Medical student shadowing - lumbar disc herniation (L5S1)
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The patient has been experiencing severe burning pain in their right lateral lumbar region for 5 months. Associated symptoms include pain and numbness radiating down the right leg. Physical examination and imaging showed an L5S1 disc protrusion compressing the right S1 nerve root, consistent with lumbar disc herniation. Treatment includes lidocaine injections, B vitamins, topical gels, and a pepper plaster with no relief of symptoms.
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This document discusses Wilson's disease, an autosomal recessive genetic disorder that causes copper to accumulate in the liver, brain, and other vital organs. Key points include:
- It is caused by mutations in the ATP7B gene which reduces copper excretion from the liver. This leads to copper deposition and toxicity.
- Presentations can vary greatly from patient to patient but include liver disease, neurological symptoms, and psychiatric issues.
- Diagnosis involves testing for low ceruloplasmin levels, elevated urine/liver copper, and Kayser-Fleischer rings on eye exams. Liver biopsies can also detect high copper levels.
- Treatment options are medications that promote copper excretion
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This clinical case study describes a 16-year-old boy presenting with fever, vomiting, headache, and convulsions. His past medical history is significant for bilateral cataracts, recurrent convulsions since age 10, headaches, weakness, and reduced growth. Physical exam reveals wasting, hypotonia, areflexia, and pseudophakia. Investigations show features of Fanconi syndrome including metabolic acidosis, hypokalemia, hyperchloremia, proteinuria, and glucosuria. Radiographs show reduced bone density. The constellation of findings are consistent with Lowe syndrome, a rare X-linked condition causing Fanconi syndrome, cataracts, and neurological impairment.
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Wilson's disease is a genetic disorder caused by a mutation on the ATP7B gene that results in too much copper being absorbed and retained in the body's organs like the liver and brain. It is typically diagnosed through tests measuring copper levels in the blood and liver tissue. Lifelong treatment focuses on removing excess copper through medication or transplant and preventing further copper absorption through diet.
lowe-syndrome poster
Lowe syndrome is a rare genetic disorder caused by mutations in the OCRL1 gene. It primarily affects males and causes eye, kidney, and central nervous system problems. The main symptoms are cataracts, glaucoma, renal Fanconi syndrome resulting in loss of substances in the urine, and neurological issues like developmental delays. While there is no cure, treatment focuses on managing symptoms like replacing lost substances, eye drops or surgery for glaucoma, and tube feeding for nutritional issues. More research is still needed to fully understand the disease mechanisms.
6. fernandez wilson's disease
Wilson's disease is a genetic disorder that causes copper to accumulate in the body's tissues. It manifests as neurological or psychiatric symptoms and liver disease. Common signs include tremors, easy bruising, jaundice, and behavioral changes. Kayser-Fleischer rings, which are dark rings around the iris, can indicate copper deposition in the liver. Dentists must take precautions with patients who have Wilson's disease due to risks like tremors during procedures and potential drug interactions. The disorder is caused by mutations in the ATP7B gene.
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This document discusses Wilson's disease, an autosomal recessive genetic disorder that causes copper to accumulate in the liver, brain, and other vital organs. Key points include:
- It is caused by mutations in the ATP7B gene which reduces copper excretion from the liver. This leads to copper deposition and toxicity.
- Presentations can vary greatly from patient to patient but include liver disease, neurological symptoms, and psychiatric issues.
- Diagnosis involves testing for low ceruloplasmin levels, elevated urine/liver copper, and Kayser-Fleischer rings on eye exams. Liver biopsies can also detect high copper levels.
- Treatment options are medications that promote copper excretion
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This clinical case study describes a 16-year-old boy presenting with fever, vomiting, headache, and convulsions. His past medical history is significant for bilateral cataracts, recurrent convulsions since age 10, headaches, weakness, and reduced growth. Physical exam reveals wasting, hypotonia, areflexia, and pseudophakia. Investigations show features of Fanconi syndrome including metabolic acidosis, hypokalemia, hyperchloremia, proteinuria, and glucosuria. Radiographs show reduced bone density. The constellation of findings are consistent with Lowe syndrome, a rare X-linked condition causing Fanconi syndrome, cataracts, and neurological impairment.
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lowe-syndrome poster
Lowe syndrome is a rare genetic disorder caused by mutations in the OCRL1 gene. It primarily affects males and causes eye, kidney, and central nervous system problems. The main symptoms are cataracts, glaucoma, renal Fanconi syndrome resulting in loss of substances in the urine, and neurological issues like developmental delays. While there is no cure, treatment focuses on managing symptoms like replacing lost substances, eye drops or surgery for glaucoma, and tube feeding for nutritional issues. More research is still needed to fully understand the disease mechanisms.
6. fernandez wilson's disease
Wilson's disease is a genetic disorder that causes copper to accumulate in the body's tissues. It manifests as neurological or psychiatric symptoms and liver disease. Common signs include tremors, easy bruising, jaundice, and behavioral changes. Kayser-Fleischer rings, which are dark rings around the iris, can indicate copper deposition in the liver. Dentists must take precautions with patients who have Wilson's disease due to risks like tremors during procedures and potential drug interactions. The disorder is caused by mutations in the ATP7B gene.
Erection physics witkov modification
Erectile dysfunction is a growing problem that affects over 150 million men worldwide. It is caused by various vascular, neurological, endocrine, psychological, and pharmacological factors that can impair blood flow or nerve signaling in the penis. Common medical treatments include phosphodiesterase type 5 inhibitors like sildenafil (Viagra), which help maintain blood flow; penile injections; vacuum devices; testosterone replacement therapy; and penile implants. Counseling may also help address psychological aspects.
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Acute liver failure with hemolysis
This document summarizes a case discussion of a 10-year-old female patient presenting with acute liver failure and hemolysis who was potentially in need of a liver transplant. The patient had symptoms for 4 weeks and was initially evaluated at a nearby hospital before being referred for further evaluation. On examination, she had pallor, icterus, periorbital puffiness, distended abdomen, and enlarged liver and spleen. Investigations showed abnormal liver function tests and signs of hemolysis. Based on further testing, she was diagnosed with Wilson's disease. Due to developing grade 2 encephalopathy, she underwent living-related liver transplantation with her mother as the donor. She recovered well after the transplant.
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Niemann-Pick Disease Type A (NPD-A) is a genetic metabolic disorder. It is a rare disease which occurs largely in certain ethnic groups. Due to its rarity, it is difficult to diagnosis and considered untreatable by Western medicine. Based on the theory, diagnosis and therapeutic methods of Traditional Chinese Medicine (TCM) Pediatrics, the author has implemented a regular course of herbs, acupuncture and an over 2000 year old, Chinese baby Tuina (massage) treatments for the NPA child. This treatment plan is designed to stimulate immunity and detoxification, as well as to improve the immune, neurological and digestive systems.
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This document outlines the key points to consider when evaluating a patient presenting with unexplained jaundice. It emphasizes that obtaining a thorough medical history is the most important part of the evaluation. The history should explore the length of symptoms, presence of abdominal pain, fever, appetite changes, weight changes, bowel habit changes, and pruritus. The physical examination focuses on assessing nutritional status, abdominal tenderness, liver and spleen size, ascites, and stigmata of chronic liver disease. Based on the clinical evaluation, appropriate imaging studies, serological tests, and pathology evaluation are selected to determine if the cause is hemolysis, a hepatobiliary disease, or another condition.
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Metastatic breast cancer occurs when cancer cells break away from the original tumor and spread to other parts of the body through the lymph nodes or bloodstream. The most common sites of metastasis from breast cancer are the bones, lungs, brain, and liver. A metastatic tumor is made up of breast cancer cells, not cells from the organ they spread to. For example, a bone metastasis would be made up of breast cancer cells, not bone cells. Breast cancer most often spreads from the lining of the milk ducts in the breast.
Berlin wall
The document summarizes the partitioning of Berlin following World War 2. Germany was divided into four occupied zones, including Berlin. Over time, the Soviets tried to drive out Western allies from Berlin, leading to the Berlin Airlift and later the building of the Berlin Wall in 1961 to stop East Germans from fleeing to the West. The wall divided the city until 1989 when reforms led East Germany to open its borders and the wall fell, reunifying Berlin.
Anorexia nervosa - patient case
The patient was struggling with an eating disorder and had lost their self-confidence. They kept trying to be skinny due to social pressures but it was negatively impacting their physical and mental health, causing issues like their period stopping, hair loss, and trouble concentrating. Eating disorders are often related to genetic and hormonal factors but can also stem from issues like low self-esteem, perfectionism, or wanting peer approval. Treatment focuses on psychotherapy, nutrition counseling, medications, and sometimes hospitalization for severe cases.
Patient History
The document summarizes a 63-year-old female patient's medical history, including her chief complaint of difficulty breathing and swollen legs. It details her medical background of med urethral stone disease and past surgery. Laboratory tests revealed issues with her kidney function and a urinary tract infection. Her diagnosis was acute kidney insufficiency, fluid overload, breathing issues, and a urinary stone disease. She was given various medical treatments and remained hospitalized.
Healthcare system of germany
The German healthcare system is a universal multi-payer system that provides coverage for all citizens and permanent residents. It is funded through statutory health insurance contributions that are paid by both employees and employers. Around 86% of the population is covered through the statutory health insurance system, while the remaining 11% have private health insurance. The system is based on principles of solidarity and subsidiarity. It provides coverage for a wide range of medical services and has consistently delivered a very high quality of care, though costs have increased and reforms have sought to control spending while maintaining standards.
Medical specialties - Pathology
Pathology is the study of disease and how it affects the human body. There are two main divisions of pathology: anatomical pathology, which involves examining organs and tissues, and clinical pathology, which involves examining body fluids. Pathologists determine diagnoses, support medical research, and determine causes of death. They work in hospitals, medical centers, and independent laboratories. Training to become a pathologist takes 12-14 years in the US and 12-13 years in the UK and involves obtaining a medical degree and completing a residency program. While the work is important, pathologists may receive less recognition than other specialties and salaries can be less than other medical specialties as well despite long training requirements.
Samoa - medical anthropology
Samoa is an island country in Oceania consisting of 9 volcanic islands. It has a population of around 198,263 people and a population density of 70 people per square kilometer. The population is mostly located on the islands of Upolu and Tutulia. Samoan society is organized around extended families, villages, and councils. The main religions are Christian denominations. Traditionally, Samoans enjoyed good health due to their environment, diet and isolation, but European arrival introduced diseases like leprosy, tuberculosis and elephantiasis. Healthcare has advanced from traditional healers to include hospitals, clinics, and medical practitioner training abroad.
Cleopatra
Cleopatra VII was the last pharaoh of ancient Egypt, ruling in the 1st century BC. She stabilized Egypt's economy, curbed corruption, and provided relief during a drought without any revolts. As a skilled diplomat, she allied with Julius Caesar and Marc Antony of Rome to maintain power. However, her alliance with Antony put her in conflict with Octavian, and their forces were defeated in battle. Believing Cleopatra had died, Antony committed suicide, and Cleopatra herself then took her own life rather than be captured by Octavian, bringing an end to the Ptolemaic dynasty and Egypt's independence.
Gustav klimt
This document provides information about a lecture on Gustav Klimt presented to medical students in Tbilisi, Georgia. It includes biographical details of Klimt's life and training in Vienna. It describes his style as a master of symbolism who rejected realism and used symbols to express individual spirit. Examples of Klimt's works discussed include the Beethoven Frieze, Portrait of Jozef Pembaur, panels for the University of Vienna, Hygieia, and Adele Bloch-Bauer I. Klimt is known for his lavish use of materials and gold in his golden period. The document provides links to further resources about Klimt and his life as an
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1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Medical student shadowing - lumbar disc herniation (L5S1)
- 3. Right lateral lumbar region 5-6 Severe, burning pain Continuous pain 5 months
- 5. Associated symptoms Pain and numbness in the right leg Right leg paraesthesia Perineal numbness Urinary retention Neurological deficits which are limited to one nerve root
- 7. o Lidocaine - intramuscular injection – 150-200 mg, once in 4-6 hours o Nopain – B vitamin – intramuscular injection - - 200 mg, once in 24 hours o Muscomed gel – twice a day o Pepper plaster
- 8. Past medical History Up to date with his vaccination Underwent tonsillectomy at the age of 14 No chronic diseases No hospitalizations Often Undergoes medical checkups
- 9. Allergies Seasonal allergic rhinitis Spring Sneezing itchy, watery, red eyes Alertec - 1 pill a day
- 10. Family history
- 11. Social history
- 12. He has problems with digestion Problems with passing urine Bothered with muscular weakness in the leg Slight change in the prostate size Names of the tests done Findings A1C blood test No diabetes CBC blood test No jaundice HCV blood test No hepatitis PSA blood test prostate specific antigen in norm
- 14. • X ray and CT • L5S1 disc protrusion with right S1 nerve root compression • lumbar disc herniation
- 15. Thank you
Editor's Notes
- 49 years old male, called I.B, entered with the chief complaint: “Low backache and pain in the leg”
- The patient feels pain in several point, nut his back is the main point, from where other pains arise. So the exact location of his pain is right lateral lumbar region (which is provided on the picture (tap to make the picture bigger)). The patient evaluates his pain as mostly 5, but it also reaches 6. He describes the back pain as severe and burning one, due to which he often can’t straighten up. The pain is usually continuous in a specific position of the body.
- 5 months ago the pain began in his lower back quite centrally and with time is starting radiating straight down the buttock, back of his right thigh and into his calf, stopping at the ankle.
- Lying down, sitting down, being still or getting cold aggravated her back and leg pain. Pain levels pain levels increase within 30 minutes of each sustained posture and take up to 2 hours to ease (mostly through walking) There was no position or movement that completely reduced his pain.
- shoulders were shunted to the left side. This shunted antalgic posture is commonly referred to as a lumbar list. if a person presents with an observable postural deformity, they are going to be more challenging to get better. The straight leg raise test (SLR) was positive in reproducing his posterior thigh pain and limited at 20 degrees on the right side. Palpation was conducted in the left side lying position with pressure applied only to the onset of pain (P1) The presence of generalised hyperalgesia made it difficult to establish a comparable finding.
- Lumbar spine CT reported a L5S1 disc protrusion with right S1 nerve root compression.