Student Corner

Quiz - 90

# ISCCM Hyderabad Quiz 90🧐

An young female was admitted to the icu with respiratory distress over night.

An icu registrar has performed emergency procedure but the patient continued to be dyspneic.

  • Q1. What are the various findings on X-ray❓
  • Q2. What has gone wrong with the procedure❓

Quiz - 89

# ISCCM Hyderabad Quiz 89🧐

  • Q1. Identify the the tracing in pic 1️⃣❓
  • Q2. What’s the machine being shown in pic2️⃣❓
  • Q3. Who’s the person in pic 3️⃣❓
    How is he related to 1️⃣ and 2️⃣❓

Quiz - 88

# ISCCM Hyderabad Quiz 88🧐

You are reviewing the X Ray of a patient in surgical ICU who’s admitted with polytrauma.

  • Q. What are the various findings on X-ray including lines and tubes ❓

ETT is virtually at the level of the carina and should be withdrawn. Nasogastric tube is in the stomach.

Left intercostal catheter at tip is against the mediastinum and left Pneumocath tip is projected over the heart.

Small bilateral pneumothoraces are present together with multiple bilateral rib fractures.

No right sided intercostal catheter is seen.

Elevated left hemidiaphragm.

Quiz - 87

# ISCCM Hyderabad Quiz 87🧐

  • Q1. Who’s the famous Greek philosopher in the painting pic 1️⃣ and what’s happening there❓
  • Q2. What’s the plant being shown in pic 2️⃣❓
  • Q3. How are both the pictures 1️⃣& 2️⃣ relevant to the “Field of Toxicology” ❓

Ans1- The famous greek philosopher in the painting was Socrates and he is being given the poison Hemlock as a part of death sentence.

Ans2- the plant is Conium maculatum known as hemlock.

Ans3- 1️⃣ & 2️⃣ shows one of the most famous poisons killing a one of the most famous philosophers.

Quiz - 86

# ISCCM Hyderabad Quiz 86

  • Q. 64 year old male admitted in SICU post op.
    What are the findings in his chest X ray in pic❓

This is a Xray of patient who had Esophagectomy and gastric pull-up performed on the same day earlier.

CXR was done to assess position of central venous catheter, chest drains, and endotracheal tube.

Double lumen endotracheal tube should not be misdiagnosed as ET being malpositioned.

Quiz - 85

# ISCCM Hyderabad Quiz 85

  • Q. 65 year old female admitted in ICU.
  • Q1. What are the findings in her chest X ray in pic❓
    what’s your first step after seeing the X-ray ❓

Ans.1- XRay of female shows

1. right bronchial intubation with complete opacification of the left lung
2. an unusual course of the left subclavian central venous access malpositioned in the left internal mammary vein.

Ans.2- Repositioning of the ETT and chest drainage tube.

Quiz - 84

# ISCCM Hyderabad Quiz 84

  • Q1. Identify the famous physiologist who passed away on this date of 3 rd April 20 years back❓
  • Q2. Why is he considered among the greatest in cardiovascular physiology❓
  • Q3. What’s the name of the physiology text book written by him and why is it unique in the history of medical publishing❓

Ans.1- Arthur C Guyton.

Ans.2- His research which include more than 600 papers and 40 books led to understanding of most of the cardiovascular disorders like Hypertension, heart failure and others.

He pioneered the concepts of CO, venous return, interstitial fluid pressure, fluid volumes, blood flow auto regulation, renal pressure natriuresis and long term blood pressure regulation.

Ans.3- Textbook of Medical physiology. It’s the best selling physiology textbook in world translated into 15 languages.

Unlike most major textbooks, the first eight editions of the book were written entirely by Dr Guyton which is unprecedented in any medical text.

Quiz - 83

# ISCCM Hyderabad Quiz 83

  • 1️⃣. Identify the great person who has recently passed away.❗️
  • 2️⃣. What is he famous for which he was recognised by Guinness book of world records ❓
  • 3️⃣. What was the famous book written by him ❓

Ans.1- Paul Richard Alexander. An paralytic polio survivor, lawyer and writer.
He was the last man to live in an “Iron Lung”.

Ans.2- He has been recognised by Guinness world records as the person who has spent longest time living in iron lung.

Ans.3- Three Minutes For A Dog, My life in an Iron lung. He has spent more than 8 years writing the book using a plastic stick and pen to tap out on a keyboard or by dictating the words to nurse Norman D.Brown, his friend.

Quiz - 82

# ISCCM Hyderabad Quiz 82

  • Q. 75 year old female with history of RTA in ICU.
  • What are the findings in her chest X ray in pic1️⃣❓what’s the clinical relevance to the findings❓

Ans.- Multiple bilateral rib fractures seen laterally and right subcutaneous emphysema including gas tracking in the right pectoralis muscle.

Bilateral intercostal catheters have been inserted.

The patient is intubated with the endotracheal tube tip almost at the level of the carina. This should be pulled back a few centimetres for ideal positioning.

While the superior mediastinum appears widened and the aortic knuckle is poorly seen this does not necessarily imply mediastinal haematoma as the patient is supine and significantly rotated.

There is however the suggestion of left apical pleural capping which can be a feature of aortic injury.

Subsequent CT revealed a normal mediastinum and small volume extra-pleural haematoma at the lung apices due to first rib fractures.

Quiz - 81

# ISCCM Hyderabad 🎅 Christmas special Quiz 81

  • Identify the pictures and the medical diseases related to them 🧐❗️
  • Clue- All are related to the name christmas 😀

Quiz - 80

# ISCCM Hyderabad Quiz 80

  • A 75 year old gentleman presented with shortness of breath, significant weight loss and Pruritic migratory rash as shown in pic 1️⃣.
  • What’s the rash showed in pic 1️⃣ ❓
  • What does his imaging show in pic2️⃣❓
  • What’s the diagnosis of patient ❓

Ans.- He had erythematous skin lesions that appeared in concentric, raised, serpiginous bands, with desquamation.
The rash affected mainly the trunk and proximal extremities.

clinical diagnosis - erythema gyratum repens

CT scan shows a pulmonary mass measuring 59 by 43 mm.

Bronchoscopy with biopsy revealed squamous-cell carcinoma of the lung

Erythema gyratum repens is a rare syndrome typically associated with an underlying malignant condition. It occurs most frequently in conjunction with lung cancer and next most frequently with esophageal and breast cancer.