1. A 60 year old gentleman presents with anaemia, Hb 6.8 gm/dl. Apart from weakness, there are no localizing symptoms or signs. He was diagnosed with myocardial infarction 8 years earlier and remains asymptomatic on atorvastatin and low dose aspirin since the M.I.
(a) What is the likely cause of anaemia in this patient?
(b) Which laboratory investigations are helpful in his management?
(c) What is the appropriate treatment for this condition?
2. A 45 year old gentleman presented in emergency with haemetemesis. Examination revealed massive splenomegaly.
(a) List five differential diagnosis of massive splenomegaly.
(b) What is the most likely diagnosis in this patient?
(c) Which investigations are warranted in the patient described above?
(d) Enumerate the steps in the initial management of this patient in emergency.
3. An 18 year old, unmarried, young lady, highly conscious of her body image develops severe weight loss. She has amenorrhoea since 7 months and her food intake is minimal.
(a) What is the most likely diagnosis?
(b) What is the management in such a case?
4. A 23 year old young man presents to medical emergency with recurrent seizures for 2 days.
(a) Enumerate the points in clinical history and examination that are relevant to the diagnosis.
(b) Which investigations are warranted to arrive at the diagnosis?
(c) List the steps in the management of this patient in emergency.
(d) Name three common diseases that can manifest with recurrent seizures.
5. A 42 year old lady, from rural area has come with hugely distended abdomen, protuberant umbilicus and visible veins. She recently had bleeding per rectum. She has been running low grade fever and cough for long.
(a) Give your differential diagnosis giving five important diagnostic features of each.
(b) Give a flowchart for your approach to this case.
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