Painful swelling back of leg

28 year old male in his normal state of health presented with acute painful swelling of the back of his right leg. 1.What is the likely diagnosis?

___2.What step is advised to

confirm diagnosis? ____

46 year old man presented six month history of with fatigue, fever on and off, joint pains and weight loss of 7 Kg. O/E Tender maculopapular rash on his shins, cervical lymphadnopathy. Investigations:CBC: Hb 14.6 g/dl

WBC 4.7 X 10 /dlU/E’s Sodium 136 mmol/l

Potassium 4.2 mmol/Calcium 3.4 mmol/l

1. Describe the abnormality of chest x-ray? _______

2. What is the most likely diagnosis? ______

1. Describe the abnormal ECG finding? ________

2. What is the diagnosis? ________________

Twenty four year old man presented with 2 day H/O: nausea myalgia anorexia headache.

Two days later developed rash all over body

1. Describe characteristics of the rash? ___

2. What is the clinical diagnosis? ________

This man was being investigated in the infertility clinic for hypogonadism

Investigations showed:Testosterone 4.6 nmol/l (NR 10 –

30)LH 28U/l (NR <6)FSH 42 U/l (NR <6)Buccal smear: Positive for Barr

bodies

A man with gynaecomastia

1. What is the most likely clinical diagnosis? 2. What is most essential laboratory test for working

diagnosis?

A 54-year-old female is admitted with chief complaint of neck pain for one month.

The pain is at the back of the neck, excruciating in character, 10/10 on scale,

temporarily relieved by pain medications, exacerbated by movement, and radiating down the left arm..

She has never had similar symptoms before.

O/E No neurological deficits. Limited range of motion (ROM)

in the neck but no true neck rigidity.

Local tenderness at the back of the neck.

1. What are the imaging findings? --

2. What is the diagnosis? ----

80 year old lady admitted with two month history of fever, weight loss and abdominal distention. There is no other relevant medical history. Examination reveals ascites.The following results were obtained:

Hb 10.2 g/dlWBC 15.2 x 10/lESR 70 mm in first hour

Serum bilirubin 30µmol/l (NR 2-17 µ mol)Alk. Phosphatase 147 iu/l (NR 44 –

147IU)Aspartate transferase 60 iu/l (NR 8-20

U/L)Ascetic fluid: lymphocytes ++

+ , nopolymorphs, no organism

seen, protein 38g/l1.  Suggest possible diagnosis?

_____________________________2. Suggest relevant investigation?

__________________________

16 year old girl presented with generalized body aches and pains. There was no history of steatorrhoea. She was on nutritious diet.Investigations showed:Serum calcium 1.7 mmol/lPhosphate 0.5 mmol/lAlk . Phosphatase 661 iU/lParathyroid hormone 250pmol/l (NR 10 – 90)1,25 hydroxvitamin D10 pg/ml (NR 30 – 75) What is the likely diagnosis?

_____What is the x-ray findings?

______

A 15 year-old boy with a history of first episode generalized tonic-clonic convulsion.

He was afebrile and had GCS 13 (E3 V4 M6) fluctuating for about 4 hours without improvement.

Pupils were equal and reactive No focal neurological deficits. His CT head was normal. After returning from the scan he

had another self-limiting seizure that lasted 2 minutes.

U/E’sNa 125 mmol/L   K 4.1 mmol/L    Urea 3.7 mmol/L    Cr 49 umol/L   

Venous blood gaspH 7.37    PCO2 42 mmol/L HCO3 24 mmol/L    Cl 96 mmol/L   glucose 7.2 mmol/L  lactate 1.9 mmol/L   

FBC and LFTs were normal.

1. What are the laboratory abnormalities? ______________ 2. What is the likely cause of his seizure? ______________

Thirty year old man presented with sudden chest pain:

1. What is the abnormal chest X-ray finding?

__________2. What is the

next step for treatment

___________