can anyone please help regarding the imp case scenarios

To the Admin

with due all respect well i have requested some case scenarios regarding medicine and surgery ,ent ,optho, but yet no reply from any member of PFMSG .
will someone help

 

Search the PMDC guidelines thread or PMDC related topics bro. Its a bit tough to type all those topics again and again. You will get all topics scattered in different threads. Don't mind but that's a time consuming job.. Hope you understand!

 

well dr rix
this forum is based basically to help isnt it ???????????????????

 

the answer to dr rix

and from the threads there is none of any case scenarios diagnois ,there are only a long list of case scenarios ,but none of the diagnosis ,

 

dear drjawad, i respect for ur concern.
u r ryt this forum is for help.sorry, i am not getting time to solve those case scenarios u asked for, as i am the only one running this site.
Me or other members have provided u with the scenarios and questions, but not the answers to them, and u still have complain that we didnt provide answers to them so why dont u solve them and put answers online? Thousands of PFMSGs take questions from here, solve for themselves but why dont they put answers here for others?
me too have complaint from other PFMSGs that why dont they contribute for others here?? Only few persons here are contributing among more than 2500 members, and i am thankful to the contributors.

I hope u understand this.

 

MY HUMBLE REPLY TO SIR WATSON WITH DUE ALL RESPECT

WELL
SIR SALAM FIRST OF YOU , SIR I AM HERE NOT TO CRITICIZE YOU, BUT MY MAIN AIM IS TO GET HELP , NOTHING MORE THAN THIS. AS YOU SAID YOU ARE THE ONLY PERSON RUNNING THIS ,THATS GOOD AND THATS GREAT ,WELL SIR , WHAT I DEMANDED IS NOTHING MORE THAN YOU EXPECTED FOR EXAMPLE

SIR I HAVE SIMPLY POSTED THOSE CASE SCENARIOS THAT ARE DIFFICULT AND COMPLICATED , ACCORDING TO YOU I HAVE NOT CONTRIBUTED ,FOR YOUR THIS CRITICISIM I WANT TO ANSWER AND ANSWER IN A VERY POLITE AND FRIENDLY ENVIRONMENT AND WHAT IS THAT I LET YOU EXPLAIN
SIR ,YOU HAVE PASSED THE NEB ,EXAM ,I HAVE PASSED ONE PART ONLY , IAM IN THE LEARNING STAGE , THERE ARE POSSIBLIITIES THAT WHAT I ASNWER THOSE QUESTIONS MIGHT BE WRONG ,AND THE WRONG ANSWERS WILL NOT INFLUENCE ME ONLY ,IT WILL AFFECT ALL THOSE STUDENT WHO ARE USING THIS FORUM ,SO THATSS WHY I DIDNT POSTED THE DIAGNOSIS ,I NEED THE CONFIRMATION FIRST ,
MY SECOND ANSWER TO YOU THAT SIR I WHOLE HEARTEDLY CONTRIBUTE ALL THE KNOWLDEGE AND ALL THE NOTES ,ALL THE DATA ,WHAT I STUDIED INSHALLAH THIS WILL SOON BE ON THIS FORUM ,

you are the seniors and i am a juniors ,and like others i need help ,this forum is for needy people like me ,if someone like you ,like dr xavier help it will be a great help for me and for the others.

i will post what i know whatever i studied inshallah you will see this will be on PFMSG FORUM.

 

My answers to the STEP 2 CASE SCENARIOS

20. A 64 years old women fall on ground 2 hours back and brought to emergency with clinical feature of severe pain on movement of leg. When the leg abducted and externally rotated ,a pain slight relieved.
What is the possible diagnosis regarding damage? What could be other possible diagnosis of injury? Why leg was laterally rotated?

This question was answered by dr Watson himself
Q1: Yes fracture shaft of femur! The proximal segment gets medially rotated! On rotating the leg laterally, distal n proximal segments come in line and pain is relieved
Osteoporosis
Post menopausal women.
D/D:

Q2:
Q: Morphological features of appendectomy performed by suregeon ,with biopsy fetures , This was also answered by dr Watson
MACROSCOPICALLY:
1. normal appendix,
2. 2. acutely inflamed: erythematous with vascular injection
3. 3. suppurative: with surrounding pus
4. 4. Gangrenous: dark discoloration of a part of whole of appendix
5. 5. Perforated.

6. MICROSOCPICALLY:

1. normal appendix,
2. 2. acutely inflamed:
3. with neutorphilic infiltrate in muscularis propria and mucosal ulceration
4. 3. gangrenous: with necrosis in muscularis propria and absent mucosa
5. 4. ischemic: with above + thrombosed vessels 5.
Chron's disease: with lymphocytic infiltrates in muscularis propria

5) A 25 years old female has come to you with the history of oligomenorrhoea, weight gain and hirsutism.
a) What is the diagnosis?
b) How would you investigate her?
c) Give the treatment plan.

Answer is Polycystic ovaraian syndrome PCOS

7) A primigravida has come to you in 10th week gestation with blood group B -ve. How would you give antenatal care to her?

Answer is i have to write complete antenatal care Plus the management of Rh + baby

8) A 41 years old lady has come to you with severe joint pain. X-ray shows bony erosions.
a) What is the diagnosis?
b) Which vitamin and minerals deficiency can lead to this condition?
c) Write down the role of parathormone in human body.

I think OSTEOARTHRITIS OR GOUT

9) A 27 years old man after the death of his father 1 month back, suffered from lack of sleep and interest, crying spells and loss of energy.
a) What is the most likely diagnosis?
b) What are the differential diagnoses?
c) What would be the drug choices to start the treatment?

Post traumatic stress disorder

10) A 30 years old sportsman has come with ring shaped lesions on his back with well defined margins.
a) What is the diagnosis?
b) How would you confirm the diagnosis on clinic and lab?
c) How will you treat him?

Athletes foot ringworm infection

11) a) What are the Non-pharmacological interventions of behavioral changes?
b) Write down the DON'Ts of communication skills.
I dont know this one

12) A 3 days old child presents with high grade fever, irritability and reluctant to feed.
a) What are the risk factors of neonatal sepsis?
b) How would you investigate a case of neonatal sepsis?

This is meningitis , MOSTLY STATED THE CONDITION OF NEONTAL SEPSIS


13) A patient with history of proteinurea ++, BP 130/90, TLC 25000, Glycocylated Hb 9.
a) What is the most likely diagnosis?
b) What is the treatment to reduce the proteinurea?
ANSWER IS NEPHROTIC SYNDROME


14) A young female presents with swelling in-front of the neck with history of palpitations and perspiration.
a) What other clinical signs would you look for?
b) How would you investigate her?
c) How would you treat her?

hyperthyroidism

15) A child presents with to you with itchy eyes. He has a family history of atopy.
a) Write down the differential diagnosis.
b) How would you treat the child?

Allergic conjunicivivits, AND Why because there is a strong positive family history ,


18) A young boy got fever with rigors and chills. On examination, there is splenomegaly. Lab investigations show anemia, thrombocytopaenia. Blood smear shows Plasmodium Falciparum.
a) How would you further investigate him?
b) What are the complications of malaria?
c) How will you teat a case of falciparum malaria?
This is malaraia falciparum as said in the peripheral smear


20) A 42 years old lady has presented with fever of 101 °F, anorexia, nausea and pain in right mid abdomen. On examination, there is guarding and tenderness in the right mid abdomen.
a) What is the most likely diagnosis?
b) Write down FOUR differential diagnoses.
c) Give the steps of management.
Acute cholecystitis
1) A man of 40 years with drooping of eyelids presented to Medical OPD with complains of difficulty in swallowing towards the end of the meal intake and severe musde weakness few minutes after the start of exercise.
a)from which disorder the man is suffering? b) what is the course of this disorder? C) Which drug is effective In this disorder?
I think this is My asthenia gravis

2) A young man sustained injury to the chest in a road accident.Effective ventilation was compromised by a large flail segment of the thoracic wall. His investigations showed: Arterial PCO2~ 60 mmHg (40 mmHg) Arterial PO2~ 65 mmHg (95 mmHg) Arterial pH 7.25 (7.4) Arterial bicarbonate 25 mmol/L (24 mmol/L) •) a)Which disorder the young man developed7 b)explain the compensatory mechanisms initiated in the man to correct the disorder?



this is metabolic acidosis

4) An 8 year old school going chlid had severe bacterial pharyngitis, which was treated by the familv physician. Alter 3 weeks, he developed fever, migratory polyarthritis and carditis.
This is rheumatic fever



6)A 2 year old girl who has cough and difficulty in breathing is brought to a basic Health Unit. On examination her respiratory rate is 65 breaths / min and she has chest In-drawing.
This is RDS , respiratory distress syndrome


7)A 1 year old boy has high grade fever and sore throat for one day, He develops generalized tonic clonic seizure which last for five minutes. His elder brother also has similar episode when he was 9 months old.. a)what is the most likely diagnosis? B)how would you manage this child? C)what is the prognosis of this condition? .

Neonatal sepsis or epilepsy cant tell you exactly

8)A 37 year old man presents with four months history of having loose motions with blood and mucous. He has not responded to repeated courses of antibiotics and metronidazole. He has also developed backache and polyarthralgia. There is no history of significant weight loss..

a) What is the most likely diagnosis? B) list TWO relevant investigations with likely abnormalities c) briefly outline the treatment.

Ulcerative colitis
9）A 52 year old clerk Who had myocardial infarction two months earlier presents with shortness of breath on exertion.. He is also woken up at night with severe shortness of breath and bouts of cough. a) What is the most likely diagnosis b) list Five Important principal signs to be looked for c) list TWo most relevant Investigations to make the diagnosis
Congestive heart failure
10）A 33 year old lady who is known to have mitral stenosis and regurgitation presents with sudden onset weakness of left half of body.her pulse is irregularly irregular.

Atrial fibriallation is the case



11）A 15 year old girl is brought to emergency with vomitting, shock and pain abdomen. She is having rapid breathing. She is afebrile, her chest is clinically clear and there Is no abdominal rigidity. Her laboratory results shows; Blood Glucose 18 mmol/L Sodlum 131 mmol/L Potassium 5.8. mmol/L Bicarbonate 08 mmol/L pH (Arterial Blood) 6.9

a)what is the most likely diagnosis ?b)what acid base abnormality is present? c) outline briefly the management
Metabolic acidosis, and why be cz low bicarb ,and decrease ph

12)A 48 year old man under treatment for hypotension comes to the clinic for follow-up visit.Blood pressure is well controlled with diurerics.Examination shows bilaterally palpable kidneys.His urea and creatinine are slightly elevated.his elder brother is also being treated for hypertension and renal disease.
a)what is the most likely diagnosis? b)which investigation is required to confirm the diagnosis?c)list the likely renal complications
This one i think is hydronephroisis ________________________________________
13）A 40 year old patient presents to you with grouped vesicles and blisters in a band like distribution on the right side of his chest.he has a history of pain in the same region,three days prior to eruption.
a)what is your diagnosis?justify your diagnosis. b)how will you treat this patient?


know herpes zooster

14)A boy 19 years of age comes to you with severe pain in the throat on right side with fever and dysphagia for one day.On examination his saliva is drooling from right angle of mouth.He is unable to open his mouth properly.throat examination shows swollen and congested right tonsil and anterior pillar.


Acute tonsillitis can be ,but these Clinical features are suggestive of Quinsy
Quinsy can be 90% after tonsillitis but in 10% without H/O of acute tonsilitis

In D/d : it can be acute pharyngitis

15)A 9 years old boy presents with burning,itching and thick ropey discharge from the eyes.The symptoms get aggravated in summer season and respond well to medication.
a)what is the probable diagnosis?
b)what is the aetiology of the disease?
c)what are the treatment options?


bacterial conjucnctivivtiss, this one was answer b Dr Xavier ealier ,
16)A 26 years old P2+O presented with severe abdominal pain and attacks of faintness.Last menstrual period(LMP)was unsure.Her pulse was 110/minutes and blood pressure was 90/60 mmHG.
A)WHAT IS THE MOST LIKELY DIAGNOSIS?
B)HOW WILL YOU MANAGE HER?

Ectopic pregnacycy

17)A 40 year old lady has presented with pain in right hypochondrium with radiation to right shoulder and jaundice with temperature.
a)what is your appropriate investigation plan?
b)what are the treatment options for bile duct stones?

This is choledocholithiasis


20)A 36 year old primigravida is followed up at the health centre and referred to the hospital antenatal clinic at 37 weeks of gestation.On abdominal examination the size of the uterus corresponds to the dates and the head was not engaged but instead felt in the fundus with a longitudinal lie.
a)what is the most likely presentation in this case?

BRECCH PRESENTATIION



23)Healthcare is at cross-roads,as regards the ideal model of healthcare
a)list the four the major differences between the conventional Medical model of healthcare and Engels biopsychosocial model of healthcare.
b)Which model of healthcare will you prefer to use in your clinical practice?Justify your choice by Highlighting briefly the advantages that your choice carries.

I DONT KNOW THIS ONE becz i haven’t studied behaviour sciences

24)As a doctor working in a remote village of Pakistan with no reproductive Health facilities,You notice that a number of new borns delivered by traditional birth attendants are dying within a week after developing spasm of body ,jerks,arching of the back refusal to take mother feed and eventually difficulty in breathing.
a)what would be the most likely cause of these deaths?
b)what preventive steps would you put into place to stop these deaths?

This is the question from Community Medicine , open book PARK AND PARK ,chapeter 9 , preventive medicine in obstetirics and pediatics and geraiatrics,page 384
And the answers you have to write are
For prevention of childhood and maternal mortality are
You have to prevent the intranatal causes.
Antenatal causes ,
And postnatal causes ,
Complete Epi programm , you have to write
Breast feeding ,and then weaning you have to write
Mother care , antenatal care
Instituntional care you have to write
So firs step is to care the mother ,as baby are part of mother during prgencncy,



25)A 29 Years old Housewife present with feeling fatigue and lethargy in the morning that improves as the day passes for the last three months.she feels that she can no longer cope with ‘Heavy-workload’ at home and that she is unable to enjoy her sex-life.Her appetite is reduced and tends to wake up repeatedly at night after fearful dreams.She feels that this could be a ;punishment ‘for the thousands of sins that she has committed.
She states that her symptoms started just after she recovered from a prolonged fever and that did not respond to antibiotics.and that she feels better after taking –rest.
a) List Four clinical conditions that you will consider in the differential diagnosis ;choosing also the most probable /likely diagnosis.
b) Name TWO drugs that she is likely to respond with their doses
c) What would you tell the patient and family about the nature of patients illness
GENERALIZED ANXIETY DISORDER OR OBSEESIVE COMPULSIVE DISOIREFDER

 

Brother, I havent said that why did you not contribute, u r a new member so i dont ask you to contribute, but i said that i have complaint with other PFMSG members that they dont contribute which are senior too. Dont take it to heart, i didnt say about you. and i didnt post answers coz i have to confirm them first, coz i dont know all of them, n i dont have time till 3-4 days.