This patient is a 32-year-old male who presented with intermittent right chest stabbing pain since November 29th. He had a history of COVID-19 infection in September 2021. Imaging showed signs suggestive of chronic pulmonary embolism including Hampton's hump on CXR and enlargement of the right pulmonary artery on CT scan. Echocardiogram also supported chronic thromboembolic pulmonary hypertension. He was treated with 5 days of enoxaparin and then switched to dabigatran. Further workup was suggested to investigate possible causes of thrombophilia. The duration of anticoagulation in chronic thromboembolic pulmonary hypertension is indefinite to prevent recurrent pulmonary embolism.
A pulmonary embolism occurs when a blood clot or embolus travels through the bloodstream and lodges in the pulmonary arteries of the lungs. This case report describes a 29-year old woman who presented with leg swelling, cough, and chest pain. Investigations revealed she had multiple blood clots in her heart and lungs. She was diagnosed with postpartum cardiomyopathy and pulmonary embolism. She received treatment including blood thinners and antibiotics. Her condition improved and she was discharged on oral medications.
This document presents a case report of a 35-year-old man who presented with fever, night sweats, cough, pallor, fatigue, sore throat, anorexia, lymphadenopathy, hepatosplenomegaly, and bone tenderness over 4 months. Initial biopsy suggested Hodgkin's lymphoma but review suggested non-Hodgkin's lymphoma. Further workup found pancytopenia, lymphoblasts on peripheral smear, and nodular lymphoma infiltration on bone marrow biopsy, consistent with a diagnosis of both NHL and autoimmune hemolytic anemia. The diagnostic challenges and treatment considerations for NHL and its association with autoimmune diseases like AIHA are discussed.
This case presentation discusses a 20-year old female patient who presented with worsening right arm and shoulder pain over the past year. Key findings on examination included decreased pulse and sensation in the right upper extremity. Imaging showed thickening of the right radial artery suggestive of vasculitis. The differential diagnoses discussed were Takayasu arteritis, giant cell arteritis, polymyalgia rheumatica, and polyarteritis nodosa. Polyarteritis nodosa was then described in more detail regarding its epidemiology, etiology, clinical manifestations, and laboratory features.
Case presentation No 3 IM group 1 sgd 2 by 211100113.pptxvimrv1
A 71-year-old woman presented with fever, productive cough, and chest pain. Her physical exam revealed mild respiratory distress, decreased breath sounds on the left side of her chest, and a left lower lobe infiltrate on chest X-ray. She has a history of heart failure and smoking. Differential diagnoses included viral pneumonia, tuberculosis, and community-acquired pneumonia. Based on her moderate risk profile, treatment with IV antibiotics and hospital monitoring were recommended. Signs of improvement would include clinical stability allowing for oral antibiotics and discharge.
This case presentation describes a 16-year-old male student who presented with joint pain and swelling involving his left hip, right knee, and both ankles. His symptoms began 12 days prior and migrated between joints. Physical examination found mildly swollen joints with reduced movement due to pain. Investigations showed elevated inflammatory markers, a positive streptococcal antibody test, and ECG changes. He was diagnosed with acute rheumatic fever based on his migrating arthritis, lab results, and supporting investigations. He was treated with antibiotics, aspirin, steroids, and advised long-term antibiotic prophylaxis.
A 45-year-old male presented with severe central chest pain and loss of consciousness. He was found to be in ventricular fibrillation and resuscitated. He was diagnosed with cardiac arrest due to acute myocardial infarction. He underwent percutaneous coronary intervention where a stent was placed in his left anterior descending artery. He was discharged on medical treatment and advised coronary angiography, which later showed single vessel coronary artery disease.
This case involves a 36-year-old Indian woman (DK) newly diagnosed with HIV who presented with fever and progressively worsening back pain. Imaging showed sacroiliitis and she was ultimately diagnosed with disseminated coccidioidomycosis after multiple negative tests. Her symptoms improved with antifungal treatment. The second case involves a 41-year-old transgender woman (Terry) who presented with dysphagia, abdominal pain, and chest pain. Imaging revealed cardiac masses and she was diagnosed with Burkitt's lymphoma involving the heart.
This document provides an overview of congenital heart diseases, including:
1) It discusses the fetal circulation and transitional circulation that occurs after birth when ducts and shunts close.
2) Common congenital heart diseases are classified as acyanotic or cyanotic and examples like VSD, PDA, coarctation, Tetralogy of Fallot are discussed.
3) The epidemiology, pathophysiology, clinical presentation, investigations and general management principles of congenital heart diseases are outlined. Detailed descriptions are provided for VSD, PDA, coarctation and Tetralogy of Fallot.
A pulmonary embolism occurs when a blood clot or embolus travels through the bloodstream and lodges in the pulmonary arteries of the lungs. This case report describes a 29-year old woman who presented with leg swelling, cough, and chest pain. Investigations revealed she had multiple blood clots in her heart and lungs. She was diagnosed with postpartum cardiomyopathy and pulmonary embolism. She received treatment including blood thinners and antibiotics. Her condition improved and she was discharged on oral medications.
This document presents a case report of a 35-year-old man who presented with fever, night sweats, cough, pallor, fatigue, sore throat, anorexia, lymphadenopathy, hepatosplenomegaly, and bone tenderness over 4 months. Initial biopsy suggested Hodgkin's lymphoma but review suggested non-Hodgkin's lymphoma. Further workup found pancytopenia, lymphoblasts on peripheral smear, and nodular lymphoma infiltration on bone marrow biopsy, consistent with a diagnosis of both NHL and autoimmune hemolytic anemia. The diagnostic challenges and treatment considerations for NHL and its association with autoimmune diseases like AIHA are discussed.
This case presentation discusses a 20-year old female patient who presented with worsening right arm and shoulder pain over the past year. Key findings on examination included decreased pulse and sensation in the right upper extremity. Imaging showed thickening of the right radial artery suggestive of vasculitis. The differential diagnoses discussed were Takayasu arteritis, giant cell arteritis, polymyalgia rheumatica, and polyarteritis nodosa. Polyarteritis nodosa was then described in more detail regarding its epidemiology, etiology, clinical manifestations, and laboratory features.
Case presentation No 3 IM group 1 sgd 2 by 211100113.pptxvimrv1
A 71-year-old woman presented with fever, productive cough, and chest pain. Her physical exam revealed mild respiratory distress, decreased breath sounds on the left side of her chest, and a left lower lobe infiltrate on chest X-ray. She has a history of heart failure and smoking. Differential diagnoses included viral pneumonia, tuberculosis, and community-acquired pneumonia. Based on her moderate risk profile, treatment with IV antibiotics and hospital monitoring were recommended. Signs of improvement would include clinical stability allowing for oral antibiotics and discharge.
This case presentation describes a 16-year-old male student who presented with joint pain and swelling involving his left hip, right knee, and both ankles. His symptoms began 12 days prior and migrated between joints. Physical examination found mildly swollen joints with reduced movement due to pain. Investigations showed elevated inflammatory markers, a positive streptococcal antibody test, and ECG changes. He was diagnosed with acute rheumatic fever based on his migrating arthritis, lab results, and supporting investigations. He was treated with antibiotics, aspirin, steroids, and advised long-term antibiotic prophylaxis.
A 45-year-old male presented with severe central chest pain and loss of consciousness. He was found to be in ventricular fibrillation and resuscitated. He was diagnosed with cardiac arrest due to acute myocardial infarction. He underwent percutaneous coronary intervention where a stent was placed in his left anterior descending artery. He was discharged on medical treatment and advised coronary angiography, which later showed single vessel coronary artery disease.
This case involves a 36-year-old Indian woman (DK) newly diagnosed with HIV who presented with fever and progressively worsening back pain. Imaging showed sacroiliitis and she was ultimately diagnosed with disseminated coccidioidomycosis after multiple negative tests. Her symptoms improved with antifungal treatment. The second case involves a 41-year-old transgender woman (Terry) who presented with dysphagia, abdominal pain, and chest pain. Imaging revealed cardiac masses and she was diagnosed with Burkitt's lymphoma involving the heart.
This document provides an overview of congenital heart diseases, including:
1) It discusses the fetal circulation and transitional circulation that occurs after birth when ducts and shunts close.
2) Common congenital heart diseases are classified as acyanotic or cyanotic and examples like VSD, PDA, coarctation, Tetralogy of Fallot are discussed.
3) The epidemiology, pathophysiology, clinical presentation, investigations and general management principles of congenital heart diseases are outlined. Detailed descriptions are provided for VSD, PDA, coarctation and Tetralogy of Fallot.
Approach to a patient with cardiovascular diseasedrfarhatbashir
This document provides guidance on evaluating patients presenting with cardiovascular complaints such as chest pain, shortness of breath, palpitations, syncope, and edema. It emphasizes taking a thorough history as the key to diagnosis, as initial investigations may be normal. Common life-threatening causes of these symptoms include myocardial infarction, aortic dissection, pulmonary embolism, and tension pneumothorax. The document outlines approaches to categorizing different types of chest pain, dyspnea, palpitations, syncope, and edema. It provides diagnostic criteria and recommends focused physical exams and initial tests such as ECG, CXR, and cardiac enzymes.
This document discusses HIV-associated wasting and gastrointestinal opportunistic infections. It begins with an index case of a 28-year-old female diagnosed with HIV two weeks prior who presents with weight loss, diarrhea, cough, and oral thrush. The document then reviews the epidemiology, etiology, clinical presentation, diagnosis, and treatment of HIV-associated wasting and common GI opportunistic infections like candidiasis, cytomegalovirus, and Pneumocystis jirovecii pneumonia. Key findings from the patient's history, exam, and labs are also presented, assessing her for conditions like anemia, candidiasis, and likely PJP.
This document presents a case study of a 28-year-old male who presented to the emergency department with chest pain. His initial troponin level was negative but later increased. His ECG showed ST elevations. He was diagnosed with an ST elevation myocardial infarction (STEMI) based on his symptoms, elevated troponin level, and ECG changes. He was admitted and managed medically with aspirin, clopidogrel, heparin, oxygen, nitroglycerin, and morphine as needed. He had an uneventful recovery and was discharged after 5 days.
CHD 4B Revised Dengue Case Management.pptTineanigra
1) The document provides revised guidelines for the clinical management of dengue cases in the Philippines, outlining classifications, case definitions, disease progression, and treatment recommendations.
2) It describes the typical course of dengue illness as consisting of three phases - febrile, critical, and recovery - and emphasizes the importance of monitoring for warning signs and clinical deterioration during defervescence from fever.
3) Treatment approaches are categorized into three groups: patients who can be sent home with instructions (Group A), those requiring hospital referral for monitoring or comorbidities (Group B), and severe cases needing emergency care (Group C). Home care, discharge criteria, and when to seek medical attention are also outlined.
LAPORAN JAGA SERAFIM ENGLISH 8 Agustus 2022 NY. J.pptyogieirawan1
- A 73-year-old female patient presented with shortness of breath for 3 months. On examination, decreased breath sounds and dullness were found on the right lung. Chest X-ray and ultrasound showed a pleural effusion.
- Diagnostic thoracentesis revealed an exudative pleural fluid. The patient has a history of weight loss and being a passive smoker, placing her at higher risk for lung cancer.
- A preliminary diagnosis of malignant pleural effusion, likely due to lung adenocarcinoma or metastases, was made. Further diagnostic tests such as thoracentesis, biopsy and imaging are planned to confirm the diagnosis.
This document discusses several medical malpractice cases related to cardiology. It summarizes key details from 5 cases:
1. A case involving failure to diagnose an acute myocardial infarction based on electrocardiogram misinterpretation that resulted in a large settlement.
2. A case where a patient presented with wide complex tachycardia that was misinterpreted and treated inappropriately for atrial fibrillation, resulting in cardiac arrest and a settlement.
3. Two cases of missed diagnoses of thoracic aortic dissection, one where a young patient died and another where an older patient died, both resulting in lawsuits.
4. Two cases of missed diagnoses of long QT syndrome, one involving
A 24-year-old woman presented with headache and left-sided weakness. Imaging showed cerebral venous thrombosis involving the superior sagittal sinus and draining veins. She was diagnosed with antiphospholipid syndrome based on recurrent pregnancy loss and positive lupus anticoagulant. She was treated with anticoagulation and anticonvulsants and showed gradual improvement over 10 days with residual mild weakness. Her long-term management plan includes lifelong anticoagulation and screening for recurrent thrombosis.
Grand round presentation on Dieulafoy's lesionsnadiagulnaz
A 78-year-old man presented with syncope and was found to have gastrointestinal bleeding from a Dieulafoy's lesion. He underwent endoscopic clipping of the lesion, but rebled requiring a partial gastrectomy. Dieulafoy's lesions are an uncommon but potentially life-threatening cause of gastrointestinal bleeding, characterized by abnormally large tortuous arteries in the stomach wall. They typically present with hematemesis or melena and are diagnosed and treated endoscopically when possible, but may require angiography, embolization, or surgery for refractory bleeding.
1. This case discusses a 45-year-old female patient presenting with progressive breathlessness, swelling of the lower limbs, and hard nodules on the palms and soles.
2. Differential diagnoses considered include mixed connective tissue disease, lupus, scleroderma, and rheumatoid arthritis.
3. Investigations revealed a strongly positive ANA, elevated markers of inflammation, interstitial lung disease, pulmonary hypertension, and features consistent with calcinosis cutis.
4. The final diagnosis was mixed connective tissue disease with interstitial lung disease, pulmonary hypertension, and calcinosis cutis. Management involves immunosuppressants like corticosteroids and
1) A 45-year-old female presented with progressive breathlessness, swelling of the lower limbs, and hard nodules on her palms and soles.
2) Testing revealed features of multiple autoimmune diseases including a strongly positive ANA, interstitial lung disease, pulmonary hypertension, and calcinosis cutis.
3) She was diagnosed with mixed connective tissue disease based on Sharp's criteria, characterized by overlapping features of systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and polymyositis as well as high titers of anti-U1 RNP antibodies.
Cardiovascular diseases can be congenital or acquired later in life. Common congenital heart diseases include ventricular septal defect (VSD), tetralogy of Fallot (TOF), and transposition of the great arteries (TGA). VSD is the most common congenital heart disease, causing a left-to-right shunt. TOF is characterized by pulmonary stenosis, VSD, overriding aorta, and right ventricular hypertrophy, causing cyanosis. TGA has the aorta arising from the right ventricle and pulmonary artery from the left ventricle, requiring urgent intervention to maintain ductal patency. Physical exams, imaging like echocardiography and chest x-rays, and cardiac
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: January ...Sean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Hepatic Abscess
- Colo-renal Fistula
- Splenic Artery Aneurysm Rupture
Case Report : Integrating Review Inflammation and Commorbid diseasesSoroy Lardo
Diabetes is associated with atherosclerosis and COPD contributed to the chronic inflammation within the systemic vascular. Management of CVI with diabetes and COPD requires multi-disciplinary approach
Management of pulmonary embolism in emergency departmentdrbarai
An short overview of the diagnostic approach and treatment options for Pulmonary Embolism which is a Medical Emergency. In the USA alone about 600,000 people are diagnosed with Pulmonary Embolism every year. However, this is just the tip of the iceberg as many more people have sudden head due to this notorious condition. This Power Point presentation will give you some idea based on my experience in the Emergency Departments in 3 continents of the world.
03. Congenital abnormalities of the cardiovascular system.pptxassefa desalew
The document provides information on common cardiac disorders in neonates. It begins with an overview of normal heart anatomy and physiology. The most common congenital heart defects seen in neonates include ventricular septal defect, atrial septal defect, patent ductus arteriosus, coarctation of the aorta, tetralogy of Fallot, and transposition of the great arteries. Clinical signs, diagnosis, and treatment approaches for each of these conditions are discussed in detail across multiple pages.
Decompensated undiagnosed liver disease 2ry to brucellosis
Lever involvement in brucellosis :
Brucellosis involves the liver in varying ways, ranging from benign subclinical increases in serum aminotransferase levels to chronic suppurative disease
A diagnostic schema is a cognitive tool that allows clinicians to systematically approach a clinical problem by providing an organizing scaffold. A commonly used schema for acute kidney injury (AKI) separates this problem into pre-renal, intrinsic, and post-renal causes. By approaching AKI using these categories, clinicians can systematically access and explore individual illness scripts as potential diagnoses.
The document discusses the evaluation and management of chest pain in primary care settings. It outlines that chest pain is a common complaint accounting for 5-8% of emergency room visits. The most common causes differ based on the healthcare setting, with musculoskeletal and gastrointestinal issues more common in primary care, while serious cardiovascular diseases are more prevalent in emergency rooms. The evaluation involves obtaining a thorough history including characteristics of the pain, risk factors assessment, physical exam, electrocardiogram and cardiac biomarkers to differentiate between urgent versus non-urgent causes and rule out conditions like heart attacks, pulmonary embolisms and aortic dissections. Clinical decision rules can help determine the likelihood of coronary artery disease, myocardial infarction or pulmonary embolism as the cause.
The 22-year-old female presented with sudden severe abdominal pain, renal impairment, and was found to have HBV infection. Renal biopsy showed focal ischemic cortical necrosis and hyalinization consistent with HBV-related polyarteritis nodosa (PAN). She was treated with pulse steroids, antiviral therapy with lamivudine, and hemodialysis, and her renal function improved though remained impaired.
Approach to a patient with cardiovascular diseasedrfarhatbashir
This document provides guidance on evaluating patients presenting with cardiovascular complaints such as chest pain, shortness of breath, palpitations, syncope, and edema. It emphasizes taking a thorough history as the key to diagnosis, as initial investigations may be normal. Common life-threatening causes of these symptoms include myocardial infarction, aortic dissection, pulmonary embolism, and tension pneumothorax. The document outlines approaches to categorizing different types of chest pain, dyspnea, palpitations, syncope, and edema. It provides diagnostic criteria and recommends focused physical exams and initial tests such as ECG, CXR, and cardiac enzymes.
This document discusses HIV-associated wasting and gastrointestinal opportunistic infections. It begins with an index case of a 28-year-old female diagnosed with HIV two weeks prior who presents with weight loss, diarrhea, cough, and oral thrush. The document then reviews the epidemiology, etiology, clinical presentation, diagnosis, and treatment of HIV-associated wasting and common GI opportunistic infections like candidiasis, cytomegalovirus, and Pneumocystis jirovecii pneumonia. Key findings from the patient's history, exam, and labs are also presented, assessing her for conditions like anemia, candidiasis, and likely PJP.
This document presents a case study of a 28-year-old male who presented to the emergency department with chest pain. His initial troponin level was negative but later increased. His ECG showed ST elevations. He was diagnosed with an ST elevation myocardial infarction (STEMI) based on his symptoms, elevated troponin level, and ECG changes. He was admitted and managed medically with aspirin, clopidogrel, heparin, oxygen, nitroglycerin, and morphine as needed. He had an uneventful recovery and was discharged after 5 days.
CHD 4B Revised Dengue Case Management.pptTineanigra
1) The document provides revised guidelines for the clinical management of dengue cases in the Philippines, outlining classifications, case definitions, disease progression, and treatment recommendations.
2) It describes the typical course of dengue illness as consisting of three phases - febrile, critical, and recovery - and emphasizes the importance of monitoring for warning signs and clinical deterioration during defervescence from fever.
3) Treatment approaches are categorized into three groups: patients who can be sent home with instructions (Group A), those requiring hospital referral for monitoring or comorbidities (Group B), and severe cases needing emergency care (Group C). Home care, discharge criteria, and when to seek medical attention are also outlined.
LAPORAN JAGA SERAFIM ENGLISH 8 Agustus 2022 NY. J.pptyogieirawan1
- A 73-year-old female patient presented with shortness of breath for 3 months. On examination, decreased breath sounds and dullness were found on the right lung. Chest X-ray and ultrasound showed a pleural effusion.
- Diagnostic thoracentesis revealed an exudative pleural fluid. The patient has a history of weight loss and being a passive smoker, placing her at higher risk for lung cancer.
- A preliminary diagnosis of malignant pleural effusion, likely due to lung adenocarcinoma or metastases, was made. Further diagnostic tests such as thoracentesis, biopsy and imaging are planned to confirm the diagnosis.
This document discusses several medical malpractice cases related to cardiology. It summarizes key details from 5 cases:
1. A case involving failure to diagnose an acute myocardial infarction based on electrocardiogram misinterpretation that resulted in a large settlement.
2. A case where a patient presented with wide complex tachycardia that was misinterpreted and treated inappropriately for atrial fibrillation, resulting in cardiac arrest and a settlement.
3. Two cases of missed diagnoses of thoracic aortic dissection, one where a young patient died and another where an older patient died, both resulting in lawsuits.
4. Two cases of missed diagnoses of long QT syndrome, one involving
A 24-year-old woman presented with headache and left-sided weakness. Imaging showed cerebral venous thrombosis involving the superior sagittal sinus and draining veins. She was diagnosed with antiphospholipid syndrome based on recurrent pregnancy loss and positive lupus anticoagulant. She was treated with anticoagulation and anticonvulsants and showed gradual improvement over 10 days with residual mild weakness. Her long-term management plan includes lifelong anticoagulation and screening for recurrent thrombosis.
Grand round presentation on Dieulafoy's lesionsnadiagulnaz
A 78-year-old man presented with syncope and was found to have gastrointestinal bleeding from a Dieulafoy's lesion. He underwent endoscopic clipping of the lesion, but rebled requiring a partial gastrectomy. Dieulafoy's lesions are an uncommon but potentially life-threatening cause of gastrointestinal bleeding, characterized by abnormally large tortuous arteries in the stomach wall. They typically present with hematemesis or melena and are diagnosed and treated endoscopically when possible, but may require angiography, embolization, or surgery for refractory bleeding.
1. This case discusses a 45-year-old female patient presenting with progressive breathlessness, swelling of the lower limbs, and hard nodules on the palms and soles.
2. Differential diagnoses considered include mixed connective tissue disease, lupus, scleroderma, and rheumatoid arthritis.
3. Investigations revealed a strongly positive ANA, elevated markers of inflammation, interstitial lung disease, pulmonary hypertension, and features consistent with calcinosis cutis.
4. The final diagnosis was mixed connective tissue disease with interstitial lung disease, pulmonary hypertension, and calcinosis cutis. Management involves immunosuppressants like corticosteroids and
1) A 45-year-old female presented with progressive breathlessness, swelling of the lower limbs, and hard nodules on her palms and soles.
2) Testing revealed features of multiple autoimmune diseases including a strongly positive ANA, interstitial lung disease, pulmonary hypertension, and calcinosis cutis.
3) She was diagnosed with mixed connective tissue disease based on Sharp's criteria, characterized by overlapping features of systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and polymyositis as well as high titers of anti-U1 RNP antibodies.
Cardiovascular diseases can be congenital or acquired later in life. Common congenital heart diseases include ventricular septal defect (VSD), tetralogy of Fallot (TOF), and transposition of the great arteries (TGA). VSD is the most common congenital heart disease, causing a left-to-right shunt. TOF is characterized by pulmonary stenosis, VSD, overriding aorta, and right ventricular hypertrophy, causing cyanosis. TGA has the aorta arising from the right ventricle and pulmonary artery from the left ventricle, requiring urgent intervention to maintain ductal patency. Physical exams, imaging like echocardiography and chest x-rays, and cardiac
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: January ...Sean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Hepatic Abscess
- Colo-renal Fistula
- Splenic Artery Aneurysm Rupture
Case Report : Integrating Review Inflammation and Commorbid diseasesSoroy Lardo
Diabetes is associated with atherosclerosis and COPD contributed to the chronic inflammation within the systemic vascular. Management of CVI with diabetes and COPD requires multi-disciplinary approach
Management of pulmonary embolism in emergency departmentdrbarai
An short overview of the diagnostic approach and treatment options for Pulmonary Embolism which is a Medical Emergency. In the USA alone about 600,000 people are diagnosed with Pulmonary Embolism every year. However, this is just the tip of the iceberg as many more people have sudden head due to this notorious condition. This Power Point presentation will give you some idea based on my experience in the Emergency Departments in 3 continents of the world.
03. Congenital abnormalities of the cardiovascular system.pptxassefa desalew
The document provides information on common cardiac disorders in neonates. It begins with an overview of normal heart anatomy and physiology. The most common congenital heart defects seen in neonates include ventricular septal defect, atrial septal defect, patent ductus arteriosus, coarctation of the aorta, tetralogy of Fallot, and transposition of the great arteries. Clinical signs, diagnosis, and treatment approaches for each of these conditions are discussed in detail across multiple pages.
Decompensated undiagnosed liver disease 2ry to brucellosis
Lever involvement in brucellosis :
Brucellosis involves the liver in varying ways, ranging from benign subclinical increases in serum aminotransferase levels to chronic suppurative disease
A diagnostic schema is a cognitive tool that allows clinicians to systematically approach a clinical problem by providing an organizing scaffold. A commonly used schema for acute kidney injury (AKI) separates this problem into pre-renal, intrinsic, and post-renal causes. By approaching AKI using these categories, clinicians can systematically access and explore individual illness scripts as potential diagnoses.
The document discusses the evaluation and management of chest pain in primary care settings. It outlines that chest pain is a common complaint accounting for 5-8% of emergency room visits. The most common causes differ based on the healthcare setting, with musculoskeletal and gastrointestinal issues more common in primary care, while serious cardiovascular diseases are more prevalent in emergency rooms. The evaluation involves obtaining a thorough history including characteristics of the pain, risk factors assessment, physical exam, electrocardiogram and cardiac biomarkers to differentiate between urgent versus non-urgent causes and rule out conditions like heart attacks, pulmonary embolisms and aortic dissections. Clinical decision rules can help determine the likelihood of coronary artery disease, myocardial infarction or pulmonary embolism as the cause.
The 22-year-old female presented with sudden severe abdominal pain, renal impairment, and was found to have HBV infection. Renal biopsy showed focal ischemic cortical necrosis and hyalinization consistent with HBV-related polyarteritis nodosa (PAN). She was treated with pulse steroids, antiviral therapy with lamivudine, and hemodialysis, and her renal function improved though remained impaired.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
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112/04/28 高雄地區第487次小兒科聯合病例討論會.pdf
1. Chest pain after COVID-19
infection, merely bad luck or the last straw?
許琬宜 廖優美 林佩瑾 邱世欣
高雄醫學大學附設中和紀念醫院 小兒科部 小兒血液腫瘤科
Apr/28/2023
一一二年度高雄地區兒科聯合病例討論會
2. Patient profile
• Gender: male
• Age: 32 year-old
• BW: 59.9 kg
• BH: 170 cm
• Admission date: 2022/Dec/05
• Chief complaint:
• Intermittent right chest stabbing pain
during 11/29-12/01
• Underlying disease
• HbH disease, without regular blood
transfusion, with splenectomy in 2006
• IgA Nephritis with persisted hematuria
and protienuria, CKD stage II
• Cholinergic allergic disease
• Cholecystitis with cholelithiasis, post
cholecystectomy in 2005
• Personal history
• Cigarette smoking, 1 pack per week for
1 year during collage
• Family history
• Grandfather and grandmother: HTN
• Mother: cervical cancer
3. Current Medicine
● Valsartan (Diovan 160mg/Tab), 0.5 Tab PO QD AMPC
● Dipyridamole (Dipyridamole 25mg/Tab), 1 Tab PO BID PC
● Benzbromarone (Nogout 100mg/Tab), 0.5 Tab PO QD HS
● Calcitriol (U-Ca 0.25 mcg/Cap), 1 Cap PO QOD AM
● Zinc gluconate (Zinga 78mg/Tab (Elemental Zn: 10mg)), 1 Tab PO QOD AM
● Buclizine (Buclizine 25mg/Tab), 1 Tab PO BID PC
● Ketotifen (Zatizen 1mg/Tab), 1 Tab PO BID PC
● Methylephedrine (DL-Methylephedrine 30mg/Tab), 1 Tab PO BID PC
4. Brief history
09/21
11/29
COVID-19 infection
Intermittent right chest stabbing pain
→ 他院ER: CXR, 3-day antibiotics for pneumonia
12/02 → 他院Chest OPD : mild right pleural effusion
→ 他院CV OPD : arrange EKG and MRI on 12/07
12/05 KMUH PED HEMA OPD : arrange admission
5. Brief history
09/21
11/29
Exacerbation: position (-), movement(-), breathing (-)
Relief: taking deep breathe gradually without any analgesics
Associated S/S: fever (-), dyspnea (-), orthopnea (-), radiation
pain / numbness (-), edema (-), bodyweight increased/loss (-),
poor appetite (-), fatigue (-), strain injury (-), trauma (-)
COVID-19 infection
Intermittent right chest stabbing pain
→ 他院ER: CXR, 3-day antibiotics for pneumonia
12/02 → 他院Chest OPD : mild right pleural effusion
→ 他院CV OPD : arrange EKG and MRI on 12/07
12/05 KMUH PED HEMA OPD : arrange admission
6. Physical Examination
SpO2:98.0 % BT:36.7 ℃ PR:98.0 bpm RR:20.0 cpm
BP:113/78 mmHg
Consciousness: alert
Conjunctiva: not pale
Sclera/Conjunctiva: anicteric
Neck: supple。
Chest: symmetric movement with respiration
Breath sound:
Right side: clear。 Left side: clear
Other site: not applicable
Heart sound:
Rhythm: regular
S1 and S2: normal S3: absent S4: absent
Murmur: absent Other extra sound: absent
Abdomen:
Inspection: normal
Bowel sound: normoactive
Palpation:
general: soft flat
tenderness: absent
rebound pain: absent
Percussion: normal
Flank knocking pain: absent
General appearance: grossly normal
Edema: absent
22. Final Diagnosis
• Pulmonary embolism
• Inactive disease
• Pulmonary hypertension
• suspect chronic thromboembolic pulmonary hypertension
• HbH disease
• without regular blood transfusion
• with splenectomy when 16 y/o
• Thrombocytosis
• IgA Nephritis with persisted hematuria and protienuria, CKD stage II
• Chronic venous insufficiency in the right popliteal vein
• Resolved event
• COVID-19 infection
• Suspected resolved thrombosis in the left popliteal vein
24. Incidence of venous thromboembolism (VTE) in COVID-19 patients
• 3% in non-ICU hospitalized patients
• 13% in ICU patients
• did not increase in non-hospitalized patients in the subsequent 30 days
Blood Adv. 2020 Nov 10;4(21):5373-5377.
JAMA. 2020 Aug 25;324(8):799-801.
J Emerg Med. 2022 Jun;62(6):716-724
34. In the absence of confirmed or suspected VTE
• All hospitalized adults with COVID-19 should at a minimum receive
pharmacologic thromboprophylaxis, unless the risk of bleeding even on
prophylactic dosing outweighs the risk of thrombosis
• LMWH is preferred over unfractionated heparin (UFH)
• In patients for whom anticoagulants are contraindicated or unavailable,
mechanical thromboprophylaxis (e.g., pneumatic compression devices) can be
used
• ICU patients: standard prophylactic doses of anticoagulants
• Non-ICU patients: therapeutic-intensity anticoagulation
COVID-19-associated coagulopathy
Treatment suggestion
36. Back to our case……
Q1: Old or new pulmonary embolism?
37.
38. Pulmonary embolism diagnosis
• Lab finding
• Unexplained hypoxemia in the
setting of a normal chest
radiograph
• D-dimer
• Negative (<5ng/dL) predictive
value in patients with a low or
intermediate probability of PE
46. Back to our case……
Q1: Old or new pulmonary embolism?
• Chest stabbing pain
• Fluctuated SpO2
• No elevated D-dimer
• CXR: Palla sign (right descending pulmonary artery enlargement)
• Cardiac echo:
• suspect chronic thromboembolic pulmonary hypertension (CTPH)
Hemostasis and Thrombosis Basic
Principles and Clinical Practice 6/E 2012
47. Back to our case……
Q1: Old or new pulmonary embolism?
Q2: The duration of anti-coagulant ?
Hemostasis and Thrombosis Basic
Principles and Clinical Practice 6/E 2012
48. Back to our case……
Q1: Old or new pulmonary embolism?
Q2: The duration of anti-coagulant ?
Hemostasis and Thrombosis Basic
Principles and Clinical Practice 6/E 2012