Surgery collections Videos and quizez 2021

2022-11-02 08:18:03 Open / Comment

2022-11-02 08:17:02 A 7-year-old boy is brought to the emergency department due to fever, headache, vomiting, and confusion. He has no prior medical conditions and is up to date with immunizations. The patient has not traveled recently, and his parents report no exposure to individuals with similar symptoms or ingestion of anything out of the ordinary. They have recently noticed several dead birds around their neighborhood. Temperature is 39 C (102.2 F). Physical examination shows neck rigidity and right lower extremity weakness with fasciculations. Cerebrospinal fluid analysis shows a leukocyte count of 200/mm3 with 20% neutrophils and 80% lymphocytes. Open / Comment

2022-11-01 21:17:02 Educational objective: Huntington disease is an autosomal dominant neurodegenerative disease that leads to the accumulation of abnormal, toxic huntingtin protein in neural cells. Inhibitory GABAergic neurons in the caudate nuclei are most susceptible, and their loss is responsible for the characteristic manifestations of Huntington disease (eg, chorea, behavioral abnormalities). Open / Comment

2022-11-01 08:16:02 Open / Comment

2022-11-01 08:16:01 A 52-year-old man is brought to the office due to social withdrawal and inability to care for himself. The patient is divorced and lives alone, and he was found to be living in disarray by his daughter, who is visiting from out of state. His neighbors and friends say the patient rarely comes out of the house or contacts them. During previous visits, his daughter noticed fidgety movements of his hands, but now he has marked jerky movements of his extremities with frequent facial grimaces. He has a history of depression with frequent angry outbursts that led to his divorce several years ago. The patient has no other medical conditions and does not use tobacco, alcohol, or illicit drugs. He was adopted and his family history is unknown. On physical examination, the patient is forgetful and has slowed mental processing.
Involuntary,
spasmodic movements of the hands and facial muscles are present. Deep tendon reflexes and sensation are normal. Open / Comment

2022-10-31 20:16:01 Educational objective: Cavernous hemangiomas are vascular malformations that occur most commonly within the brain parenchyma; they carry an increased risk of intracerebral hemorrhage and seizure. Open / Comment

2022-10-31 08:15:04 Open / Comment

2022-10-31 08:15:04 A 45-year-old man is brought to the emergency department due to new-onset seizure. His family witnessed an episode of blank staring followed by a generalized tonic-clonic convulsion with tongue biting and urinary incontinence. The patient has a past medical history of seasonal asthma and takes no prescription medications. He does not use alcohol or illicit drugs. Vital signs and neurologic examination are normal. Noncontrast head CT and brain MRI are consistent with a diagnosis of cavernous hemangioma. Open / Comment

2022-10-30 20:14:02 Educational objective: Injury to the axillary nerve most commonly occurs in the setting of shoulder trauma (eg, anterior dislocation, humeral fracture) and presents with sensory loss over the lateral shoulder and weakness on shoulder abduction (due to denervation of the deltoid muscle). Open / Comment

2022-10-30 08:14:03 Open / Comment