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Slideshow Revision. Ian Anderson March 2008. Question 1. What is the diagnosis? (1 mark) What cells might you see on a blood film? (1 mark). Question 2. What is this sign? (1 mark) What is the diagnosis? (1 mark) How long will it typically take to heal? (1 mark). Question 3. - PowerPoint PPT Presentation
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Slideshow Revision
Ian AndersonMarch 2008
Question 1
WCC 8.24 Ferritin LowHb 8.06 Folate NormalMCV 69 Vit B12 NormalPlts 350 TIBC High
a) What is the diagnosis? (1 mark)
b) What cells might you see on a blood film? (1 mark)
Question 2
a) What is this sign? (1 mark)
b) What is the diagnosis?(1 mark)
c) How long will it typically take to heal? (1 mark)
Question 3
a) What is your diagnosis in this patient who presented with chest pain? (1 mark)
b) How would you further investigate this patient?
Question 4a) What is this sign called?
(1 mark)
b) What is it diagnostic of?(1 mark)
Question 5What is your diagnosis in this lady who has deranged LFTs?
(1 mark)
Question 6
a) What is the diagnosis? (1 mark)
b) What should you do? (1 mark)
Question 7
a) What is this investigation?(1 mark)
b) What is the diagnosis?(1 mark)
Question 8
a) What is the diagnosis? (1 mark)
b) Name two life-saving treatments that you would give. (1 marks)
Question 9
a) What is the diagnosis? (1 mark)
b) Name two treatments. (2 marks)
Question 10a) What is the
diagnosis?
(1 mark)
Question 11a) What is the diagnosis?
Question 12
a) What operation has this elderly gentleman had?
Question 13
This man has started a new tablet because he’s “Got blood pressure, Dr”.
a) What is your diagnosis of this painful toe?
b) What class of tablet is likely to be responsible?
Question 14a) What is this sign?
(1 mark)
b) What is it usually predictive of?(1 mark)
Question 15a) What is this sign?
b) What is the underlying pathology?
Question 16a) What is this
procedure?(1 mark)
b) Name a potential complication(1 mark)
Question 17a) What is the diagnosis in this patient with a history of atrial fibrilation and collapse? (1 mark)
Question 18
a) Diagnosis (1 mark)
b) Treatment in non-diabetic(1 mark)
Question 19a) What does the
arrow denote?
b) What is it diagnostic of?
Question 20
a) What is this? (1 mark)
Question 21a) What is this clinical
sign?
b) What is the diagnosis in this 30 year old man with chronic backache?
Question 22a) What did this patient die of?
Question 23
a) What is the device that has been circled? (1 mark)
b) What are the indications for this?(1 mark)
Question 24
a) What procedure has been performed here?
b) What complication has occurred?
Question 25
a) What procedure has been performed?
b) What is the indication for doing this?
Question 26A) Diagnosis? B) Treatment?
Answers
Answer 1WCC 8.24 Ferritin LowHb 8.06 Folate NormalMCV 69 Vit B12 NormalPlts 350 TIBC Higha) Iron deficiency anaemia (microcytic anaemia with low ferritin)
b) Poikilocytosis / anisocytosis
NB: Other microcytic anaemias include: Chronic disease (where MCV may be normal or low but ferritin is
high and TIBC is low)Thalassaemia / sideroblastic anaemia (where ferritin is high and
TIBC is low)
Answer 2
a) Dinner fork deformity
b) Colle’s fracture of left hand
c) 6 weeks
Answer 3
a) PE (1 mark)
b) D-dimer, V/Q Scan or CTPA
Answer 4a) Pepperpot skull
(1 mark)
b) Multiple myeloma(1 mark)
NB: If you suspect myeloma in a patient, first line investigation is Bence Jones protein (urine sample) together with myeloma screen (blood electrophoresis), not a skull x-ray!
Answer 5Wilson’s Disease
(1 mark)
These are Kayser-Fleischer rings
You will never diagnose Wilson’s disease as a Dr. as is almost always picked up in childhood
a) Acute angle closure (blockage of the drainage angle causes IOP to rise. High pressure results in a constellation of signs seen in acute angle closure glaucoma including redness of conjunctiva (red arrow), haziness of the cornea, and a mid-dilated pupil (white arrow).
b) Get help! (We think that this was the answer they were looking for, rather than starting IV acetazolamide)
Answer 6
Answer 7
a) Barium swallow(1 mark)
b) Oesophageal stricture(1 mark)
Answer 8
a) Non ST-elevation MI (MI alone is not enough)
b) Oxygen, Aspirin, (GTN & Morphine)
Answer 9
a) Atrial Flutter (1 mark) [With 4:1 block – for the geeks]
b) DC cardioversion, pharmacological cardioversion (flecanide, sotalol), digoxin, beta blockers, verapamil, AV node ablation & PPM, overdrive pacing.
Answer 10
a) Cystic fibrosis
Frontal chest x-ray in cystic fibrosis shows diffuse interstitial disease with bronchiectasis and nodular densities of mucoid impaction
Answer 11a) Left pleural effusion
Answer 12
a) Pnemonectomy
Answer 13
This man has started a new tablet because he’s “Got blood pressure, Dr”.
a) Gout
b) Thiazide diuretics (e.g. bendroflumethiazide)
Answer 14a) Cullen’s sign
(peri-umbilical bruising)
b) Acute pancreatitis
Answer 15a) Ascites
b) Cirrhosis of the liver
Answer 16a) Coronary
angiogram
b) Stroke, MI, rupture, death, femoral haematoma & (pseudo) aneurysms
Answer 17a) Extradural haematoma(Subdual shown for comparison)
Answer 18
a) Cellulitis
b) Ben-pen & fluxlox
Answer 19a) “Looser’s
zone” (pseudo-fracture)
b) Osteomalacia(Note diffuse osteopenia)
Answer 20
a) Incisional hernia
Answer 21a) Bamboo spine
b) Ank Spondy
Answer 22a) Saddle PE
Answer 23
a) REVEAL implant (not a pacemaker, see top image)
b) Dizziness, syncope, palpitations, collapse, brady/tachy arrhythmias
Answer 24
Answer 25
a) Fasciotomy
b) Compartment syndrome
Answer 26A) Small bowel obstruction B) Drip & suck!
Good luck in your finals
You’ll all be fine. If I can pass, ANYONE can!