Problem solving 1

1. 32 years man presented with worsening lethargy 2/52.

No fever. Splenomegaly 6cm.

Wbc 230 hb 9.4 neu high plt 150

Blast 5%

Myelocyte 35%

1. Interpret investigation 2m

2. What is your diagnosis 2m

3. 2 investigation and expected finding 2m.

4. How to manage the acute presentation 2m.

2. 45 years old man previously nkmi presented with sob, orthopnea and PND.he is taller than his
sibling.

Height 190cm wt 50kg.

O/e alert,conscious,

Distended neck vein.

bp 160/90 pr 80 spo2 90 under RA.

Lungs fine crepitation bibasal.

Cvs diastolic murmur over aortic area.

1.give 4 other clinical signs.2m

2. Complete diagnosis.3m

3.give 2 investigation and expected findings. 2m

4. Give 3 principle management. 3m

3. 32 years old man presented with diarrhea for 6months. Lost 5kg. Noted mucosal ulcer and anal
ulcer.

Barium follow through done.

1.describe 3 findings. 3m

2.what is the diagnosis

3. Give 3 extra intestinal complications.

4. Give 3 investigation and expected finding.

4. 35 years old man presented with fever, non productive cough for 5 days history of unprotected
sexual intercourse with multiple partners. He lost 10 kg in the last 4 months, LOA and LOW. On
examination, no lymphadenopathy, auscultations reveal fine crepitations through out both lungs.
Spo2 90 under room air, rr 32.

X ray given

1. Describe the xray given

2. State the complete diagnosis

3. State diagnostic lab investigations to reach your diagnosis

4. Management

5. Possible complications from this condition

5. 60 year old fisherman, presented with fever and cough productive of greenish sputum for 1
month. He was started on anti tb empirically while awaiting his sputum smear and culture results.
However his condition not improving with persistent fever. On examination temperature 38.
Auscultation revealed bronchial breathing right upper lobe and course crepitations. Pa
hepatosplenomegaly.

Hba1c 10

Twc 20

Xray

1. Describe the chest xray

2. List down investigations

3. 3 differentials

4. Initial medication
Problem solving 2

1. 30 year old male, recurrent renal calculi, polyuria polydipsia, no constitutional symptoms.

Fbc normal

Corrected ca 3.2

Phosphate 0.7

Potassium 3.5

Urea 12

Creat 200

1. What other 4 investigations and reasoning

2. Complete diagnosis

3. Management

4. Give 2 long term complications

2. 16 year old school boy presented with generalised tonic clonic seizure for 15 minutes. He is on
carbamazepine and sodium valproate. His last attack was 4 months ago. In ed noted that he has
jerky movements of both upper and lower limbs. He was given iv valium 2 x 15 minutes apart but
thw fitting was not aborted. Plantar upgoing bilaterally.

1. Immediate diagnosis 1m

2. Possible cause 1m

3. 4 investigations and expected findings

4. 3 immediate managements

5. Give 2 complications

3. 45 year old man, brought by his wife as he was found collapsed at home. At ed noted that he has
bilateral ballotable abdominal mass. No significant family history as he was adopted

Ct brain :SAH
1. Describe 2 abnormalities 2m

2. Complete diagnosis 3m

3. give 2 investigations to find the underlying etiology

4. Give 2 systemic complications

4. 45 year old gent from india presented with deformed limbs and numbness at ulnar area, with
annular rash with hypoaesthesia and erythematous base lesion.

1. Give 2 Other expected signs

2. Possible organism

3. Give 3 Other complications

4. Give 2 investigation to diagnose

5. 2 medications for treatment

5. 46 year old lady, nkmi, developed bilateral thigh swelling. She had to sit for long hours as part of
her profession. Us revealed thrombus at bilateral popliteal veins.

Ana positive 1:1000

Anti cardiolipin positive

Lupus anticoag positive

1. Complete diagnosis 3m

2. 3 further investigations to support dx

3. Management and how long the duration

4. 2 Complications from this condition