For a doctor working in the red zone with more than 450 covid-19 positive patients, its highly insulting and heartbreaking for me when i hear people claiming ‘corona is just a hoax’ ‘govt is lying’ ‘its just a flu’
NO, NO AND ABSOLUTELY NOT!
➡️Classical CXR of Rt Upper Lobe collapse
1-Homogenous opacity Rt upper & middle zones with a ‘S’ shaped lower border (Marked by green arrow)
2- Another small opacity just below the medial part of S
shaped border (Marked Red arrow)
3- Tenting of Right Hemidiaphragm.
1️⃣ Cont👇
Today in OPD:
Male, 19, presented with gradual development of shortness of breath over a period of 2 months.
High vol pulse, water hammer, early systolic murmur, pigmentation of hands, pale conjunctiva.
CBC attached.
Diagnosis with Cause ?
#MedicalStudents
70 yrs old gentleman presented with weight loss, fatigue & blood-tinged sputum. Over a period of last few weeks painless multiple lesions appear on his chest wall.
Thoughts ?
DDx?
#MedX
#MedTwitter
Courtesy
@NEJM
۱۹۷۳ یا ۷۴ کی بات ہے بھٹو صاحب کی حکومت تھی اسلم اظہر صاحب پی ٹی وی کے ایم ڈی تھے
عید قربان کی رات ٹی وی پر ایک کھیل نشر ہوا جسکا نام تھا “ حج اکبر “
مرکزی کردار ذہین طاہرہ نے کیا تھا جنہیں ایک متوسط محلے کی خاتون دکھایا گیا تھا جو محنت مزدوری کر کے اپنا گزارا کرتیں اور کچھ پیسے
@docxusofficial
➡️ Vein Milking Technique
➡️ Normal veins: Umbilicus is the watershed. Hence flow is cephalad above umbilicus and caudad below umbilicus.
➡️ Portal Hypertension: The normal physiology is accentuated respecting the umbilical watershed.
Source: Dr Arun K Valsan
@NicoGagelmann
This is from Leonardo Da Vinci's "Organ networks of the thoracoabdominal cavity", detailed description of Ectopia cordis interna or Tin Man syndrome
@Neuromed_
➡️ Dupuytren's Disease (Fibromatosis) a genetic disorder,more common in people of Northern European or Scandinavian descent. Involves different parts of body;
➡️Palm - Dupuytren’s Contracture
➡️Foot - Ledderhose disease.
➡️Penis - Peyronie's Disease
➡️Knuckle - Garrod’s Pads
✅Sharing Video with patient’s consent.
-This evening, 25 years old gentleman presented with cough, sore throat and fever of one day’s duration.
Old habit of going through systemic review even in a patient with Tracheo-Bronchitis led to this 👇
Your input please.
55 years old male presented with a month long history of pain in central upper abdomen, indigestion & malaise. He suddenly developed these skin lesions. Name the sign and probable diagnosis.
#MedTwitter
36 years old lady, known Diabetic presented with 4 days Hx of Fever and red, swollen, painful nose.
Name the sign ?
Diagnosis ?
Most fearsome complication associated with it ?
#MedX
#MedEd
➡️Myoedema or Mounding
➡️Sign of
#Hypothyroidism
, refers to a small lump rising on the surface of a muscle when struck with percussion hammer
🟥It is characteristic of Hypothyroid Myopathy
➡️Lasts for 30-60 sec
It’s due to sustained contracture associated with delayed relaxation
@walinjom
▶️ST elevation in II, III & aVF with ST depression in I, aVL (Reciprocal) ➡️ Inferior Wall STEMI
▶️Injury to AV node resulting from Inferior Wall MI presenting as Complete (3rd Degree) Heart Block.
Very low LDL‐C levels <70 mg/dL are associated with increased risks of all‐cause, cardiovascular disease and stroke mortality.
Keep it above 70 and below 100.
کیا #نواز_شریف_رجیم_چینج کے پیچھے سعودی اور خلیجی حکمران خاندانوں کا ہاتھ تھا ؟ کیا اپریل 2015 میں #یمن کی جنگ میں #متحدہ_عرب_دنیا کا ساتھ نہ دینے کا فیصلہ #نواز_شریف کے اقتدار سے ہٹاۓ جانے کا سبب بنا ؟ فروری 2018 میں پاکستان نے فوجی دستے سعودی عرب بھیجنے کا اعلان کیا۰
@Xadeejournalist
@ImranKhanPTI
“You are free; you are free to go to your temples. You are free to go to your mosques or to any other places of worship in this State of Pakistan” ............. AT YOUR OWN RISK
@ShireenMazari1
سچ بولیں پلیز! یہ دراصل 46 کلومیٹر طویل پشاور - طورخم شاہراہ کے اس حصے کا فضائی جائیزہ لیا جا رہا ھے جو امریکی حکومت کے ادارے USAID کے 8 کروڑ 70 لاکھ ڈالرز کے مالی تعاون سے بنی ہے۰ اسی ادارے سے چند روز قبل PTI کی KP حکومت 36 گاڑیاں وصول کی تھیں، اس وقت آپ خاموش رہیں۰
@IhabFathiSulima
▶️Classical Singet Ring 💍 Sing
▶️Dx: Bronchiectasis
In a cross section Bronchus and the branch of Pulmonary Artery should be the same size, while in Bronchiectasis, Bronchus is markedly dilated.
Marked & Zoomed for easy understanding 👇
28 years old male, smoker, no known co-morbidities. CXR was done as a part of medical evaluation, a prerequisite for job he applied for.
Finding(s) ?
#MedX
#MedEd
#MedTwitter
@docxusofficial
Any Hx of recent endoscopic procedure ?
🟥Dx: Methaemoglobinemia most probably Acquired.
▶️Causes other than Haemoglobin M👇
-Exposure to direct oxidizing agents (Benzocaine & Prilocaine)
-Indirect oxidation (Nitrates)
-Metabolic activation (Aniline & Dapsone)
▶️Rx:Methylene Blue
@docxusofficial
➡️Finger To Nose Test to assess
#Dysmetria
/Cerebellar Ataxia due to lesions of the cerebellum
➡️Individual is asked to reach for the examiner’s finger with an outstretched arm,then touch his own nose many times
➡️Examiner observe for
Tremor at rest
Intention Tremor
Past Pointing
@fawadchaudhry
In July 2021, Press watchdog Reporters Without Borders (RSF) released a list of 37 heads of states who massively cracked down on press freedom. Pakistan PM Imran Khan named among the “predators of press freedom”,
But your govt didn’t allow press to publish this news.
-It’s Classical Kussmaul’s Sign, paradoxical rise of Jugular Venous pressure during inspiration.
-For PGs and Residents it’s a good video to appreciate sharp x and y descents, known as Friedreich’s sign.
-Best response from
@4donjohn
🏅👍🏻
میرے حلقے
#NA243
کے MNA جناب عالمگیر خان محسود، جن کا تعلق
#PTI
سے ھے، نے بلاک 7 گلشن اقبال کراچی میں واقع اپنے پورے گھر کو کراچی پورٹ ٹرسٹ کی مدد سے ڈس انفیکیٹ کروایا ھے۰
پوچھنا یہ ھے کہ اس حلقے کے عوام کے لیۓ یہ سہولت کب سی مہیا ہو گی ؟
@Xadeejournalist
غداری کے بائیس کروڑ سرٹیفیکیٹ چھپے رکھے ہیں اور مجاز اتھارٹی کے دستخط اور مہر بھی لگی ہوئی ھے،صرف نام کا خانہ خالی ھے۰ آج میرا نام تو کل آپ کا نام۰
-Severe Subcutaneous Emphysema (Gas in both Supra-Clavicular fossae)
-Right Pneumothorax with collapse of lung
-Pneumomediastinum
-Ginkgo Leaf Sign on Left Side
-Continuous Diaphragm Sign
🔺Subcutaneous Emphysema with Rt Pneumothorax + Atelectasis and Pneumomediastinum
@realMuneebAhmed
@IhabFathiSulima
@fxgodzeuss
➡️CXR
-Very wide mediastinum
-Mottled Appearance
-One Air Fluid level is visible
🔺Mega-Oesophagus due to
1) Achalasia
2) Hypothyroidism ?
❗️Hypothyroidism could initiate a metabolic myopathy/neuropathy associated with a megaesophagus
@docxusofficial
▶️DDx:
1) Giant C-V Wave in Severe Tricuspid Regurgitation (Lancisi sign)
2) Corrigan’s Sign of AR
*Lancisi's sign is seen in severe TR & is caused by obliteration of the normal x descent, with subsequent fusion of c & v waves that occur during systole with with carotid Impulse
Both X Rays of the spines are marked and labelled.
1-
#Winking_Owl_Sign
as on Pedicle is missing
2-
#Blind_Vertebrae
as both Pedicle are absent.
These findings are highly suggestive of metastatic disease of the vertebral column. 👇
Observation makes one a better Clinician. Here is a challenge for you.
Photograph of a 16 years old girl with Noonan’s Syndrome.
Closely observe and identify the features that point’s to Noonan’s Syndrome.
#MedEd
#MedX
@docxusofficial
🟥 Enhanced Ptosis/Curtain Sign, when one eyelid is lifted, & the contralateral eyelid develops ptosis/worsening of pre-existing ptosis
This sign is due to Hering’s Law of equal innervation that yoke muscles acting in the same direction are innervated equally.
🔺Myasthenia Gravis
A 37-year-old man presented with a brownish-black nail on the great toe of the right foot. A darkly pigmented linear patch had started to form within the toenail 4 years earlier and had widened and darkened over time. What is the likely diagnosis?
#medEd
پروگریسو سوچ دی اس کھیل نے جو ۱۹۷۷ تک ہر عید قربان پر نشر ہوا مگر اسکے بعد ملک میں ضیا کی آمریت آگئی عدم برداشت کے ماحول نے سارے ملک کو اپنی لپیٹ میں لے لیا۔ پاکستان کی پروگریسو سوچ کی کہانی بدل گئی ۔ اب حج اکبر کے معنی پاکستان میں کچھ اور ہی ہیں۔
@docxusofficial
➡️Differential Clubbing
➡️Eisenmenger’s Syndrome Sec to Patent Ductus Arteriosus.
➡️There is AV mixing causing deoxygenated blood to reach lower limbs exclusively as the PDA connects pulmonary artery to aortic arch distal to the left subclavian artery with sparing of Upper Limbs
25 old lady, primigravida was diagnosed with ‘Pregnancy Induced Hypertension’ and put on treatment.
On her 3rd Antenatal visit she was found to be anaemia with a normal BP. Her lab shows Hb of 10.5 G%, MCV 90fl, Normal TLC & Platelets. Total Bili 1.5 mg%.
Probable Cause ?
Test ?
@docxusofficial
▶️
#Hashitoxicosis
presenting as Acute Adrenal Crisis Precipitated by Thyroxin in a patient with underlying Adrenal Insufficiency.
▶️Hashitoxicosis may present as Adrenal Crisis &/or Thyroid Crisis
▶️ Cause is APS type 2 also known as Schmidt’s Syndrome ( Hashimoto’s & Addison’s)
@AbsarAlamHaider
طلال چوہدری نے PCO ججز کا ذکر کیا تھا، معافی بھی مانگ لی تھی لیکن ثاقب نثار نے معافی مسترد کر کے 5 سال کے لیۓ نااہل کر دیا تھا۰
دانیال عزیز نے معافی نہیں مانگی تھی۰
جسٹس کھوسہ نے نہال ہاشمی سے ایک سے زیادہ بار معافی منگوانے کے باوجود انہیں سزا سنائی تھی۰
@DrSanjay277
@AdityaBurje
@DrAkhilRaghavan
@aakashparab17
The sign named after Adolf Kussmaul originally discovered by Greisinger
Kussmaul’s sign is seen in conditions that restrict right ventricular filling such as,
Constrictive pericarditis
Restrictive CMP
Right Heart failure
RV infarction
Tricuspid stenosis
Massive pulmonary embolism
@MoeedNj
Bakhtawar Cadet College is named after legendary Sindhi Hari icon Mai Bakhtawar Lashari Shaheed, who was gunned down by Choudhary Saeedullah on June 22nd 1947 for demanding her share of harvest. She fought against feudal lords for peasants rights.
Please read history.
@docxusofficial
➡️Locomotor Brachii Sign
➡️Causes
1- Severe AR with Hyperdynamic Circulation
2- Advanced Atherosclerosis of Brachial Artery in elderly.
-Oppenheim’s Sign +Ve
-Gordon’s Reflex +Ve
-Chaddock Reflex +Ve
-Rossolimo’s Sign +Ve
Which Track in involved ?
Are these 4 different Signs/Reflexes or different names for same response ?
#MedEd
#MedX
#MedicalStudents
i plead you all to stay home, if you dont go to the parlour or if you dont get new dresses for eid, its okay. You are healthy you are safe, thats what matters.
Please bump this post and feel free to share it so it reaches more people, especially those who are questioning
56 years old gentleman, a diagnosed case of ESRD secondary to Hypertensive Nephropathy, on Haemodialysis twice weekly, presented with painful skin lesions 👇
Thoughts
Imagine staying in a ward full of corona patients with a 3 layered PPE in this heat while fasting. You cant go to the washroom because you are completely sealed. you cant scratch your face.
Designated caretaker CM of
#KPK
#ManzoorAfridi
is in meeting with
@ImranKhanPTI
at BaniGala.
Do you expect fair n free elections in KPK with this setting ?
@docxusofficial
@StanfordMed25
▪️Is it really clubbing ? Did someone check absence of Shamroth’s window ?
I can see intact Lovibond angle.
▪️Since I didn’t examine the patient, considering nail findings as drum stick clubbing, then the only diagnosis is Eisemenger’s Complex (Reversal of Shunt) with PDA
@walinjom
➡️Persistent ST elevation 2 weeks after Anterior STEMI
➡️R waves in aVR - Goldberger's sign
➡️Dx: Post MI Left Ventricular Aneurysm
▶️Next Step: Echo & Anti-Coagulation
@OGdukeneurosurg
➡️Weber Test to assess Air Vs Bone conduction. Perform it with Rinne’s test
A lateralization test.Normally AC is better than BC
🟥No lateralization - Normal
🟥Heard better in normal ear- Unilateral SN Hearing Loss
🟥Lareralized to affected ear- Unilateral Conductive Hearing Loss
@IhabFathiSulima
▪️ Opisthotonus, i.e. the body is bent backward (hyperextension of spine) making it rest on the occiput and heels like a bow.
▪️Opisthotonus is a symptom/sign of following disease
-Tetanus
-Rabies
-Encephalitis
-Meningitis
-Syphilis of Brain
-Strychnine poisoning.
@shundeshagen
With fissured tongue,If there is a Hx of Facial Palsy and patient’s lips are also swollen, the diagnosis is
🔺 Melkersson-Rosenthal syndrome
🟥Other causes
Down’s Syndrome
Psoriasis
Orofacial granulomatosis
Geographic tongue
Malnutrition (B12, Iron & Zinc Deficency)
There are 7 types of
#Psoriasis
-Plaque Psoriasis
-Guttate Psoriasis
-Inverse Psoriasis
-Pustular Psoriasis
-Erythrodermic Psoriasis
-Nail Psoriasis
-Psoriatic Arthritis
There are 2 types of #
#Parapsoriasis
-Small-plaque
-Large -plaque