OSPE : Clinical ImagingProf. Dr M Azizul Kahhar

Department of Medicine

Anwer Khan Modern Medical College

Dhanmondi, Dhaka

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A 42-year-old female presented with6-month history of persistent drycough and 3-month history ofprogressively deteriorating dyspnea.She has a 1-year history of colourchanges of both hand on exposureto cold.

1. Name the modality of the image.

2. Mention three radiologicalchanges.

3. What is the most importantclinical sign you look for?

4. List three antibodies associatedwith this condition?

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A 65-year-old smoker presentedwith 4 months history of cough withstreaky hemoptysis, progressivedyspnea, 13-kg weight loss, and 1-week history of chest pain. He hadPTB treated successfully 30 yearsback.

1. Mention four radiological signspresent in the chest film.

2. What is your radiologicaldiagnosis?

3. What could be the most likelyunderlying cause?

4. List five investigations you cando to reach a diagnosis?

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A 70-year-old male, smoker with ahistory of myocardial infarction withcomplete heart block followed bypacemaker implantation 10 years agopresented with a 10-day history ofrecurrent syncope. Study the chest filmand answer the following questions.

1. Identify three radiological signs.

2. Mention four importantcomplications that may beassociated with the presentcondition

3. Suggest five investigations.

4. How to plan the next step ofmanagement?

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A 55-year-old rich businessmanwith a 3-year history of type 2diabetes mellitus controlled withmetformin and sitagliptinpresented with 4-hr history ofsevere upper abdominal pain. Thisis contrast-enhanced CT abdomendone on 13th day of admission.

1. Identify two radiological signs

2. Mention three possibleunderlying causes.

3. List three impending localcomplications.

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A 30-year-old femalepresented with 6-monthhistory of dry cough, 2-monthhistory of progressivedyspnea, and 6-week historyof hand pain.

1. Identify three importantradiological signs

2. Mention three furtherclinical signs would youlook for ?

3. List two immunologicalmarker of this disease?

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A 38-year-old religious muslimhouse-wife, presented with 6-month history of progressivelygeneralized pain and weakness,& difficulties in standing fromsitting position.

1. What does the x-ray show?

2. List four investigations toconfirm the clinicaldiagnosis?

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A 24-year-old womendeveloped ataxic nystagmusafter 1 month of delivery ofher 1st baby. 5 days after,she developed weakness ofall four limbs and urinaryretention.

1. Mention two diagnosticradiological features.

2. What is your diagnosis?

3. List two otherinvestigations tosupport your diagnosis.

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A 71-year-old manpresented with 2-monthhistory of intermittent dullaching lower abdominalpain.

1. Identify two radiologicalsigns.

2. List three possiblecomplications of thiscondition

3. What furtherinvestigation would yousuggest?

4. Mention next step ofmanagement

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A 33-year-old man presented with10-day history of swinging feverwith sweating, right upperabdominal discomfort.

1. Mention the modality ofimaging.

2. What is the abnormality in theimaging?

3. List five investigations toestablish the diagnosis.

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A 63-year-old man presentedwith 1-week history of graduallyprogressive right sided weaknessand disorientation

1. Identify two radiologicalsigns?

2. List four important commonprecipitating factors?

3. Mention four importantsteps of management in brief.

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A 54-year-old man with a longstanding bronchial asthmapresented with exacerbation at theharvesting season. He has a 6-month history of progressivedyspnea and 3-week history ofproductive cough and fever.

1. Mention three radiological signspresent in this HRCT scan?

2. What is the most likelydiagnosis?

3. List four lab markers of thedisease.

4. Mention two most importantpharmacological management.

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A 60-year-old female,presented with 30-yearhistory of multiple joint pain,now on spontaneousremission for the last 6months. Study the x-ray andanswer the followingquestions

1. Identify four radiologicalsigns

2. What is the most likelydiagnosis?

3. Mention 3 options forfurther management