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DATA INTERPRETATION By Dr. Zahoor.

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Presentation on theme: "DATA INTERPRETATION By Dr. Zahoor."— Presentation transcript:

1 DATA INTERPRETATION By Dr. Zahoor

2 Question 1 1. What is the diagnosis?

3 Answer 1 1. Acute Anterior Myocardial Infarction (deep Q waves, elevated ST segments and T wave inversion are seen in V1 – V5)

4 Question 2 A 60 year old man is admitted unconscious Blood glucose 72 mmol/ Sodium 154 mmol/ Potassium 4.9 mmol/ Bicarbonate 22 mmol/ Total protein 82 g/ Osmolality 405 mmol/kg (NR: ) What is the diagnosis? What treatment you will start?

5 Answer 2 Hyperosmolar hyperglycemic non-ketotic coma
i.v normal saline, half normal saline - i.v insulin infusion 2-6 unit/hour - s.c heparin

6 Question 3 A 60-year old man has the following blood count :
Hb g/dl RBC 8200 × 109 /l (8.2 million/mm3) PCV 65% WBC 21 × 109/l (21 000/mm3) Neutrophils 85% Lymphocytes 15% Platelets 800 × 109/l ( /mm3) ESR 1 mm/hr Leuocyte Alkaline Phosphatase (LAP) score 85/100 neutrophils (NR : 20-70) What is the diagnosis? Give two complications of this condition.

7 Answer 3 Polycythemia Rubra Vera (PRV) Thrombosis Hypertension
Hyperuricaemia and gout

8 Question 4 What is most likely diagnosis? Name two possible causes.
A 26 year old woman is brought into casualty semiconscious. There has been a three month history of weight loss, abdominal pain and general fatigue. The results of her blood and urine tests are shown below. What is most likely diagnosis? Name two possible causes. Na 128 mmol/L K 6.8 mmol/L Urea 14.0 mmol/L Bicarbonate 12.8 mmol/L Urine dipstick Negative for blood, protein and glucose

9 Answer 4 Primary adrenal failure (Addison’s disease) Autoimmune
Tuberculosis

10 Question 5 What is the most likely diagnosis?
A 19-year old woman is referred for investigation of amenorrhea. It has been 12 months since her last period. She has no past medical history and is not on any medication. What is the most likely diagnosis? What investigation you will perform? βHCG 2.0 U/L (normal < 5) FSH 66 U/L (normal 1-10) LH 45 U/L (normal 2.5 – 21) Oestradiol 90 pmol/L (normal mid-cycle)

11 Answer 5 Ovarian failure Laparoscopic ovarian biopsy

12 Question 6 What immediate investigation you will perform?
A 46 year old man is brought to A and E room complaining of severe central abdominal pain radiating to the back and associated with vomiting. Examination shows bruising around the umbilicus. What immediate investigation you will perform? What is the likely cause of acute presentation? Na 144 mmol/L K 5.8 mmol/L Urea 14 mmol/L Bicarbonate 18 mmol/L Calcium 3.60 mmol/L ( ) Phosphate 0.55 mmol/L ( )

13 Answer 6 Serum amylase Acute pancreatitis secondary to hypercalcaemia

14 Question 7 What acid base disturbance is present?
A 34 year old insulin dependent diabetic is found semiconscious by a neighbor. He is a known alcoholic. On examination he is pyrexial at 38.5oC and has coarse criptations at the base of his right lung. What acid base disturbance is present? What is the most likely cause? Na 145 mmol/L K 5.4 mmol/L Urea 10.0 mmol/L Glucose 25.0 mmol/L paO2 7.8 kPa (10.6 kPa) paCO2 7.2 kPa (4.7-6 kPa) Bicarbonate 15 mmol/L pH 7.12

15 Answer 7 Mixed respiratory and metabolic acidosis.
Diabetic ketoacidosis and pneumonia causing respiratory acidosis.

16 Question 8 A 28 year old man is admitted a two day history headache and lethargy. Over the past 12 hour he has pyrexia of 38.4oC. What is the diagnosis? Glucose 5.3 mmol/L Lumber puncture Opening pressure 28 cm CSF Red cells 10/ml White cells 200/ml (85% N) Protein 192mg% (15-40mg%) 2.2 mmol/L (3.5 mmol/L)

17 Answer 8 1. Bacterial meningitis

18 Question 9 What is the cause of the abnormal neurology?
A 56 year old woman is referred for investigation of intermittent diplopia. Further questioning reveals that she often has difficulty with chewing and swallowing towards the end of a large meal. What is the cause of the abnormal neurology? What investigation would you perform to confirm the diagnosis? Hb 9.8 g/dL WCC 4.2 × 109/L Platelets 120 × 109/L CT brain Normal EMG Progressive reduction in amplitude of evoked potentials with repetitive stimulation

19 Answer 9 1. Myasthenia gravis
2. Anti-acetylcholine receptor antibody or tensilon test

20 Question 10 1. What is the most likely diagnosis?
A 28 year old woman has been referred by her GP for investigation of a chronic cough. She has also begun to wake up short of breath at night. Her lung function is shown below. 1. What is the most likely diagnosis? FEV1 (L) 1.85 (actual) (predicted) FVC (L) 3.01 (actual) (predicted) FEV1/FVC (%) (actual) (predicted)

21 Answer 10 1. Obstructive lung disease – Bronchial asthma

22 Question 11 1. What anatomical defect could account for this data?
Following pressure recordings were taken from cardiac catheterization data on a 14 year old boy. 1. What anatomical defect could account for this data? Site Pressure mm Hg RA Mean 8 RV 120/0-8 PA Mean 20 LV 110/0-8 Aorta 110/60 mean 85

23 Answer 11 1. Pulmonary stenosis

24 Thank you


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