Medical cases

11/20/2023

A 38-year-old hospitalized woman is evaluated for new-onset confusion. The patient has a prolonged history of Crohn disease and was admitted 2 days ago due to worsening abdominal pain, nausea, and watery diarrhea. She tested positive for Clostridioides (formerly Clostridium) difficile infection and is receiving oral vancomycin and intravenous fluids. Her gastrointestinal symptoms have been improving but since yesterday the patient has been incoherent, disoriented, and unsteady. She has no other medical conditions but has had small bowel resections due to stricture and fistula in the past and has lost 10 kg (22 lbs) over the past 6 months. The patient does not use to***co, alcohol or illicit drugs Temperature is 36 6 C (98 F), blood pressure is 120/70 mm Hg, and pulse is 92/min with no orthostatic changes. BMI is 19.5 kg/m² On examination, she is not oriented to time or place. Pupils are equal and reactive to light. Abduction of the right eye is limited and elicits bilateral honzontal nystagmus Motor strength and deep tendon reflexes are normal throughout. Finger-to-nose and heel-tu-shin testing are normal, but the gait is wide based Which of the following is the most likely cause of this patient's neurologic symptoms?

A. Immune-mediated demyelination

B. Medication-induced delirium

C Microbial meningoencephalitis

D Nutritional vitamin deficiency

E Vertebrobasilar arterial occlusion

10/31/2023

🛑in patients with IE in whom a decision is made to continue anticoagulant therapy (eg, for a mechanical valve), we generally replace direct oral anticoagulant (DOAC) or vitamin K antagonist (VKA) therapy (eg, warfarin) with unfractionated heparin or low molecular weight heparin therapy at the time of presentation while stability and the potential need for an invasive procedure is assessed.

10/27/2023

عند معالجة الملاريا(Malaria) عند الحامل لازم ننتبه للآتي:

١- في الثلاثه الأشهر الأولى من الحمل نستخدم(Mefloquine) مع(Clindamycin).

او نستخدم(Quinine) مع(Clindamycin).

٢- في السته الأشهر الأخيرة من الحمل نستخدم
( artemether-lumefantrine)

References
Medscape
CDC

10/24/2023

10/01/2023

10/01/2023

A 45-year-old woman comes to the physician because of a 5-month history of recurrent retrosternal chest pain that often wakes her up at night. Physical examination shows no abnormalities. Upper endoscopy shows hyperemia in the distal third of the esophagus. A biopsy specimen from this area shows nonkeratinized stratified squamous epithelium with hyperplasia of the basal cell layer and neutrophilic inflammatory infiltrates
What is the diagnosis
التشخيص في اول تعليق في الصفحة الرئيسية