case 15

الصوره منقوله

general aspect: 28 years old patient with primary infertility since 4 years.she is not obese ,no abnormal hair distribution and no galactorhea. she complains uterine bleeding since 11 days.she had apast history of mastectomy secondary to breast cancer 1 year ago ,taking chemotherapy uptil now which affected her liver functions as she said .she mentioned extreme oligomenorrhea and cycle irrigularities.her u/s showed ovarian enlargment and multiple follicles(12)all of small size

questions

to identify the cause of bleeding in this case all except

D&C biopsy

prothrombin time & activity

cervical smear

prolactin level

hormonal profile in PCOS may include all except

elevated serum FSH

elevated LH

elevated prolactin

elevated androstendione

elevated estrogen

to treat acase of PCOS all except

metformine

clomephine citrate

spironolactone

aromatase inhibitors

parlodel
progestagen

case 14

general aspect : 27 years old primigravida in her 34 week of gestation complains watery vaginal discharge which is milky white ,spontaneous and increases with movement since 5 days .u/s was done and proved to be acase of preterm premature rupture of membranes

questions

amniotic fluid index will be in case of oligohydraminos: choose

less than 5

between 5-10

between 10-15

more than 20

if this case was complicated by infection ,leukocytes number over 11,000 will be

suggestive .t/f

for management of this case GA 34 wks while tocolytic score is <4:choose>

except

tocolytics

antibiotics

excessive hydration

betamethazone L/S is 2:1

after delivery immediate cord clamping is indicated t/f

case 13

Male patient presented with fracture shaft of both tibia and fibula .reduction & fixation was done by pop cast .later on the next mornoing he experienced severe pain and tingling in his foot and tightness in his leg after initial improvement.the cast was removed and his leg was covered by haemorrhagic bullae as in the photo.the preripheral pulse is palpable but pale extremeties with painful foot movement

the diagnosis may be choose

acute osteomyelitis

compartment syndrome

crush syndrome

fat embolism

to confirm the previous diagnosis choose

1retrograde after fasciotomy

2muscle enzymes
3measuring intracompartmental pressure

4abscent peripheral pulsation

5non of the above

as amanagement of fracture tibia and fibula all except choose

external fixation

skin graft

intramedullary nail

plate and screws for the fibula

case 12

what could it be

i couldnot get the clinical case but what is your opinion about this x_ray

case 11 from Tanta tropical centre

general aspect: 24 years old female is noticed to have rapidly developing diffuse abdominal distention within 20 days.on examination no jaundice ,no ll edema, no organomegally,just pallor and dullness allover the abdomen.

by investigations :

HB:10.2

prothrombin activity:92%

liver functions:billirubin D:0.2

IND:0.8

SGPT :22

SGOT :26

albumin:3.6gm

ascitic fluid :total protein 5 (normally no ascitic fluid or protein)and no RBCS, cells:50

U.S:hepatosplenomegally ,cirrhotic liver,patent portal vein

E.S.R:32,68

WHAT IS YOUR DIAGNOSIS

case 10

general aspect:49 years old male with periumbilical abdominal pain ,fever and diarhoea for 5 days

no rash no ronchi no splenomegaly yet

leuckocytic count is 12600

CRP is 96 mg/L

against widal in this case is :choose

leuckocytosis

duration of symptoms

diarhoea

all of the above

after 1 weaks he developed severe epigastric tenderness and mild generalized abdominal

distention

U.S showed thrombosis of the left branch of portal vein

how to manage this case.......

case 9

thanks Dr semsema for your useful participation

] semsema يقول...
أول مشاركة لي في المدونة ويارب تفيدكم

male patient aged 45 ,came to hospital complaining of feeling drowsy during doing exercise in the morning and some dysnea last night,nausea and mild chest pain which releaved spontaneously he had D.M 5 years ago and it is controlled by treatment

how to deal with this case??