This document contains multiple patient case summaries and medical images/reports with questions related to diagnosis and management. Some key cases include: - A 55-year-old male presenting with shortness of breath, whose chest X-ray shows cardiomegaly and upper lobe diversion. - A 35-year-old male with progressive shortness of breath and cough presenting with bilateral hilar lymphadenopathy on chest X-ray, leading to a diagnosis of sarcoidosis. - An ECG showing findings of atrial fibrillation in a 35-year-old female presenting with palpitations. - A CT scan of a 30-year-old IV drug user presenting with fever

1. 01
X ray
55 year old male with
history of hypertension
presents with shortness of
breath for 6 hours.
Here is his chest X Ray
1. What are the findings?
2. What is the diagnosis?

2. 01 Key
Findings: Cardiomegaly, Upper lobe
diversion

3. A 35 year old male presents with
progressive shortness of breath for last
6 month. He also has dry cough and
joint pains.
What are the findings in this chest X
Ray?
What is the diagnosis?
List two differentials.

4. 02 - Key
Findings:
Bilateral Hilar Lymphadenopathy
Right Paratracheal Strip enlargement
Bilateral infiltrates involving
predominantly the mid zones
Diagnosis: Sarcoidosis
DD, TB, Lymphoma

5. 03 - ECG
A 35 year old female presents with sudden onset palpitations. Here is her ECG.
a) What are the findings?
b) What is the diagnosis?
c) If her BP is 80/ 60 mmHg, what immediate step will you take?

6. 04 - ECG
A 55 year old male presents with sudden onset chest pain and vomiting for two
hours. Here is her ECG.
a) What are the findings?
b) What is the diagnosis?
c) List immediate management steps.

7. 05 - CT
A 30 year old male, IV drug abuser
presents with fever, focal fits and
altered mentation. On examination,
there is left sided weakness.
a) List four possible differential
diagnoses.

8. 06 - CT
A 55 year old hypertensive male
presents with sudden onset of
headache and irritibility.
What is the diagnosis?
How will you manage?

9. • A 23 year old female has an
impulsion to check the
door locks again and again.
She checks the locks 6 to 7
times before sleeping but
still feels insecure and
wants repeated
reassurances.
What is the diagnosis?
How will you manage?

10. • A 50 year old female
survivor of a bus bomb
blast has difficulty sleeping
6 months after the
incident. She has frequent
flashbacks of the event and
avoids public
transportation. There are
also frequent episodes of
weeping.
What is the diagnosis?
How will you manage?

11. Identify the skin lesion.
What is the treatment?

12. Identify the skin lesion.
How will you treat?

13. a) What is the lesion?
b) What lab investigation will you
suggest?

14. An 18 year old girl presents with fever,
sore throat and cervical
lymphadenopathy.
a) Identify the peripheral film.
b) What further investigation will
you suggest?

15. Identify the peripheral film
What is the diagnosis?

16. Identify the peripheral film.
What further investigations will you
order?

17. • CSF RE Report
– Appearance: Turbid
– Xanthrochromia: Nil
– TLC: 250
– N 95 %
– L 05 %
– Proteins 78mg/dl
– Sugar 27mg/dl (BSR 120
mg/dl)
Interpret the given CSF report

18. • ABGs
– pH 7.31
– pCO2 65 mmHg
– pO2 47 mmHg
– HCO3 30 mEq/L
– O2 Sat 76%
Interpret the given Arterial Blood
Gases Report.

19. • A 31 year old female
presents with history of fever
and jaundice for 7 days, and
altered conconciousness for
1 day.
• On exam, she has bruises all
over her body.
• Labs reveal
– Bilirubin 14 mg/dl
– ALT 3327 IU/ml
– AST 2980 IU/ml
– Alk Phos 380 IU/ml
– PT 50/13 sec
– aPTT 78/33 sec
What is the diagnosis?
What further investigations will you
order?
How will you manage?

20. • A 35 year old female
presents with worsening
fatigue over the past 6
months. On examination
she has bilateral partial
ptosis. Power 4/5 in all 4
limbs.
What is your diagnosis?
List one important differential.
How will you investigate?

21. • Station 3
• (3) Instrument
• (a) Identify the instrument.
• (B) Contraindications for its use.
• (c) specific precautions during the procedure.

22. Identify the rhythm
Treatment?
Station 6

23. Station 9
• A 14 year school girl presents in emergency with
03 days severe abdominal pain and vomiting. On
examination she is drowsy, severely dehydrated
and has labored breathing. She has a BP of
90/60mm Hg and her temp is 100⁰F. Her blood
sugar is 600mg/dl.
•
• What is the diagnosis?
• How will you investigate?
• How will you manage?

24. Station 10
• Identify this drug.
• State the indications and contraindications of
its use.
• State the adverse effects.

25. Station 11
• A 21 year old woman gave birth to a child 2
days ago. After birth she is unable to sleep
and reluctant to hold her child or feed him.
But she claims of not harming her child.
• Diagnosis
• If treatment required? If yes then describe.
• Name the other pregnancy related psychiatric
disorder.

26. Station 13
A 60-year-old male presented at the
Emergency Room with
severe chest pain of sudden onset. This was
his CXR (Fig. 12.1). What is
the diagnosis?

28. • (Interactive)
• A 23 year old male, known asthmatic for 4
years presents with worsening shortness of
breath for 6 hours. On exam, he has Pulse of
140/min, RR of 40/min, and BP 90/60mmHg.
He is cyanosed. Chest is bilateral silent.
• How will you manage this patient?

29. • (Interactive)
• A 28 year old female has recently been
diagnosed with HIV while screening at the
time of delivery of her first baby. She is
worried and apprehensive about the disease.
• How will you counsel her?

30. • Key of HIV
– Validity of Diagnosis, ELISA, Western blot?
– History (Needlestick, Blood transfusion, sexual
activity)
– Reassurance
– Counsel about HAART
– Counselling regarding the risk of vertical
transmission and breast feeding.

31. • BLS – Dummy
• A 50 year old male suddenly collapses in the
market. You happen to be at the site. How will
you proceed?

32. Warfarin
What are the indications of this drug?
List 3 side effects

33. Clubbing

34. Lid Lag