sᴘᴏᴛ ᴅɪᴀɢɴᴏsɪs

2021-12-27 00:23:09 3 days old newborn in NICU outcome of Preterm (28w) vaginal delivery to a multiparous with cervical
incompetence, present with Generalized hypotnia, lethargy, seziures and weak cry #O/Ex Wt 1.04 kg, head circumference : 28.3 (increased by 0.3 since yesterday), tense bulging fontanelle #investigation CRP insignificant, LP: - Ve, other sepsis screening - Ve
Transfontantell U/S was done (#image).

#Source:
Uworld neurology block Open / Comment

2021-12-25 22:21:31 1- Change in mental status (encephalopathy). 2-Subdural hematoma
3-Retinal hemorrhage
4-Multiple fractures.

#Spot_diagnosis:
Shaken baby syndrome.

Always indicate abusive injuries and Warrent your attention. Open / Comment

2021-12-25 14:25:57 https://t.me/spotdiagnosis/364 Open / Comment

2021-12-25 00:44:33 Open / Comment

2021-12-25 00:36:18 Open / Comment

2021-12-23 01:04:36 Open / Comment

2021-12-21 01:08:21 #Pharmacology:
Antipsycotics:

1st generation (typical) :
#Example:
-High potency: Halopridol.
-Low potency: Chloropramzine

2nd generation (atypical) :
#Example: Clozapine.

#Side_effect:
1- anti HAM effect:
H: antiHistamine: sedation, weight gain
A: antiAdrensrgic: Hypotension
M: antiMuscrinic: dry mouth, Constipation, urinary retention.

2- Neurolyptic malignant syndrome (NMS).
3- Tardive dyskinesia.
4- Extrapyramidal symptoms : Parkinsonism, akathesia (restlessness) and Dystonia.
5- Metabolic syndrome : common with 2nd generation.
6- Long QT syndrome.

#Further_reading :

FIRST AID Psychiatry clerkship 4th edition/page:190. Open / Comment

2021-12-21 00:51:18 #Spot_diagnosis:
Tardive dyskinesia (TD):

Irreversible involuntary orofacial (mainly) movements typical Hx is that of an old female patient with long Hx of using atypical antipsycotic.

Type D adverse drug reaction.
Common with chronic use of #typical antipsycotic (1st generation) .

TD is less common with #atypical antipsycotic (2nd generation)
Females are more likely to develop TD.

#Sources:
-First aid Psychiatry clerkship 4th ed /page 190

https://pubmed.ncbi.nlm.nih.gov/10223432/#:~:text=It%20is%20commonly%20held%20that,in%20the%20younger%20age%20groups.



(TD). Open / Comment

2021-12-20 00:16:01 #Pharmacology:

Adverse drug reactions (ADR):
1- #Type_A (augmented) ADR:
dose dependent drug toxicity, it's when a drug reach a certain level that cause adverse effects #Example: acetaminophen and warfarin toxicity.

2- #Type_B (Bizarre) ADR:
Dose independent unexpected drug reaction (aka idiosyncratic) the smallest dose Can trigger adverse reaction #Example: Aspirin & Reye syndrome, hypertensivity reaction with Penicillin and #NMS with halopridol.

3- #Type_C (continuous) ADR: continuous adverse reaction for long time #Example : jaw osteonecrosis (picture) with bisphosphonate.

4- #Type_D (delayed) ADR also ADR:
Adverse effect appear late on similar to type B but this occur later on #Example Tardive dyskinesia with antipsycotics, teratogenic effect of anticonvulsants on fetus (fetal hydantoin syndrome) and analgesic nephropathy with Analgesics.

#Reference:
-Guidance on adverse drug reactions UK government pdf.
Image ONJ:
-https://ar.iiarjournals.org/content/33/9/3917
See:
https://t.me/spotdiagnosis/507 Open / Comment

2021-12-17 02:26:53 Open / Comment