A woman aged 30 years complains of generalised fatigue,
breathlessness on exertion, giddiness, headache, palpitation
On examination the patient showed pallor of the skin and mucous
membranes, tachycardia, glossitis, spooning of the nails.
OSPE
INVESTIGATIONS REVEALED
Haemoglobin : 6 g/100 ml
4.4
R. B. C count : 3 millions/cu.mm of blood
M.C.H.C. : 28%
M.C.V. : 60 cubic microns
WHICH OF THE FOLLOWING SUBJECTS IS MOST LIKELY TO HAVE
OBSTRUCTIVE LUNG DISEASE? -
1)Subject A VC = 5.0 L FEV1 = 4.0L
OSPE
2)Subject B VC = 4.0 L FEV1 = 2.2L 4.7
3)Subject C VC = 2.4 L FEV1 = 2.0L
OSPE
4.6
A 55 years old obese man, complained of headache, giddiness,
irritability for the last two months. On examination by a doctor, OSPE
his BP was found to be 130/100 mm Hg by auscultatory method.
Three days later he visited another doctor. According to him, his 4.9
BP was found to be 170/100 mm Hg after using both palpatory
and auscultatory methods.
OSPE
4.3
Serum bilirubin 4.0 mg%
Unconjugated bilirubin 0.2 mg%
Conjugated bilirubin- 3.8 mg %
Van den bergh test – Direct positive reaction
OSPE
Urine bilirubin – Present 4.12
Urine urobilinogen- decreased
Faecal stercobilinogen absent
Faecal fat level increased
Peripheral blood film- normal
Serum Alkaline Phosphatase increased
OSPE
4.8
OSPE
4.13
A 63 year old woman, suddenly collapsed and became
unconscious and when consciousness returned she was OSPE
unable to move the left arm and leg. 6 weeks later, examination
showed spastic paralysis of the left arm and left leg with increased 4.18
muscle tone and exaggerated tendon reflexes on the same side.
There was left sided facial paralysis involving muscles below the eye.
OSPE
4.15
Normal Values Patient’s value
Total S. T4 3-8 µg/dl 1 µg/dl
Total S. T3 0.15 µg/dl 0.01 µg/dl
OSPE
Free S. T4 2 ng/dl 1 ng/dl 4.16
Free S. T3 0.3 ng/dl 0.01 ng/dl
S.TSH 0.2-5 µIU/ml 58 µIU/ml
OSPE
4.19
A young female complained of abnormal fatiguability of OSPE
muscles. Muscular movements, though initially strong, rapidly
tires as the day advances or after a vigorous exercise. The 4.5
symptoms to appear were ptosis, weakness of chewing,
swallowing & speaking. Remarkable recovery was seen after
injection of Neostigmine intramuscularly.
OSPE
4.14
OSPE
4.20
OSPE
4.10
OSPE
4.1
A 65 year old male came to Emergency Department with
history of sudden onset of central chest pain radiating to
OSPE
left shoulder and left arm. History shows the duration of
chest pain is more than 30 minutes and is exertional. 4.11
There was history of profuse sweating.
ECG shows ST segment elevation
OSPE
4.17
OSPE
4.2
