الاثنين، 27 أبريل، 2009

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

الأربعاء، 25 مارس، 2009

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




الأربعاء، 11 مارس، 2009

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

الأحد، 14 ديسمبر، 2008

case 12


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




الأحد، 30 نوفمبر، 2008

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

الجمعة، 28 نوفمبر، 2008

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.......

الخميس، 13 نوفمبر، 2008

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??