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68 yo male patient presents to your clinic with postprandial pain. X-ray below, whats the dx?
USMLE images
- Thread starter Zuhal
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horseshoe kidney
you knew it...esp when given answer choices
wayyyyyyyy off
That's crazy though. Good one!wayyyyyyyy off
crazy, eh...always used to seeing in in x-ray point of view...here's my lunch time contributions
dx
looking for the complication, of this dx
bonus points if you can give me the disease it's found in
7 days old dyspnea/ hypoplastic lungs due to diaphgramatic hernia.
1) What could have caused this?
2) What's the SaO2 in this pt (i.e. increased/decreased?)
1. paraesophageal hernia
2. SaO2 = saturation of rbcs with hemoglobin, right? other lung is still working fine and being able to oxygenate the rbcs...so shouldn't it be normal?
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crazy, eh...always used to seeing in in x-ray point of view...here's my lunch time contributions
dx
looking for the complication, of this dx
bonus points if you can give me the disease it's found in
Toxic Megacolon
Complications could be perforation (leading to peritonitis), sepsis, dehydration from chronic diarrhea.
Related to C. Diff colitis with pseudomembranes.
Also, I once had a patient with C. Diff Ileitits (which I didn't even know was possible).
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7 days old dyspnea/ hypoplastic lungs due to diaphgramatic hernia.
1) What could have caused this?
2) What's the SaO2 in this pt (i.e. increased/decreased?)
1) Defective development of the pleuroperitoneal membrane (which becomes the diaphragm)
2) I gotta think the SaO2 is decreased.
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didnt know CDif could cause this, but that's cool. was looking for inflammatory bowel disease...specifically, ulcerative...
Yeah CUC is probably more common, but Pseudomembranous Colitis is definitely a cause, and Toxic Megacolon is one of the more serious complications.
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Thyroid. What's the path?
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Figured its about time for me to join in on this fun instead of just lurking.
It does look like a germinal center, but I don't think that's scalloping. That would be with Grave's disease anyway, no scalloping in Hashimoto's I believe?
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I assume you picked up on this since you say you understand it, but I typoed and said carotid when I meant subclavian for what's blocked
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Last edited:
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Yeah, thats what I was thinking too haha.
point to it...because i don't see it...would be helpful to the others...if not
here's my question:
what cell is responsible for the changes seen in the lung...
hint: not looking for what the picture below is...
macrophagepoint to it...because i don't see it...would be helpful to the others...if not
here's my question:
what cell is responsible for the changes seen in the lung...
hint: not looking for what the picture below is...
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point to it...because i don't see it...would be helpful to the others...if not
here's my question:
what cell is responsible for the changes seen in the lung...
hint: not looking for what the picture below is...
Fibroblasts, which are stimulated by the macrophages which ingest the asbestos fibers.
Causes interstitial pulmonary fibrosis, and there's a risk of mesothelioma and other lung CA as well.
nice fellas...
i think theres a typo in pathoma...he talks about T2Pneumocytes are responsible for causing fibrosis...
btw, who here knows their skin pathology really really well...to the point they're banking on getting skin questions because they feel confident they'll get it right...
I know melenoma, bcc, scc, psoriasis, and urticaria...what else is there to know??
yeah i guess at our level that's about it...and the blisters...was hoping somebody here has a good thorough skin knowledge...wanted to ask a personal question actually
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I don't know what in particular lol it's just that the supposed follicle looked like a granuloma. It even looks like there could be a giant cell in there.
This is a granuloma. I guess those cells are too blue (i.e. lymphocytes) to be macrophages, and probably nuclei a little smaller. But they definitely do have some resemblance at least on that particular picture.
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(I had to cheat and look this one up to be sure: http://oac.med.jhmi.edu/pathconcepts/ShowImage.cfm?TutorialID=5&ConceptID=21&ImageID=136 )
No granuloma according to that, it is Hashimoto's. On the right is the follicle, with the germinal center that was already pointed out on the left.
Looked at some other pics. A LOT less lymphocytes in subacute thyroiditis outside of the granulomas. Whereas in hashimoto's there is a follice but filled with lymphocytes all over the place elsewhere too.
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It's herpes, Jonari
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too shy...it's ok, thanks anyways though fellas
Syphilis…Is the sore painful?
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ok lets get back on topic
whats dis?
I want to say Giardia? Although it doesn't exactly match what I'm picturing since this is a little more round.
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ok lets get back on topic
whats dis?
Looks like scabies to me
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ok lets get back on topic
whats dis?
Pubic Lice
- allright late 20s male...no drug abuse, drink rarely because of the studying.
- no family history of skin problems, besides my uncle having a case of psoriasis
- no drugs besides finasteride & minoxidil...sucks but not willing to accept the blade just yet
- have seen a dermatologist, was placed on -rotene class of drugs, and it was effective for a while, but ran out and haven't gone back since; also want to get an opinion from another derm
my right temple...doesn't itch, just more of a cosmetic thing that i hate. i apply neutrogena's t-gel shampoo on it and keto 2% combo every other day, but using the t-gel for sure everyday on the temple. the skin when you feel it - you can feel that it's dented in. it's like the skin over the area has thinned out compared to the rest of the skin on the face.
my right cheek, the wrinkle is the nasolabial fold, and rash adjacent to it. it's most prominent right out of the shower. i was guilty of taking really hot showers, but the past month ive kept it to cooler showers, and no more than 5 minutes in there...also apply the same regiment as i do to my scalp
ugh the worst, the ears....same as above. apply the shampoo and the keto 2%. for the ears, the keto 2% worked wonders on it. it went away, and now it's come back, and it seems like it's not going away at all. hate it, because when we have guests over, i'm always checking every 20 minutes to see how it looks...the crusting/scaling used to be on the backside of the ear, but now it's more so just right there...the 2nd picture, the crusting is around the tragus, of my right ear. the skin feels like it's fibrosed and sclerotic...kinda like CREST...you know how the skin just really tightens up, that's how it feels and looks
i decided to an experiment and see what would happen if i didn't shower for 2 days...the skin cleared up and was practically clear...tried it for 3 days, and same. im thinking maybe some heavy metal toxicity in the water system. never had this issue while i was away studying at school, but nobody else in my family &/or neighborhood is having this problem
yes, im going to the derm right after my exam...just wanted to see what you guys thought. i have an inkling, from doing some research...but lets see. im hoping this is just a transient thing, from the stress of the exam, lowered immune system, so body is susceptible to whatever this thing maybe...
- no family history of skin problems, besides my uncle having a case of psoriasis
- no drugs besides finasteride & minoxidil...sucks but not willing to accept the blade just yet
- have seen a dermatologist, was placed on -rotene class of drugs, and it was effective for a while, but ran out and haven't gone back since; also want to get an opinion from another derm
my right temple...doesn't itch, just more of a cosmetic thing that i hate. i apply neutrogena's t-gel shampoo on it and keto 2% combo every other day, but using the t-gel for sure everyday on the temple. the skin when you feel it - you can feel that it's dented in. it's like the skin over the area has thinned out compared to the rest of the skin on the face.
my right cheek, the wrinkle is the nasolabial fold, and rash adjacent to it. it's most prominent right out of the shower. i was guilty of taking really hot showers, but the past month ive kept it to cooler showers, and no more than 5 minutes in there...also apply the same regiment as i do to my scalp
ugh the worst, the ears....same as above. apply the shampoo and the keto 2%. for the ears, the keto 2% worked wonders on it. it went away, and now it's come back, and it seems like it's not going away at all. hate it, because when we have guests over, i'm always checking every 20 minutes to see how it looks...the crusting/scaling used to be on the backside of the ear, but now it's more so just right there...the 2nd picture, the crusting is around the tragus, of my right ear. the skin feels like it's fibrosed and sclerotic...kinda like CREST...you know how the skin just really tightens up, that's how it feels and looks
i decided to an experiment and see what would happen if i didn't shower for 2 days...the skin cleared up and was practically clear...tried it for 3 days, and same. im thinking maybe some heavy metal toxicity in the water system. never had this issue while i was away studying at school, but nobody else in my family &/or neighborhood is having this problem
yes, im going to the derm right after my exam...just wanted to see what you guys thought. i have an inkling, from doing some research...but lets see. im hoping this is just a transient thing, from the stress of the exam, lowered immune system, so body is susceptible to whatever this thing maybe...
lol take my guess with a grain of salt... it just seems similar to what i get. although I mostly get it around my nose. A little hydrocortisone once or twice a week when its really bad clears it up in no time.
yeah...no, i came to the same conclusion and the derm said the same thing too...hopefully it'll go away when the test is done...thanks for the insight...back on topic now
