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OPEN MEDIQUIZ MAINS
2018
QUIZ PREPARED BY :
Sriyanka Mohapatra (2015)
Anil Dash (2015)
Pritam Panigrahi(2015)
ROUND 1 : CROSSWORD
RULES
• . Questions will be displayed. Team has to answer within 30s.
• Crossword must be submitted at the end of the round.
• +1 for each correct answer
• No negative marking
• PLEASE DO NOT SHOUT ANSWERS ( UNLESS YOU WANT YOUR
OPPONENTS TO WIN :P )
DOWN
Q1. What is the stain used to see
contraction band necrosis as shown in
figure below?
Q3. Drug implicated in Drug-induced lupus.
Q5. The following histopathology appearance
is seen in Lichen ________ ?
Q7) Anuria, oligohydramnios and hypoplastic lungs
secondary to oligohydramnios are seen in _______
sequence.
Q8) worsening of neurologic symptoms in
multiple sclerosis (MS) and other
neurological, demyelinating conditions
when the body gets overheated from hot
weather, exercise, fever, or saunas and hot
tubs is known as ____________ sign.
ACROSS
Q2) Alternate flushing and
blanching of forehead in aortic
regurgitation?
Q4) 5HT3 ANTAGONIST FOR
PONV?
Q6) Which protein is deposited in
Senile Systemic Amyloidosis?
Q9) DX?
• A 40 year old patient, G3P3, with no significant medical or surgical
history, was admitted to the intensive care unit with hemorrhagic
shock due to postpartum hemorrhage following a normal delivery at
home. The clinical examination on arrival confirmed the state of
shock. The short-term evolution was marked by lactational failure and
hypoglycemic crisis. Hormone profiles including cortisol, plasma
ACTH, thyroid hormones, TSH, FSH, LH and prolactin were all low as a
result of panhypopituitarism.
Q10) Mention the type of Posterior capsular
opacification observed here.
• Q) IVORY SEQUESTRUM IS FOUND IN?
• Q) port-wine stain, varicose veins, and bony and soft tissue
hypertrophy involving an extremity. WHICH SYNDROME?
Q1. What is the stain used to see
contraction band necrosis as shown in
figure below?
PTAH
Q3. Drug implicated in Drug-induced lupus.
Hydralazine
Q5. The following histopathology appearance
is seen in Lichen ________ ?
Nitidus
Q7) Anuria, oligohydramnios and hypoplastic lungs
secondary to oligohydramnios are seen in _______
sequence.
Potter
Q8) worsening of neurologic symptoms in
multiple sclerosis (MS) and other
neurological, demyelinating conditions
when the body gets overheated from hot
weather, exercise, fever, or saunas and hot
tubs is known as ____________ sign.
Uhthoff
Q2) Alternate flushing and
blanching of forehead in aortic
regurgitation?
LIGHTHOUSE SIGN
Q4) 5HT3 ANTAGONIST FOR
PONV?
Ondansetron
Q6) Which protein is deposited in
Senile Systemic Amyloidosis?
transthyretin
Q) DX?
• A 40 year old patient, G3P3, with no significant medical or surgical
history, was admitted to the intensive care unit with hemorrhagic
shock due to postpartum hemorrhage following a normal delivery at
home. The clinical examination on arrival confirmed the state of
shock. The short-term evolution was marked by lactational failure and
hypoglycemic crisis. Hormone profiles including cortisol, plasma
ACTH, thyroid hormones, TSH, FSH, LH and prolactin were all low as a
result of panhypopituitarism.
SHEEHAN SYNDROME
Q10) Posterior capsular opacification after
cataract surgery. What is your observation?
ELSCHNIG
ROUND 1 : CASE SCENARIO
RULES
• Total of 6 questions with 1 question per team. Pounce is allowed.
• Plus 10 for correct answer. Minus 5 for incorrect guess.
• 1 minute for answering questions.
• Pounce window closes in 40 seconds.
• Negative marks are only for pounce. Teams having direct question won’t
have any negative marking.
• IF YOU POUNCE , PLEASE DO NOT SHOUT THE ANSWER. JUST SAY
POUNCE AND WRITE THE ANSWER IN THE SHEET WHICH WILL BE
CHECKED BY VOLUNTEERS.
•A male term newborn of wt 3 kg was born by vaginal
delivery and the labor was prolonged. A few hours later,
because of the development of cyanosis followed by fever
and hyperreactivity, he was admitted to the NICU.
• The initial blood test revealed leukopenia, increased C-
reaction protein (CRP, > 200 mg/L) and procalcitonin (PCT, >
100 ng/mL).
• CSF revealed hypoglycorrhachia , increased neutrophils,
increased protein concentration.
•Sepsis was suspected and the following characteristic
culture media was used and the diagnosis was confirmed :
Q) WHAT IS
YOUR DIAGNOSIS?
ANS
• EARLY ONSET NEONATAL SEPSIS BY GROUP B STREPTOCOCCUS
• ISLAM MEDIA SHOWING CHARACTERISTIC ORANGE COLONY OF GBS
• An 86-year-old Caucasian male was admitted with a three-day history of
nausea, vomiting, left lower quadrant abdominal pain and three episodes of
melena. He had a past medical history significant gallstones.
• Two months prior to this presentation, the patient had been admitted with
elevated liver function tests. Abdominal computed tomography (CT) revealed
choledocholithiasis and on ERCP, a sphincterotomy was performed. No
complications were there.
• PA examination reveals distended abdomen with decreased bowel sounds and
mild epigastric tenderness without peritoneal signs
• CT of the abdomen revealed pneumobilia, a distended stomach and a 3.3 cm
hypodense oval object in the second portion of the duodenum
Q) WHAT IS YOUR DIAGNOSIS ?
BOUVERET SYNDROME
• Riglers triad present
• A 33-year-old man visited our clinic with the complaints of sudden
blurred vision and severe pain in his left eye since 4 days
• From his past history, the patient was found to have HIV infection under
treatment with HAART .
• His treatment regimen includes lopinavir , stavudine and zidovudine
• Also, in addition he is under clarithromycin, levofloxacin,rifabutin (300
mg/day) and sulfamethoxazole–trimethoprim for MAC infection and
simultaneous Pneumocystis carinii pneumonia.
• Slit lamp examination showed silent anterior chamber in the right eye
and hypopyon with 3+ aqueous cells and flare in the left eye.
• Stoppage of a drug resulted in silent anterior chamber after 2 months.
Q) WHAT IS THE DRUG IMPLICATED??
RIFABUTIN INDUCED ANTERIOR UVEITIS
• A 59yr old male presented with symptoms of fatigue , RUQ pain,
steatorrhea, bone pain and pruritus which was worse in evening.
• LFT reveals 4x elevated ALP levels and elevated GGT levels , elevated
bilirubin and liver enzymes. pANCA was also positive.
• The treating physician also suggested the patient to undergo
colonoscopy.
• ERCP reveals the following :
Q1) DIAGNOSIS?
Q2) REASON FOR:
COLONOSCOPY?
PSC
UC association
LIVER TRANSPLANT
• A 53-year old woman came for a 1½-month history of headache. Beginning
in 2007, she noted generalized mucocutaneous hyperpigmentation. In
February , she began to experience headache, described as a sensation of
heaviness.This was accompanied by blurring of vision, nausea and
generalized weakness.
• Further history reveals bilateral total adrenalectomy was performed 10yrs
ago d/t cushings disease .
• Physical examination showed normal vital signs and generalized skin
hyperpigmentation . Laboratory results showed hypokalemia, hyponatremia,
normal serum creatinine and elevated morning ACTH
• MRI eventually revealed a pituitary macroadenoma
Q) WHAT IS YOUR DIAGNOSIS?
NELSON SYNDROME
• A 47 year old male with one year history of exertional dyspnea &
palpitation was admitted with complaints of syncopal attacks of sudden
onset. He denied any head ache, chest pain, palpitation, edema legs,
persistent fever, weight loss or loss of appetite.
• He had multiple spotty pigmentations (lentigines) on his lips , eyelids and
conjunctiva for several years
• Trans-thoracic Echo cardiography revealed an intra-cardiac tumour
attached to inter atrial septum, which was almost filling the left atrium &
obstructing the mitral inflow. Patient underwent surgical excision and it
was a cardiac myxoma.
• Blue nevi were also found over his bodies
• Q) DIAGNOSIS???
LAMB subset of CARNEY COMPLEX
AUDIENCE QUESTION
ROUND 3 : CONNECT
RULES
• 45s for each connector. Pounce is allowed.
• Pounce window will be closed in 15 sec.
• +20 for each correct answer with explanation. +10 for each correct answer with
no explanation. -10 for each wrong answer.
• Negative marks are only for pounce. Teams having direct question won’t have
any negative marking.
• IF YOU POUNCE , PLEASE DO NOT SHOUT THE ANSWER. JUST SAY POUNCE
AND WRITE THE ANSWER IN THE SHEET WHICH WILL BE CHECKED BY
VOLUNTEERS.
ENDOMETRIOSIS
• POWDERED GUN SHOT APPEARANCE
• MUSHROOM CAP SIGN ON T2WI MRI
• CHOCOLATE CYST
• DANAZOL – used for tx.
Q) CONNECT
TAKUTSUBO CMPATHY
• Broken heart syndrome
• Octopus jar
• Modified mayo criteria
• Catecholamine induced.
Q) MENTION THE M/C CARDIAC MANIFESTATION
TUBEROUS SCLEROSIS COMPLEX
• Shagreen patch
• Cortical tubers
• Retinal hamartoma
• Bourneville’s disease
• Pringle’s disease
• CARDIAC RHABDOMYOMA
SACD
• Lhermitte/barber chair sign
• GLOVE AND STOCKING DEFORMITY
• Hypersegmented neutrophils
• Vegeterian diet
INFECTIVE ENDOCARDITIS
• DUKE’s CRITERIA
IV DRUG ABUSE
GLOMERULONEPHRITIS
3 BLOOD CULTURES 24 hrs apart
SARCOIDOSIS
• Panda and lambda sign
• Lupus pernio
• 7th N LMN palsy
OTOSCLEROSIS
• BLUE MANTLES OF MANASSEH
• FLAMINGO TINGE
• NaF used
• STAPES PISTON PROSTHESIS
TB SPINE
• White plague
• Military attitude
• Kissing sequestrum
• Tb spine mri
GCS
ANKYLOSING SPONDYLITIS
• Bamboo spine
• CARROT STICK FRACTURE
• ROMANOS LESION
• SCHOBER TEST
COTARDS DELUSION
METHOTREXATE
• Megaloblastic anemia
• RA
• AMOXYCILLIN increases toxicity
• CHORIOCARCINOMA
AUDIENCE QUESTION
RULES
• A hint for the question will be showed as a picture
• Based on the hint ,Teams have to guess what the question could be and bid
certain amount of points
• Maximum amount of points that a team could bid is the exact number of
points the team is having at that moment.
• Minimum amount of point that could be bid is 1 point.
• Team can also choose not to bid. However they will not be eligible to
answer the particular question.
• If the team answers correctly , they get the amount of points they have bid.
However , if the answer is wrong they lose half the points they have bid.
CONNECT
ALLGROVE SYNDROME
• Ms. X is a 75 year old female who came to Neurology Clinic for evaluation
of her long-term neurologic complaints. The patient relates that for many
years she had noticed some significant changes in neurologic functions,
particularly heat intolerance precipitating a stumbling gait and a tendency
to fall. Her visual acuity also seemed to change periodically during several
years.
• she could not hold objects in her hands, has scanning speech and
intention tremors and nystagmus.
• You suspect a disease and order an investigation which reveals the
following :
Q) MENTION THE
TRIAD IN THIS
CASE?
CHARCOT’S NEUROLOGICAL TRIAD
• Ms. X is a 75 year old female who came to Neurology Clinic for
evaluation of her long-term neurologic complaints. The patient
relates that for many years she had noticed some significant changes
in neurologic functions, particularly heat intolerance precipitating a
stumbling gait and a tendency to fall. Her visual acuity also seemed to
change periodically during several years.
• she could not hold objects in her hands, has scanning speech and
intention tremors and nystagmus.
• 11 years old boy came to our department with abnormal posturing of head and
limbs and difficulty in walking since last 4 years. Parents noticed that since 5
years of age he had history of frequent falls which later progressed to stiffness
and abnormal posturing in lower limbs progressing to the upper limbs.
• His pre and post birth history was uneventful and attained developmental
milestones at appropriate age till 5 yrs of age. Family history revealed same
complaints in 2 cousin siblings i.e. children of maternal aunt and paternal uncle.
• There was generalised hypertonia with lead pipe rigidity and marked dystonic
posturing which increased on activity with presence of facial dystonia and
oromotor dyskinesia.
• Laboratory tests revealed no abnormality. MRI brain revealed area of low center
abnormality in medial globus pallidus bilaterally on T2 images.
Q) DIAGNOSIS????
ANS : HALLERVORDEN SPATZ/PKAN
BID 2
CONGENITAL RUBELLA SYNDROME
• Celery stalk appearance in metaphyses
• A 4 months old boy was brought to pediatric department with chief complains
of shortening of limbs and progressive enlargement of head.
• Clinical examination revealed height of less than 3rd per-centile and head
circumference more than 97th percentile. Craniofacially the head appeared
large with frontal bossing, wide open anterior fontanelle with midfacial
hypoplasia, depressed nasal bridge and short neck with redundant skin folds.
• both upper and lower limbs showed rhizomelic pattern of shortening.
• Milestones were delayed. Radiographs of all bones were taken a Skull was large
with relatively small skull base. Iliac wings were small and squared, with
horizontal acetabular roof. Limb bones were short with metaphyseal cupping
and flaring, with irregular growth plates .Hands were broad with short
metacarpals and phalanges. All tubular bones were short.
Q) DIAGNOSIS?
ACHONDROPLASIA
• A 59yr old female with past medical history of bronchieactasis presented
to pulmonary opd due to shortness of breath.
• She was a non smoker and a high school teacher and lived in a semi rural
area of odisha
• She was a keen lover of birds and had doves and parakeets in her home
for the last 8 years.
• She was diagnosed with bronchieactasis 3 yrs back but her medical
condition is deteorating despite treatment
• O/E she has bilateral Velcro crackles. PFTs were consistent with severe
restrictive lung disease. BAL shows lymphocytosis with CD4/CD8 ratio
0.48.
• HRCT lungs revealed ground glass opacities with multiple small blebs and
scattered bronchieactasis
Q) DIAGNOSIS?
HYPERSENSITIVITY PNEUMONITIS
Mediquiz mains July 2018

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Mediquiz mains July 2018

  • 1. OPEN MEDIQUIZ MAINS 2018 QUIZ PREPARED BY : Sriyanka Mohapatra (2015) Anil Dash (2015) Pritam Panigrahi(2015)
  • 2. ROUND 1 : CROSSWORD
  • 3. RULES • . Questions will be displayed. Team has to answer within 30s. • Crossword must be submitted at the end of the round. • +1 for each correct answer • No negative marking • PLEASE DO NOT SHOUT ANSWERS ( UNLESS YOU WANT YOUR OPPONENTS TO WIN :P )
  • 5. Q1. What is the stain used to see contraction band necrosis as shown in figure below?
  • 6. Q3. Drug implicated in Drug-induced lupus.
  • 7. Q5. The following histopathology appearance is seen in Lichen ________ ?
  • 8. Q7) Anuria, oligohydramnios and hypoplastic lungs secondary to oligohydramnios are seen in _______ sequence.
  • 9. Q8) worsening of neurologic symptoms in multiple sclerosis (MS) and other neurological, demyelinating conditions when the body gets overheated from hot weather, exercise, fever, or saunas and hot tubs is known as ____________ sign.
  • 11. Q2) Alternate flushing and blanching of forehead in aortic regurgitation?
  • 12. Q4) 5HT3 ANTAGONIST FOR PONV?
  • 13. Q6) Which protein is deposited in Senile Systemic Amyloidosis?
  • 14. Q9) DX? • A 40 year old patient, G3P3, with no significant medical or surgical history, was admitted to the intensive care unit with hemorrhagic shock due to postpartum hemorrhage following a normal delivery at home. The clinical examination on arrival confirmed the state of shock. The short-term evolution was marked by lactational failure and hypoglycemic crisis. Hormone profiles including cortisol, plasma ACTH, thyroid hormones, TSH, FSH, LH and prolactin were all low as a result of panhypopituitarism.
  • 15. Q10) Mention the type of Posterior capsular opacification observed here.
  • 16.
  • 17. • Q) IVORY SEQUESTRUM IS FOUND IN? • Q) port-wine stain, varicose veins, and bony and soft tissue hypertrophy involving an extremity. WHICH SYNDROME?
  • 18. Q1. What is the stain used to see contraction band necrosis as shown in figure below?
  • 19. PTAH
  • 20. Q3. Drug implicated in Drug-induced lupus.
  • 22. Q5. The following histopathology appearance is seen in Lichen ________ ?
  • 24. Q7) Anuria, oligohydramnios and hypoplastic lungs secondary to oligohydramnios are seen in _______ sequence.
  • 26. Q8) worsening of neurologic symptoms in multiple sclerosis (MS) and other neurological, demyelinating conditions when the body gets overheated from hot weather, exercise, fever, or saunas and hot tubs is known as ____________ sign.
  • 28. Q2) Alternate flushing and blanching of forehead in aortic regurgitation?
  • 30. Q4) 5HT3 ANTAGONIST FOR PONV?
  • 32. Q6) Which protein is deposited in Senile Systemic Amyloidosis?
  • 34. Q) DX? • A 40 year old patient, G3P3, with no significant medical or surgical history, was admitted to the intensive care unit with hemorrhagic shock due to postpartum hemorrhage following a normal delivery at home. The clinical examination on arrival confirmed the state of shock. The short-term evolution was marked by lactational failure and hypoglycemic crisis. Hormone profiles including cortisol, plasma ACTH, thyroid hormones, TSH, FSH, LH and prolactin were all low as a result of panhypopituitarism.
  • 36. Q10) Posterior capsular opacification after cataract surgery. What is your observation?
  • 38. ROUND 1 : CASE SCENARIO
  • 39. RULES • Total of 6 questions with 1 question per team. Pounce is allowed. • Plus 10 for correct answer. Minus 5 for incorrect guess. • 1 minute for answering questions. • Pounce window closes in 40 seconds. • Negative marks are only for pounce. Teams having direct question won’t have any negative marking. • IF YOU POUNCE , PLEASE DO NOT SHOUT THE ANSWER. JUST SAY POUNCE AND WRITE THE ANSWER IN THE SHEET WHICH WILL BE CHECKED BY VOLUNTEERS.
  • 40.
  • 41. •A male term newborn of wt 3 kg was born by vaginal delivery and the labor was prolonged. A few hours later, because of the development of cyanosis followed by fever and hyperreactivity, he was admitted to the NICU. • The initial blood test revealed leukopenia, increased C- reaction protein (CRP, > 200 mg/L) and procalcitonin (PCT, > 100 ng/mL). • CSF revealed hypoglycorrhachia , increased neutrophils, increased protein concentration. •Sepsis was suspected and the following characteristic culture media was used and the diagnosis was confirmed :
  • 42. Q) WHAT IS YOUR DIAGNOSIS?
  • 43.
  • 44. ANS • EARLY ONSET NEONATAL SEPSIS BY GROUP B STREPTOCOCCUS • ISLAM MEDIA SHOWING CHARACTERISTIC ORANGE COLONY OF GBS
  • 45.
  • 46. • An 86-year-old Caucasian male was admitted with a three-day history of nausea, vomiting, left lower quadrant abdominal pain and three episodes of melena. He had a past medical history significant gallstones. • Two months prior to this presentation, the patient had been admitted with elevated liver function tests. Abdominal computed tomography (CT) revealed choledocholithiasis and on ERCP, a sphincterotomy was performed. No complications were there. • PA examination reveals distended abdomen with decreased bowel sounds and mild epigastric tenderness without peritoneal signs • CT of the abdomen revealed pneumobilia, a distended stomach and a 3.3 cm hypodense oval object in the second portion of the duodenum
  • 47. Q) WHAT IS YOUR DIAGNOSIS ?
  • 48.
  • 50.
  • 51. • A 33-year-old man visited our clinic with the complaints of sudden blurred vision and severe pain in his left eye since 4 days • From his past history, the patient was found to have HIV infection under treatment with HAART . • His treatment regimen includes lopinavir , stavudine and zidovudine • Also, in addition he is under clarithromycin, levofloxacin,rifabutin (300 mg/day) and sulfamethoxazole–trimethoprim for MAC infection and simultaneous Pneumocystis carinii pneumonia. • Slit lamp examination showed silent anterior chamber in the right eye and hypopyon with 3+ aqueous cells and flare in the left eye. • Stoppage of a drug resulted in silent anterior chamber after 2 months.
  • 52. Q) WHAT IS THE DRUG IMPLICATED??
  • 53.
  • 55.
  • 56. • A 59yr old male presented with symptoms of fatigue , RUQ pain, steatorrhea, bone pain and pruritus which was worse in evening. • LFT reveals 4x elevated ALP levels and elevated GGT levels , elevated bilirubin and liver enzymes. pANCA was also positive. • The treating physician also suggested the patient to undergo colonoscopy. • ERCP reveals the following :
  • 57. Q1) DIAGNOSIS? Q2) REASON FOR: COLONOSCOPY?
  • 58.
  • 60.
  • 61. • A 53-year old woman came for a 1½-month history of headache. Beginning in 2007, she noted generalized mucocutaneous hyperpigmentation. In February , she began to experience headache, described as a sensation of heaviness.This was accompanied by blurring of vision, nausea and generalized weakness. • Further history reveals bilateral total adrenalectomy was performed 10yrs ago d/t cushings disease . • Physical examination showed normal vital signs and generalized skin hyperpigmentation . Laboratory results showed hypokalemia, hyponatremia, normal serum creatinine and elevated morning ACTH • MRI eventually revealed a pituitary macroadenoma
  • 62. Q) WHAT IS YOUR DIAGNOSIS?
  • 63.
  • 65.
  • 66. • A 47 year old male with one year history of exertional dyspnea & palpitation was admitted with complaints of syncopal attacks of sudden onset. He denied any head ache, chest pain, palpitation, edema legs, persistent fever, weight loss or loss of appetite. • He had multiple spotty pigmentations (lentigines) on his lips , eyelids and conjunctiva for several years • Trans-thoracic Echo cardiography revealed an intra-cardiac tumour attached to inter atrial septum, which was almost filling the left atrium & obstructing the mitral inflow. Patient underwent surgical excision and it was a cardiac myxoma. • Blue nevi were also found over his bodies • Q) DIAGNOSIS???
  • 67.
  • 68. LAMB subset of CARNEY COMPLEX
  • 70. ROUND 3 : CONNECT
  • 71. RULES • 45s for each connector. Pounce is allowed. • Pounce window will be closed in 15 sec. • +20 for each correct answer with explanation. +10 for each correct answer with no explanation. -10 for each wrong answer. • Negative marks are only for pounce. Teams having direct question won’t have any negative marking. • IF YOU POUNCE , PLEASE DO NOT SHOUT THE ANSWER. JUST SAY POUNCE AND WRITE THE ANSWER IN THE SHEET WHICH WILL BE CHECKED BY VOLUNTEERS.
  • 72.
  • 73.
  • 74. ENDOMETRIOSIS • POWDERED GUN SHOT APPEARANCE • MUSHROOM CAP SIGN ON T2WI MRI • CHOCOLATE CYST • DANAZOL – used for tx.
  • 76.
  • 77. TAKUTSUBO CMPATHY • Broken heart syndrome • Octopus jar • Modified mayo criteria • Catecholamine induced.
  • 78. Q) MENTION THE M/C CARDIAC MANIFESTATION
  • 79.
  • 80. TUBEROUS SCLEROSIS COMPLEX • Shagreen patch • Cortical tubers • Retinal hamartoma • Bourneville’s disease • Pringle’s disease • CARDIAC RHABDOMYOMA
  • 81.
  • 82.
  • 83. SACD • Lhermitte/barber chair sign • GLOVE AND STOCKING DEFORMITY • Hypersegmented neutrophils • Vegeterian diet
  • 84.
  • 85.
  • 86. INFECTIVE ENDOCARDITIS • DUKE’s CRITERIA IV DRUG ABUSE GLOMERULONEPHRITIS 3 BLOOD CULTURES 24 hrs apart
  • 87.
  • 88.
  • 89. SARCOIDOSIS • Panda and lambda sign • Lupus pernio • 7th N LMN palsy
  • 90.
  • 91.
  • 92. OTOSCLEROSIS • BLUE MANTLES OF MANASSEH • FLAMINGO TINGE • NaF used • STAPES PISTON PROSTHESIS
  • 93.
  • 94.
  • 95. TB SPINE • White plague • Military attitude • Kissing sequestrum • Tb spine mri
  • 96.
  • 97.
  • 98. GCS
  • 99.
  • 100.
  • 101. ANKYLOSING SPONDYLITIS • Bamboo spine • CARROT STICK FRACTURE • ROMANOS LESION • SCHOBER TEST
  • 102.
  • 103.
  • 105.
  • 106.
  • 107. METHOTREXATE • Megaloblastic anemia • RA • AMOXYCILLIN increases toxicity • CHORIOCARCINOMA
  • 109.
  • 110. RULES • A hint for the question will be showed as a picture • Based on the hint ,Teams have to guess what the question could be and bid certain amount of points • Maximum amount of points that a team could bid is the exact number of points the team is having at that moment. • Minimum amount of point that could be bid is 1 point. • Team can also choose not to bid. However they will not be eligible to answer the particular question. • If the team answers correctly , they get the amount of points they have bid. However , if the answer is wrong they lose half the points they have bid.
  • 111.
  • 113.
  • 115.
  • 116. • Ms. X is a 75 year old female who came to Neurology Clinic for evaluation of her long-term neurologic complaints. The patient relates that for many years she had noticed some significant changes in neurologic functions, particularly heat intolerance precipitating a stumbling gait and a tendency to fall. Her visual acuity also seemed to change periodically during several years. • she could not hold objects in her hands, has scanning speech and intention tremors and nystagmus. • You suspect a disease and order an investigation which reveals the following :
  • 117. Q) MENTION THE TRIAD IN THIS CASE?
  • 118.
  • 119. CHARCOT’S NEUROLOGICAL TRIAD • Ms. X is a 75 year old female who came to Neurology Clinic for evaluation of her long-term neurologic complaints. The patient relates that for many years she had noticed some significant changes in neurologic functions, particularly heat intolerance precipitating a stumbling gait and a tendency to fall. Her visual acuity also seemed to change periodically during several years. • she could not hold objects in her hands, has scanning speech and intention tremors and nystagmus.
  • 120.
  • 121. • 11 years old boy came to our department with abnormal posturing of head and limbs and difficulty in walking since last 4 years. Parents noticed that since 5 years of age he had history of frequent falls which later progressed to stiffness and abnormal posturing in lower limbs progressing to the upper limbs. • His pre and post birth history was uneventful and attained developmental milestones at appropriate age till 5 yrs of age. Family history revealed same complaints in 2 cousin siblings i.e. children of maternal aunt and paternal uncle. • There was generalised hypertonia with lead pipe rigidity and marked dystonic posturing which increased on activity with presence of facial dystonia and oromotor dyskinesia. • Laboratory tests revealed no abnormality. MRI brain revealed area of low center abnormality in medial globus pallidus bilaterally on T2 images. Q) DIAGNOSIS????
  • 122.
  • 123. ANS : HALLERVORDEN SPATZ/PKAN
  • 124. BID 2
  • 125.
  • 126.
  • 127. CONGENITAL RUBELLA SYNDROME • Celery stalk appearance in metaphyses
  • 128.
  • 129. • A 4 months old boy was brought to pediatric department with chief complains of shortening of limbs and progressive enlargement of head. • Clinical examination revealed height of less than 3rd per-centile and head circumference more than 97th percentile. Craniofacially the head appeared large with frontal bossing, wide open anterior fontanelle with midfacial hypoplasia, depressed nasal bridge and short neck with redundant skin folds. • both upper and lower limbs showed rhizomelic pattern of shortening. • Milestones were delayed. Radiographs of all bones were taken a Skull was large with relatively small skull base. Iliac wings were small and squared, with horizontal acetabular roof. Limb bones were short with metaphyseal cupping and flaring, with irregular growth plates .Hands were broad with short metacarpals and phalanges. All tubular bones were short.
  • 131.
  • 133.
  • 134. • A 59yr old female with past medical history of bronchieactasis presented to pulmonary opd due to shortness of breath. • She was a non smoker and a high school teacher and lived in a semi rural area of odisha • She was a keen lover of birds and had doves and parakeets in her home for the last 8 years. • She was diagnosed with bronchieactasis 3 yrs back but her medical condition is deteorating despite treatment • O/E she has bilateral Velcro crackles. PFTs were consistent with severe restrictive lung disease. BAL shows lymphocytosis with CD4/CD8 ratio 0.48. • HRCT lungs revealed ground glass opacities with multiple small blebs and scattered bronchieactasis
  • 136.