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Slideshow Revision

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.

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Slideshow Revision

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  1. Slideshow Revision Ian Anderson March 2008

  2. Question 1 • What is the diagnosis? (1 mark) • What cells might you see on a blood film? (1 mark)

  3. Question 2 • What is this sign? (1 mark) • What is the diagnosis?(1 mark) • How long will it typically take to heal? (1 mark)

  4. Question 3 • What is your diagnosis in this patient who presented with chest pain? (1 mark) • How would you further investigate this patient?

  5. Question 4 • What is this sign called?(1 mark) • What is it diagnostic of?(1 mark)

  6. Question 5 What is your diagnosis in this lady who has deranged LFTs? (1 mark)

  7. Question 6 • What is the diagnosis? (1 mark) • What should you do? (1 mark)

  8. Question 7 • What is this investigation?(1 mark) • What is the diagnosis?(1 mark)

  9. Question 8 • What is the diagnosis? (1 mark) • Name two life-saving treatments that you would give. (1 marks)

  10. Question 9 • What is the diagnosis? (1 mark) • Name two treatments. (2 marks)

  11. Question 10 • What is the diagnosis? • (1 mark)

  12. Question 11a) What is the diagnosis?

  13. Question 12 a) What operation has this elderly gentleman had?

  14. Question 13 • This man has started a new tablet because he’s “Got blood pressure, Dr”. • What is your diagnosis of this painful toe? • What class of tablet is likely to be responsible?

  15. Question 14 • What is this sign?(1 mark) • What is it usually predictive of?(1 mark)

  16. Question 15a) What is this sign?b) What is the underlying pathology?

  17. Question 16 • What is this procedure?(1 mark) • Name a potential complication(1 mark)

  18. Question 17 a) What is the diagnosis in this patient with a history of atrial fibrilation and collapse? (1 mark)

  19. Question 18 • Diagnosis (1 mark) • Treatment in non-diabetic(1 mark)

  20. Question 19 • What does the arrow denote? • What is it diagnostic of?

  21. Question 20 a) What is this? (1 mark)

  22. Question 21 • What is this clinical sign? • What is the diagnosis in this 30 year old man with chronic backache?

  23. Question 22 a) What did this patient die of?

  24. Question 23 • What is the device that has been circled? (1 mark) • What are the indications for this?(1 mark)

  25. Question 24 • What procedure has been performed here? • What complication has occurred?

  26. Question 25 • What procedure has been performed? • What is the indication for doing this?

  27. Question 26 A) Diagnosis? B) Treatment?

  28. Answers

  29. Answer 1 • Iron deficiency anaemia (microcytic anaemia with low ferritin) • 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)

  30. Answer 2 • Dinner fork deformity • Colle’s fracture of left hand • 6 weeks

  31. Answer 3 • PE (1 mark) • D-dimer, V/Q Scan or CTPA

  32. Answer 4 • Pepperpot skull(1 mark) • 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!

  33. Answer 5 Wilson’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

  34. Answer 6 • 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). • Get help! (We think that this was the answer they were looking for, rather than starting IV acetazolamide)

  35. Answer 7 • Barium swallow(1 mark) • Oesophageal stricture(1 mark)

  36. Answer 8 • Non ST-elevation MI (MI alone is not enough) • Oxygen, Aspirin, (GTN & Morphine)

  37. Answer 9 • Atrial Flutter (1 mark) [With 4:1 block – for the geeks] • DC cardioversion, pharmacological cardioversion (flecanide, sotalol), digoxin, beta blockers, verapamil, AV node ablation & PPM, overdrive pacing.

  38. Answer 10 • Cystic fibrosis • Frontal chest x-ray in cystic fibrosis shows diffuse interstitial disease with bronchiectasis and nodular densities of mucoid impaction

  39. Answer 11a) Left pleural effusion

  40. Answer 12 a) Pnemonectomy

  41. Answer 13 • This man has started a new tablet because he’s “Got blood pressure, Dr”. • Gout • Thiazide diuretics (e.g. bendroflumethiazide)

  42. Answer 14 • Cullen’s sign (peri-umbilical bruising) • Acute pancreatitis

  43. Answer 15a) Ascitesb) Cirrhosis of the liver

  44. Answer 16 • Coronary angiogram • Stroke, MI, rupture, death, femoral haematoma & (pseudo) aneurysms

  45. Answer 17 a) Extradural haematoma(Subdual shown for comparison)

  46. Answer 18 • Cellulitis • Ben-pen & fluxlox

  47. Answer 19 • “Looser’s zone” (pseudo-fracture) • Osteomalacia(Note diffuse osteopenia)

  48. Answer 20 a) Incisional hernia

  49. Answer 21 • Bamboo spine • Ank Spondy

  50. Answer 22 a) Saddle PE

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