By Dr. Zahoor
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Question 1:
1. What is shown in the picture?
2. What is most likely cause?
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Answers 1
1. Carpopedal spasm
2. Hypocalcaemia
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Question 2:
1. What abnormality does this chest X-ray show?
2. What is the likely diagnosis?
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Answers 2
1. Bilateral hilar lymphadenopathy
2. Lymphoma
Sarcoidosis
Leukemia
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Question 3
1. What abnormality is shown?
2. What is the most likely cause?
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Answers 3
1. Haemorrhages
- Exudates
2. Diabetic retinopathy
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Question 4
1. What is seen in the picture?
2. What could be the cause?
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Answers 4
1. Petichel Hemorrhages (purpura)
2. Thrombocytopenia
- Drugs e.g. Thiazide diuretic, heparin ,
Quinine, NSAID drugs, Ranitidine
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Question 5
1. What abnormality is shown?
2. What could be the cause?
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Answers 5
1. Mediastinal mass
2. Lymphoma
Thymoma
Metastatic carcinoma
Leukemia
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Question 6
1. What abnormality is shown?
2. What is the most likely cause?
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Answers 6
1. Koilonychia
2. Iron deficiency anaemia
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This patient had
progressive dysphagia.
Barium swallow was
done.
Question 7
1. What does the X-ray show?
2. What is the diagnosis?
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Answers 7
1. Narrowing of lower end of Esophagus
2. Achalasia
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Chest X-ray of
middle aged
man
Question 8
1. What does this X-ray show?
2. What is likely diagnosis?
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Answers 8
1. White shadow left apex
2. Most likely left apical carcinoma, Pancoast tumor
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This patient was
presented with
headache.
Question 9
1. What is shown in the picture?
2. What could be the cause?
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Answers 9
1. Papilloedema
2. Raised intracranial pressure e.g. brain tumor, meningitis
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This patient is
presented with weight
loss.
Question 10
1. What this X-ray chest is showing?
2. What is the diagnosis?
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Answers 10
1. Chest X-ray shows multiple rounded shadows in the lung
fields
2. Multiple secondaries - cannonball secondaries (primary
carcinoma site in kidney or testes)
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Question 11
1. What is the diagnosis?
2. What is the treatment that you would give?
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Answers 11
1. Acute gout
2. Anti-inflammatory drugs e.g. Voltaren, Brufen
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Question 12
1. What does the skull X-ray show?
2. Give two causes.
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Answers 12
1. Multiple lytic lesions in the skull
2. Multiple myeloma
Multiple secondaries
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Question 13
1. What is shown in the picture?
2. Give two pulmonary conditions which may cause this
appearance.
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Answers 13
1. Finger clubbing
2. Bronchial carcinoma
Bronchiectasis
Fibrosing alveolitis
Empyema
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Question 14
1. What is this skin condition?
2. What disease are associated with it?
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Answers 14
1. Pyoderma gangrenosum (skin ulceration with clear cut
margin)
2. Ulcerative colitis
Crohn’s diasease
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This patient aged 35
years had diabetes
mellitus.
Question 15
1. What is this lesion?
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Answers 15
1. Necrobiosis lipoidica
It is closely associated with diabetes mellitus.
Ulcerated Plaques look yellow because of high lipid
content.
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Question 16
1. Give two abnormal physical sign.
2. What is the most likely diagnosis?
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Answers 16
1. Arthritis of proximal interphalangeal and metacarpophalangeal
joints
Vasculitis
2. Rheumatoid arthritis
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Question 17
1. What this picture is showing?
2. What is likely diagnosis?
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Answers 17
1. Hands are thick
2. Acromegly
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Question 18
1. What physical sign is shown?
2. Give two likely causes.
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Answers 18
1. Erythema nodosum (hypersensitivity vasculites)
2. Sarcoidosis
Streptococcal infection
Tuberculosis
Drugs e.g. oral contraceptives
Chronic inflammatory bowel disease
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Question 19
1. What is the abnormality?
2. What could be the cause?
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Answers 19
1. Optic atrophy
2. Glaucoma
Multiple sclerosis
Methyl alcohol
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Question 20
1. What this picture is showing?
2. What is the differential diagnosis?
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Answers 20
1. Cushingoid appearance with moon face and plethora
2. Cushing syndrome
Exogenous Glucocorticoids
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Question 21
1. What is the diagnosis?
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Answer 21
1. Psoriasis
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This boy presented
with abdominal pain
following upper
respiratory tract
illness.
Question 22
1. What this picture is showing?
2. What is the diagnosis?
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Answers 22
1. Purpuric rash
2. Henoch-Schonlein purpura
Aetiology is unknown, precipitating factors include
streptococcal infection, drugs e.g. penicillin
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Question 23
1. What is the diagnosis?
2. How will you confirm the diagnosis?
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Answer 23
1. Acromegly
2. Increased level of growth hormone which fails to
suppress during oral glucose tolerance test
- Lateral skull X-ray
- CT
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This is the
peripheral blood
film.
Question 24
1. What does it show?
2. What could be the possible cause?
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Answers 24
1. Lymphocytosis
2. Viral infection
Chronic lymphatic leukemia
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This patient had
renal transplant and
is on drug therapy
Question 25
1. What this picture is showing?
2. What drug causes it?
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Answers 25
1. Gingival hyperplasia
2. Cyclosporin
Note
Other causes of gingival hyperplasia
include drugs phenytoin, cyclosporin,
oral contraceptives
- Pregnancy
- Scurvy
- Acute monocytic leukemia
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This young girl has deep
voice and blood
pressure 180/105
Question 26
1. What physical signs are present?
2. What is the likely diagnosis?
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Answers 26
1. Cushingoid features and hirsutism
2. Congential adrenal hyperplasia
Androgen secreting ovarian neoplasm
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Question 27
1. Give two observations you find in this picture.
2. What is the diagnosis?
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Answers 27
1. Right eye ptosis and meiosis (smaller pupil)
2. Horner syndrome (lesion affecting sympathetic supply to the
eye)
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Thank you
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