1. By Dr. Zahoor 1

2. Question 1: 1.What is the diagnosis? 2.Name one other manifestation. 2

3. Answers 1 1.Yellow nail syndrome 2.Pleural effusion - Lymphodema 3

4. Question 2: 1.What is the diagnosis? 2.Give one complication. 4

5. Answers 2 1.Neurofibromatosis 2.Acoustic neuroma Phaeochromocytoma 5

6. Question 3 1.What is the diagnosis? 2.Give one associated feature. 6

7. Answers 3 1.Scleroderma 2. Reynaud's phenomenon Telangiectasia 7

8. Question 4 1.What is the diagnosis? This patient with maturity onset diabetes developed necrolytic migratory Erythema rash 8

9. Answers 4 1.Glucogonoma 9

10. Question 5 1.What is the diagnosis? 10

11. Answers 5 1.Psoriasis (Distal interphalangeal joints are involved and there is nail pitting). 11

12. Question 6 1.What is the diagnosis? 12

13. Answers 6 1.Rheumatoid arthritis (Arthritis of proximal interphalangeal and metacarpal phalangeal joints and Vasculitis) 13

14. Question 7 1.What is the diagnosis? This patient presented with severe abdominal pain and is in shock. He had bruising in the flank. (Grey Turner’s sign) 14

15. Answers 7 1.Acute pancreatitis 15

16. Question 8 1.What is the diagnosis? 16

17. Answers 8 1.Herpes zoster of ophthalmic division of trigeminal nerve with secondary bacterial infection 17

18. Question 9 1.What is the diagnosis? 18

19. Answers 9 1. Hypertensive retinopathy 19

20. Question 10 1.Name the physical sign. 20

21. Answers 10 1.Lupus pernio 21

22. Question 11 1.What is the diagnosis? This patient has mucocutaneous pigmentation and was found to have gastrointestinal polyposis. 22

23. Answers 11 1.Peutz Jegher syndrome – it is Autosomal dominant. 23

24. Question 12 1.What is the likely diagnosis? 24

25. Answers 12 1.Hereditary hemorrhagic telangiectasiae. Autosomal Dominent 25

26. Question 13 1.What is the diagnosis? 26

27. Answers 13 1.Vitiligo 27

28. Question 14 1.What are these lesions? 2.Give one cause of this lesion. 28

29. 29 Answers 14 1.Spider naevi 2.Cirrhosis of liver Pregnancy

30. 30 Question 15 1.What is the abnormal physical sign? 2.What is most likely diagnosis?

31. 31 Answers 15 1.Exopthalmos 2.Graves’ disease

32. 32 Question 16 1.What is the diagnosis?

33. 33 Answers 16 1.Tendon xanthomas over the Achilles tendon. They occur in familial hypercholesterolemia.

34. 34 Question 17 1.What is the physical sign? 2.Give one condition, this sign is associated.

35. 35 Answers 17 1.Pre-tibial myxoedema – red brown thickened skin 2.Graves’ disease

36. 36 Question 18 1.What physical sign is shown? 2.What is the diagnosis? 7 year old boy, pictured with his brother was unable to play football.

37. 37 Answers 18 1.Pseudo hypertrophy of the calf muscle 2. Duchenne’s muscular dystrophy (X- linked recessive)

38. 38 Question 19 1.What is the diagnosis? 2.Give one CVS associated abnormality.

39. 39 Answers 19 1.Down’s syndrome – trisomy 21 2.ASD VSD

40. 40 Question 20 1.What is seen in the X-ray chest? 63 year old man with history of working in a navel dockyard for more than 20 years.

41. 41 Answers 20 1.Multiple calcified pleural plagues – Asbestos Plaque.

42. 42 Question 21 1. What is the diagnosis?

43. 43 Answer 21 1.Bronchiectasis Cluster of ring shadows in the right lower lobe

44. 44 Question 22 1.What is the diagnosis?

45. 45 Answers 22 1.Tension Pneumothorax

46. Thank you 46