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Cardiovascular system
Scenario Keyword Diagnosis
A 50-year-old man presents in the emergency Severe breathlessness
department with severe breathlessness. On Bilateral basal
examination, his blood pressure is 200/110 mmHg, crepitations
pulse rate is 120/min with a regular rhythm, apex
beat is heaving, and auscultation of the lung reveals Acute Left
bilateral basal crepitations Ventricular
A 55-year-old man is admitted with a long history of Uncontrolled failure
uncontrolled hypertension and breathlessness for 3 hypertension
days Breathlessness
A patient presented with generalized edema, tender Generalized edema Right Heart
hepatomegaly, and elevated JVP Tender hepatomegaly failure
Elevated JVP
A 55-year-old man presented to the medicine Recurrent chest Angina
outpatient department with a history of recurrent discomfort/Pain Pectoris
attacks of chest discomfort that radiated to the left Persisting for few
arm, persisting for 3 to 4 minutes for the last six minutes
months
A 30-year-old woman presents with palpitation and Mid-diastolic murmur Mitral
exertional breathlessness for six months. Loud first heart sound Stenosis
Examination of precordium reveals loud first heart
sound and a mid-diastolic murmur at the apex
A 13 years old girl presents with migrating Migratory Rheumatic
polyarthritis for 2 weeks. Her pulse is 120 beats/min, polyarthritis heart disease
auscultations reveal soft 1st heart sound with Soft 1st heart sound
pansystolic murmur at apex Pansystolic murmur
A 45 years-old man presented with palpitation and Early diastolic Aortic
exertional breathlessness for 6 months. Examination murmur Regurgitation
of the precordium revealed a soft aortic component Left 3rd intercostal
of 2nd heart sound and an early diastolic murmur at space (Aortic Valve)
the left 3rd intercostal space close to the sternum
A 55-year-old man presents in the emergency Severe retrosternal Acute
department with severe retrosternal chest pain for 4 chest pain (Central) Myocardial
hours with sweating Acute Onset Infarction
A 60-year-old smoker is admitted with acute central ST Elevation Acute ST
chest pain for 2 hours. His ECG shows ST elevation elevated
Myocardial
Infarction
A 50-year-old man has presented with headache Elevated BP >130/90 Hypertension
with BP 180/110 mmHg mm Hg
A 15-year-old boy presented with oligoarthritis Polyarthritis (Oligo) Rheumatic
involving large joints for 2 weeks. He had fever H/O Fever Fever
about 3 weeks back and suffered from sore throat H/O Sore throat
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Respiratory system
A 55-year-old man who smokes heavily
presents with right upper chest pain and
cough for month. Recently he develops
‘streaky hemoptysis on several occasions. He
has no history of fever. Chest examination
reveals dull percussion note and
A 30-year-old man presents with right-sided
chest pain with high fever and cough.
X-ray shows homogenous opacity with
crescentic upper margin in the right side.
a. Enumerate the physical signs suggesting
pleural effusion
A 40-year-old man presented with recurrent
breathlessness with wheezing for several
years
A 30-year-old man presented with severe
breathlessness for 3 hours. He has a history
of cough and allergy
A 30-year-old woman was admitted to the
medical ward with severe respiratory
distress. She had been suffering from
asthma since her early childhood. Her pulse
is 120/min, blood pressure is 130/85 mmHg,
and respiratory rate is 37/min, and the
patient cannot complete a sentence in 1
breath. Auscultation of the chest revealed
bilateral rhonchi with vesicular breath sound
with prolonged expiration
A 35-year-old man presents with high fever
and right-sided pleuritic chest pain, and
cough with rusty sputum for 6 days
A 30-year-old man presents with cough,
fever, and digital clubbing. His chest X-ray
shows consolidation with air-fluid level
A 50-year-old man who has been suffering
from chronic obstructive pulmonary disease
presents in the emergency department with
severe respiratory distress, fever, productive
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sputum for three days. Examination reveals
blood pressure 130\80 mm Hg, Pulse
110/min, having cyanosis & bilateral rhonchi
A 20-year-old male presented with fever,
weight loss, pallor and cervical
lymphadenopathy for 4 weeks
A 30 years old female garment worker
(weight 48 kg) presented with cough & fever
for 1 month
A young male presented to you with a
history of low-grade fever for 1 month with
hemoptysis with right sided chest pain with
respiratory distress of short duration. On
percussion stony dullness on right side of
the chest
A 30 years old male presents with recurrent
episodes of productive cough for 2 years
with digital clubbing. He had a history of
pulmonary tuberculosis 5 years ago. What
investigation you would to confirm your
diagnosis with expected findings?
A 40 years-old man presented with high-
grade fever and expectoration of copious
amount of purulent and foul-smelling
sputum for 1 month. Examination revealed
clubbing with amphoric bronchial breath
sound and crepitations over the 4th to 6th
intercostal space along the right
midclavicular line
A 65-year-old man who smokes heavily
presents with left upper chest pain and
cough with hemoptysis for 6 months. He has
no history of fever
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Endocrinology
A 35-year-old woman presented with palpitation,
sweating, restlessness, diarrhoea & weight loss
for 3 months
A 30 years-old woman presented with
palpitation, weight loss despite a good appetite,
heat intolerance, oligomenorrhea and trembling
of the body for 3 months. Examination revealed
her pulse rate: 115/min, exophthalmos, fine
tremor of outstretched hands and goiter
A 25-year-old female student presents to
outpatient department with recurrent swelling of
legs, progressive weight gain and cold intolerance
for 6 months.
A 30 years old woman presents to the OPD with a
history of fatigue, weakness, weight gain,
Constipation and menorrhagia.
A 15 years old boy gives history of rapid weight
loss, brought to emergency in unconscious state
with high fever. Bed side urine examination
reveals glycosuria.
53-year-old diabetic man presented with tremor,
profuse sweating & semi-consciousness for 1
hour. In emergency room, RBS is found to be 1.9
mmol/l.
Alimentary & Hepatobiliary System
35 years old woman present with generalized
weakness, pallor & lump at the left side of the upper
abdomen
30-year-old male presents with ascites & alteration
of bowel habit for 6 month
A 40-year-old man has presented with recurrent
acute post prandial upper abdominal pain radiating
to back for 10 years. weight loss and foul-smelling
greasy stool for 1 year. Serum amylase was found to
be elevated on several occasions. His random blood
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glucose was 17 mmol/L
A 30-year-old female presents with severe epigastric
pain radiating to back. Examination reveals BP-
90/60mm Hg
A 35-year-old man of chronic liver disease presents
with pain in the abdomen for 7 days. On
examination ascites is observed
A 50-year-old man presents with 15 days fever and
tender soft hepatomegaly. His US of liver shows a
focal hypoechoic lesion
A 48-year-old man who is alcoholic for the last 15
years presents with altered behavior and sleep
pattern for 1 month. Physical examination reveals
ascites and splenomegaly
Urinary System
A 27-year-old young female presented with high
fever, right loin pain & burning micturition
A 20-year-old newly married female presents with
burning sensation during micturition with increased
frequency
A 15-year-old boy with scabies presented with
swelling of face and body with suppression of urine
for 4 days. Write down the management plan for
him
35-year-old man who is a diagnosed case of chronic
kidney disease presents with palpitation, easy
fatigability and weakness. His hemoglobin level is
7.5 gm/dl and serum electrolytes reveal Na++ 142
meq/L, K++7.5 meq/L, Cl−− 101 meq/L, HC₀₅ 14
meq/L
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Hematology
55-year-old man presents with weakness, dizziness
& palpitations for the last 3 months. On
examination, he is anemic & has koilonychia with a
smooth tongue
A 15-year-old boy presents with easy fatigability,
weakness and pallor for 4 years. Examination reveals
moderate anemia, mild jaundice and splenomegaly
A 25-year-old woman presents with fever and gum
bleeding for two weeks. On examination, she is
severely anemic
A 50-year-old man presents with low back pain of
one month duration. Initial investigations reveal a
total count of WBC 10,000/mm33. Hb is 8gm% and
ESR-110 mm in the 1st hour.
20-year-old female present with fever for 2 weeks &
purpura for 1 week. On examination, she is
moderately anemic & having sternal tenderness
with splenomegaly
Rheumatology
50 year old woman presents with arthritis involving
small joints of hands & both knee for 3 months
A 30-year-old young man presented with low back
pain and morning stiffness
A 50-year-old female presented with sudden severe
pain and swelling in the right great toe. She has a
history of similar attacks 6 weeks ago
A 30-year-old lady presents with polyarthralgia, oral
ulcer, and hair loss
A 30-year-old housewife presented with joint pain
with pleural effusion. She has a history of repeated
abortion
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Neurology
A 65-year-old man
presented with sudden
onset weakness of his right
side of the body for 6 hours.
He had no history of fever,
headache, or visual
problems in the past.
Examination revealed his
pulse rate was 70/min &
regular, his blood pressure
was 200/100 mm Hg, and
he had right-sided
hemiplegia