AMCQ pictures review Part II

Rodius/version2012/v1-draft

Normal CT of brain

Cholelithiasis

Left hypoglossal nerve palsy

Pneumothorax
The presence of a deep, lucent, right costophrenic angle on supine chest radiography is an indirect sign of a pneumothorax. In addition, a pneumothorax with associated rib fractures and subcutaneous emphysema is evident in the right chest.

Ruptured AAA

Acute Subdural Haematoma Demonstrating Midline Shift

Epiglottitis, 'thumb sign'

Seborrheic dermatitis

Relapsing inflammatory skin condition that is characterized by scaling and poorly defined erythematous patches. The scalp is almost invariably affected; other common sites are the face, chest, and intertriginous areas
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Small bowel obstruction

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Melanoma

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Gout

The swelling over the right first distal interphalangeal joint with associated subepidermal, yellow-white material is most consistent with gout. Light microscopy of the expressed substance demonstrated negatively birefringent urate crystals, confirming the diagnosis.
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Acute subdural haematoma

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Secondary syphilis
(nonpruritic, well-circumscribed, scale-covered, erythematous plaques )

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Junctional Tachychardia

Steeple Sign of Croup

A 1-year-old boy presented with a 3-day history of intermittent fever, barking cough, and hoarseness

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Aortic dissection

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Ectopic thyroid
Patient presents with neck mass and hypothyroidism

The supra- and infrahyoid nodules are most consistent with ectopic thyroid tissue. There was no normal thyroid gland in the usual position. Thyroglossal cysts occur in the midline but are only infrequently associated with hypothyroidism

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Right sixth cranial nerve palsy

This patient was trying to look to the right when the pic was taken

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Thoracic aortic aneurysm

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Hand, foot, and mouth disease

This 4-year-old boy presented with a 5-day history of mild fever and malaise and a 3-day history of rash. What is the diagnosis? Caused by coxsackievirus A16 or enterovirus 71. Typical skin lesions are elliptical vesicles surrounded by an erythematous halo

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Keratoacanthoma with typical volcano appearance

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Torsades de Pointes

Varicella (Chickenpox)
Polymorphic rash with vesicles, pustules, and crusty lesions is most consistent with varicella infection.

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Long QT Syndrome

Herpes zoster

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Ulcerating squamous cell carcinoma of the lip

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Mobitz 1

Pericardial effusion

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Secondary syphilis

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Corneal dendrites of HSV

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Aortic aneurysm

CTA shows mild enhancement of the thrombus in the aneurysm, so-called "dense rim sign" which is frequently seen in case of a pending rupture
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Bladder stone

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Meconium-like Ileus in Cystic Fibrosis

A 15-year-old woman with cystic fibrosis presented with a 1 day history of acute abdominal pain. Diagnosis?

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Basal cell carcinoma (BCC)

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Caecal volvulus

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Hyperkalaemia

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Substernal goitre

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Acute Extradural Haematoma

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Herpes zoster

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HYALINE MEMBRANE DISEASE

Differential diagnosis for this film could be: - Meconium aspiration syndrome (newborn would have to be post-term) - Congenital heart disease - Sepsis Premature newborn with respiratory distress - Group B Streptococcus pneumonia
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Left testicular torsion

This 6-week old presented with scrotal pain. What is the diagnosis?

Bilateral hydroceles are present, and the left scrotum is red and swollen. The flashlight test reveals transillumination of a right-sided hydrocele and opacity of the left scrotum. The most likely diagnosis of testicular torsion was confirmed with Doppler ultrasonography.

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Diaphragm
This patient presented following a high-speed motor vehicle crash. Which structure has been disrupted?

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Epidural hematome (lens-shaped)

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Herpes simplex virus infection

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Hypopyon
(pus in the anterior chamber)

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Hypopyon
(a bit more subtle but you cant miss it and this one might make you think so many other things if you dont stop and look at the anterior chamber)

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Mobitz IIa

First degree AV Block

Meconium aspiration

This again, could be either Hyaline Membrane Disease or Meconium Aspiration, so just look at the preterm/post-term condition of the newborn

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Keratoacanthoma (can be pre-SCC!)

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Pneumopericardium

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Ankylosing spondylitis
The radiograph shows extensive calcification of the intervertebral ligaments, bilateral ossification of the outer layer of the annulus fibrosis (forming bony bridges called marginal syndesmophytes), and apophyseal joint ankyloses all gave the appearance of a bamboo spine.

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Tension pneumothorax
Signs of tension The left lung is completely compressed (arrowheads). The trachea is pushed to the right (arrow) The heart is shifted to the contralateral side - note right heart border is pushed to the right (red line) The left hemidiaphragm is depressed (yellow line) Remember If you diagnose a tension pneumothorax clinically do not request an X-ray TREAT THE PATIENT!
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Pneumothorax

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19 year old male with upper chest pain with inspiration for one hour

Pneumothorax

Both inspiration and expiration CXR shown. Very cool to see how obvious the pneumothorax is on the expiration one.
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Multiple Myeloma
typical multiple small punched out lesions of multiple myeloma

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Bronchogenic carcinoma

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Small bowel obstruction

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Multiple loops of distended small bowel with air in the biliary tree (arrow).

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