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Med G

a Medical doctor who graduated in 2018 and I graduated my studies in Japan. I like sharing medical education.I hope you like my page. Contact: medgpage@gmail.com
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I am a clinical and public health doctor. Disclaimer:
The information provided is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Do not self-medicate or use any prescription drugs without proper evaluation and prescription by a licensed healthcare professional. Always consult your physician or qualified healthcare provider before starting, stopping, or changing any medication or treatment plan.

17/10/2025

A 65-year-old man with a 15-year history of type 2 diabetes mellitus presents with black discoloration and foul odor of his right toes for the past 10 days. He reports numbness and tingling in both feet for years. Examination shows dry black necrotic tissue involving the first and third toes, surrounded by erythema and mild swelling. Dorsalis pedis pulse is weakly palpable.
What is the most likely diagnosis?

17/10/2025

🩺 Syringes & Parenteral Injections

🧠 Perfect for students, nurses, and clinical practice!

17/10/2025

Stroke is a sudden interruption of blood supply to the brain, leading to brain cell death due to lack of oxygen and nutrients. It can be ischemic (caused by blockage of a blood vessel) or hemorrhagic (caused by bleeding into or around the brain), often resulting in weakness, speech difficulty, or paralysis on one side of the body.

17/10/2025

Doctor, Have you ever been sick?😂

17/10/2025

This 58-year-old male is currently an in-patient on your ward recovering from a stroke. He has been nil by mouth for three days since there is concern about his swallow. A nasogastric (NG) tube has been inserted. Is it safe to use?

17/10/2025

1. Bacterial Vaginosis (BV)
Etiology: Overgrowth of anaerobic bacteria (e.g., Gardnerella vaginalis, Mobiluncus, Atopobium) replacing normal Lactobacilli.
• Risk Factors: Multiple or new s*x partners, douching, lack of vaginal Lactobacillus.
Clinical Presentation:
• Thin, homogeneous gray or white discharge
• Fishy odor, especially after in*******se
• No itching or inflammation
Diagnosis (Amsel criteria – ≥3 required):
1. Thin, homogenous discharge
2. Vaginal pH >4.5
3. Positive whiff test (fishy odor with 10% KOH)
4. Clue cells on saline wet mount
Treatment:
• Metronidazole 500 mg PO BID x 7 days
• Alternatives: Metronidazole gel, Clindamycin cream

2. Vulvovaginal Candidiasis (VVC)
Etiology: Usually Candida albicans, an overgrowth of yeast; not typically s*xually transmitted.
• Risk Factors: Antibiotic use, diabetes, pregnancy, immunosuppression, tight clothing.
Clinical Presentation:
• Thick, white, clumpy discharge (“cottage cheese”)
• Intense itching, burning, vulvar erythema, dysuria, dyspareunia
• Normal vaginal pH (≤4.5)
Diagnosis:
• KOH prep shows pseudohyphae or budding yeast
• Vaginal culture if unclear or recurrent
Treatment:
• Fluconazole 150 mg PO single dose
• Topical azoles (e.g., clotrimazole, miconazole) for 3–7 days
• Longer treatment for recurrent or complicated cases

3. Trichomoniasis
Etiology: Trichomonas vaginalis, a flagellated protozoan parasite
Transmission: Sexually transmitted (STI)
Clinical Presentation:
• Frothy, yellow-green vaginal discharge
• Strong foul odor
• Vaginal/vulvar irritation, itching, dysuria, dyspareunia
• “Strawberry cervix” (punctate hemorrhages on cervix) in ~10%
• Vaginal pH >4.5
Diagnosis:
• Motile trichomonads seen on saline wet mount (low sensitivity)
• NAAT (nucleic acid amplification test) is gold standard
Treatment:
• Metronidazole 2 g PO single dose (or 500 mg BID x 7 days)
• Treat s*xual partners to prevent reinfection
• Avoid alcohol during and 24 hrs after treatment (disulfiram-like reaction)

17/10/2025

Spinal Cord Trauma
(Based on The 5-Minute Clinical Consult 2023)

Spinal cord trauma (SCT), or spinal cord injury (SCI), refers to damage to the spinal cord resulting from direct trauma, leading to varying degrees of motor, sensory, and autonomic dysfunction. It may be complete (total loss below the level of injury) or incomplete (partial function remains).

• Sudden loss of motor function (paralysis or weakness)
• Sensory loss (numbness, tingling)
• Loss of bowel/bladder control
• Hypotension and bradycardia (especially in cervical injuries)
• Pain at the injury site or radicular pain
• Priapism (often in complete SCI)

• History and physical exam (focus on neurologic assessment)
• Imaging:
• CT scan: preferred for bony injury
• MRI: ideal for cord, ligament, and soft tissue evaluation
• Neurologic classification: ASIA (American Spinal Injury Association) scale to assess level and completeness of injury

⸻

Differential Diagnosis
• Spinal cord compression from tumor, hematoma, or abscess
• Transverse myelitis
• Guillain-Barré syndrome
• Conversion disorder

Acute phase (first 24–48 hours):
• Immobilization of the spine (e.g., cervical collar, backboard)
• High-dose corticosteroids (controversial, not universally recommended)
• Surgical decompression/stabilization if indicated
• Blood pressure support (e.g., vasopressors) for spinal shock
• DVT prophylaxis, pain control, urinary catheterization

Rehabilitation phase:
• Multidisciplinary rehab: PT, OT, speech therapy, psychology
• Bladder and bowel management
• Prevention of complications: pressure sores, infections, contractures

-Up
• Regular neurologic and functional assessments
• Long-term rehab and social support
• Monitor for autonomic dysreflexia, especially in injuries at or above T6
• Psychosocial support for patient and family

17/10/2025

A 42-year-old male who works as a fisherman in the Amazon basin presents with a slowly enlarging nodular lesion on his upper arm for the past 5 years. The lesion began as a small, painless papule that gradually became a large, verrucous, keloid-like plaque. There is no history of trauma, pain, or systemic symptoms. The lesion is firm, well-defined, and covered with shiny lobulated nodules.
What is the most likely diagnosis?

17/10/2025

Breast-Associated Fevers

Definition
Breast-associated fevers refer to febrile conditions directly involving the breast, commonly seen in lactating women but also possible in nonlactating individuals. These fevers are typically caused by inflammatory or infectious processes.

Symptoms
• Fever >38.5°C
• Breast pain (often described as “burning cords in chest wall”)
• Localized tenderness, redness, warmth, and swelling
• Possible palpable mass or induration
• Peau d’orange appearance of skin (in severe inflammation)
• Systemic symptoms: malaise, myalgia, nausea, vomiting

Diagnosis
• Clinical history and exam are key: assess for recent breastfeeding, trauma, ni**le fissures, prior breast infections, and systemic illness.
• Physical exam shows erythema, fluctuance, warmth, lymphadenopathy, and in some cases, drainage or skin ulceration.
• Ultrasound is the preferred imaging to identify abscess or fluid collections.

Differential Diagnosis
• Mastitis (puerperal and nonpuerperal)
• Breast abscess
• Inflammatory breast carcinoma
• Idiopathic granulomatous mastitis
• Tuberculosis, fungal infections, or sarcoidosis of the breast
• Raynaud vasospasm (burning ni**le pain)
• Ductal ectasia, galactocele, Mondor disease (superficial vein thrombosis)

Treatment
• Mastitis (bacterial):
• Continue breastfeeding or pumping to empty the breast.
• Oral antibiotics (e.g., dicloxacillin or cephalexin); adjust based on culture if abscess present.
• Breast abscess:
• Drainage (needle aspiration or surgical)
• Antibiotics as above
• Supportive care:
• Warm compresses
• NSAIDs for pain and fever
• Adequate hydration and rest

Follow-Up
• Reevaluate in 48–72 hours.
• Ultrasound-guided aspiration may be repeated if fluid persists.
• Nonresolving masses or recurrent abscesses require biopsy to rule out malignancy or granulomatous disease.
• Educate patients on proper breastfeeding techniques, ni**le care, and breast emptying

17/10/2025

A 38-year-old man with advanced HIV infection (CD4 count 80 cells/μL) presents with multiple purple-red patches and nodules on his arms and legs. The lesions are non-tender, do not blanch on pressure, and have gradually increased in number over the past few months. He also complains of shortness of breath and dry cough.
What is the most likely diagnosis?

17/10/2025

Genetic disorders are health conditions caused by abnormal changes (mutations) in a person's DNA, which provides instructions for the body's growth, development, and function. These abnormalities can stem from issues with single genes, multiple genes, or entire chromosomes, and may be inherited from parents or acquired during a person's lifetime. Common symptoms include developmental delays, distinct physical features, cognitive deficits, and sensory impairments, with treatments varying from medication to physical therapy.

17/10/2025

Coffee is my everything during night shift

住所

Hiroshima, Hiroshima