sᴘᴏᴛ ᴅɪᴀɢɴᴏsɪs

2022-02-24 23:14:31 Open / Comment

2022-02-24 23:00:02 #Esophageal_Dysphagia:

Dysphagia either:
1- Oropharngeal: inability to initiate swallowing + regurgitation.

2- Esophageal: sensation of food being stuck in the chest after swallowing.

#Causes:
Mechanical:
1- Esophageal Carcinoma.
2- Peptic stricture.
3- Zencker's Diverticulum.
4- Esophageal Webs.
5- Schatzki ring.
6- Lymphoma.
7- Thymoma.

Functional:
1- Achalasia.
2-Scleroderma.
3- Diffuse esophageal spasms (DES).

#Notes:
Esophageal Carcinoma either: Adenocarcinoma or Squamous cell Ca.
Adenocarcinoma arise from the lower esophagus (area of Barret mucosa).
Adenocarcinoma greatest risk factor: Longstanding GERD.
Squamous cell Ca can arise from anywhere commonly upper and middle esophagus.
Squamous cell Ca greatest risk factors include: smoking and alcoholism.
Dysphagia in elder+ Wt loss + red flag signs = Esophageal Carcinoma.
To confirm diagnosis EGD & biobsy.
CT/PET scan for Mets.

#Reference:
1)Toronto notes 2020.
2)UWORLD Surgery.
3)https://t.me/spotdiagnosis/150 Open / Comment

2022-02-22 00:52:04 Cobblestoning of the mucosa.

https://t.me/spotdiagnosis/17 Open / Comment

2022-02-22 00:44:47 Open / Comment

2022-02-21 21:19:02 Here is the full article.

https://www.facebook.com/103634252088024/posts/152200850564697/ Open / Comment

2022-02-21 18:15:12 #Productivity:
What is learning?
Gaining either one of or all of the following:
1) Knowledge.
2)Skill: e.g. surgeries and procedures.


#Mode_Of_Thinking:
1) Focused thinking:
e.g.Nerve supply of the cornea?. Another #Example: TSB: 23/ indirect:16 how much is the serum direct bilirubin = 7 here u used your focused thinking.


2)Diffuse Mode of thinking: is the creative thinking involves the whole brain and consume a lot of energy.
#Example:55 yrs old truck driver present with loss of libido and vision problem and headache for almost 5 months now your most likely diagnosis?

The diagnosis is either:
1) Pituitary adenoma or
2) Craniopharyngoma.

#Notes:
Focus mode imply using limited area of the brain (frontal cortex).
Focus mode is used when solving an urgent matter example an equation.
Focus mode you are consciously engaging your brain.
In diffuse Mode your brain is connecting the dots you set back and let your brain find a solution.

#Reference:
https://www.coursera.org/learn/learning-how-to-learn Open / Comment

2022-02-17 21:21:51 #Pathology_Flasback:
Embolism:
Free object that detached from distant source dislodge in a distant site (systemic or pulmonary circuits) .

#Origin_of_Emboli:
1-Thromboembolism (MCC):
Arterial source: atrial fibrillation and Atheroma.
Venous: deep venous thrombosis.
2-Gas Embolism.
3-Fat Embolism:either from fracture of long bones or aggressive liposuction.
4-Tumor fragment: e.g. Atrial Myxoma.
5-Amniotic Fluid Embolism.
6-Septic Emboli: IVDU, immunosuppresed and infective endocardtitis.

Where the #Emboli_Settle?
Systemic Embolization:
1- limb Ischemia.
2- Stroke.
3- Acute Mesentric Ischemia.
4-CRAO.

Pulmonary Circulation:
1-Saddle Embolism (huge size) : sudden death.
2- Small size: SOB and chest pain.
Paradoxical Embolism:
Pulmonary emboli pass to systemic circulation via patent #Foramen_Ovale.


#Further_reading:
1) Goljan rabid pathology review.
2)https://t.me/spotdiagnosis/639 (CRAO). Open / Comment

2022-02-17 20:49:27 #Cardiothoracic_Surgery:
Atrial Myxoma.
Most common primary intracardiac benign neoplasm. Most common site is the #Left_Atrium.

#Manifestation:
1-Symptom and sign of heart faliure: tumor obstruct mitral valve during diastole decrease in C.O.
2-Embolic Phenomenon: tumor fragments detach and dislodge in systemic circulation.
3- Sudden death.
4- Constiutional symptims: tumor may release IL-6.
5-"Tumor plop" on auscultation.

#Diagnosis:
1-Echocardiography.
2-Biobsy(Confirm).

#Managment:
Resection.

#Case_report:
47 yrs old female with clear medical background present with symptoms and signs of heart faliure and the classical "tumor plop" on auscultation for 6 months. Echo report (#above) showed intracardiac tumor. Patient underwent resection and biobsy confirmed the diagnosis.

#Reference:
1)Uworld Surgery.
2)New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/NEJMicm1802693. Case report Open / Comment

2022-02-16 10:29:00 Open / Comment

2022-02-16 10:22:49 Open / Comment