Q17: I have a voice like Louis Armstrong

A 40-yr old non-smoker presents with hoarseness of voice for the past 2 months. He has a history of total thyroidectomy for thyroid cancer 2 years ago and intubation was difficult.

Q1: Describe the lesion.

Q2: What is the most likely diagnosis?

Q3: What is the theory behind the pathogenesis of this lesion? 

Q16: Multiple discharging sinuses

A 45-yr old man presents with this painful lesion for a month's duration. It started out as a scratch from a fall and has progressed to what it is now.

Q1: What type of skin infection is this?

Q2: What is the best form of treatment?

Q3: What systemic condition might predispose to it and how should it be investigated? 

Q15: Muffled and buzzing

A 50yr-old Chinese man presents with 'fullness' and 'muffled' hearing of the left ear, associated with tinnitus (humming sound) for the past 3 months. He also has blood-stained nasal discharge and a neck swelling on the same side.

What is the name of this common ear condition?

How many signs of this ear condition can you spot on this otoscopic picture of the left tympanic membrane? (What are the others that are not present? There should be at least 10 in all).

What treatment would you offer to this man for his ear condition?

What is the most important underlying condition you must rule out? 

Q14: The ear that weeps

A 35yr-old man injured his right pinna in a fall 1 week ago and applied an antiseptic solution to his ear. Subsequently he developed this painless but itchy lesion.

Q1: Describe the lesion.

Q2: What is your diagnosis?

Q3: How will you treat this condition?

Q13: Whistling in the wind

A 25yo boy complaints of a whistling sound when he breathes. This is the naso-endoscopic picture of his nasal septum.

1. Describe the abnormalities seen.

2. What is your diagnosis?

3. What are the common risk factors underlying this problem?

4. How will you manage this case? 

Q12: Trickling ear

This is the otoscopic view of the left ear of a 35yr-old man presenting with chronic ear muco-purulent discharge for the past 10yrs.

Q1: Describe the abnormalities seen.

Q2: What is the name of this condition?

Q3: Name three theories in the causation of this disease (pathogenesis).

Q11: Hoarse voice, big heart

A 16-yr old girl with chronic pulmonary hypertension presents with hoarseness of voice for 4 months' duration. Above is the view of her larynx through a flexible naso-pharyngo-laryngoscope and an accompanying chest X-ray.

Q1: Describe the abnormalities seen.

Q2: What is the diagnosis based on the laryngeal appearance?

Q3: From the chest X-ray, what do you think is the cause for this pathology?