Case Discussion

Left Ureteric Stone

40 years old lady, 3 days history of severe left loin to groin pain, associated with frequent urination and occasional haematuria. She had visited emergency department(ED), and was given pain relieve injection and antacid. Obviously pain persisted and patient came to us for treatment. Per abdomen, no mass felt but pain over left flank and …

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Pulmonary Fibrosis

CASE 1: Pulmonary Fibrosis: 57 years old gentleman, non-smoker, came to us with few weeks history of cough and mild shortness of breath. He has mild fever. No loss of appetite/weight. On examination, both lungs were full of rhonchi, no crepitations. Respiratory rate was around 14/min. Temperature at 37.2C. No recession. Occupational history unsure. Chest …

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Scoliosis

CASE 1: INCIDENTAL FINDINGS OF SCOLIOSIS DURING PRE-EMPLOYMENT CHECK UP: 25 years old lady, came for pre-employment check-up for office work. Incidental noted her to have severe scoliosis. Her job scope mainly confined to desk job, thus this physical condition does not impede her ability to work. She was supposed to have operation done years …

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Pleural Effusion

CASE 1: RIGHT PLEURAL EFFUSION: 47 years old chronic heavy smoker, came with 2 weeks history of right sided chest pain, associated with right top of shoulder pain. He has no cough, but has slight reduced effort tolerance. He has no fever. Unsure about weight loss history. Clinically, reduced air entry over right lower zone. …

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Mediastinal Mass

CASE 1: LIKELY LUNG CARCINOMA/LYMPHOMA: 60 years old gentleman, wit no known medical illness came to us with 2 months history of chronic cough and upper chest discomfort. He has no fever, no shortness of breath, no contact with people with pulmonary tuberculosis. His weight reduced by 3-4 kgs over the course of 2 months. …

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Otoscopy

CASE 1: BILATERAL PERFORATED EAR DRUM SECONDARY TO CHRONIC INFECTIONS: 37-year-old lady, office worker with no history of exposure to loud noise, came to use with bilateral ear discomfort for years. Further history revealed that she had few episodes of recurrent ear infections more than 10 years ago. Otoscopy showed bilateral perforated tympanic membrane. Audiogram …

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Leptospirosis

42-year-old gentleman, came to us with day 6 fever, associated with poor appetite, lethargic. He has no know medical illness. On further questioning, he has history of hiking to Bengoh 2 weeks ago and to Matang a week ago. On examination, he has no jaundice, hydration fair with BP 120/70, HR93/min, no baseline. He is …

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Suspicious ESR Level and Colon Cancer

77-year-old gentleman, underlying hypertension on Tablet Amlodipine 10mg, came to us for bilateral pedal edema for months. Blood test was ordered to investigate the kidney functions. However, incidental noted to have:1) Very high erythrocyte sedimentation rate(ESR) – level >100mm/Hr2) Unexplained iron deficiency anaemia(IDA) He was then referred to tertiary center for further management. Final Diagnosis: …

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