Medical Cases Flashcards

Flashcards from medical case lecture notes.

What investigations are needed for Acute Pyogenic Meningitis?

CSF Gram stain, culture, blood cultures, CBC, CRP, brain imaging (CT/MRI).

What are the differential diagnoses based on the gross appearance of CSF fluid in Acute Pyogenic Meningitis?

Bacterial meningitis, viral meningitis, tuberculous meningitis, fungal meningitis.

Based on CSF findings, what is the final diagnosis for Acute Pyogenic Meningitis?

Bacterial meningitis (cloudy CSF, high neutrophils, low glucose, high protein).

What are the common causes of Acute Pyogenic Meningitis?

Infants: E. coli, Group B Streptococcus; Adults: S. pneumoniae, N. meningitidis, H. influenzae.

What is the probable diagnosis for Case 5, the 21-year-old female with fatigue, nausea, vomiting, loose motions, abdominal pain, fever, jaundice, and dark urine, with elevated ALT, AST, and anti-HAV IgM positive?

Acute Hepatitis A (anti-HAV IgM positive, acute symptoms).

What are the histological features of Acute Viral Hepatitis (Hepatitis A)?

Ballooning degeneration of hepatocytes, Councilman bodies (apoptotic hepatocytes), lobular inflammation, portal lymphoid infiltrates.

What is the probable diagnosis for Case 6, the 35-year-old female with yellowish discoloration of eyes, fatigue, anorexia, weight loss, abdominal pain, abdominal distension, pedal edema, jaundice, ascites, edema, hepatosplenomegaly, elevated AST, ALT, gamma globulin, and prolonged prothrombin time?

Chronic Hepatitis (chronic symptoms, hepatosplenomegaly, elevated gamma globulin suggest chronic liver disease, likely HBV/HCV).

What are the histological features of Chronic Hepatitis (likely Hepatitis B or C)?

Portal inflammation, interface hepatitis, bridging necrosis, fibrosis (may progress to cirrhosis).

What is the probable diagnosis for Case 7, the 40-year-old male with jaundice, fatigue, loss of appetite, upper right quadrant pain, and hepatomegaly, where jaundice and abdominal pain resolved after 12 weeks, but fatigue and loss of appetite persist?

Hepatitis (likely viral, possibly resolving acute or early chronic). Persistent symptoms suggest possible chronicity (e.g., HBV/HCV).

What is the diagnosis for Case 8 a patient presents with fatigue, weight gain, cold intolerance, dry skin, and a firm, enlarged thyroid gland.

Hashimotos Thyroiditis (autoimmune thyroiditis causing hypothyroidism).

What are the typical lab findings in Hashimotos Thyroiditis?

Elevated TSH, low free T3/T4, positive anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies, possible mild anemia.

What are the causes of Hashimotos Thyroiditis?

Autoimmune (HLA-DR3/DR5 association), genetic predisposition, environmental triggers (iodine excess, viral infections), female predominance.

What could be the diagnosis for Case 9, the 68-year-old male with stabbing chest pain, rapid weak pulse, dyspnea, profuse sweating, nausea, and vomiting?

Acute MI (classic symptoms, suggestive of STEMI).

Describe the gross and microscopic features of Acute Myocardial Infarction (MI).

Gross: 6–12 hrs: dark mottling; 1–3 days: yellow-tan center; 7–10 days: red-gray depressed borders. Microscopic: 6–12 hrs: coagulative necrosis; 1–3 days: neutrophilic infiltration; 7–10 days: granulation tissue.

What is the most probable diagnosis for Case 10, the 67-year-old male with hypertension, nausea, generalized weakness, weight loss, and the listed lab results.

Chronic Kidney Disease (small kidneys, elevated creatinine/urea, anemia, electrolyte imbalances).

What is your probable diagnosis for Case 11, the 3-year-old male with mild pallor, icterus, on-and-off abdominal/joint pains, and mild splenomegaly?

Sickle Cell Anemia (recurrent crises, anemia, jaundice, splenomegaly).

What is your diagnosis for Case 12, the 9-month-old child with poor weight gain, delayed milestones, dull activity, severe pallor, icterus, frontal bossing, mild hepatosplenomegaly, and growth retardation?

-Thalassemia Major (severe anemia, bone changes, hepatosplenomegaly).

What is your probable diagnosis for Case 13, the 5-year-old male with fatigue, yellowish sclera, abdominal pain, pallor, koilonychia, spleen palpable 5 cm below costal margin, and jaundice?

Hereditary Spherocytosis (spherocytes, splenomegaly, jaundice).

What other tests can be done to diagnose Hereditary Spherocytosis?

Osmotic fragility test ( fragility), Coombs test (negative), EMA binding test.

What is your probable diagnosis for Case 14, the 60-year-old male with fatigue, fever, spontaneous mucosal/cutaneous bleeding, pallor, koilonychia, petechiae, and oral mucosal ulcers?

AML (myeloblasts with Auer rods, cytogenetic abnormalities).

Describe the peripheral smear findings in Acute Myeloid Leukemia (AML).

Myeloblasts (large cells, high N:C ratio, prominent nucleoli), Auer rods, anemia, thrombocytopenia.

What is your probable diagnosis for Case 15, the pediatric patient with fatigue, fever, bone pain, and easy bruising?

Acute Lymphoblastic Leukemia (common in children, presents with anemia, infections, bleeding).

What are the marrow findings in Acute Lymphoblastic Leukemia (ALL)?

Hypercellular bone marrow, >20% lymphoblasts, decreased normal hematopoietic cells.

Describe the individual cell and its classification in Acute Lymphoblastic Leukemia (ALL).

Lymphoblasts (scant cytoplasm, high N:C ratio, round nuclei, fine chromatin, prominent nucleoli). Classified as B-ALL (CD10+, CD19+, TdT+) or T-ALL (CD3+, CD7+).

What is your probable diagnosis for Case 18, the 4-year-old male with low-grade fever, headache, vomiting, altered sensorium, irritability, drowsiness, neck rigidity, and the listed CSF findings?

Tuberculous Meningitis (subacute symptoms, lymphocytic CSF, elevated ADA, cobweb formation).

What is your diagnosis for Case 19, the 40-year-old female with bleeding per vaginum, and the listed Pap smear findings?

CIN III (severe dysplasia) or squamous cell carcinoma (suggested by tumor diathesis, marked pleomorphism).

What are the cells present in the Pap smear of Cervical Intraepithelial Neoplasia (CIN)?

Dysplastic squamous epithelial cells, parakeratotic cells, keratinized cells, possible malignant squamous cells.