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04/21/2025

Penetrating chest injuries in the left fifth intercostal space, at the midclavicular line, are most likely to injure the left lung and the apex of the heart ( part of the left ventricle ).

Aortic dissections occur secondary to intimal tears, extending and allowing blood to accumulate between the tunica intim...
04/20/2025

Aortic dissections occur secondary to intimal tears, extending and allowing blood to accumulate between the tunica intima and adventitia in a false lumen. A dissection flap can be seen on chest CT, indicating the boundary between the true and false lumens.

A pulmonary embolism occurs when a venous thrombus (most commonly from deep vein thrombosis of the lower limb) lodges in...
04/20/2025

A pulmonary embolism occurs when a venous thrombus (most commonly from deep vein thrombosis of the lower limb) lodges into the pulmonary vasculature. Large emboli, which occlude the pulmonary trunk, are known as Saddle emboli. these clots limit blood flow through the pulmonary circulation and cause filling defects on contrast chest CT.
Interventricular septal rupture, pulmonary hypertension, and papillary muscle rupture do not produce filling defects on imaging.
Key Takeaway:
Pulmonary embolisms can lodge in the pulmonary trunk and prevent its filling.

DiGeorge syndrome is a genetic condition caused by a deletion mutation on chromosome 22 (22q11). Classic findings in DiG...
04/15/2025

DiGeorge syndrome is a genetic condition caused by a deletion mutation on chromosome 22 (22q11). Classic findings in DiGeorge syndrom are thymic aplasia, hypoparathyroidism, hypocalcemia, and conotruncal heart defects including tetralogy of Fallot (ToF) and truncus arteriosus. Tetralogy of Fallot seems to be the most relevant associated cardiac defect for this disorder on board exams.

Failed spiraling of the aorticopulmonary septum leads to transposition of the great vessels, a switch in the origins of ...
04/15/2025

Failed spiraling of the aorticopulmonary septum leads to transposition of the great vessels, a switch in the origins of the aorta and pulmonary trunk, not truncus arteriosus.

The aorticopulmonary septum forms from neural crest cell migration. If there is incomplete or partial formation of the aorticopulmonary septum, a persistent truncus arteriosus, or common aortic and pulmonary trunk, forms. This leads to the mixing of oxygenated and deoxygenated blood and consequently produces hypoxia and cyanosis in the neonate.

Truncus arteriosus (and tetralogy of Fallot) is associated with DiGeorge syndrome,
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**Key Takeaway:**

- Failed spiraling of the aorticopulmonary septum leads to transposition of the great vessels.
- Truncus arteriosus describes a persistent, shared connection between the aortic arch and the pulmonary trunk.

04/14/2025

the trabeculated portions of the right and left atria are derived from the primitive atrium.

superior vena cava (SVC) syndrome occurs when a tumor compresses the superior vena cava, thereby obstructing venous retu...
03/19/2025

superior vena cava (SVC) syndrome occurs when a tumor compresses the superior vena cava, thereby obstructing venous return to the right atrium. consequently, retrograde blood pooling in the head, neck, and arms produces facial plethora and upper extremity edema.
the superior vena cava is derived from the common cardinal veins.

02/17/2025

Ascending cholangitis
Ascending cholangitis is a bacterial infection (typically E. coli) of the biliary tree. The most common predisposing factor is gallstones.
Charcot's triad of right upper quadrant (RUQ) pain, fever and jaundice occurs in about 20-50% of patients
fever is the most common feature, seen in 90% of patients
RUQ pain 70%
jaundice 60%
hypotension and confusion are also common (the additional 2 factors in addition to the 3 above make Reynolds' pentad)
Other features
raised inflammatory markers
Management
intravenous antibiotics
endoscopic retrograde cholangiopancreatography (ERCP) after 24-48 hours to relieve any obstruction

In hyperglycemic states, aldose reductase converts glucose to sorbitol at a rate faster than sorbitol can be metabolized...
03/26/2024

In hyperglycemic states, aldose reductase converts glucose to sorbitol at a rate faster than sorbitol can be metabolized. Sorbitol accumulates in certain cells such as lens cells, causing an influx of water and resulting in osmotic cellular injury. Depletion of NADPH by aldose reductase also increases oxidative stress, which accelerates development of cataracts and diabetic microvascular complications (eg, neuropathy, retinopathy).

Reference:
https://pubmed.ncbi.nlm.nih.gov/15919781/

Risk Factors for Autism:There is not just one cause of ASD. There are many different factors that have been identified t...
03/05/2024

Risk Factors for Autism:
There is not just one cause of ASD. There are many different factors that have been identified that may make a child more likely to have ASD, including environmental, biologic, and genetic factors.

Although we know little about specific causes, the available evidence suggests that the following may put children at greater risk for developing ASD:

Having a sibling with ASD
Having certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis
Experiencing complications at birth
Being born to older parents

CDC

The classic triad of opioid intoxication is decreased respiratory rate, pupillary constriction (ie, miosis), and depress...
01/30/2024

The classic triad of opioid intoxication is decreased respiratory rate, pupillary constriction (ie, miosis), and depressed mental status. Hypothermia, hypotension, and decreased tidal volume are also common findings.

01/26/2024

SLE is a chronic autoimmune disease predominantly affecting women age 20-40 that causes constitutional and multisystemic symptoms. Serosal inflammation is common in SLE and most often manifests as pleuritis or pericarditis.

Pericarditis presents with severe and constant middle or left chest pain that may radiate to the neck and shoulders (particularly the trapezius ridge). The pain increases on inspiration (pleuritic) and is relieved by sitting up and leaning forward (postural). Auscultation of the chest reveals a scratchy sound called a pericardial friction rub that is best heard when the patient is leaning forward or lying prone. Additional cardiovascular manifestations in SLE include pericardial effusion, verrucous (Libman-Sacks) endocarditis, and increased risk of coronary artery disease.

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