~Spot Diagnoses..

What it means here is diagnosing the patient's condition without asking questions to the patient or relative and not touching or examining him. It is done purely just by standing in front of the bed observe the patient and guess what he has. This comes from experience..

Personally for me, this comes with experience..intuition..and a queer eye

Today is my 2nd day in my last paediatrics posting. We did a lot of spot diagnoses by ourselves..And my friends had the tendency to check if my spot diagnoses will work since they already know the cases

The first case was baby boy who was on a nasogastric tube, wearing diapers, remained in full flxed position in all limbs, head was slightly enlarged and the most prominent feature was the feet all flexed and inverted and the whole body was stiff
My Guess: Cerebral Palsy
Answer: Correct
Then i was asked to tell the age of the boy, and my colleague said 'You will be surprised'
Since he was very looking like only a few months old, i guessed as 2 years old. My friend said wrong. Then i said 6 years old. And he said close..its 7 years old

The second case was a baby boy 1 year 4 months left all alone in the cot.Tongue protuding and other features which pointed out to Down's Syndrome
My guess: Down's Syndrome
Other people guess: Normal baby
Answer: Down's Syndrome

Third patient is a 3 year old girl looking rather obese with periorbital puffiness.Moody. Saw her on my way into the ward
My guess: Nephrotic syndrome.Not remitted--> mEans Steroid Resistant Nephrotic Syndrome
Answer: Steroid resistant nephrotic syndrome..Focal Segmented Glomerularnephritis

Fourth patient was a 5 year old boy with a chipmunk round face. Saw him on my way into the ward
Diagnosis: Thalassemia,
Answer: Thalassemia, came in for blood transfusion

My last patient..left me on cloud nine. A 6 month old baby girl was just admitted. Her bed was next to the cerebral palsy boy. The doctor who brought us for case presentation moved over to this bed and asked us to observe.'Tell me what's wrong with this patient'. All 7 of us were quiet.I observed
Diagnosis: She cant see, doctor
The doctor asked me how do you know?Your friends don't seem to know this
' Her eyes are moving around, not focusing to anything'
The doctor answered' Its called rotatory nystagmus'
Answer: Cortical Blindness

This is the most interesting day for me in the ward:) Cant wait for tomorrow