DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Acquired Methemoglobinemia
Acquired Methemoglobinemia
A 25-year-old woman presented to the emergency department with a 1-day history of generalized weakness, fatigue, shortness of breath, and skin discoloration. She had a respiratory rate of 22 breaths per minute and an oxygen saturation of 88% while breathing ambient air. The oxygen saturation value displayed on the pulse oximeter did not improve with the administration of supplemental oxygen. The patient appeared cyanotic (Panel A), and she had dark arterial and venous blood (Panel B, smaller tube and larger tube, respectively). Measurements of arterial blood gases included a partial pressure of arterial oxygen of 120 mm Hg and a calculated oxygen saturation of 100%; however, when measured by CO-oximetry, the oxygen saturation was 67%. The percentage of methemoglobin was 44%. She was treated with intravenous methylene blue and had considerable improvement in her breathing and reduction in skin discoloration. She reported having used large amounts of topical benzocaine the night before for a toothache. Methemoglobinemia can occur after exposure to a number of medications, including topical anesthetic agents such as benzocaine, through metabolic pathways that appear to vary from person to person, which may account for the unpredictability of this complication. The patient had complete resolution of her symptoms, and she was referred for outpatient dental follow-up.
Dr.Abhinaya
Dr.Abhinaya
in Learning Materials
Ellis van creveld syndrome aka chondroectodermal dysplasia
Ellis van creveld syndrome aka chondroectodermal dysplasia
It is a autosomal recessive condition. EVC gene mutation in chromosome 4 short arm Features : Short limb drawfism Short stature due to metaphyseal dysplasia polydactyly , dysplastic nails and teeth Short ribs and cleft palate Heart abnormalities: M/c : ASD ostium primum Coarctation of aorta Hypoplastic left heart Patent ductus arteriosus
DR.Anupama S B💖
DR.Anupama S B💖
in Learning Materials
PREECLAMPSIA and ECLAMPSIA
PREECLAMPSIA and ECLAMPSIA
Preeclampsia is a condition that begins during pregnancy, usually after the 20th week. However, the symptoms and signs of preeclampsia may persist after delivery, and rarely the condition might not be recognized until after the baby is born. A woman with preeclampsia develops high blood pressure and usually protein in her urine, and she often has swelling (edema) of the legs, hands, face, or entire body. When preeclampsia becomes severe, it can cause dangerous complications for the mother and the fetus. One of these complications is eclampsia, the term used when seizures develop in a woman with severe preeclampsia. Another concern is the higher risk of stroke during pregnancy and after delivery. The best hypothesis is that preeclampsia occurs when the placenta does not anchor itself as deeply as expected within the wall of the uterus during the first trimester. What causes this abnormal anchoring is unclear, but it may be influenced by the mother's or father's genes or the mother's immune system, and medical conditions the mother may have, such as diabetes or high blood pressure. Eclampsia and, especially, death from preeclampsia are very rare in well-resourced countries like the United States. However, even with the best care, preeclampsia is a leading cause of illness for mothers and newborns
Swapneel Birajdar
Swapneel Birajdar
in Case Study
Dignosis...?
Dignosis...?
Suraj Maurya
Suraj Maurya
in Learning Materials
Pancreatic cyst
Pancreatic cyst
Suraj Maurya
Suraj Maurya
in Learning Materials
Schamroth sign
Schamroth sign
Abdirafi Said Elmi
Abdirafi Said Elmi
in Case Study
An amazing case of Purple Urine !! 😮
An amazing case of Purple Urine !! 😮
A 76-year-old male nursing home resident with dementia and end-stage renal disease who was undergoing hemodialysis was admitted to the hospital after a syncopal episode that occurred during dialysis. Torsades de pointes was noted on telemetry monitoring. When a urinary catheter was placed, purple urine was drained. The patient had no fever, lower urinary tract symptoms, or leukocytosis. The urinalysis showed a pH of 9.0 and bacteriuria but no hematuria or pyuria. The urine culture showed 105 colony-forming units or more per milliliter for both Pseudomonas aeruginosa and enterococcus species. Over the next 3 days, the urine gradually became yellow and clear, in the absence of antibiotic treatment. Purple discoloration can occur in alkaline urine as a result of the degradation of indoxyl sulfate (indican), a metabolite of dietary tryptophan, into indigo (which is blue) and indirubin (which is red) by bacteria such as Providencia stuartii, Klebsiella pneumoniae, P. aeruginosa, Escherichia coli, and enterococcus species. The clinical course is benign, and the urine typically clears with resolution of the bacteriuria and acidification of the urine. This patient had no further episodes of torsades de pointes and returned to the nursing home in stable condition.
Chandana.Aluri
Chandana.Aluri
in Discussion | 4 hours ago
Sakshi Modi
Sakshi Modi
in General
Scapula and humerus and clavical
Scapula and humerus and clavical
Fatma R. Badr
Fatma R. Badr
in General
Central retinal artery occlusion
Central retinal artery occlusion
64-year-old woman watching TV when she noticed that her vision had becom dim in her left eye. She felt well otherwise and had no pain. She came to emergency room. Vision was limited to light perception in the left eye but right eye was 6/9.There was a left afferent pupillay defect. The Fundus of the left eye showed narrow vessels, pale retina, macula showed a (cherry red spot) It was a case of CRAO which is sudden unilateral painless loss of vision. Death of the inner half of the retina supplied by CRA occurs in 5-10 minutes and it's irreversible. Treatment was done immediately to lower the intraocular pressure and dilate the artery by: -ocular massage -IV Acetazolamide -Anterior chamber paracentesis -IV streptokinase prognosis is very poor
AshleyCooper
AshleyCooper
in General
Kartagener's Syndrome VS Situs Inversus Totalis
Fatma R. Badr
Fatma R. Badr
in General
MRI of love 😍
MRI of love 😍
MRI of mother kissing her baby. Her kiss has caused a chemical reaction in her baby's brain that released a burst of oxytocin (a hormone that produces feelings of affection and attachment)
Dr. Sáïshă
Dr. Sáïshă
in Case Study
For the correct answer do have a look at the comment section. Thanks.
Time for some Medicine
Time for some Medicine
The clinical finding in the image is most compatible with the Dx of? A. Rocky mountain spotted fever B. Hand foot mouth disease C. Constrictive pericarditis D. Secondary syphilis
Dr. Sáïshă
Dr. Sáïshă
in Learning Materials
Amino acids classification in a jiffy
Amino acids classification in a jiffy
Biochem is no fun without mnemonics.. To me.. 😁
Medicalcortex
Medicalcortex
in General
DX
DX
A 40 Y.O female patient presented to the clinic complaining of lump and pain on the right breast since 2 days, she denies any fever, the skin of the breat is normal (no color or temperature change). The surgeon aspirated this fluid(pus) using syringes which immediately improved her symptoms. The samples were sent for culture & analysis to determine the bacteria. and for cytology to rule out inflammatory breast cancer. She was started on broad spectrum antibiotics and to be followed up in the upcoming days. What do you guys think? what should be done? your DDX?
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Hyperviscosity-Related Retinopathy in Waldenström’s Macroglobulinemia
Hyperviscosity-Related Retinopathy in Waldenström’s Macroglobulinemia
A 60-year-old man presented with a 2-month history of bilateral blurry vision. The best corrected visual acuity was 10/20 in each eye. Funduscopic examination revealed bilateral retinal-vein dilatation and tortuosity with retinal hemorrhages (Panels A and B show the right and left eyes, respectively). Fluorescein angiography revealed retinal-vein beading patterns with multiple aneurysmal changes and vessel-wall staining (Panels C and D). Serum protein immunofixation assay showed prominent monoclonal bands against the antiserum of IgM and kappa light chains. Bone marrow biopsy revealed infiltration of plasmacytoid lymphocytes (10 to 13%) with expression of CD138 and CD20 markers. After seven rounds of plasmapheresis, visual acuity gradually improved to 20/20. Follow-up funduscopic examination revealed resolution of retinal-vein abnormality. Waldenström’s macroglobulinemia is a lymphoproliferative B-cell disorder characterized by the overproduction of monoclonal IgM. Persons with this disorder can present with the hyperviscosity syndrome, which can manifest as vision changes, cutaneous bleeding, and neurologic symptoms. Vascular abnormalities are not uncommon findings in the hyperviscosity syndrome.
Andy Wells
Andy Wells
in General
Anatomical position, planes, movements
Back to basics we're looking at the anatomical position, some anatomical terminology that lets us describe where things are, planes of section through the body, movements and that sort of thing.
Dirty Harry
Dirty Harry
in General
Tricuspid Valve Replacement Using CorMatrix® Extracellular Matrix Cylindrical Construct
This is a video of the authors’ experience with tricuspid valve replacement using the CorMatrix® extracellular matrix cylindrical construct at UC Davis Medical Center.
DR.MOHAMMED IRFAN SHEIKH
DR.MOHAMMED IRFAN SHEIKH
in Case Study
Percutaneous Rotational Pulmonary Thrombectomy
Percutaneous Rotational Pulmonary Thrombectomy
A 77-year-old woman was admitted to the emergency department 4 hours after the sudden onset of chest pain, palpitations, and dyspnea. Her blood pressure was 60/40 mm Hg. An electrocardiogram showed sinus tachycardia, right bundle-branch block, S1Q3T3 pattern, and ST-segment elevation in the inferior leads that mimicked myocardial infarction (Panel A, arrows). Transthoracic echocardiography was performed at the bedside; the right ventricle chamber seemed larger than the left ventricle chamber, with severe tricuspid regurgitation. The patient was brought to the catheter laboratory for evaluation, and her coronary arteries were found to be normal. She received a diagnosis of pulmonary emboli with bilateral extensive thrombi in the proximal pulmonary arteries (Panels B and C, arrows). A 6-French pigtail catheter was advanced into the embolus site and then rotated back to the desired position (Video). Tissue plasminogen activator was subsequently delivered directly into the clot through the pigtail catheter. The patient was given norepinephrine to stabilize her hemodynamic status and then transferred to the intensive care unit. Tissue plasminogen activator was administered over the next 90 minutes, and therapy with unfractionated heparin was initiated. Repeat transthoracic echocardiography performed at the bedside revealed impaired right ventricular function, dilatation of the right chamber of the heart with severe tricuspid regurgitation, elevated systolic pressure of the pulmonary artery (45 mm Hg), and preserved left ventricular function. The next day, the patient had a cardiac arrest as a result of cardiogenic shock due to right ventricular failure and died despite resuscitative efforts.
Sakshi Modi
Sakshi Modi
in General
Knee ligaments
Knee ligaments
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