Case 1 (For Roll no 1-10)

1. Omar, a twenty-eight-year-old teacher suddenly suffers intense pain in his

side and lower back whilst at his desk one evening. Deep breathing
helped the pain to subside but discomfort remained. An appointment was
made to see his doctor for the next morning, and during the car journey
Omar again experienced severe pain radiating into his abdomen and
groin, accompanied by nausea. The doctor ordered an abdominal x-ray,
blood samples and a urinalysis. Visible haematuria was noted and
confirmed by urinalysis. Omar was prescribed non-steroidal anti-
inflammatory drugs for his pain, advised to rest and drink four-to-six
pints of water every day. Omar was advised to continue drinking four-to-
six pints of water daily and was also given a list of foods containing
oxalate to avoid. What are your suggestions on this case?

Case 2 (For Roll no 11-20)

Mr. John Smith presented to the emergency department with complaints of

abdominal pain, fatigue, and jaundice for the past two weeks. He reported a
gradual increase in the severity of his symptoms, and his family members had
noticed that his skin and eyes had become increasingly yellow. Mr. Smith had a
history of alcohol abuse, consuming approximately 8 to 10 standard drinks daily
for the past 20 years. Upon examination, the following findings were noted:
1. Jaundice: Mr. Smith's skin and sclera were visibly jaundiced.
2. Abdominal tenderness: There was tenderness in the right upper quadrant
of the abdomen.
3. Splenomegaly: An enlarged spleen was palpable.
4. Spider angiomas: Spider-like blood vessels were observed on the skin.
Liver function tests:
Elevated serum bilirubin levels.
Elevated liver enzymes (AST and ALT).
Decreased albumin levels.
Elevated INR (international normalized ratio), indicating impaired blood
clotting.
Complete blood count:
Mild anemia.
Thrombocytopenia.
Imaging:
Ultrasound showed signs of an irregular liver surface and ascites
(abdominal fluid accumulation).
FibroScan demonstrated liver stiffness

What do you conclude from these results?

 Case 3 (For Roll no 21-30):

Mr. M presented to his primary care physician with complaints of swelling in his legs
and ankles, fatigue, and dark, foamy urine for the past several weeks. He also
mentioned that he had experienced occasional episodes of blood in his urine.
Medical History: Mr. M had been diagnosed with hypertension two years ago, for
which he was taking antihypertensive medication. He had not experienced any
significant illness or infection recently.
Physical Examination: Upon examination, the following findings were noted:
 Peripheral edema: Mr. M had significant swelling in his legs and ankles.
 Hypertension: Blood pressure readings were consistently elevated.
 Decreased urine output: He reported reduced urine output.
 Mild to moderate anemia: Hemoglobin levels were below the normal range.
 Proteinuria: A urine dipstick test showed significant proteinuria, and the urine
appeared foamy.
 Hematuria: Microscopic analysis of the urine revealed the presence of red blood cells.
 Renal function: Blood tests showed elevated serum creatinine and blood urea
nitrogen (BUN) levels, indicating impaired kidney function.
Laboratory Investigations:
 Urinalysis: Abnormal urinalysis indicated hematuria, proteinuria, and red cell casts.
 Kidney function tests: Elevated serum creatinine and BUN levels suggested impaired
renal function.
 Serology: Autoimmune and infectious serology tests were conducted to determine the
underlying cause. Serology tests revealed the presence of anti-glomerular basement
membrane (anti-GBM) antibodies
What do you conclude from the given findings?
Case 4 (For Roll no 31-40 ):
Miss E (Age 12) was brought to the pediatrician's office by her mother with complaints of a
fever, painful swelling of the parotid glands, headache, and discomfort while eating and
drinking. Her mother mentioned that several other children in her school had recently been
diagnosed similar condition.
Medical History: Miss E had no prior history such conditions and was up-to-date on her
childhood vaccinations, including the measles, mumps, and rubella (MMR) vaccine. Her
immunization records indicated that she had received both doses of the MMR vaccine as
recommended.
Physical Examination: Upon examination, the following findings were noted:
 Parotid gland swelling: Bilateral parotid gland swelling was observed, more
prominent on the right side.
 Fever: Miss E had a mild fever.
 Tenderness: She experienced pain and tenderness in the parotid gland region.
 Oral symptoms: Miss E reported discomfort while eating and drinking due to the
pain associated with chewing and swallowing.
Laboratory Investigations: To confirm the diagnosis and rule out other conditions, a
serologic test for the disease-specific IgM antibodies was conducted, which returned positive
results.

What could be your conclusion

Case 5 (For Roll no 41-50)

A women patient is noticed to have difficulty in generating speech at times,

but finds it easier for herself to give simpler answer as it is less frustrating
and effortful, patient herself has noticed progressive balance issues/feeling
unsteady, reduced activity due to fear of falling. The patient suffers several
cognitive deficits related to concentration, communication, and
organization. The patient also demonstrates physical deficits manifested in
psychomotor slowness, poor balance, weakness, and overall slow motor
function, impacting their ability to complete daily activities. The CT scan of
the brain shows the brain lesions typical of the disease including widespread,
microscopic areas of damage to the brain resulting from the thickening and
narrowing (atherosclerosis) of arteries that supply blood to the subcortical
areas of the brain.
Try to diagnose the disease/disorder from the given outcomes.
Note: Besides CT scan, many other tests and parameters were diagnosed for
the patient.