Video 1

Abdomen Imaging anatomy   

MCQ 3

A 16 year old youth is brought to the physician by his mother. She claims he has been very depressed lately and attributes this to teasing from school friends because he is so tall.Since he is usually rather impulsive and tends to have bursts of sudden anger ,she is worried he may retaliate violently and get 'into a big fight'. During his childhood he had severe language deficits and very significant academic difficulties .The mother also stated that a genetic study carried out during childhood showed the karyotype to be 47xxy. During the course of examination, he is noted to have a small testes . This boy most likely has

a) Down's syndrome 

b) Klinefelter's syndrome 

c) Turner's syndrome 

d) Edward's syndrome 

e) Marfan's syndrome

Correct Answer: 

b) Klinefelter's syndrome

Explanation:

Klinefelter syndrome is the principal cause of male infertility.
It is found to appear about once in every 500 to one in every 1,000 live born males. The 47XXY complement is the most common chromosomal pattern in persons with Klinefelter Syndrome, although mosaic (i.e. 46XY/47XXY) and variant (i.e. 48XXXY) patterns are also observedAbsence of sperm cells (azoospermia) present in almost all patients. only consistent finding seen in all patients is hypogonadism. Testes is small and atrophied to produce sufficient amounts of testosteroneSpeech and language delay is commonly exhibited by XXY males in early childhood Most XXY males are of normal intelligence, although a somewhat decreased global intelligence has been observed as compared to siblings and controls, which appear related to decreased verbal cognitive skills.
Verbal deficits have consistently been observed in childhood and appear to continue into adulthood.Patient’s mental function is normal. There may be impulse control disorder, depression, emotionally disturbed, personality disorder, learning disabilities, and communicatively impaired.

Increase in length between the soles & pubic bone is characteristic. This is due to the epiphyseal openings near the joints remaining open longer than is typical. One major factor in the closing of the epiphyseal plate is when testosterone reaches the desired adult levels. Insufficient testosterone in the body of an XXY therefore often prompts the epiphyseal plate to stay open longer than average and to promote long bone growth in the limbs and extremities.

MCQ 2

?What is the diagnosis

a ) Lichen planus

b ) Mycosis fungoides

c ) Ostraceous psoriasis

d ) Para-neoplastic pemphigoid

e ) Staphylococcal scalded skin syndrome

Correct answer : c ) Ostraceous psoriasis

Explanation:

These sharply demarcated, erythematous, well-defined limpet-like plaques covered with 

scales and crust are most consistent with ostraceous psoriasis.

MCQ 1

A 45 year old man is referred to a surgeon by his physician because of a swelling in his jaw. The same patient had been regularly visiting his GP with a variety of symptoms,including muscular aches and pains in his arms and legs and abdominal pain. He has a known history of renal calculi. The surgeon suspects the mass in the neck is a Brown's tumour (osteoclastoma).Which of the following biochemical profiles is likely to be elevated?

a) Serum phosphate

b) Serum glucose

c) Serum uric acid

d) Serum amylase

e) Serum calcium

Correct Answer: E

Explanation:

Brown's tumours are found in Primary hyperparathyroidism. Brown tumours (due to 

increased osteoclastic activity) are particularly common in the jaw and mandible Primary

hyperparathyroidism is usually detected by an elevated serum calcium during routine

biochemical screening.