MEDICAL ROOM

Spot Diagnosis 023

2011-12-31T09:39:00.000-08:00

What is your diagnosis?

Can you imagine this!!!

2011-12-31T09:37:00.000-08:00

What would you do if a patient like this came to ER?

Unbelievable X-Ray

2011-12-30T03:53:00.000-08:00

Benefits of having Alzheimer's disease

2011-12-30T03:17:00.000-08:00

5. You never have to watch reruns on television.

4. You are always meeting new people.

3. You don't have to remember the whines and complaints of your spouse.

2. You can hide your own Easter eggs.

1. Mysteries are always interesting.

Spot Diagnosis 022

2011-12-30T03:14:00.000-08:00

What isyour diagnosis?

Spot Diagnosis 021

2011-11-04T13:19:00.000-07:00

A 57-year-old man with severe abdominal pain presents to a local emergency department (ED)

Dermatomyositis

2011-09-17T10:21:00.000-07:00

Dermatomyositis is one of a group of muscle diseases known as the inflammatory myopathies, which are characterized by chronic muscle inflammation accompanied by muscle weakness. Dermatomyositis’ cardinal symptom is a skin rash that precedes, accompanies, or follows progressive muscle weakness. The rash looks patchy, with purple or red discolorations, and characteristically develops on the eyelids and on muscles used to extend or straighten joints, including knuckles, elbows, knees, and toes. Red rashes may also occur on the face, neck, shoulders, upper chest, back, and other locations, and there may be swelling in the affected areas. The rash sometimes occurs without obvious muscle involvement. Adults with dermatomyositis may experience weight loss, a low-grade fever, inflamed lungs, and be sensitive to light such that the rash or muscle disease gets worse. Children and adults with dermatomyositis may develop calcium deposits, which appear as hard bumps under the skin or in the muscle (called calcinosis). Calcinosis most often occurs 1-3 years after the disease begins. These deposits are seen more often in children with dermatomyositis than in adults. In some cases of dermatomyositis, distal muscles (muscles located away from the trunk of the body, such as those in the forearms and around the ankles and wrists) may be affected as the disease progresses. Dermatomyositis may be associated with collagen-vascular or autoimmune diseases, such as lupus.

The association between dermatomyositis (and possibly polymyositis) and malignancy has been recognized for a long time. Dermatomyositis is a systemic disorder that frequently affects the esophagus and lungs and, less commonly, the heart. Calcinosis is a complication of dermatomyositis that is observed most often in children and adolescents.

Case no.2

2011-09-17T06:22:00.000-07:00

A 56-year-old woman presented with complaints of an ulcerating lesion at the inner corner of right eye for the past 8 months. There had been an off and on history of yellowish discharge from the lesion; occasionally it is blood tinged. She had a history of trauma with a wooden stick at the affected site, 10 months earlier. Clinically, a firm mass could be palpated. Extraocular movements were full. Slit lamp and fundus examination were within normal limits in both eyes. CT scan showing coronal and axial view is shown above.

1. The most probable diagnosis is:
a. sebaceous gland carcinoma
b. canaliculitis (Actinomyces)
c. chronic dacryocystitis with fistula
d. basal cell carcinoma

2. The treatment would be:
a. curettage of canaliculi and Amphoteracin B
b. dacryo-cystorhinostomy with stent
c. incisional biopsy
d. wide excision of the lesion with margin control

Spot Diagnosis 020

2011-09-17T01:01:00.000-07:00

What is the diagnosis?

Spot Diagnosis 019

2011-09-16T13:11:00.000-07:00

What is the diagnosis?

Spot Diagnosis 018

2011-09-15T14:13:00.000-07:00

What is the diagnosis?

The correct answer is!

Spot Diagnosis 017

2011-09-15T10:04:00.000-07:00

What is the diagnosis?

Staring At An Eclipse Can Blind You

2011-09-15T07:53:00.001-07:00

True. Never view the sun directly with the naked eye or with any unfiltered optical device, such as binoculars or a telescope!.

As sunlight enters the eye, it can damage the light-sensitive nerve endings in the back of the eye -- known as the retina -- causing vision loss.

Total and partial eclipses can lead to serious damage if precautions are not taken to prevent blindness. This is why there are only a few safe ways to view an eclipse, such as with a referred image. Regular sunglasses, exposed film, and even a welder's helmet are not safe.

Waardenburg syndrome

2011-09-15T05:04:00.000-07:00

Waardenburg syndrome (WS) is an inherited disorder often characterized by varying degrees of hearing loss and changes in skin and hair pigmentation. The syndrome got its name from a Dutch eye doctor named Petrus Johannes Waardenburg who first noticed that people with differently colored eyes often had a hearing impairment. He went on to study over a thousand individuals in deaf families and found that some of them had certain physical characteristics in common.

One commonly observed characteristic of Waardenburg syndrome is two differently colored eyes. One eye is usually brown and the other blue. Sometimes, one eye has two different colors. Other individuals with Waardenburg syndrome may have unusually brilliant blue eyes.

People with WS may also have distinctive hair coloring, such as a patch of white hair or premature gray hair as early as age 12. Other possible physical features include a wide space between the inner corners of eyes called a broad nasal root. In addition persons with WS may have low frontal hairline and their eyebrows may connect. The levels of hearing loss associated with the syndrome can vary from moderate to profound.

Individuals with Waardenburg syndrome may have some or all of the traits of the syndrome. For example, a person with WS may have a white forelock, a patch of white hair near the forehead, and no hearing impairment. Others may have white patches of skin and severe hearing impairment. The severity of the hearing impairment varies among individuals with WS as do changes in the skin and hair.

On rare occasions, WS has been associated with other conditions that are present at birth, such as intestinal disorders, elevation of the shoulder blade, and disorders of the spine. A facial abnormality, known as cleft lip and/or palate, also has been associated with WS.

Pancoast Tumor

2011-09-15T04:32:00.000-07:00

Pancoast tumors are tumors that form at the extreme apex (very top) of either the right or left lung in the superior sulcus (a shallow furrow on the surface of the lung). Pancoast tumors are a subset of lung cancers that invade the top of the chest wall. Because of their location in the apex of the lung, they invade adjoining tissue.

Pancoast tumors originate at the top margin of the lung. They form an abnormal patch of tissue over the lung apex and principally involve the chest wall structures rather than the underlying lung tissue. They invade the following structures:

Lymphatics (small, thin vessels that carry lymph fluid through the body)

Lower roots of the brachial plexus (a complex network of nerves that is formed chiefly by the lower 4 cervical [neck] nerves and the first thoracic [chest]nerve)

Intercostal nerves (nerves that lie between a pair of adjacent ribs)

Stellate ganglion (a mass of nerve tissue containing nerve cells that form an enlargement on a nerve or on 2 or more nerves at their point of junction or separation)

Sympathetic chain (either of the pair of ganglionated lengthwise cords of the sympathetic nervous system that are situated on each side of the spinal column)

Adjacent ribs

Vertebrae

Carcinomas (cancerous tumors) in the superior pulmonary sulcus produce the Pancoast syndrome, which is characterized by pain in the shoulder and along the inner side of the arm and hand. Pancoast tumors tend to spread to the tissue surrounding them in the early stage of the disease. As long as the cancer has not metastasized (spread) and involved the regional lymph nodes (small, bean-shaped structures found throughout the body), these tumors can be successfully treated.

Spot Diagnosis 016

2011-09-15T04:27:00.001-07:00

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Spot Diagnosis 015

2011-09-14T12:57:00.000-07:00

What is the diagnosis?

Spot Diagnosis 014

2011-09-14T10:01:00.000-07:00

What is the diagnosis?

The Man Who Can Eat Everything

2011-09-14T05:21:00.000-07:00

This basically means the guy can eat and even digest metal, glass and even toxic and poisonous material. Michel Lotito's stomach lining is twice as thick as normal, a rare condition that most doctors agree developed in the womb, though nobody is sure how. Lotito does not often suffer from ill-effects due to his diet, even after the consumption of materials usually considered poisonous.

When performing he consumes around a kilogram of material daily, preceding it with mineral oil and drinking considerable quantities of water during the 'meal'. He apparently possesses a stomach and intestine with walls of twice the expected thickness, and his digestive acids are, allegedly, unusually powerful, allowing him to digest a certain portion of his metallic meals.

Lotito even entered the Guinness book of records when he ate an airplane. The airplane took roughly two years to be 'eaten' from 1978 to 1980

See the video:

Spot Diagnosis 013

2011-09-14T02:50:00.000-07:00

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Surprising things that give you headaches

2011-09-13T11:54:00.000-07:00

You've been staring at the computer for hours. You've worked late all week and have in-laws coming this weekend. You have a raging case of PMS. Eyestrain, stress, and hormonal shifts are fairly common causes of headaches, which afflict 45 million Americans (most of them women).

Some people say the roots of their hair hurt when they get a headache.

But sometimes the usual suspects don't explain that pain in your head. That's because some triggers are just plain weird -- like perfume, storms, earrings -- . Here's how to identify the source of your headache so you can send it packing.

Perfume

"Strong scents bother me instantly," says Bethany Hegedus, 35, a writer and receptionist from Brooklyn, New York. She can get a headache from a whiff of Lovely by Sarah Jessica Parker or a stroll past a Yankee Candle. Her sense of smell is so acute that she can sniff out whether a co-worker has changed laundry detergents or hand lotions, a degree of sensitivity common among scent-driven headache sufferers. The headaches can be fleeting if exposure is brief -- or they can last all day.

Why it hurts: Strong odors may activate the nose's nerve cells, which stimulate the nerve system associated with head pain. Ironically, the offending scents are often pleasant, says Vincent Martin, M.D., a headache specialist at the University of Cincinnati College of Medicine.

What to do: Avoid perfumes, strong household cleansers, fragranced soaps and shampoos, and air fresheners. That's a challenge when just about everything these days is "Clothesline Clean" or "Citrus Fresh," but Hegedus does her best with unscented laundry detergent and deodorant, and wears no fragrances. At the office, she politely asks colleagues not to wear heavy perfumes. And if all else fails? "I keep a bottle of Excedrin Extra Strength at my desk," she says. Health.com: A power punch against headaches

That remedy has aspirin, acetaminophen and caffeine, a combination endorsed by several medical organizations for migraine and tension headaches. However, you might want to try aspirin or acetaminophen individually rather than mixed together with caffeine, says Andrew Charles, M.D., director of the Headache Research and Treatment Center at the University of California, Los Angeles, School of Medicine. Frequent use of medicines with caffeine can lead to dependency and "rebound" headaches, the kind that come right back as soon as the meds wear off. Aspirin, ibuprofen, and naproxen treat pain and the inflammation often associated with headaches. Acetaminophen fights pain, but not inflammation. (Another caveat: If over-the-counter meds don't help, a trip to the neurologist may be needed, Martin says.)

Weather
Studies show that the headache-prone are especially attuned to changes in barometric pressure, rising temperatures, high humidity, lightning, and cloudy skies. Rebecca Kinney, a 31-year-old librarian from Newton, Massachusetts, calls herself a human barometer. Gray skies and rain on the way trigger excruciating pain. "The headache is usually on one side of my head, and it pulsates, as if someone is drilling into me," she says.

Why it hurts: The meteorological shifts are thought to trigger chemical and electrical changes in the brain that irritate nerves -- sometimes causing fairly dramatic pain. In fact, "50 to 60 percent of migraine patients will identify a weather change as the trigger for their headaches," Martin says.

What to do: On bad-weather days, Kinney puts an ice compress on her eyes in the morning. "Sometimes I can catch the headache before it gets worse," she says. Another trick: Record your symptoms and the weather to piece together patterns. Then check out the "Aches and Pains" forecast on Weather.com; it breaks down how the day is dawning in terms of temperature, barometric pressure, and wind patterns. Pretreat with 400 milligrams of ibuprofen a day or two before expected weather changes, says Mark W. Green, M.D., director of headache medicine at Columbia University. (Naproxen or aspirin may work, as well.) Health.com: Take that! for pain

Earrings, headbands, and ponytails
Some people say the roots of their hair hurt when they get a headache. Kinney describes it as a "hair cramp." Other women swear that their earrings can lead to head pain. And they're all correct!

Why it hurts: The muscle groups around your scalp don't have pain fibers, but their connective tissues do. "Ponytail headaches" result when tightly pulled hair irritates the muscle system. And your swingy updo isn't the only thing contributing to your pain: Tight-fitting hats, headbands, and heavy earrings are also culprits, says Stephen Silberstein, M.D., director of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia, Pennsylvania. Why earrings? It's possible that earrings can pull on that same connective tissue. But some studies suggest that skin sensitivity around your scalp, face, and ears often accompanies a migraine. The earring supersensitivity could be a sign that a migraine's coming, but not the cause of the headache.

What to do: It probably didn't take a study in the journal Headache to tell you that loosening your ponytail relieves a ponytail ache. Researchers have found that this simple action decreased headache pain within 30 minutes, and, in some cases, instantly. Kinney makes a conscious effort to reposition her ponytail throughout the day. Typically, the thicker your hair or the heavier your headwear, the more likely you'll experience this type of headache. Best bet: Save tight updos and heavy earrings for nights out, when you won't be wearing them for long. Health.com: Best new pain cures for women

Hunger

There's a reason some nutrition gurus recommend that we eat several small meals a day: It keeps our blood sugar on an even keel. Dieting, fasting, skipping lunch -- they all can cause you to bottom out, which may trigger a headache.

Why it hurts: Experts believe low blood sugar may stimulate nerve pathways that bring on these common headaches, but the exact mechanism is murky.

What to do: Uh, eat? Exactly. But remember that what you grab may play a role in whether your headache returns. "Sugar headaches" may occur when we binge on sweets on an empty stomach. The spike in blood sugar ratchets insulin levels, which eventually cause blood sugar to sink even lower. Instead, balance a protein with a complex carbohydrate, such as fish and brown rice, or a snack of whole-wheat toast with almond butter. Martin adds that eating foods rich in magnesium (spinach, beans, nuts, and seeds) and riboflavin (dairy products, lean meats, leafy greens, enriched breads and cereals) may prevent and alleviate head pain. Riboflavin is a B vitamin; large doses are thought to help prevent migraines.

Bear in mind, too, that cheese, chocolate, lunch meats, caffeine, and additives such as monosodium glutamate (MSG) may trigger headaches. In general, if you suffer from moderate, severe, or frequent headaches (more than two a week), consult a headache specialist about your diet. You may need to keep a food diary to hunt for culprits. Health.com: Could painkillers be hurting your heart?

Spot Diagnosis 012

2011-09-13T09:33:00.001-07:00

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Spot Diagnosis 011

2011-09-13T07:46:00.000-07:00

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Spot Diagnosis 010

2011-09-13T07:34:00.001-07:00

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Spot Diagnosis 009

2011-09-12T08:49:00.000-07:00

What is the diagnosis?