Posted by JK on April 14, 2002 at 15:34:05:

1.DIAGONOSIS OF HEARING LOSS
(acoustic neuroma, blast injury ,petrous bone fracture, wax obstruction, acute otitis media, ototoxitiy)
1 .male 50 years,poor hygiene,c/o deafness and has bad hygeineafter shower.
2.male 70 year old treated with gentamycin comes 10 days later with hearing loss
3.male 20 year h/o head injury,some bruising on side of head comes with hearing loss
4.female 40 yrs,comes with sensorineural deafness + corneal anaesthesia.ct scan show widenining of internal acoutic meatus
(answers :wax, ototoxicity,petrous temporal fracture,acoustic neuroma)

2.management of orthopaediatrics condition
(strapping and discharge, usg wrist , x ray thumb, immediate orthopaediatrics reference, wrist scan, x ray wrist including scaphoid view, strapping and review in hospital)
5.10 yrs boy h/o fall from tree comes with tenderness in wrist,x ray normal,no other injury
6.female h/o fall c/o tender wrist and clinically no other abnormality
7.20 male,h/o truama,x ray show impacted fracture tibia
8.male 25 year,fell on outstretched hand c/o tenderness in anotomical snuff box
(answers ; ?strapping and review,x-ray wrist with scaphoid veiw,referral,?referrral)

3.contraception
( cocp, abstinence, mirena coil, iucd, male sterlization, female sterlization, cocp + condom, diaphragm, condom, postcontraceptive pills, progesterone only pill, depot injection)
9. 14 yr old comes for contraception.living with boyfreind for 2 months.
10.35 yrs smoker,4 children comes for contraception,donot want to sterlize,donot want to gain weight
11.female 35 yr family complete c/o dysmenorrhoe + heavy menstrual loss,donot want any chemical in body,donot want sterlize,husband donot like condoms,
12.20 yr old female on cocp,has a room mate that got meningitis,now on rifampicin for prophylaxis
13.mentally retarded female, found by male student attractive,parents and teachers r concerned that no pregnancy
(answers : ?cocp,iucd,mirena,cocp+condom,?iucd).

4.diagonsis of altered bowel habits.
(ca colon, diverticular disease, duodenal ulcer, inflammatory bowel disease, irritable bowel disease,faecal impaction, ischemic colitis)
14.55 yr male ,2 months h/o altered bowel habbit + 6 kg wt loss
15.70 yr old female longstanding h/o constipation c/o diarroe now + enuresis.on examination rectum full of faeces
16.30 yr old female h/o alterating diarrhoea and constipation with rabbity stools.no wt loss,distension of abdomen
17.22 yr old male c/o crampy abdominal pain and bloody diaarohoe.no h/o foreign travel
18.70 yr old female h/o diarrhoe,abdominal pain.she is mildly dehydrated,temp is 39 c
(answers : ca colon,?fecal impaction,irritable bs,inflamm bd,ac ge)

5. investigation.of different condition(exactly donot remember the theme)
( mri brain,ecg, x ray chest, pulse oximetry, msu, blood culture, coronary angiogram, lfts, liver biopsy)
19.alcohlic c/o flappy tremors and confusion.
20.pt h/o anterior resection of colon one day back now c/o anterior chest pain radiating to left arm
21.70 yr old female c/o confusion,constipation and frequency of urine
22.pt h/o prolonged copd,comes with central cyanosis and breathlessness.
23.female 60 yrs comes with fluctuating level of conciosness,personality changes.
(answers : lft,ecg,MSU,blood gases,?mri)

6.epistaxis diagonosis.
(nasophrangeal fibroma, ca maxillary antrum, septal perforation, orf, nasal polyposis, hypertensive disease, coagulopathy, sarcoidosis, anticoagulation over dose, truama)
24.pt with epistaxis and h/o artificial heart valves on medication
25.40 year old sheep farmer c/o unilateral epistaxis.o/e a polyp on anterior septum of nose
26.chromium industry worker c/o bleeding nose +wheezing voice from noise.
27.furniture worker comes with bleeding nose,ptosis and cheek swelling ,anesthesia over cheek .
28.80 year old male comes with 2 hour h/o epistaxis.
(answrrs : anticoag overdose,?orf,septal perforation,?ca max antrum,hypertension)

7.nonaccidental injury
(child protection conference, coagulation profile +platelet count, nutritional assessment, skeletol survey, routine child health care,examination under anaesthesia, high vaginal swab, ct scan head)
28.6 month female comes with swelling of thigh.x ray show femur fracture.no other h/o truama
29.6 yr gal comes with teacher with bruising on the area where her mother is supposed to hold.her mother said she hold her arm to prevent from running somewhere.
30.unempoyed parents,gp suspect there children is thin.his weight remain same over last 6 months.
31.6 month male child,mother 18 year old comes with drowsiness ,cyanosis for few months.his right pupil is dilated.
32.9 yr female child comes with parents with h/o bleeding vagina,perineum is red and tender,h/o dysuria too.
(answers : skeletal survey,coag profile+plat count,nutritional assessment,ct scan,child prot centre)

8. abdominal injury.
(aortic rupture,diaphragmatic rupture, spleen rupture,mesentteric vascular rupture, liver rupture, bladder rupture, cardiac tamponade, renal pedicle avulsion, renal contusion, urethral rupture,pancreatic rupture)
33.male cyclist hit by car vital stables c/o upper lt quadrant tenderness
34.male fall from stairs c/o renal tenderness.iv constrast fail to show renal excretion for 10 minutes.
35.20 yr male c/o 10 cm blade stab in upper left abdomen initially stable for 20 minutes then comes with bp 90/60 on usg no free fluid in abdomen.
Answers :spllen rupture,renal pedicle avulsion,?cardic tamponade,

9.vaccination in children
(delay vaccination for 2 wks, omit pertussis and meningitis vaccine, give vaccine in hospital, give inactivated vaccine, continue routine vaccine schedule,stop this vaccination)
36.6 months old child has got dpt,polio,meningitis b comes with h/o crying for two hours last time injection
37.child has family history of allergy to egg+ h/o acute otitis media is going to get mmr,polio
38.3 month old child about to go for first dose of dpt+ polio.has family history of epilepsy
39.6 month old child hiv parents is going to get mmr vaccination.
Answers;?routiine immun, stop this vaccination,routine vaccinn,routine vaccinn

FROM ANSWERS ARE BESIDE,,,,,,,,,,,,,,
10.mi complication.
(acute pericarditis, acute atrial fibrillation, ventricular fibrillation, complete heart block, pulmonary embolism, mitral valve prolapse rupture, ccf, pneumonia)
40.male 40 years h/o syncope,pulse 40/min - comp heart block
41.female 5 days after mi c/o chest pain worse on inspiration ecg shows persistant st elevation. -PERICARDITIS
42.male c/o harsh pansystolic murmur at apex- RUPTURE OF CHORDAE
43.60 yr male h/o irregural pulse of 140/min. - AF
44.pt has h/o anterior resection operation 6 days back then had a mi and after 5 days comes with unilateral pleuritic chest pain and breathlessness. - PNEUNONIA

11.sudden loss of vision.

45.80 yr male h/o curtain falling on the eye.also gives h/o tia. =- CAROTID DOPPLER
46.pt c/o sudden loss of vision.history of headache.o/e bitemporal scalp tenderness - ESR
47.man with bitemporal hemianopia and increase in shoe size. –MRI PITITARY
48.pt with upper quadrantopia. MRI TEMPORAL

12.interpretation of renal investigations.
(dialysis, iv methyl prednisilone, oral azathiopurine, adequate i/v fluids, i/v glucose and insulin, urinary cathetor, ace inhibitor,IV PAMIDRONATE)
49.diabetic with mild renal impairment, urea 18 mmol/l,creatinine 350 umol/l,na 138mmol, ca 2.3 mmol, k 7.4 mmol. – GLU+INSIL
50.pt with multiple myeloma,urea 18 mmol,creatinine 350 umol,na 142 mmol,k 3.5 mmol,ca 3 mmol -?IV PAMIDRONATE
51.pt with sle urea 18 mmol,creatinine 350umol,urine microscopy contains red cell casts.- IV METHL PREDNISONME
52.rhabdomyolysis patient,urea 18mmol,creatinine 350umol,cpk 2500 iu,k 5.2 - IV HYDRATION
53.male 60 yr with features of urinary tract obstruction.urea and ceratine and k r raised. - CATHETER

13.management of prostatic carcinoma.
(psa, isoenzyme alkaline phophatase,gallium scan,technitium bone scan, skeletol survey, transrectal ultrasound, transrectal biopsy, acid phosphatase,serum calcium, abd usg.)
54.80 yr male with prostatic carcinoma c/o 4 month h/o lower back pain. TECH SCAN
55.pt with prostatic carcinoma getting gnrh agonists therapy comes for followup. PSA MEASURE
56.pt of prostatic carcinoma complains of thirst,constipation,polyurea.fundoscopy normal. SER CALCIUM
57.pt with basically the features of renal failure. ?USG ABDOMEN

14.epilepsy.
(add another anticonvulsant, i/v lorazapam, first line anticonvulsant, check anticonvulsant level, increase anticonvulsant dose, arrange eeg, arrange ct scan, give rectal diazepam to parents )
58.child comes in a&e comes with fits and still fitting.i/v line is maintained. IV LORAZEPAM
59.9 yr gal with h/o one episode of generalized tonic clonic attack during sleeping EEG
60.female child with h/o epilepsy and on some anticonvulsant drugs comes with parents,parents have two complaints.increase fit attacks and absence from schools.o/e child is mildly obese. CHECK ANTI CON LEVEL
61.8 month child with h/o convulsion for 5 minutes.pt is febrile.has strong family history of febrile convulsions. PARENTS PERRECTAL DIAZE STOCK

15.asthma
(nebulized b2 agonist,inhaled short acting b2 agonist,inhaled long acting b2 agonist,oral short acting b2 agonist,oral long acting b2 agonist,leukotriene antagonist,sodium cromoglycate oral, oral theophylline,oral prednisolone,inhaled steroides, b 2 antagonists,aspirin, ca channel antagonist)
62.15 yr female c/o severe brethlessness in a& e .doesnot have any h/o previous asthamatic treatment.must get quick response. NEB SALBUTAMOL
63.this is contraindicated in chronic asthamatics with heart failure B BLOCKERS
64.pt on high dose steroids comes with nocturnal brethlessness. ?ORAL LONG ACT B AGONIST
65.first line of management in mild asthma. INHAL SALBUT

15.postoperative complications.
(usg abdomen and pelvis, x ray chest, wound swab, serum urea and eloctrolytes, blood culture, v/p scan)
66.male 30 yrs postappendicectomy presented after 10 days with rigors,tenesmes, and diarrhoea UGG ABD PELVIS
67.smoker 40 yrs after splenectomy comes with chest pain and haemoptysis and fever. X RAY CHEST
68.pt post cholecystectomy ,wound red,tender ,swollen with discharge. WOUND SWAB
69.lady after operation presented on 9 day with dysponea and chest pain – V/Q SCAN
170 child post operatoin has raised jvp ,,,... _FLUID OVERLOAD

16.management of varicose veins.
(sclerotherapy, crepe bandage, vein surgery, massage, graded stocking, heat waves , faradic stimulation.)
70.obese below knee varicosities not relieved with graded compression stocking has eczema,lipodermatosclerosis .RDUCE WEIGHT
71.pt,male going on flight abroad.donot want any surgery.father died of pulmonary embolism.need prophlaxis, COMP STOCKING
72.60 yr female previous two operation of vericose now presented with vericosties.lipodermatosclerosis present but no eczema. ?SCLEROSANT

17.dementia.(

(alzeimer,pseudodementia,lewy body dementia,cjb , frontal dementia,multiinfarct dementia, hiv dementia,schizophrenia)
73.commonest cause of dementia ALZEIMERS
74.associated with hypertension. VASCULAR DEMENTIA
75.can be treated with antidepression drugs PSEUDODEMENTIA
76.characterized by early personality changes but normal cognition FRONTAL LOBE SYNDROME.
77.this is characterized by senile plaques and neurofibrally tangles. ALZEIMERS

18.abdominal conditions.
(acute pancreatitis, chronic pancreatis, ca pancreas, ca stomach, barrett esophagitis, chronic atrophy gastritis, h pylori associated gastritis, hiatus hernia)
78.associated with esophageal reflux disease and epithelial dysplasia +metastatic changes BARRETS
79.characterized by necrosis of adjacent tissues, free fluid space formation. ACUTE PANCREAT
80.low grade persistant inflammatory contidion associated with low grade lymphoma H PYLORI GAST
81.inflammatory condition associated with megaloblastic anemia CHRNIC GASTRIC ATROPHY
82.pt c/o severe epigastric pain radiating to back,faeces which cannot be flushed away and strong association with alcohal. CHR PANCREAT

19.side effect of psychhiatric drugs.

(risperidone,chlorpromazine,clozapine, amitryptaline, lithium, phenelzine, lofepramine)
83.long standing schizophrenic pt comes with c/o sore throat(+ all the association of agranulocytosis) CLOZAPINE
84.bipolar affective disorder pt comes with raised t3 and t4.LITHIUM
85.longstanding schizophrenic pt comes to u.has features of extrapyrimidal effects.also impotence and prolactin level is raised. ?//?
86.pt with depression comes with dry mouth,urinary retention,constipation.???????
87.schizophrenic pt with basically the complaint of malignant hyperpyrexia ???????

20.mechanism of action of drugs.
(salbutamol,theophylline, doxapram, amoxicillin,trimethoprim,oxygen,lintic,ipratropium)
88.interfere with bacterial cell wall synthesis AMOX
89.activate b 2 receptors SALBUT
90.inactivate muscrinic receptors IPRATPOIUM
91.increase respiratory muscles power. DOXAPRAM

21.head injury
(mild head injury, moderate head injury, subarachnoid hemmorhage,subdural haematoma, extra dural haematoma,# base of skull,postconcussion syndrome)
92.child with h/o fall vitals stable,x ray normal only headache.MILD HEAD INJURY
93.pt with h/o head injury,gcs 12/15,vital r stable ??MOD HEAD INJURY
94.alcohlic pt comes with h/o increasing confusion.recurrent falls SUB DURAL
95.footballer comes with h/o head injury,talks to a& e staff now becoming progressive drowsy EXTRADURAL
96.male with head injury with haemotypanium.FRAC BASE OF SKULL

22.rhematology management
(nsaids, intramuscular steroid, local steroid injection, methotrexate, splinting, exercise training programme,allopurinol,i/v cyclophosphamide,i/v bisphophanate, antibiotics)
97.man comes with pain in left hip region ????????.
98.pregnant woman comes with h/o paraesthesia in lateral half of palm and fingers LOCAL STEROID
99.pt on antihypertensive comes with red hot tender metatarsal joint NSAIDS/ALLOPERUNOL ?/
100.female 25 yr comes with symmrtical inflammatory finger joint pain not releived by paracetamol ??
101.female with basically the features of hypercalcemia. IV BIPHOSPHON

23.diagonosis of psychiatric pateint.
(delirium, dementia, ch anxiety states, depression, late onset shizophrenia,drug induced toxicity)
102.80 yr old lives in old home ,3 days h/o aggression,donot recognize any body,incontinence and says he see things in the room that other ppl r not seeing. DELIRIUM
103.70 yr female living lonely cared by neighbours.now comes with episode of aggression in shop.neibours say she was alright before however that her memory is not as good as before.DEMENTIA
104.pt 60 yr comes with low mood,slow speed,said he is not worth talking and he dont desereve to live in world.DEPRESSION
105.female come with her husband which is 55 yr teacher.complains his husband becomes aggressive,removes his clothes.on examination abusive sexual talk.LATE ONSET SCHIZO
106.female came with her husband.said husband has lost conciousness and confused.perfectly all right before.one day back has history of fever and cough. DELIRIUM

24.eczema management.
(emollient + 1 % hydrocortisone, emollient + 0.3 % betacortisone,admit in hospital, regular emollient, prolonged oral steroids, desensitization, antihistamine)
107.6 month baby with flexural eczema.mother is already not giving any soaps. EMOLL+1%HYDRO
108.2 yr old gal comes with flexural eczema.gp has prescribed emmoliant and 1 % hydrocortisone but does not help. ANRTI HISTAM
109.baby with moderate flexoral eczema already has 2 children with h/o eczema.mother is extremely exhausted. ORAL STEROIDS
110.6 yr gal with lip swelling after taking peanuts.ADMIT IN HOSP

25.infectious disease investigations.
( lyme disease serology, mri hand, hepatitis a serology,hepatitis b serology,viral antibodies, blood film for malaria, skin swab test, skin prick test,leptospirosis serology)
111.police officer catches a heroine addict which bites him,now come in a&e with deep wound on the hand. VIR ANTIBODIES
112.gal comes with a rash on thigh with central clearing.h/o passing through thick forest.LYME DISEASE
113.a buisness man comes from zambia with a 10 day h/o of rigors,fever and headache. MALARIA

26.testicular swelling.
(usg scrotal contents, urethral swab for gram -ve bacteria, hiv antibodies,transrectal usg, syphilis serology,urgent surgical exploration,msu)
114.20 yr male c/o dysuria and scrotal swelling.h/o unprotected sex 10 days back. SWAB FOR –VE ORG
115.40 yr male c/o dysuria and frequency and scrotal swelling. ????
116.40 yr male comes with 3 months(or year) painless scrotal swelling.USG SCRO
117.25 yr male comes with 3 weeks h/o painless testicular swelling. ????
118.19 yr male comes with pain in testis,vomiting and nausea. SURG EXPLOR

27.tyhroid swelling
(hashimoto thyroiditis,autoimmune hypothyroidism,throtoxic goitre,drug induced thyrotoxicosis, thyroid adenoma,anaplastic ca, follicular ca, papillary ca, reiter thyroiditis,simple goitre,lateral aberrant cysts)

119.40 yr female c/o rapidly growing hard swelling.h/o dysphagia and hoarseness? ANAPL CA
120.50 yr male h/o heart disease complain of night glare and tinge while driving.t3 and t4 raised,tsh decreased. DRUG IND TYROTOX
121.female 25 yr c/o sweating,palpitation,heat intolerance.o/e soft thyroid swelling with bruit is found. THYRO TOX GOITRE
122.female with constipation,bradycardia .she has megalolastic anemia. HYPOTHY

28.management of wt loss.
(enteral feeding by oral tube, parenteral nutrition, percutaneous gastrotomy, low protein diet + antibiotics, low fat diet,high calorie diet, gluten free diet, lactose free diet)
123.pt with colon resection now septicemic in icu.doesnot eat anything for 2 weeks. PAR NUT
124.pt with h/o stroke.when food is given she aspirate it. NG TUBE
125.pt with parkinsonism is complaining of dysphagia and aspiration pneumonia. ?NG TUBE
126.pt with cirrhosis and ascites.LOW PROT+ANTIBIO
127.a 3 yr gal comes with h/o diarrhoea and villous atrophy.GLUTEN FREE

29.terminal management.
(nsaids,opiods, dexamethasone tablet,prednisolone suppositories, hyoscine, haloperidol, quinine sulphate, metronidazole gel)
128.a pt with bronchogenic carcinoma getting radiotherapy develops superior vena caval obstruction.DEXAMETH
129.a patient coming with intractable hiccups.??
130.a pt coming with bronchial rattles.disturbing to his attendant.HYOSCINE
131.a pt with breast carcinoma has foul smelling discharge which is intolerable to bear.METRO AOPPL
132.a pt getting radiotherapy for some pelvic ca develops bloody diarrhoea and tenesmes.STEROID SUPPO

30.management of urinary condition.
(ring pessarie, prophlactic antibiotics, high fibre diet, colposuspension,local oestrogen,intermittent self catheterization,permananet catherization)
133.an 80 yr old female ,5 child h/o severe heart failure comes with dysuria,discharge and feeling of pressure in perineum. RING PESS
134.a sexually active 80 yr female comes with dusparenea and dysuria LOCAL OESTRO
135.a female with diabetic history comes with recurrent urinary tract infection.PROP ANTIBI
136.a female with h/o multiple sclerosis comes distending bladder. ?/INTER CATHETER
137.an 70 yr female with h/o recurrent dysuria.also prolonged history of altered bowel habit. ????

31.diagonosis of metabolic complication.
(metabolic alkalosis,metabolic acidosis, dehydration,hypokalemia, respiratory acidosis)
138.a pateint comes with projectile vomiting and gastric peristalsis.h/o gastic ulcer.pyloric stenosis is seen.investigation show base excess,low na and k MET ALK
139.a pt comes with listlessness.c/o diarrhoe with excess mucus production.on/e villus adenoma of colon is seen. MWET ALK
163 pa of ca pros comes with dry mouth and dehyration ??META BOLIC ACIDOSIS

32.jaundice investigation.
(hepatitis viral serology, antimitochondrial antibodies, antismooth musclle antibody, alpha fetoprotien, serum ferritin, ercp, percutaneous transhepatic cholangiography.)

140.a young male comes with anorexia,nausea,jaundice,dark urine and pale stool.h/o foreign travel HEP VIR SER
141.a female comes with pruritis, dark urine, pale stools and jaundice ANTI MITO ANTI
142.a male with h/o haemachromatasis has comes with high ferritin level.he now comes with malaise ,wt loss ,pale stool and dark urine.he also admit heavy alcohal consumption. ?LIVER BIOPSY
169 femle ,pale stools dark urineruq pain fever before _ERCP
33.haemoptysis causes
(ca bronchogenic, wegener granolmatosis, inhaled foreign body, bronchiecyasis , tuberculosis)
143.a 40 yr old female c/o cough with excess sputum production for many years.sometime sputum contain blood. BRONCHIEC
144.a male comes with haemptysis and wheeze.has history of tooth extraction one monthg ago.INH FB

34.confusion in adoloscent
(panic attacks,opiate withdrawal, opiate overdose ,diabetic ketoacidosis,epilepsy)
145.18 yr female comes in a&e incresing confused and terrified.c/o perioral paresthesia. PANIC ATTACK
146.a 16 yr male has been brought by police.increasing confused and has pin point pupils. OPIATE OVERDOSAGE
147.a 18 year gal comes to a& e saying her stock of medicine has finished.she is tearful and keep asking for pain releif. OPIATE WITHDRAWAL
148.10 yr old female comes with his mother.she is dehydrated,confused and has deep breathing.?DKA
149.a male teen is brought by his freind with incontinence of urine,bleeding from mouth and confusion. EPILEPSY

35.mechanism of hypertension
(analgesic nephropathy, polycystic kidney disease,conn syndrome,cushing syndrome, pheochromocytoma,coarcation of aorta,chronic glomerulonephritis)
150.this is autosomal dominant condition. POLYCYS KIDNEY
151.associated with increased aldosterone CONN SYN
152.associated with increased cathecolamines PHEOCHROMO
153.associated with antigen antibody complex deposition in renal glomerual membrane. CGN

36. progression of breast carcinoma

171female ca bresat complains of thirst dehydrated -HYPER CALCEMIA
172 incresg confusion,headache drowsy – CEREBRAL METASTASIS
173 cont backache reflexes abnormal ,,,,,,- //??spinal cord comp
174 ca breast shoulder tip pain and jaundice --??????

37.investigation of anemia.
(serum folate,serum b12,antiparietal antibodies,bone marrow examination,serum iron etc etc)
154.a 60 yr man with leghargy hb 7 gm,blood film contain immature cells BONE MARROW
155.a 50 yr lady with lathargy,hb 4 gm/dl, sensory loss of vibration in lower legs.have history of family anemia. SER B12

38.vaginal bleeding
161 post menopauseal lady bleeding pv,per vag and per sec exam normal – CA ENDOMET
162 lady on oc pills h/o bleed pv and dypareuinia -ECTROPION

39) Burns
(IV fluids, burns specialist referral, IV opioid, dressing, escharotomy, reassurance and advice, anaesthesia & intubation)
156. Adult male with singed nasal hairs (inhalational) asking about his family.REFERRAL
157. Adult male >40% scald - trunk and legs IV FLUIDS
158. Hand involvement with electrical injury ?REFERRAL
159. Little boy tipped off a cup of hot tea over his chest and ?arms less than 35 berns crying excessively and very uncooperative. ?/ICE PACK
160. Adult male slept while sunbathing, comes with redness. Otherwise well. REASSSURANCE

40Theme Cranial nerve lesions
1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th CN
164 Anosmia OLFAC
165) Ptosis, constricted pupil not responding to light and accomodation.
THIRD NERVE
166Chest injury patient not able to shrug rt shoulder. 11 TH NERVE
167 one side.7 TH NERVE
168 Loss of motor function on one side of face the forehead is spared.7 TH NERVE

41 UYRINARY OBSTRUCTION
175 normal male h/o dysuria and noctiruia now after beer in day time 2 bottles devolpos diffi in passinf urine in evenibg -//?/BLADDER STONE
176 known ca bladder with sudden obstruction of urine – CLOT ODSTRUCTION
177post trauma to backurinary obstructiooon –NEUROLOGICAL
178patient with urinary problem increased psa -CA PROSTATE
179. Ca prostate with bladder enlargement, with dry tongue, dehydrated (answer ? renal failure)
)

Theme EXTRA. Investigation of Anaemia

180. Old lady, anaemia of long duration, Barium studies, scopies already done. Now comes with fresh rectal bleeding and Hb 6gm (Answer ? Mesenteric angio)


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