What is the Diagnosis ?

1. What is the diagnosis: a child presents with unilateral ptosis ?

2. What is the diagnosis: C-spine film with a 25 % over-ride ?

3. What is the diagnosis: C-spine film with a 50 % over-ride ?

4. What is the diagnosis: a patient presents with bilateral pinpoint pupils ?

5. What is the diagnosis: ‘brownish-fluid leaking from a wound, with Gm + Rods ?

6. What is the diagnosis: a patient steps on a nail and develops subsequent infection ?

7. What is the diagnosis: a trauma patient has a positive Sudan's stain ?

8. What is the diagnosis: a patient develops nuchal rigidity just after intubation ?

9. What is the diagnosis : upper GI reveals a “stack of coins” ?

10. What is the diagnosis: a dropping fluid level on CXR, s/p pneumonectomy ?

11. What is the diagnosis: esophageal manometry demonstrates an elevated resting LES pressure with non-relaxation during swallowing ?

12. What is the diagnosis: pediatric patient with massive UGI bleeding ?

13. What is the diagnosis: young male with syncopal episode, BP 60/30, HR 40 ?

14. What is the diagnosis: barium swallow demonstrates a “corkscrew esophagus” ?

15. What is the diagnosis: plain radiograph with “double bubble” appearance ?

16. What is the diagnosis: persistent hypocalcemia despite multiple bolus replacements ?

17. What is the diagnosis: RQ > 1.1 ?

18. What is the diagnosis: sudden chest pain during esophageal dilation ?

19. What is the diagnosis: a positive osmotic fragility test ?

20. What is the diagnosis: amyloid deposition on fine needle aspirate of a thyroid nodule ?

21. What is the diagnosis: scimitar sign on angiographic evaluation ?

22. What is the diagnosis: palpable neck mass with hypercalcemia ?

23. What is the diagnosis: elevated airway pressures with decreased urine output ?

24. What is the diagnosis: 8 wk. old male infant with projectile vomiting and dehydration ?

25. What is the diagnosis: 26 yr. old pregnant female with LUQ “egg-shell calcifications” ?

Answers

1. Myasthenia gravis – thymoma
2. Unilateral locked facet
3. Bilateral locked facet
4. Pontine hemorrhage
5. Clostridium perfringens
6. Psuedomonas
7. Fat emboli syndrome
8. Malignant hyperthermia
9. Duodenal hematoma
10. Bronchpleural fistula
11. Achalasia
12. Portal vein thrombosis
13. Vasovagal episode
14. Diffuse Esophageal spasm
15. Duodenal atresia
16. Hypomagnesemia
17. Over-feeding
18. Rule-out MI, likely an esophageal perforation
19. Hereditary spherocytosis
20. Medullary thyroid cancer
21. Popliteal cystic disease
22. Parathyroid cancer
23. Abdominal compartment syndrome
24. Pyloric stenosis
25. Splenic artery aneurysm

Correspondence to

Bradley J. Phillips, MD Dept. of Trauma & Critical Care Medicine Boston Medical Center Boston University School of Medicine CCM 2707 One Boston Medical Center Place Boston, MA 02118 Phone: (617) 638-6406 Fax: (617) 638-6452 Email: bjpmd2@aol.com