Surgery collections Videos and quizez 2021

2023-01-16 08:40:04 A 27-year-old woman comes to the office for follow-up. She was last seen 2 months ago for generalized musculoskeletal pain and several months of fatigue. Evaluation revealed multiple soft-tissue tender points, negative inflammatory and serological markers, and normal thyroid studies. The patient was diagnosed with fibromyalgia and prescribed a low-impact exercise program and pharmacotherapy. Her pain and fatigue have subsequently improved, but she now notes intermittent episodes of dizziness. Most of the episodes are short-lived, but she occasionally needs to brace herself against a wall or sit until the dizziness resolves. There have been no associated falls or loss of consciousness. She also notes worsened lethargy and frequent dry mouth. Other medical history includes migraines and irritable bowel syndrome. The patient currently takes daily amitriptyline for fibromyalgia, occasional acetaminophen for muscular pains, and polyethylene glycol as needed for constipation. She does not use tobacco, alcohol, or illicit drugs and has no known drug allergies. Temperature is 36.8 C (98.2 F), blood pressure is 110/70 mm Hg, pulse is 70/min, and respirations are 14/min. BMI is 21 kg/m2. Mucous membranes are pink and moist and there is no jugular venous distention. Cardiopulmonary auscultation is normal. The abdomen is soft and nontender. Neurologic examination reveals intact cranial nerves and normal muscle strength in all extremities. Open / Comment

2023-01-15 20:39:02 Educational objective: Tick-borne paralysis is characterized by rapidly progressive ascending paralysis (which may be asymmetrical), absence of fever and sensory abnormalities, and normal CSF examination.
Ticks must feed for 4-7 days and are typically found on patients after meticulous searching . Removal of the tick results in spontaneous improvement in most patients. Open / Comment

2023-01-15 08:38:01 A 32-year-old man is brought to the emergency department with progressive ascending paralysis that began 18 hours earlier. He initially noticed paresthesias in his lower extremities, followed by a sense of fatigue and weakness that was more pronounced in his left leg. He has no history of headache, fever, or recent infection or illness. He had just returned from a hiking trip to Colorado. His blood pressure is 122/81 mm Hg, pulse is 86/min, respirations are 16/min, and temperature is 37.3 C (99.2 F). Physical examination reveals intact cranial nerves, absent deep tendon reflexes in the left lower extremity and 1+ in the right lower extremity, and a normal sensory examination. Both lower extremities show weakness, with no motor activity in his left leg. Laboratory results show a normal WBC count No abnormalities are noted on CSF examination. Open / Comment

2023-01-14 21:38:01 Educational objective: Vasovagal (neurocardiogenic) syncope occurs due to excessive vagal tone that can be triggered by emotional stress, pain, or prolonged standing. Episodes typically involve a prodrome of nausea, diaphoresis, and pallor. Open / Comment

2023-01-14 14:45:19 A 27-year-old woman comes to the emergency department after losing consciousness for 2 minutes while standing in line at a supermarket She recalls nausea and a feeling of warmth spreading over her body immediately before passing out Her friend, a nurse who was with her during the episode, noted a weak pulse of 40/min. The patient was not confused after the episode and has never experienced a similar event She has not seen a doctor in several years and takes no medications. She does not use tobacco, alcohol, or illicit drugs. The patient's father suffered a heart attack at age 50, and her sister has a seizure disorder. Vital signs are within normal limits. ECG shows normal sinus rhythm with no other abnormalities. Open / Comment

2023-01-14 09:54:08 Watch this video to know How to create a System wise test ?

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