sabeha slidespediatrics slides slides 2.ppt

pediatrics

2. 25 y old patient presented with
history of heart burn &
regurgitation ( especially on
bending ) >2 times/week for
the last 6 months.
Examination was unremarkable

3. What is the most probable diagnosis?
What are the investigations you have
to do for this patient to reach to the
diagnosis?
How you will treat this patient?

5. 50 year old male patient presented with history
of dysphagia for solid relieved by drinking
fluid & walking or changing position after
meal for the last 10 years .
Patient also had nocturnal cough & some
times chest pain .
He is neither smoker nor alcohol drinker.

6. What is your provisional diagnosis?
How you investigate this patient?
What is the treatment?

8. 50 year old male patient presented with history
of dysphagia for solid increasing in severity
to be even to liquid for the last 3 months
associated with history of loss of about 15 kg
of his weight.
The patient is chronic heavy smoker & also
alcohol drinker.
Q1-What is your Provisional diagnosis:
Q2-How you investigate this patient?

10. 25 year old patient presented with history of
dyspepsia for the last month.
Examination was normal .
Q1: How you will investigate this patient to
diagnose H-Pylori ?
Q2:What are the diseases caused by H-Pylori?
Q3:What is the regimen for H-Pylori
eradication?

13. 60 year old patient presented with history of
dyspepsia for the last 3 months associated
with loss of about 15 Kg of patient weight.
O/E: Patient was pale ,emaciated with
palpable left supraclavicular lymph nodes.
Abdominal examination: Palpable mass in the
epigastric area.
Q1: What is the provisional diagnosis?
Q2: What are the risk factors for this
condition?
Q3:What is the management?

15. 35 year old patient presented with history of
sudden severe abdominal pain of few hours
duration.
His plain abdominal X-ray is shown below.
Q1-What is the diagnosis?
Q2-What are the causes?

17. 17 year old female brought by her mother
because of short stature & delayed puberty
with past history of diarrhea.
Examination: revealed anemia with angular
stomatitis & absence of secondary sexual
characters.
Q1: What is the diagnosis?
Q2:How you investigate this patient?

21. 30 year old male patient presented with H/O
frequent attacks of bloody diarrhea for the last 2
years.
O/E: Patient looked anemic ,emaciated with tender
abdomen.
Q1-What is the most probable diagnosis:
Q2-How you assess the severity of his condition?
Q3-What are the lines of management for this
patient?

24. 65 year old patient admitted to
the casaulity because of history
of haematamesis & malena of
one day duration.

25. A-How clinical examination may help
you to know the cause of patients GI
bleeding?
B-list the risks of death in this patient?
C-what are the lines of management?

26. 60 year old male patient presented with history
of altered bowel months , abdominal
discomfort with bleeding per rectum &
weight loss of few months duration.
O/E: Patient is pale & emaciated with
palpable abdominal mass .
Q1- What is the most probable diagnosis?
Q2-What are the risk factors?
Q3-How you investigate this patient?

28. 70 year old male patient presented with history
of abdominal pain , fever & bloody diarrhea
of few days duration he gives history of
urinary tract infection 6 weeks ago for which
he received antibiotics.
On examination: Patient is toxic feverish &
dehydrated
Abdominal examination revealed tenderness
of left abdomen
Q1-What is differential diagnosis .
Q2-What is the management?

30. 60 year old patient presented with history of
anaroxia ,abdominal discomfort & weight loss
for the last 6 months.
On examination: Patient looks pale ,emaciated
Abdominal examination revealed hepatomegaly
( liver span of 18cm) the liver is hard in
consistency with irregular surface.
Q1- What is the most probable diagnosis?
Q2- How you investigate this patient?

32. What are the causes of the following
deformity?

34. 55 year old male patient presented with history of
jaundice of few months duration , recently he is
discovered to have diabetes mellitus. also he
complains of shortness of breath & joint pain with
darkening of his skin.
On examination: He is jaundiced ,His JVP was 6 cm
above the sternal angle with spider telengectasia &
bilateral leg oedema.
Abdominal examination revealed :
hepatosplenomegaly & positive shifting dullness .
Q1-What is the most probable diagnosis?
Q2-How you investigate this patient?
Q3- What is the treatment?

38. 55 year old female patient presented with history of
generalized fatigue with progressive itching of 5
years duration recently patient developed jaundice,
with bone pain & diarrhea .
On examination: The patient is jaundiced with
periorbital xanthoma.
Abdominal examination revealed
hepatosplenomegaly .
Q1-what is the most probable diagnosis?
Q2-How you investigate this patient?
Q3-What is the treatment?

46. 17 year old patient presented with history of recurrent jaundice
with abnormal involuntary movement of 2 years duration.
On examination: He was jaundiced with brownish pigmented
ring at the periphery his iris , with choreoathetotic
movement .
Examination of his abdomen revealed hepatosplenomegaly.
A-What is the most probable diagnosis?
B-what are the investigations you have to do for this patient?
C-What is the treatment?

49. 55 year old male patient known case of
ulcerative colitis presented with history of
recurrent right upper abdominal pain ,fever
& jaundice for the last 3 years.
On examination : The patient was jaundiced ,
his temp. was 39C , abdominal examination
revealed liver span of about 11cm with
palpable spleen & shifting dullness was +ve.
A-What is the most probable diagnosis?
B How you investigate this patient?
C- What is the treatment?

53. 25 year old female patient presented with history of
jaundice , generalized fatigue , joint pain ,
abdominal distention & bilateral leg oedema she
gives history of amenorrhea too.
On examination: She was jaundiced , pale with
spider telengectasia & bilateral leg oedema.
Abdominal examination: revealed
hepatosplenomegaly , shifting dullness was +ve.
A- What is the most probable cause of her chronic
liver disease?
B-How you investigate this patient?
C- What is the treatment?

55. 30 year old patient presented with history of jaundice
& upper abdominal discomfort & anaroxia for the
last 3 months.
He is not alcohol drinker & has no history of
jaundice before.
On examination : He was jaundiced & abdominal
examination revealed tender hepatomegaly.
Investigations: AST:400U/L(normal up to 40 ),ALT
500U/L ( normal up to 40 ),TSB :54umol (normal
up to17) 35 umol direct & 19 umol indirect,
Alkaline phosphetase 180U/L.
A-What is your investigations to know the cause of
his condition?

56. 50 year old male patient known case of alcoholic liver
cirrhosis admitted to hospital for treatment of
increasing ascites.
On examination :The patient was conscious ,
oriented , he was jaundiced with many spider
telengectasia on his trank.
Abdomen was distended , transmitted thrill was +ve.
Two days after admission patient becomes agitated
with altered level of consciousness .
Reexamination revealed confused patient with
flapping tremor.
A-What is this complication?
B-What is the management?

57. 55 year old male patient known case of liver cirrhosis
due to chronic hepatitis B viral infection for the
last 10 years , he was Ok on conservative
treatment .Last few months patient developed
increasing ascites , anaroxia & weight loss.
On examination: He was emaciated , pale &
jaundiced .
Abdominal examination revealed distended abdomen
with palpable mass felt at right upper abdomen
with positive transmitted thrill.
A- What is the most probable diagnosis.
B- what are the investigations that you have to do for
this patient?

58. 50 year old male patient who is a known case
of primary Polycythemia presented with
history of right upper abdominal pain &
abdominal swelling of few days duration.
On examination: there was tender
hepatomegaly & shifting dullness was
positive

59. A- What is the diagnosis?

B-how will you investigate this patient?
C-What is the treatment?

60. 25 year old patient presented with H/O
fever ,rigor & right hypochondrial pain of 3
weeks duration , he had had H/O of
appendecectomy 2 months ago.
O/E: There was pallor , temperature 39 c with
tender right hypochondrium.

61. A-What is the most probable diagnosis?
B-List 3 important investigations?
C-what is the treatment?