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DATA INTERPRETATION 2 By Dr. Zahoor
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Question 1
1. What is the diagnosis?
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Answer 1
1. Acute Anterior Myocardial Infarction (deep Q waves, elevated ST segments and T
wave inversion are seen in V1 – V5)
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Question 2This is the ECG of
55 year old who is drowsy and confused.
1. What abnormalities are present?
2. What is the diagnosis?
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Answer 2
1. Bradycardia heart rate of 30/min - Absent P-wave - Tall T wave
2. Hyperkalemia
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Question 3 A woman of 50 with nausea and anorexia. Calcium 1.63 mmol/L (N 2.25 – 2.62
mmol/L) Phosphate 2.50 mmol/L (N 0.8 – 1.4
mmol/L) Urate 0.88 mmol/L (N 0.21 – 0.37
mmol/L)
1. What is the diagnosis?
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Answer 3
1. Chronic renal failure High urate and phosphate are due to
glomerular failure Hypocalcaemia is common in renal failure
cause may be failure of conversion of vitamin D
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Question 4 A 35 year old man complains of weight loss and abdominal
distention. Three years ago he was treated successfully for an itchy vesicular rash on his buttocks.
Hemoglobin 8.3 g/dl MCHC 31 g/dl (N 32 – 36 g/dl) MCV 96fl (N 76 – 98 fl) Blood film : macrocytosis+ microcytosis+ anisocytosis+ poikilocytosis+
1. What is the diagnosis?2. What investigation will confirm the diagnosis?3. What was the rash?
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Answer 4
1. Coeliac Disease He has mixed macrocytic and microcytic anaemia suggesting iron and Folate (possibly B12 deficiency)
2. Jejunal biopsy
3. Dermatitis Herpetiformis (itchy vesicular rash is associated with celiac)
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Question 5 A 25 year old Asian is admitted with headache and neck stiffness. He has
been on no treatment.
CSF findings: Pressure 24 cm water RBC 0 WBC 275 × 106 (275/mm3) Lymphocyte 8o% Monocyte 10% Neutrophils 10% Protein 0.8 g/L (N 0.15 – 0.4 g/l) Glucose 1.8 mmol/L (N 3.3 – 5 mmol/L) Blood Glucose 5.7 mmol/L
1. What is the diagnosis?
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Answer 5
1. Tuberculous Meningitis
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Question 6A man of 55 collapses outside a restaurant. He is on no drug
therapy:
1. What is the underlying endocrine abnormality?
2. What test you will do to confirm the diagnosis?
Na 115 mmol/L (N 133 – 145 mmol/L)
K 4.2 mmol/L (N 3.5 – 5 mmol/L)
Urea 1.8 mmol/L (3.3 – 7 mmol/L)
Total protein 52 g/L
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Answer 6
1. Inappropriate ADH secretion
2. Plasma and Urine Osmolality In inappropriate ADH secretion plasma
Osmolality is low and urinary Osmolality is high
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Question 7An obese 56 year old woman complains of daytime
somnolence. Her husband says that she snores loudly. Investigations showed: Arterial blood (breathing air): PO2 10.4 kPa (78 mmHg) PCO2 5.6 kPa (43 mmHg)
1. What is the most likely diagnosis?2. How can this diagnosis be confirmed?
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Answer 7
1. Sleep apnea
2. Polysomnography
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Question 8A woman with Vitiligo became anemic. MCV 120
fl.
1. What is the diagnosis?
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Answer 8
1. Pernicious anemia (due to anti bodies to intrinsic factor)
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Question 9A 60 year old man admitted for a hernia repair is found to
have
1. What metabolic derangement is present?
2. Give two possible causes.
Plasma sodium 144
Potassium 2.9
Bicarbonate 35 mmol/L
Blood urea 5.5 mmol/L
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Answer 9
1. Hypokalemic alkalosis with normal renal function
2. Long term diuretic therapy Corticosteroid therapy Conn’s syndrome
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Question 10A 38 year old woman presents with swollen neck. Her
blood pressure is 190/115 mmHg. Investigations: Serum Calcium 2.9 mmol/L (N 2.25 – 2.6 mmol/L) Creatinine 130 µmol/L (N 60 – 140 µmol/L ) Resting Calcitonin - normal T3 2.8 nmol/L (1.2 – 3 nom/L) TSH 3mU/l ( 1-6 mU/l)
1. What is the most likely diagnosis?
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Answer 10
1. Multiple Endocrine Neoplasia – MEN IIa or Sipple’s Syndrome
Raised calcium – parathyroid adenoma Mass in the neck with normal T3 and TSH
– Medullary carcinoma of thyroid Hypertension - Phaeochromocytoma
X RAYS & ECGs
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Question 11
1. What is the diagnosis?
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Answer 11
1. Pleural Effusion
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Question 12
1. What is the diagnosis?
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Answer 12
1. Left sided Pneumothorax
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Question 13
1. What is the diagnosis?
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Answer 13
1. Tension Pneumothorax
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Question 14
1. What is the diagnosis?
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Answer 14
1. Mitral stenosis (Left border of the heart is straight, there is a loss of concavity in its shape)
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Question 15
1. What is the diagnosis?
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Answer 15
1. Left ventricular aneurysm (there is outward and upward bulge of left
ventricular apex)
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Question 16
1. What is the diagnosis?
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Answer 16
1. Pericardial Effusion Heart shadow is enlarged and globular in
shape and covers both hila
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Question 17
Patient presented with Raynauds PhenomenonWhat do you see in this X Ray Hand?
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Answer 17
Soft Tissue Calcification
Osteolysis
Systemic Sclerosis
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Question 18
1. What will you do?
This is X-ray abdomen of a young child. He swallowed an engagement ring incidentally.
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Answer 18
1. Should pass spontaneously
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Question 19
1. What is heart rate ? 2. See the rhythm strip, what do you find ?
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Answer 19
1. Heart rate 50/minute (Sinus Bradycardia)
2. APCs – Atrial Premature Contractions
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Question 20
1. What is heart rate ? 2. What abnormality do you find?
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Answer 20
1. Heart rate 94/minute
2. Left axis deviation VPC – Ventricular Premature Contraction
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Question 21
1. What is the diagnosis ?
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Answer 21
1. Ventricular Tachycardia – wide complex tachycardia
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Thank you
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