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● Let's get Telegram medically useful :) ● Only 4 Medical professionals/ students. ● Any one who has a useful addition to this project, please contact me @ahmedCo88 or ahmedco.you@gmail.com
https://www.racgp.org.au/afp/2017/september/much-more-than-prescribing-a-pill
Erectile dysfunction has a similar or greater predictive value for cardiovascular events than traditional risk factors including smoking, hyperlipidemia, and family history of myocardial infarction.
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Key Learning Point
In an inpatient who has received vancomycin and ceftriaxone, the most likely cause of a new thrombocytopenia that develops during or shortly after hospitalization is drug-induced thrombocytopenia.
Detailed Feedback
Thrombocytopenia is a common laboratory abnormality in hospitalized patients. Perhaps the most common etiology is drug-induced thrombocytopenia.
More than 100 agents have been implicated in drug-induced thrombocytopenia; among those most frequently cited are heparin, quinine, and some antibiotics.
In a large case series of vancomycin-treated patients who then developed thrombocytopenia, vancomycin-dependent platelet-reactive antibodies were identified.
Immune thrombocytopenia is unlikely to develop this acutely during or shortly after hospitalization in a patient who presents with a normal platelet count.
Disseminated intravascular coagulation is possible but unlikely in a patient who is improving clinically.
Folate deficiency is a cause of thrombocytopenia but would not cause thrombocytopenia that developed acutely.
Thrombotic thrombocytopenic purpura has a classic pentad: fever, acute kidney failure, thrombocytopenia, microangiopathic hemolytic anemia, and altered mental status.
Source: NEJM, Dec 2020.
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You will learn everyday a disease by spending 2 to 3 minutes on this channel. 👇
One Disease Daily
/channel/dailydisease
Question of the week:
A 32-year-old woman with no notable medical history presents to the emergency department with pain in her back, left knee, and right ankle. She reports that the back pain began 3 weeks ago, frequently wakes her from sleep, is associated with stiffness in the morning, and improves with activity.
Her left knee and right ankle have become warm, swollen, and painful during the past week, impairing her ability to work. Naproxen at therapeutic levels provides only mild relief.
The patient also reports conjunctivitis and dysuria. She has multiple sexual partners who use condoms intermittently. She states that she does not experience fevers or rash.
Physical examination reveals moderate swelling in the left knee, warmth and redness of the right ankle, and tenderness at the right upper buttock.
Arthrocentesis of the knee effusion reveals cloudy synovial fluid containing 15,400 leukocytes per high-power field, with 85% neutrophils. Cultures of synovial fluid are negative.
Urine polymerase-chain-reaction testing is positive for Chlamydia trachomatis but negative for Neisseria gonorrhoeae.
Obe of the best dermatology sources.
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Answer is Group A streptococcus
(Sorry for the late reply, busy with work!)
Answer: Weed Pollen
Allergies in the late summer and early fall are most likely to be caused by weed pollen.
Allergic rhinitis is associated with nasal and ocular symptoms during times of allergen exposure. Weed pollen is most common in late summer and in the fall.
Tree pollen is the most prominent environmental allergen in the early spring.
Grass pollen is most common in the late spring into summer.
Cat and dog dander, as well as dust mites, are perennial allergens that cause symptoms year-round.
Question of the week:
A 36-year-old woman who lives in the United States presents for evaluation of nasal symptoms. She reports symptoms of rhinorrhea, nasal pruritus, and ocular pruritus that occur every year for 3 to 4 weeks in the late summer and early fall. She has a cat and a dog.
@MedicalBooksStore 2017 Dacie and Lewis Practical Haematology 12th ed
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" Saying the product of the kidneys is urine is like saying the product of a factory is pollution. Urine is a by-product. The product is homeostasis "
- Joel Topf. MD.
Best 3 interventions to reduce the chances of colorectal cancer?
1. Reduce Alcohol intake
2. Increase cereal fibre intake
3. Aspirin 100mg PO daily for at least 2.5 years duration, between age 50-70
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Question of the week.
A 73-year-old woman with a history of hypertension and chronic obstructive pulmonary disease presents to the emergency department with red streaking on her right arm.
She grazed the arm 2 days ago and stopped minimal bleeding from the wound by applying local pressure. She reports a fever of 38.7°C.
She has a platelet count of 243,000 per mm³ (reference range, 150,000–350,000). She is started on intravenous vancomycin and ceftriaxone. She is then hospitalized, improves quickly, and is discharged on day 3.
Five days after discharge, the patient notices a petechial rash on her legs and presents again for evaluation.
A complete blood count reveals these results: hemoglobin 11.4 g/dL (reference range, 12.0–16.0), leukocytes 4200 per mm³ (4500–11,000), platelets 18,000 per mm³ (150,000–350,000), and a normal fibrinogen level.
Review of the peripheral-blood smear reveals marked reduction of the platelet count, but normal platelet morphology. No schistocytes are present.
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Answer for the 👆🏻: Azithromycin + Indomethacin
Reactive arthritis (formerly known as Reiter syndrome) is a spondyloarthritis, which classically manifests as arthritis, urethritis, and conjunctivitis. Uveitis, fever, and other constitutional symptoms are also common features, as are acute pustular skin lesions known as keratoderma blennorrhagica.
However, in more than 50% of affected patients, extra-articular manifestations are absent. Joint involvement, typically oligoarticular and asymmetric, may involve the spine (most frequently the sacroiliac joints).
Causative pathogens include Chlamydia trachomatis and enteric bacteria, such as Salmonella, Shigella, Yersinia, Campylobacter, and Clostridioides difficile. Treatment involves eradicating the pathogen if there is evidence of ongoing infection, but in many cases, the precipitating infection has resolved before arthritis develops. In this patient, azithromycin treats the active chlamydial infection.
Nonsteroidal antiinflammatory drug (NSAID) therapy is the first choice for control of arthritis, and it is not uncommon for more than one NSAID to be tried in an attempt to find an effective agent.
Systemic or intra-articular glucocorticoids are indicated if NSAIDs are ineffective. Average disease duration is 3 to 6 months.
In the up to 20% of patients with reactive arthritis who have arthritis that persists beyond several months, disease-modifying antirheumatic drugs, such as methotrexate, can be considered.
Prolonged antibiotic treatment (with rifampin plus azithromycin or doxycycline) may benefit patients who have refractory, Chlamydia-induced reactive arthritis, particularly if there is evidence for persistence of bacteria in an attenuated form.
However, testing for such persistent infection by polymerase chain reaction of synovial tissue is not generally available.
Source: NEJM
Last reviewed Sep 2019. Last modified Jul 2019.
Evaluation of anemia - Approach
@medicalethiopia
#Dermatology Made Easy, Amanda Oakley 1st Edition 2017
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Common Nutritional Deficiencies Quiz by Medscape
https://reference.medscape.com/viewarticle/909390?src=wnl_fastquiz_190316_mscpref&uac=287655CV&impID=1907220&faf=1
Q: An otherwise healthy 9-year-old girl presented to the primary care clinic with a sore throat and fever. Her temperature was 38.5°C. Physical examination revealed swollen and tender cervical lymph nodes, an inflamed uvula, enlarged tonsils, and “doughnut” lesions on both the hard and soft palates. What is the underlying cause?
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To which one of the following allergens is this patient most likely to be sensitive?
public poll
Grass pollen – 68
👍👍👍👍👍👍👍 45%
Weed pollen – 55
👍👍👍👍👍👍 36%
Dust mites – 15
👍👍 10%
Cat or dog dander – 10
👍 7%
Tree pollen – 4
▫️ 3%
👥 152 people voted so far.
@MedicalBooksStore 2017 Dacie and Lewis Practical Haematology 12th ed
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oral Intake of Vancomycin Vial
Indication
Pseudomembranous Colitis/Staphylococcal Enterocolitis
Dose : 125 mg/dose (q6hrs)
for 7-10 days
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من ولايات امريكا الساحلية هية ولاية مين وولاية كاليفورنيا
ويتميز ساحل ولاية مين في الخارطة بانه ذات حافات متعرجة
عكس ساحل ولاية كاليفورنيا والتي تتميز بان ساحلها في الخارطة ذات حافات ملساء
هذا التشبيه يقتبس منه التفريق ب café au lait spot
حيث ان الcafe au lait spot
ذات الحواف الملساء والتي تشبه ساحل ولاية كاليفورنيا تكون في
مرض neurofibromatosis
اما ال café au lait spot
ذات الحواف المتعرجة والتي تشبه ساحل ولاية مين
يكون في مرض ال mccune albright syndrome
المقارنة اعلااااااااه