Abdomen-clinical cases, Summaries of Anatomy

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Clinical cases-Abdomen

A 40 year old chronic alcoholic presented with profuse and projectile vomiting of blood due to rupture of dilated vessels, He was diagnosed with alcoholic liver cirrhosis and portal hypertension.

• 1. What is the condition of dilated vessels called ?1m
• 1. What is the condition of vomiting of blood called? 1m
• What is the normal portal pressure?.1m
• 4)Name any two sites of portosystemic anastomosis. 2m

A 40 year old multiparous female attended obstetrics and gynaecology OPD and complained that for past 1 month she feels that something enters in her vagina from above when she strains during defecation.on history taking, she told that she has given birth to the baby few months back

• 1)What is the probable diagnosis? 1m
• 1. Name any four supports of the involved organ .2m
• 1. Name the muscles which form the pelvic diaphragm. 2m

A 17 year- old boy brought to the hospital

with complaints of acute pain around the

umbilicus, fever and vomiting .On

examination ,the surgeon found the area of

maximum tenderness at the McBurney’s

point.The psos test was positive.

1) Name the clinical condition 1m

2)Give the surface marking of Mcburney’s point

2M

3) Name the two different positions of the

affected organ. 2m

4) Mention the most common position of

affected structure .1m

• (^) An educated mother brought her 6 month- old son to the hospital and complained that the right scrotum of her son was empty. On physical examination ,the doctor found the presence of testis only in the half of the scrotum and a small swelling about 1.5cm in the inguinal region on the right side.
• (^) 1) What could be the diagnosis ?1m
• (^) 2)Enumerate any two factors responsible for descent of testis 2m
• (^) 3)What is ectopic testis 2m

A 68 – year old male patient was admitted

to the hospital with the following

complaints ;progressive jaundice ,pale

greasy stools, itching of skin, loss of

appetite and weight ,and back pain.On

examination, the doctors found palpable

gall bladder and ascites.

1.What is the probable diagnosis? 1m

2.What is Courvoisier’s law? 2m

What are the important posterior relations

of the head of pancreas ?2m

• (^) A 67 year- old man was admitted in the hospital with history of pain in the perineum,with difficulty ,urgency, and frequency in micturition. Per rectal examination revealed an enlargement of the prostate. It was smooth and nodular.
• (^) 1) What is the probable diagnosis? 1m
• (^) 2) What are the common sites of occurrence of the benign prostatic hypertrophy and carcinoma of prostate? 2m
• (^) Where does the prostatic venous plexus lies? 2m

A 55 year- old woman complained that

since the past 2 months, she has been

feeling the sensation of something coming

down into the vagina.She also complained

of dribbling of urine on forceful coughing

and frequency of micturition.

1) What is the probable diagnosis? 1m

2) Name any two chief supports of uterus

2m

3) Define the angle of anteflexion .Give its

measurement 2m

A 37 year old patient came to the emergency with excruciating abdominal pain in left flank and inguinal region.A urine sample was positive for blood.The plain X ray of abdomen (KUB film) revealed a possible calculus in lower left quadrant of the abdomen.A diagnosis of ‘renal colic’ was made

• 1.What is renal colic? 1m
• 2.What is KUB film? 1m
• 3.Name the radiological technique used to visualize the lumen of ureter and calyces 1m
• 4.Why the patient first complaint of pain in loin inguinal region and then into thigh and scrotum? 2m

Extra

• (^) A 50-year-old male visited the hospital and complained of swelling of the scrotum associated with periodic fever and passage of milky urine. On examination, the doctor found that scrotum as a whole was enlarged. The scrotal skin was thickened mainly at the bottom. On aspiration of scrotum, a milky fluid came out. He was diagnosed as a case of chylocele and chyluria due to obstruction of thoracic duct.
• (^) QUESTIONS
• (^) 1. What is chylocele?2m
• (^) 2. What is the cause of chylocele?2m
• (^) 3. What is the cause of thickening of scrotal skin? 1m

A 57 years old policeman came to the hospital with complaints of chronic dull ache in both legs .On examination clinician noticed dilated & tortuous veins on the medial side of his both legs .The skin on the medial malleolus was found to be discolored and dry.

• 1. Name the clinical condition mentioning the vein involved. (1m)
• 1. Describe the brief course of vein involved (2m)
• 1. Name the veins that connect it to the deep veins of lower limb (2m)

A 45 year – old patient was admitted in

hospital with severe pain in abdomen

associated with fever and tachycardia.On

palpation , the doctor found tenderness

and guarding of the abdominal wall , and

on auscultation ,he noted the absence of

bowel sounds.His pulse rate increased

gradually

1) What could be the diagnosis 1M

2)What is the anatomical basis of

tenderness and guarding of anterior

abdominal wall 2m