Toxo in cml
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A 19-year-old boy presented with defective vision in his right eye for 2 weeks along with general fatigue and weakness. On examination, he had pallor and enlarged cervical lymph nodes. His right eye vision was 6/24 and fundus examination revealed signs of retinochoroiditis. Blood tests showed anemia and markers positive for toxoplasmosis. A bone marrow biopsy indicated chronic myeloid leukemia. He was diagnosed with posterior uveitis caused by toxoplasma retinochoroiditis as well as chronic myeloid leukemia.
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Motiur, a 3-year old boy, was admitted to the hospital with a 15-day history of intermittent fever, 7-day history of progressive pallor, and a 7-day history of rectal bleeding. On examination, he was found to be severely anemic with lymphadenopathy. Initial test results showed bicytopenia with a few atypical cells. A bone marrow examination revealed 95% blast cells, leading to a diagnosis of acute lymphoblastic leukemia (ALL) FAB-L1. He received a blood transfusion, multivitamins and was referred to another hospital for chemotherapy.
Macrophage activation
This document discusses the case of a 63-year-old woman with rheumatoid arthritis and diabetes who presented with chest pain and was diagnosed with a myocardial infarction. She subsequently developed fever and pancytopenia. Further tests found very high ferritin levels and a bone marrow biopsy confirmed macrophage activation syndrome, a severe complication caused by overly active immune cells. She was started on treatment including steroids and IVIG but unfortunately died shortly after being transferred to the ICU. The key lessons are that macrophage activation syndrome can occur in adults with autoimmune conditions and be fatal if not recognized and treated promptly.
A Case of Henoch-Schonlein Purpura
The patient, a 23-year-old male, presented with abdominal pain and was found to have palpable purpura on his lower extremities. He was initially diagnosed with acute appendicitis but developed a skin rash. Biopsy of the skin rash showed leukocytoclastic vasculitis. He was ultimately diagnosed with Henoch-Schonlein purpura (HSP), characterized by palpable purpura, arthritis/arthralgia, gastrointestinal involvement, and renal involvement. HSP is an immune complex-mediated vasculitis that commonly affects children and is generally self-limiting, though steroids may help with symptoms. Prognosis depends on factors like age of onset, severity
Unusual cause of Renal failure
This document presents a case study of a 55-year-old female patient admitted with abdominal distention and leg swelling over the past month. Her history and examination findings are detailed. Investigations show signs of cirrhosis and portal hypertension likely related to hepatitis B. She develops renal impairment and a renal biopsy reveals diffuse proliferative glomerulonephritis. Further tests confirm hepatitis B virus infection is the cause of her kidney disease. She is diagnosed with hepatitis B virus related diffuse proliferative glomerulonephritis and treated accordingly.
orbital_pseudotumor presentation dhir hospital bhiwani.pptx
This document presents a case of a 35-year-old male taxi driver who presented with swelling in his left eye for 1 month and double vision in his left eye for 10 days. On examination, he was found to have swelling and warmth in his left eye as well as restricted eye movements. Imaging showed retrobulbar cellulitis. He was diagnosed with left orbital pseudotumor and treated with oral steroids and topical medications, with improvement in symptoms. The document then provides an overview of non-specific orbital inflammatory diseases, discussing different subtypes such as dacryoadenitis, myositis, diffuse cellulitis, and optic perineuritis.
Clinical presentation
A 40-year-old male presented with a 4-month history of painless protrusion of the left eye associated with decreasing vision. Examination found unilateral, axial proptosis of the left eye measuring 25mm. Imaging and lab tests were performed to rule out other causes. The patient underwent an excisional biopsy via orbitotomy, which was sent for histopathology.
AVM of eyelid
This document presents the case of a 7-year-old boy with a swelling in his left upper eyelid that had progressively enlarged over the past 3 years. On examination, the swelling was found to be a soft, compressible, non-tender mass causing ptosis. Imaging studies including CT scan and duplex ultrasound revealed features consistent with an arteriovenous malformation in the eyelid. The provisional diagnosis was confirmed and a multidisciplinary management plan involving vascular and oculoplastic surgery was proposed.
A case report of nephropathy
This case report describes a 37-year-old woman with a history of systemic lupus erythematosus, hypothyroidism, and iron-deficiency anemia who presented with general weakness, fatigue, and left neck lymphadenopathy. Laboratory tests showed anemia, leukopenia, and proteinuria. She was admitted for symptomatic management and treatment of a suspected lupus flare-up. A kidney biopsy was planned to evaluate her proteinuria.
A Case of CNS Toxoplasmosis
1. A 40-year-old man presented with left-sided weakness and slurred speech for 10 days. On examination, he had left hemiparesis and facial weakness. Brain CT showed ring-enhancing lesions. He tested positive for HIV and toxoplasma antibodies.
2. He was diagnosed with cerebral toxoplasmosis due to reactivated infection from his immunocompromised state due to HIV infection. He responded well to anti-toxoplasmosis treatment with pyrimethamine, sulfadiazine and steroids.
3. Toxoplasmosis is a common opportunistic infection in HIV patients that typically presents as multiple ring-enhancing brain lesions. Diagnosis involves
Pregnancy Induced Hypertension - Pre eclampsia
This document provides information about a 33-year-old pregnant woman admitted to the hospital with mild preeclampsia at 36 weeks of gestation. It includes her medical history, symptoms, physical exam findings, lab results, diagnosis, and notes on preeclampsia and its management. The key details are that she presented with swelling in her lower limbs and a history of amenorrhea for 8 months, and was found to have elevated blood pressure and mild preeclampsia at 36 weeks of pregnancy.
NSAID induced AKI in pediatrics ((case))
A 7 year old girl presented with worsening fatigue and vomiting, and was previously treated with ibuprofen and diclofenac for tonsillitis, which likely caused acute interstitial nephritis and acute kidney injury. Further workup revealed polycystic kidney disease as an underlying cause of chronic kidney disease. Her kidney function improved after stopping the NSAIDs and hydration, but she ultimately required long-term dialysis due to her polycystic kidney disease.
Hunting for a diagnosis
This 94-year-old man presented with a three-week history of painful blackening of his bilateral finger tips. Examination found peripheral gangrene involving the finger tips bilaterally while sparing the feet. Laboratory tests showed elevated inflammatory markers and a positive rheumatoid factor. A biopsy found gangrene following vasculitis as the favored diagnosis. The presentation fits symmetrical peripheral gangrene, a rare syndrome characterized by bilateral distal ischemic damage and gangrene in the absence of major vascular disease. A wide range of infective and non-infective factors can cause this condition.
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1. Define an electrocardiogram (ECG) and electrocardiography
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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/
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Toxo in cml
- 2. 19 year old boy presented with c/o defective vision RE of 2 weeks duration Slowly progressive painless defective vision Ass with fatigue , generalised weakness h/o contact with cats h/o
- 3. No h/o floaters, flashes of light No h/o trauma or ocular surgery No h/o anorexia ? Loss of weight
- 4. General examination Pallor present Multiple soft to firm cervical lymph nodes palpable No icterus/cyanosis / clubbing/ pedal oedema PR- 90/mt BP- Git – firm to hard spleen palpable in left hypochondrium extending upto the umbilicus Other systems - WNL
- 5. Ocular examination RE vision 6/24 Ant segment WNL Pupil brisk Fundus
- 6. Fundus RE
- 8. Fundus LE
- 9. IOP EOM
- 10. Investigations Hb- 5.2gm% TC Peripheral smear - normocytic normochromic anaemia s/o myeloproliferative disorder Toxoplasma Ig G 252.7 Mantoux -negative
- 11. Investigations Bone marrow Trephine biopsy
- 12. Diagnosis Posterior uveitis- toxoplasma retinochoroiditis Chronic myeloid leukemia
- 13. Management