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path quiz Round 4
1.
2. ROUND 4
• This round has a set of two images followed by a history .
• Each image will be shown for 1 minute. They won’t be
reshown
• If you diagnose at first image you will be given maximum
points and then the points decrease if you demand for the
next image and will further decrease on demanding history
• You may not answer in the first two images but its compulsory
to answer after the history. Marking pattern is shown.
• All the answers should be diagnosis ie names of disease.
Correct Incorrect No Answer
1st image +50 -20 0
2nd image +40 -30 0
History +20 -50
You don’t have
a choice !
5. Ct of a young female with no history of
smoking.
6. A 34 YEAR OLD FEMALE , MOTHER OF TWO BOYS ,PRESENTED TO
THE EMERGENCY WITH BREATHLESSNESS AND DRY COUGH .HER
EXAMINATION REVEALS SHE IS CYANOTIC AND HAS DECREASED
AIR ENTRY ON RIGHT SIDE. SUSPISION WAS CONFIRMED WITH A
CHEST X RAY REVEALING A RIGHT CHYLOTHORAX. SHE GIVES NO
HISTORY OF SMOKING , HIV OR DIAGNOSED AUTOIMMUNE
DISORDERS?
Q1) WHAT IS THE DIAGNOSIS ?
12. A 29 years Hindu female has persistent cough, sputum production and
shortness of breath for last 16 years. She has recurrent wheezing, nasal
stuffiness and rhinorrhea since childhood for which she was treated
frequently with bronchodilators, steroids, antihistaminic drugs and
antibiotics. At the age of 13 years she was first admitted in hospital with fever,
cough and expectoration and was mistreated for pulmonary tuberculosis. Her
bowel habits are normal with passage of well formed stools. She has no
abdominal complaints.. Examination reveals clubbing of fingers. Chest x-ray
revealed bilateral bronchiectatic changes. Straight x-ray of paranasal sinuses
revealed chronic sinusitis Sweat chloride was 129.5 mEq /L(Normal – 40
mmol/l)
ID the disease.
18. A 7 year old boy presented to the emergency complaining of
severe abdominal pain and a visible lump in right flank. He had
rectal temperature of 100.4 degrees Fahrenheit which the
mother recalls is on and off .Oral examination revealed soft,
fluctuant, tender bilateral diffuse bluish swelling of posterior
part of hard palate adjacent to the primary molars. Examination
further reveals b/l proptosis and ecchymosis periorbitally .
Urinary HVA levels are high .
Q1 Whats your diagnosis ?
24. A 15-year-old boy presented with a 6-month history of a mass
increasing in size over the right proximal tibia. Conventional
radiographs showed a 2.0 × 1.5 cm eccentric lytic lesion localized
to and expanding the involved cortical bone. CT and histopath
findings are shown.
Diagnosis?
30. A 16-year-old male who came to the clinic, complaining of right-
sided hearing loss and vertigo. He also noted that about a year
before coming to the clinic he had had some right-ear pressure
or fullness. He visited his primary care physician about six
months before seeing us and was found to have fluid in the right
middle ear space. That was treated and the fluid resolved, but
he still noticed a hearing loss in the right ear, so he sought out
further evaluation. The audiogram indicates a mild low-
frequency sensorineural hearing loss on the right side and with
absent acoustic reflexes in the right ear, but excellent word
recognition scores bilaterally. The VNG yielded a unilateral
weakness
36. 3 year old boy is referred for investigation of weight loss, failure
to thrive and frequent diarrhoea. Stools are semi-formed and
greasy.
Child has pallor, is emaciated, is below 10th percentile for both
height and weight.
He is irritable, listless and has markedly reduced appetite with
severe muscle wasting at pelvic and shoulder girdle.
Fecal fat excretion- 24hr fecal fat estimation is markedly
increased.
Hemoglobin-9.7g/dL
Serum protein and albumin slightly decreased
PBS shows hypochromic microcytic RBC
