1. General Appearance You are going to be presented with clinical photographs. Answers will be provided in the next slide

2. Your observations.

3. My son the handsome devil. Normal healthy male

4. One on left 20 years old. Diagnosis?

5. Stunted growth. Fanconi anemia

6. Observations. Diagnosis?

7. Tall and thin Long limbs and fingers Span greater than height Marfan Syndrome

8. Doctors waiting room. No response to calls.

9. Slightly obese Sleeping in waiting room Sleep apnea syndrome

10. Observations. Diagnosis?

11. Cachectic Gibbus of spine Tb of Vertebra

12. Describe the facies. Diagnosis?

13. Leonine facies Diffusely enlarged lymph nodes B Cell Lymphoma

14. Findings on face. Diagnostic considerations.

15. Drooping of left eye lid Horner’s syndrome Cancer left apex Pancoast tumor

16. Describe face. Diagnosis?

17. Malar rash Butterfly rash Lupus

18. Your observations?

19. Thin boy Surgical scar on right Past Lobectomy

20. Cannot lay head on pillow. Diagnosis?

21. Inability to lay head on pillow Ankylosing spondylitis

22. Your findings?

23. Upper body emaciation Protruberant abdomen Ascites Cirrhotic

24. Extensive CXR Changes. Diagnosis?

25. Disparity beteween CXR and clinical appearnce. Extensive Lung changes Healthy looking Sarcoidosis

26. Slow thick voice. Diagnosis?

27. Myxoedema Coarse dry hair Other not evident features Loss of hair outer eye brow Coarse skin

28. Nervous and jittery. Diagnosis?

29. Wide eye stair Potentiation of sympathetic activity Thyrotocicosis

30. Fowl smelling. Diagnosis?

31. Three layered sputum Fowl smelling Top foam Middle liquid Bottom sediment Bronchiectasis

32. Possible diagnosis?

33. On 2 liters of nasal oxygen Low flow and low FIO2 Patient with COPD