MEDizzy - Free medical cases, photos, videos & more

Sarah

in General

Conventional Repair of Supracardiac Total Anomalous Pulmonary Venous Connection

This video demonstrates the conventional repair of total anomalous pulmonary venous connection supracardiac type with low volume crystalloid cardioplegia.

#SURGERY

#SURGEON

#MEDICINE

DR.MOHAMMED IRFAN SHEIKH

in Case Study

Ear Replantation

A 19-year-old woman presented with amputation of her left ear by a pit bull (Panels A and B). The patient's tetanus vaccination and the dog's rabies vaccination were up to date. The ear was débrided and replanted by microvascular anastomosis of a 0.3-mm branch of the posterior auricular artery. Since no suitable veins were found, medicinal leeches (Hirudo medicinalis) provided venous drainage for 17 days (Panel C). Ciprofloxacin was administered as prophylaxis against Aeromonas hydrophila bacteria, which are found in a leech's digestive tract. Aspirin and heparin, followed by enoxaparin, were administered to prevent thrombosis. The patient recovered without complications. The ear did not lose viability, and 24 days postoperatively, a normal appearance had been restored (Panel D); 4 months postoperatively, the result was stable and the normal appearance was maintained. Although advances have been made in bioengineering and allogeneic transplantation of facial structures, replantation of a patient's own tissue is ideal when possible.

Medicalcortex

in General

67 Year old male patient, came to the clinic complaining of shortness of breath, orthopnea since 4 days ago, he denies any fever, weight loss or night sweats. his CXR shows obliteration of the right costophrenic angle due to pulmonary effusion. multiple nodules are noted as well. whats your differential diagnosis?

Orpit A Oyshorj O

in Learning Materials

Bone ☻

#MBBS

#BONE

#SKELETON

Abdullah AlFitouri

in General

Anatomy of heart ❤️

#HEART

#ANATOMY

#GENERAL

J.D.E.

in Learning Materials

Today's topic: intercostal muscles, supporting breathing mechanism and 'closing' intercostal space... Have a good study session today! 🥂👍📚

intercostal muscles

for inhalation: Mm.intercostales externi Mm. intercartilaginei for exhalation: Mm.intercostales interni et intimii Mm.subcostales Mm. tranversus thoracis

#ANATOMY

#INTERCOSTALSPACE

#MEDSTUDENT

DR.MOHAMMED IRFAN SHEIKH

in Case Study

Neonatal Thyrotoxicosis

An infant born after 36 weeks of gestation was admitted to the intensive care unit and treated empirically for sepsis. His mother, who was 22 years of age, had been referred at 31 weeks of gestation for assessment of oligohydramnios. The fetal heart rate was 158 beats per minute. Ultrasonography was repeated every 2 weeks. At 35 weeks of gestation, intrauterine growth retardation was evident. No goiter was noted, and the fetal heart rate was 150 beats per minute. At birth, the boy weighed 1800 g. Apgar scores were normal, but the pulse was 200 beats per minute; no palpable goiter was present. Retraction of the upper eyelids was evident (Panel A), and subcutaneous fat was virtually absent (Panel B). One day after delivery the mother received a diagnosis of Graves' disease (hyperthyroidism). When asked about weight loss, the mother reported an unexplained weight loss of 28 kg during the preceding year, including a loss of 6 kg during pregnancy. Consequently, neonatal thyrotoxicosis was diagnosed in the infant, whose level of thyrotropin was less than 0.01 μU per liter (normal range, 0.5 to 5.0), free thyroxine, more than 70 pmol per liter (5.4 ng per deciliter; normal range, 14 to 30 pmol per liter [1.1 to 2.3 ng per deciliter]), and thyrotropin-binding inhibitory immunoglobulins, 56 U per liter (normal range, <1.5). The boy was treated with propranolol, methimazole, and potassium iodide. Within 5 days, free thyroxine levels normalized and the tachycardia resolved. Levothyroxine was added to the treatment regimen.

Sarah

in General

Awake surgery - Brain tumour

Join Hayley in her journey through awake surgery for a brain tumour. *This video contains real footage of awake surgery so may not be appropriate for all viewers* The technology used to view the tumour is the Synaptive Modus V - a digital robotic exosocope which is the first to be used in the UK, at The Royal London Hospital. This was kindly donated to us by Barts Charity (https://bartscharity.org.uk/).

#AWAKE_SURGERY

#AWAKE_SURGERY_ANESTHESIA

#AWAKE_SURGERY_FOR_BRAIN_TUMORS

#AWAKE_BRAIN_SURGERY

#BRAIN_SURGERY

#BRAIN_TUMOR

#BRAIN_TUMOR_TREATMENT

#HEALTH_CARE_(ISSUE)

#HEALTHCARE_SCIENCE_(FIELD_OF_STUDY)

#NEUROSURGEON

#NEUROSURGERY_(MEDICAL_SPECIALTY)

#BRAINBOOK

#CANCER_TREATMENT

#AWAKE_BRAIN_SURGERY_EXPERIENCE

#AWAKE_DURING_SURGERY

DR.MOHAMMED IRFAN SHEIKH

in Case Study

Reexpansion Pulmonary Edema after Thoracentesis

A 67-year-old-man with advanced alcoholic cirrhosis presented with progressive dyspnea. Chest radiography showed findings suggestive of a large right pleural effusion (Panel A). Since hepatic hydrothorax was suspected, thoracentesis was performed, resulting in the aspiration of 1500 ml of transudative fluid. Four hours later, the patient started coughing and had tachypnea and tachycardia, with right lung crackles heard on physical examination. The oxygen saturation was 82% while he was breathing ambient air. Computed tomography (CT) of the chest showed diffuse areas of consolidation and ground-glass opacity in the right lung (Panel B, arrows), suggestive of reexpansion pulmonary edema. After the patient received diuretics and high-flow oxygen through a reservoir mask, there was progressive improvement in his condition. After 4 days, a complete resolution of radiologic findings was seen on CT (Panel C). Reexpansion pulmonary edema can be a complication of thoracentesis. Treatment is largely supportive. Risk factors for this condition include a young age, a long duration of lung collapse, and rapid reexpansion.

Doctor Bharat Pokhrel

in Case Study

Renal question of the day

Which Kidney is taken during donor transplantation and why?

Muhammad Haris

in Discussion | a day ago

*Common Medical Abbreviations* > *Rx* = prescription > *Hx* = History > *Dx* = Diagnosis > *q* = Every > *qd* = Every day > *qod* = Every other day > *qh* = Every Hour > *S* = without > *SS* = One & half > *C* = With > *SOS* = If needed > *AC* = Before Meals > *PC* = After meals > *BID* = Twice a Day > *TID* = Thrice a Day > *QID* = Four times a day > *OD* = Once a Day > *BT* = Bed Time > *hs* = Bed Time > *BBF* = Before Breakfast > *BD* = Before Dinner > *Tw* = Twice a week > *SQ* = sub cutaneous > *IM* = Intramuscular > *ID* = Intradermal > *IV* = Intravenous > *Q4H* = (every 4 hours) > *QOD* = (every other day) > *HS* = (at bedtime) > *PRN* = (as needed) > *PO or "per os"* (by mouth) > *Mg* = (milligrams) > *Mcg/ug* = (micrograms) > *G or Gm* = (grams) > *1TSF* (Teaspoon) = 5 ml > *1 Tablespoonful* =15ml ~ *DDx* =differential Diagnosis *Tx* =Treatment *RTx* =Radiotherapy *CTx* =Chemotherapy *R/O* =rule out *s.p* =status post *PMH(x)* =post medical history *Px* =Prognosis *Ix* =Indication *CIx* =contraindication *Bx* =biopsy *Cx* =complication...

#COMMON

#ABBREVIATIONS

#MEDICAL

Latifa ALEEMI

in Case Study

A 37-year-old man was referred to the dermatology clinic for evaluation of skin lesions that had been present since birth. On physical examination, two types of lesions were observed: brownish hyperkeratotic papules following Blaschko’s lines (arrowhead) and pigmented papules distributed in a segmental pattern (arrow). Biopsy specimens obtained from the right arm and the left side of the neck indicated that the hyperkeratotic papules were sebaceous nevi and the pigmented papules intradermal melanocytic nevi. An additional biopsy specimen obtained from a lesion on the right forearm (not shown) revealed squamous-cell carcinoma. Genetic testing was performed on both types of nevi and revealed the same HRAS c.181C→A (p.Gln61Lys) mosaic mutation in both samples. A diagnosis of phakomatosis pigmentokeratotica was made. Owing to the increased risk of cancer involving the skin and other organs that is associated with this rare disorder, regular surveillance and cancer screening are important. The patient underwent complete excision of the squamous-cell carcinoma. He remains under regular surveillance.

Medicalpedia

in General

$A patient with lower third leg open fracture with soft tissue loss, covered by gracilis free flap and the result at 5 weeks with complete healing of the wounds.$

A patient with lower third leg open fracture with soft tissue loss, covered by gracilis free flap and the result at 5 weeks with complete healing of the wounds.

Anatomical features of the lower third of the leg like subcutaneous bone surrounded by tendons with no muscles, vessels in isolated compartments with little intercommunication between them make the coverage of the wounds in the region a challenging problem. Free flaps continue to be the gold standard for the coverage of lower third leg wounds because of their ability to cover large defects with high success rates and feasibility of using it in acute situations by choosing distant recipient vessels. The perforators in the lower third leg on which these flaps are based are often damaged during the injury. In medium-sized defects of less than 50 cm(2) size, local transposition flaps, perforator flaps, or propeller flaps can be used. Free flaps continue to be the first choice for coverage of wounds in the lower third leg with gracilis muscle flap for small and medium defects, latissimus dorsi muscle flap for large defects and anterolateral thigh flap when a skin flap is preferred. Credit: Indian Journal of Plastic Surgery Tag a friend and follow us @Medicalpedia for more!

Andy Wells

in General

Far lateral approach for microsurgical ligation of C1 dAVF: surgical anatomy and technical nuances

Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio This video demonstrates the diagnosis and surgical ligation of a C1 dural arteriovenous fistula via a far lateral, transcondylar approach. The patient’s dural arteriovenous fistula was identified by MRI signal changes in the spinal cord and a cerebrospinal angiogram demonstrating an abnormal hypertrophied early venous drainage pattern suggestive of a C1 vessel origin. Indocyanine green was used to verify surgical treatment of the fistula intraoperatively. A postoperative angiogram and MR image demonstrate fistula occlusion and resolution of the spinal cord edema. Anatomic details and technical nuances of the approach are demonstrated. Varun R. Kshettry, MD, Nina Z. Moore, MD, and Mark Bain, MD

#DURAL_ARTERIOVENOUS_FISTULA

#MICROSURGICAL_LIGATION

#FISTULA

DR.MOHAMMED IRFAN SHEIKH

in Case Study

Zosteriform Metastases from Malignant Melanoma

A 30-year-old man with a history of metastatic malignant melanoma presented with painful and itchy papulonodular lesions on the right side of his trunk (Panel A) that had developed over a period of 7 days. A computed tomographic scan showed extensive metastatic disease with necrosis throughout the right axilla and right lateral chest wall. The lesions were adjacent to the site of excision of the primary melanoma. The dermatomal distribution prompted a diagnosis of herpes zoster infection, and acyclovir was administered but with little response. A dermatologist made a diagnosis of zosteriform metastases caused by the metastatic malignant melanoma, although other considerations included postherpetic granulomatous dermatitis and cutaneous sarcoidosis. The patient was treated with vemurafenib, an oral selective BRAF inhibitor, and within 2 weeks after the start of treatment, the zosteriform lesions had dissipated (Panel B). After 140 days of treatment, meningeal metastasis developed, and treatment with vemurafenib was therefore stopped.

#MALIGNANT_HYPERTENSION

#DOCTOR

Doctor Bharat Pokhrel

in Case Study

Biochem Question challenge of the day

A 6-year-old girl presents to your office accompanied by her mother, who is concerned about her daughter’s recent difficulty walking. She states that her daughter was born full term and there were no complications during the pregnancy, but she has had frequent respiratory infections throughout her life. When you ask the girl to stand, you notice that she wobbles from side to side. The eye exam reveals branching blood vessels patterns. What is your diagnosis?

Rufaida Elhouderi

in Discussion | 2 days ago

What is the fastest acting physiological buffer system? 1. Renal 2. Respiratory 3. Chemical 4. Circulatory

IMtɩʌʑ KHʌŋ

in Case Study

Treatment ?

Medfloaters

in General

Medfloaters

#CVS

#PEDIATRICS

#MEDFLOATERS

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