dyspnoea. On lung function tests, restrictive pattern of decreases lung function is seen. Chest x-ray showed few reticular opacities in bilateral lung. HRCT of lung was performed which shows GGO in bilateral lung fields sparing sub-pleural region. | Interstitial Lung Disease UIP (Usual interstitial pneumonia) NSIP (Non - specific interstitial pneumonia) Reticular opacities Traction bronchiectasis Subpleural honeycombing Subpleural sparing | NSIP |
de6e23eb-8209-474b-8159-a56fe9f24069 | A 22 year old boy was all alright 2 days back. But since then he claims that people are abusing him and he c/o hearing of voices when no one is around, aggressive behavior since 2 days. He has fever since only 2 days. No past history. Which is the most likely diagnosis? | A 22 year old boy was all alright 2 days back. But since then he claims that people are abusing him and he c/o hearing of voices when no one is around, aggressive behavior since 2 days. He has fever since only 2 days. No past history. | Ans. B. Acute Psychosis* Hearing of voices, Aggressive Behaviors, muttering to self is a sign of psychosis as it less than 1 month it is Acute Psychosis.* It is not fever induced or Delirium because in these conditions the orientation is usually impaired but is not impaired in this question.* In delusional disorder - t... | Acute psychosis |
ae6a8d72-5242-437f-94d2-a45acb1dd296 | A 35-year old lady G4 P3 presents to the emergency dept. with amenorrhea of 12 weeks with excessive vomiting and bleeding per vaginum. On examination her pulse is 90/min., BP is 150/110 mm Hg, on PA examination uterus is of 20 wks size. Your most possible diagnosis is:- | A 35-year old lady G4 P3 presents to the emergency dept. with amenorrhea of 12 weeks with excessive vomiting and bleeding per vaginum. On examination her pulse is 90/min., BP is 150/110 mm Hg, on PA examination uterus is of 20 wks size. | The above given history is suggestive of molar pregnancy as: women have uterine growth that is more rapid than expected.(uterine size>POG) excessive nausea and vomiting are significant. on USG, snowstorm /honeycomb appearance is seen in molar pregnancy Gestational hypeension is characterized by hypeension after 20 week... | Molar pregnancy |
8f6ecfae-518f-4da8-bd2d-1c9fbf15b0a7 | A 39-year-old man repos seeing red-colored urine in the morning. The CBC reveals anemia, low serum iron, and an elevated reticulocyte count. Laboratory studies show increased lysis of erythrocytes when incubated with either sucrose or acidified serum. Which of the following is the appropriate diagnosis | A 39-year-old man repos seeing red-colored urine in the morning. The CBC reveals anemia, low serum iron, and an elevated reticulocyte count. Laboratory studies show increased lysis of erythrocytes when incubated with either sucrose or acidified serum. | - Given clinical features suggests the diagnosis of PNH - Despite its name, the disorder is nocturnal in only a minority of cases. - PNH is a clonal stem cell disorder characterized by episodic intravascular hemolytic anemia; secondary to increased sensitivity of erythrocytes to complement-mediated lysis. - It is d/t s... | Paroxysmal nocturnal hemoglobinuria |
30af852c-9cf9-45fd-a814-756e3ccbaf4a | An 18-year-old male presented with acute onset descending paralysis of 3 days duration. There is also a history of blurring of vision for the same duration. On examination, the patient has quadriparesis with areflexia. Both the pupils are non-reactive. The most probable diagnosis is - | An 18-year-old male presented with acute onset descending paralysis of 3 days duration. There is also a history of blurring of vision for the same duration. On examination, the patient has quadriparesis with areflexia. Both the pupils are non-reactive. | Botulism is caused by neurotoxins of Clostridium botulinum, which are extremely potent & cause disease after ingestion of even picogram amounts. Its classical form is an acute onset of bilateral cranial neuropathies associated with symmetric descending weakness.The toxin causes predominantly bulbar & ocular palsies(dif... | Botulism |
3458f971-59ef-4497-ab93-01e7e5b570bc | A 45 year old woman develops abdominal and pelvic discomfo. Physical examination reveals a large mass in the right lower quadrant, which is surgically resected. The mass consists of a large (25 cm) cystic sac containing thick mucinous fluid within a thin wall. On careful inspection, the pathologist finds an area of inc... | A 45 year old woman develops abdominal and pelvic discomfo. Physical examination reveals a large mass in the right lower quadrant, which is surgically resected. The mass consists of a large (25 cm) cystic sac containing thick mucinous fluid within a thin wall. On careful inspection, the pathologist finds an area of inc... | Classification of ovarian tumors, like testicular tumors, is based on putative cell of origin. Thus, ovarian tumors can be divided into neoplasms of germ cells,surface epithelium, or stromal origin. Two thirds of all ovarian neoplasms derive from the surface (coelomic) epithelium. These cystic tumors may contain clear ... | Borderline mucinous tumor |
669ac0aa-46c0-4b8c-803f-922d2065eaa5 | A 22-year-old woman is admitted to the hospital because of right-hand anaesthesia, that developed after an argument with her brother. She is in good spirits and seems unconcerned about her problem. There is no history of physical trauma. The neurologic examination is negative EXCEPT for reduced sensitivity to pain in a... | A 22-year-old woman is admitted to the hospital because of right-hand anaesthesia, that developed after an argument with her brother. She is in good spirits and seems unconcerned about her problem. There is no history of physical trauma. The neurologic examination is negative EXCEPT for reduced sensitivity to pain in a... | (D) Conversion disorder # Conversion disorder is characterized by symptoms or deficits of die voluntary motor or sensory functions dial cannot be explained by neurological or other medical conditions.> These symptoms are precipitated by psychological conflicts.> Term 'Hysteria' was used in die nineteenth century (and d... | Conversion disorder |
9dd8e20a-0f91-4796-a7d3-aad496ee33da | A 22 year old man presents to ENT OPD complaining of itching, earache and discharge from the ear. Discharge is watery in consistency and have musty odour. On examination, doctor found black headed filamentous growth which resembled wet blotting paper. Which of the following is likely diagnosis in this case? | A 22 year old man presents to ENT OPD complaining of itching, earache and discharge from the ear. Discharge is watery in consistency and have musty odour. On examination, doctor found black headed filamentous growth which resembled wet blotting paper. | -Patient is suffering from otomycosis due to Aspergillus niger. Otomycosis Fungal infection of the external auditary canal C/F: Intense itching Pain in the ear (More with Aspergillus flavus) Watery discharge with a musty odour The fungal mass have wet blotting paper/newspaper appearance Causes - Aspergillus niger Asper... | Otomycosis by Aspergillus niger |
d3dd46c1-b874-4b4d-a853-27b078da2259 | 23-year-old medical student complaint of feeling "worried." He fears failing his clinical exam because he feels nervous about presenting a case and performing physical examination in front of examiners. He would skip bedside teaching when it would be his turn to present a case in front of his classmates and tutors. He ... | 23-year-old medical student complaint of feeling "worried." He fears failing his clinical exam because he feels nervous about presenting a case and performing physical examination in front of examiners. He would skip bedside teaching when it would be his turn to present a case in front of his classmates and tutors. He ... | Clinical picture of fearing presentation in public, avoidance, fear of criticism is suggestive of social phobia. It is also known as social anxiety disorder. In Generalised anxiety disorder there is free flowing anxiety at all time. In panic disorder there are recurrent panic attacks with feeling of impending doom. | Social phobia |
53da0711-5b1c-4729-829f-0790bb8daec8 | A 62-year-old diabetic patient presented with a history of progressive right-sided weakness of one-month duration. The patient was also having speech difficulty. Fundus examination showed papilledema. Two months ago, she also had a fall in her bathroom and struck her head against a wall. The most likely clinical diagno... | A 62-year-old diabetic patient presented with a history of progressive right-sided weakness of one-month duration. The patient was also having speech difficulty. Fundus examination showed papilledema. Two months ago, she also had a fall in her bathroom and struck her head against a wall. | null | Left chronic subdural haematoma |
7b63f051-afa8-45e9-9e56-f0c1b56dac9e | A 16 year old girl was brought to the psychiatric emergency after she slashed her wrist in an attempt to commit suicide. On enquiry her father revealed that she had made several such attempts of wrist slashing in the past, mostly in response to tril fights in her house. Fuher she had marked fluctuations in her mood wit... | A 16 year old girl was brought to the psychiatric emergency after she slashed her wrist in an attempt to commit suicide. On enquiry her father revealed that she had made several such attempts of wrist slashing in the past, mostly in response to tril fights in her house. Fuher she had marked fluctuations in her mood wit... | A i.e. Borderline Personality DisorderSchizophrenia can easily be ruled out by absence of disorganized speech, disorganized behaviour (or catatonia), delusions, hallucinations, & negative symptoms (ex blunt affect) for more than 6 months & leading to social / occupational dysfunction. | Borderline personality disorder |
b7074fe0-aa45-4419-b2cf-e6449f94eb39 | A 9 1/2 -year-old girl presents to your office with an approximately 1 1/4 -cm nodule in her neck, just to the left of the midline and below her cricoid cartilage. It is nontender and moves when she swallows. It has been enlarging over the last several months and was not seen by the pediatrician at her 9-year-old check... | A 9 1/2 -year-old girl presents to your office with an approximately 1 1/4 -cm nodule in her neck, just to the left of the midline and below her cricoid cartilage. It is nontender and moves when she swallows. It has been enlarging over the last several months and was not seen by the pediatrician at her 9-year-old check... | While reactive lymphadenopathy is by far the most common cause of neck masses in children; a lymph node should not move with deglutition and is more likely to be tender. A branchial cleft syst should be more lateral and the thyroglossal duct cyst should be higher and in the midline (although they can sometimes present ... | Papillary thyroid cancer |
193bb7c1-ba4e-4928-bcbf-9be0f7878eba | An 83-year-old man with Parkinson's disease presents with low-grade fever and cough for several weeks. Lately, he has been experiencing more rigidity and difficulty with his walking. He is on a levodopa/carbidopa combination for treatment for the past 5 years. On examination, his gait is shuffling and slow. He has a tr... | An 83-year-old man with Parkinson's disease presents with low-grade fever and cough for several weeks. Lately, he has been experiencing more rigidity and difficulty with his walking. He is on a levodopa/carbidopa combination for treatment for the past 5 years. On examination, his gait is shuffling and slow. He has a tr... | Most lung abscesses and all anaerobic abscesses involve the normal flora of the oropharynx. Septic embolic usually contain S. aureus. Factors that predispose to Gram-negative colonization of the oropharynx include hospitalization, debility, severe underlying diseases, alcoholism, diabetes, and advanced age. Impaired co... | oropharyngeal flora |
1147973b-6b69-4447-ad7a-23ac66cfd08d | A 25 yr old female presented with malaise and generalized weakness since 6 months. Her appetite is reduced and she has giddiness and palpitations on and off. There was no organomegaly. Laboratory study showed normochromic to hypochromic anaemia, RDW=60, and MCV=50. What is the diagnosis ? | A 25 yr old female presented with malaise and generalized weakness since 6 months. Her appetite is reduced and she has giddiness and palpitations on and off. There was no organomegaly. Laboratory study showed normochromic to hypochromic anaemia, RDW=60, and MCV=50. | null | Iron deficiency anaemia |
e5c69dcf-bdbd-42d3-a3de-6ac770aa9c26 | A 12 year old girl presents with a yellowish "bihmark" on the scalp. Her mother repos that the lesion has progressively become thicker and way. She is asymptomatic but they are concern regarding the cosmetic appearance. Which is the most likely diagnosis? | A 12 year old girl presents with a yellowish "bihmark" on the scalp. Her mother repos that the lesion has progressively become thicker and way. She is asymptomatic but they are concern regarding the cosmetic appearance. | Nevus sebaceous appears usually on the scalp. Made of extra sebaceous glands in the skin. It stas as a flat pink or orange plaque (slightly raised area). Hair does not grow in a nevus sebaceous. During adolescence, they can become very bumpy and wa- like. A nevus sebaceous does not go away on its own. T/t: Surgery Seba... | Nevus sebaceous |
232792cb-b1de-4aab-84f7-ef28f7110972 | A 36-year-old woman has a cough and fever for 1 week. On physical examination, her temperature is 38.3deg C. She has diffuse crackles in all lung fields. A chest radiograph shows bilateral extensive infiltrates. CBC shows hemoglobin, 13.9 g/ dL; hematocrit, 42%; MCV, 89 mm3; platelet count, 210,000/mm3; and WBC count, ... | A 36-year-old woman has a cough and fever for 1 week. On physical examination, her temperature is 38.3deg C. She has diffuse crackles in all lung fields. A chest radiograph shows bilateral extensive infiltrates. CBC shows hemoglobin, 13.9 g/ dL; hematocrit, 42%; MCV, 89 mm3; platelet count, 210,000/mm3; and WBC count, ... | Marked leukocytosis and immature myeloid cells in the peripheral blood can represent an exaggerated response to infection (leukemoid reaction), or it can be a manifestation of chronic myelogenous leukemia (CML). Normal maturation of myeloid cells in the marrow rules out CML. Although not provided in this case, a leukoc... | Leukemoid reaction |
9351841b-34f7-4b57-bc91-41dbc30158ab | A 55-year-old male presents with features of obstructive jaundice. He also reports a weight loss of seven kilograms in last two months. On CT scan, the CBD is dilated till the lower end and the main pancreatic duct is also dilated. Pancreas is normal. The most likely diagnosis is: | A 55-year-old male presents with features of obstructive jaundice. He also reports a weight loss of seven kilograms in last two months. On CT scan, the CBD is dilated till the lower end and the main pancreatic duct is also dilated. Pancreas is normal. | Ans. (d) Periampullary carcinoma* Periampullary cancer presents with dilatation of both Pancreatic and Bile ducts.* Of the sites of cancer in Pancreas - Periampullary cancer has better prognosis than Head of pancreas cancer because of early presentation. | Periampullary carcinoma |
44326465-758f-48ec-aca1-5d98db6514ef | An 80 year old asymptomatic woman on a routine examination was detected to have a monoclonal spike on serum electrophoresis (IgG levels 1.5 g/dl). Bone marrow revealed plasma cells of 8%. Which of the following represents the most likely diagnosis? | An 80 year old asymptomatic woman on a routine examination was detected to have a monoclonal spike on serum electrophoresis (IgG levels 1.5 g/dl). Bone marrow revealed plasma cells of 8%. | Patient is showing features of monoclonal gammopathy of unknown significance. It refers to a clinical condition, defined by the presence of monoclonal immunoglobulin production without evidence of myeloma, waldenstorms macroglobulinemia or other lymphoproliferative disorder. It is an incidental finding detected by elev... | Monoclonal gammopathy of unknown significance |
1403d387-68ec-4529-a358-cec7507ec6a5 | A 20 year old woman presents with bilateral conductive deafness, palpable purpura on the legs and hemoptysis. Radiograph of the chest shows a thin-walled cavity in left lower zone. Investigations reveal total leukocyte count 12000/mm3, red cell casts in the urine and serum creatinine 3mg/dL. What is the most probable d... | A 20 year old woman presents with bilateral conductive deafness, palpable purpura on the legs and hemoptysis. Radiograph of the chest shows a thin-walled cavity in left lower zone. Investigations reveal total leukocyte count 12000/mm3, red cell casts in the urine and serum creatinine 3mg/dL. | Answer is C (Wegener's granulomatosis) The patient in question has been depicted to have one manifestation each of the classical triad as mentioned below along with skin lesion in the _Pm of palpable purpura and hence the answer is clearly Wegener's granulomatosis. Wegener's granulomatosis in its classical form present... | Wegener's granulomatosis |
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