حالـــة طبية و تشخيص , (لعبة مسلية  خيارات

[أكرم أحمد]

* the last case of patient with :
d- Wilson's disease

* the yellow brown circle in the limbus of cornea is called :
A Kayser-Fleischer ring

as here :
.

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wait the next others with :
Akram

[أكرم أحمد]

A very easy case without complexity :



* A newborn infant suffered from respiratory distress. The abdomen was unusually flat and intestinal peristaltic movements were heard over the left side of the thorax.
What congenital anomaly would you suspect ?


.
--
Akram

[الاسلام هو الحل]

A very easy case without complexity :



* A newborn infant suffered from respiratory distress. The abdomen was unusually flat and intestinal peristaltic movements were heard over the left side of the thorax.
What congenital anomaly would you suspect ?


.
--
Akram

conginetal diaphragmatic hernia

[أكرم أحمد]

true
* it is case of cong diaphragmtic hernia
thanx


.

[أكرم أحمد]

think :

A 34-year-old man has suffered severe head trauma in a motor vehicle accident

. Which of the following precautionary treatments would be most appropriate:

A. Hyperventilation
B. Hypoventilation
C. Intravenous hypotonic saline
D. Intravenous thiamine
E. Lumbar puncture

* why .....!!



.
Akram .

[الاسلام هو الحل]

think :

A 34-year-old man has suffered severe head trauma in a motor vehicle accident

. Which of the following precautionary treatments would be most appropriate:

A. Hyperventilation
B. Hypoventilation
C. Intravenous hypotonic saline
D. Intravenous thiamine
E. Lumbar puncture

* why .....!!



.
Akram .

reduces carbon dioxide levels and causes blood vessels to constrict
this decreases blood flow to the brain and
reduces ICP
but it causes ischemia and is therefore only used in the short term

[أكرم أحمد]

reduces carbon dioxide levels and causes blood vessels to constrict
this decreases blood flow to the brain and
reduces ICP
but it causes ischemia and is therefore only used in the short term

that is right ...
and u r excellent
and for more explanation to this case :

*In patients with head trauma, you would want to prevent the formation of cerebral edema and increased intracranial pressure.
Hyperventilation(A) is often used to produce a respiratory alkalosis, which in turn produces vasoconstriction and reduces the permeability of cerebral vasculature. This helps to mitigate the formation of cerebral edema.

* Hypoventilation (B )is false : because would produce a respiratory acidosis and result in vasodilation and increased permeability, exacerbating any potential edema.

IV hypotonic saline ( C ) is false : because would likely worsen cerebral edema.

IV thiamine (D)= false : is used to treat Korsakoff's syndrome, which results from a thiamine deficiency often associated with long-term alcoholism.

Lumbar puncture (E) is contraindicated ,,,,

in patients with head trauma, as a sudden decrease in pressure within the spinal canal may cause herniation.....

-----

akram

[أكرم أحمد]

A 63 year old man with a history of myocardial infarction is doing an
echocardiogram to assess the ejection fraction of his left ventricle. It is discovered that the patient has a dilated left atrium with a visible wall thrombus. He is then started on anticoagulation therapy.
Which of the following organs will receive a white (pale) infarct if the left atrial thrombus embolizes?
. A. Lung
B. Large intestine
C. Liver

D. Kidney
E. Small intestine

!!!


----

Akram

[أكرم أحمد]

D. Kidney

* An infarct describes an area of tissue undergoing coagulative necrosis resulting from decreased blood supply.Embolization of a thrombus can occlude arterial vessels, resulting in infarcted tissue in various organs. Infarcts can be classified into either red (hemorrhagic) infarcts or white (pale) infarcts based upon their gross appearance on pathology.

Red infarcts usually occur in loose tissues with collateral circulation or following reperfusion of the infarcted tissue!! .

Pale infarcts usually occur in solid tissues with a single blood supply. Of the listed organs, only the kidney (choice D) has a single blood supply without collateral circulation.
Liver (choice C), Lung (choice A), Small Intestine (choice E), and Large Intestine (choice all have more than one blood supply. An infarct in these tissues would tend to be grossly red on pathological examination...

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good night and nice dreams

Akram

[أكرم أحمد]

another case:

.

An elderly Latino man comes to your clinic for a follow-up visit. He reports increased urination since last month, when you prescribed furosemide for his hypertension. He shows you his blood pressure diary, which shows a marked improvement in his blood pressure. However, he mentions that his heart feels like it is beating irregularly at times.

What side effect of furosemide is probably causing this symptom?

A. Dehydration
B. Hyperkalemia
C. Hyponatremia
D. Hypokalemia
E. Hypomagnesemia

!!

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Akram

[روبن هود]

another case:

.

An elderly Latino man comes to your clinic for a follow-up visit. He reports increased urination since last month, when you prescribed furosemide for his hypertension. He shows you his blood pressure diary, which shows a marked improvement in his blood pressure. However, he mentions that his heart feels like it is beating irregularly at times.

What side effect of furosemide is probably causing this symptom?

A. Dehydration
B. Hyperkalemia
C. Hyponatremia
D. Hypokalemia
E. Hypomagnesemia

!!

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Akram

hypokalemia

so its preferred to take k supplementation or use k sparing drug as spironolactone


akram u r a good one

[الاسلام هو الحل]

ايوه كده يا ودييييييييييع
مستنيين القادم اكرم باشا

[أكرم أحمد]

lympho :
really , the side effect in the case is hypokalemia ( D )
and for information :
*Furosemide is a loop diuretic that inhibits the Na-K-2Cl co-transporter in the thick ascending loop of Henle in the kidney.
It can cause dehydration and electrolyte depletion, particularly potassium .

* Signs of hypokalemia include
cardiac arrhythmias,
muscular weakness,
muscle cramps,
constipation.

More severe hypokalemia can lead to
flaccid paralysis,
hyporeflexia,
tetany.

The hypokalemic effects of furosemide can be reversed with a potassium-sparing diuretic like spironolactone as u say


thanx
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islam is the solution :

[أكرم أحمد]

:



A young woman develops a high fever 2 days after menses . She reports using tampons .
after several days , the fever is accompanied by dizziness , hypotension , myalgias and a diffuse rash on the chest .With a pinicillinase-resistant penicillin and IV fluids , the symptoms resolve within 2 weeks. A desquamation of the palms is observed throughout the convalescence .

according to the previous symptoms and treatment , what is your diagnosis?the cause of that disease ?


-----------
Akram

[الاسلام هو الحل]

:



A young woman develops a high fever 2 days after menses . She reports using tampons .
after several days , the fever is accompanied by dizziness , hypotension , myalgias and a diffuse rash on the chest .With a pinicillinase-resistant penicillin and IV fluids , the symptoms resolve within 2 weeks. A desquamation of the palms is observed throughout the convalescence .

according to the previous symptoms and treatment , what is your diagnosis?the cause of that disease ?


-----------
Akram

Toxic shock syndrome (TSS
due to toxin-producing strains of Staphylococcus aureus

[أكرم أحمد]

Toxic shock syndrome (TSS
due to toxin-producing strains of Staphylococcus aureus

this is right

* Toxic Shock Syndrome...

It's associated with tampon use by menstruating women...

It's caused by infection with staph.aureus which produces toxins or by streptococcus pyogenes.!

thanx..

[أكرم أحمد]

another case :

A 18 year –old female is brought to emergency department because of increasing drowsiness and inattentiveness. Her family tell you that she take a medication for epilepsy and may have taken an extra dose that day. ON examination : she has an ataxia gait , nystagmus, gingival hypertrophy…..

*what medication does she take :
1- Phenytoin
2- Carbamazepine
3- Ethosuxamide
4- Valproic acid..


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AKram

[الاسلام هو الحل]

another case :

A 18 year –old female is brought to emergency department because of increasing drowsiness and inattentiveness. Her family tell you that she take a medication for epilepsy and may have taken an extra dose that day. ON examination : she has an ataxia gait , nystagmus, gingival hypertrophy…..

*what medication does she take :
1- Phenytoin
2- Carbamazepine
3- Ethosuxamide
4- Valproic acid..


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AKram

[أكرم أحمد]

right
-----------------------


* the correct answer is 1- Phenytoin
* and these some information about it:
Action Appears to act at motor cortex in inhibiting spread of seizure activity.
Possibly works by promoting sodium efflux from neurons, thereby stabilizing threshold against hyperexcitability. Also decreases post-tetanic potentiation at synapse.
Indications Control of grand mal and psychomotor seizures; prevention and treatment of seizures occurring during or after neurosurgery; control of grand mal type of status epilepticus (parenteral administration).
*
Contraindications: Hypersensitivity to phenytoin or other hydantoins; sinoatrial block; sinus bradycardia; second- and third-degree atrioventricular block; Adams-Stokes syndrome.





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