Post on 05-Dec-2014
description
PICTORIAL CMECITY PHYSICIAN MEET-
CHENNAI
K.M.JEYABALAJI
CASE-1 HISTORY
A 56 YEAR OLD MALE PATIENT PRESENTED WITH RECURRENT EPISODES OF MALENA FOR PAST 2 YEARS
CT ABDOMEN
CT ANGIOGRAM
OSLER RENDU WEBER SYNDROME
CURACAO CRITERIA
Spontaneous recurrent epistaxis
Multiple telangiectasias
Proven visceral AVM (lung, liver, brain, spine)
First-degree family member with HHT
CASE -2 HISTORY
A 28 year old male patient came to medical OP with complaints of
Abdominal pain for past 3 days
H/O similar episode on & off for past 2 years
INFERENCE
ERUPTIVE XANTHOMA,LIPEMIA RETINALIS
DIFFERENTIAL DIAGNOSIS:
HYPERTRIGLYCERIDEMIA SYNDROMES – TYPE 1 ,3, 5
DIAGNOSIS
HYPERTRIGLYCERIDEMIA TYPE I WITH PANCREATITIS
FREDRICKSON CLASSIFICATION
CASE – 3 HISTORY
A 26 YEARS OLD MALE PATIENT CAME WITH COMPLAINTS OF
COUGH WITH EXPECTORATION FOR PAST 3 MONTHS
DIFFICULTY IN BREATHING FOR PAST 2 MONTHS
RADIOGRAPHY
INFERENCECENTRAL BRONCHIECTASIS
DIFFERENTIAL DIAGNOSIS:
Allergic broncho pulmonary aspergillosis
Kartagener’s syndrome
young’s syndrome
Eosinophilic lung diease
CYSTICFIBROSIS
Autoimmune causes- RHEUMATOID ARTHRITIS
ABPA EXACERBATION:
worsening in clinical symptoms
new infiltrates in radiography
Serum Ig E levels going above twice the baseline
TREATEMENT:
Prednisone 0.5 mg/kg daily until resolution occurs is recommended. Resolution is achieved when symptoms improve, the infiltrate clears and IgE levels decrease by at least 35%. Steroids should be slowly taper over 3 to 6 months.
ITRACONAZOLE, VORICONAZOLE
CRITERIA
CASE – 4 HISTORY
A 46 YEAR OLD MALE PATIENT CAME WITH COMPLAINTS OF
UNSTEADYNESS WHILE WALKING
KNOWN ALCOHOLIC FOR PAST 13 YEARS
MRI
INFERENCE
EXTRA PONTINE MYELINOLYSIS
ALCOHOL INDUCED
DISRIBUTION:
MIDBRAIN
BASAL GANGLIA
CEREBELLUM
THALAMUS
DD
EPM
CEREBELLAR HEMORRHAGE
MULTIPLE SCLEROSIS
GLIOMA
CASE -5 HISTORY
A 45 YEAR OLD MALE PATIENT CAME WITH COMPLAINTS OF
PALPITATION , SHOSTNESS OF BREATH FOR PAST 2 MONTHS
ECHOCARDIOGRAM
FINDINGS
HYPER REFRACTILE SEPTUM , POSTERIOR WALL
SPECKLED PATTERN
HYPERTROPHIED SEPTUM, POSTERIOR WALL
FINDINGS SUGGESTIVE OF
AMYLOID HEART
CASE – 6 HISTORY
A 42 year old male patient referred from dermatology dept suspecting a systemic disease
FINDINGSHYPERPIGMENTED NONSCALY PLAQUE TYPE LEION IN RIGHT ARM
NODULES OF SIZE 3 mm IN ALA
MULTIPLE PAPULES IN BOTH CHEEKS
DIFFERENTIAL DIANOSIS
SARCOIDOSIS
CUTANEOUS TB
TUBERCULOID LEPROSY
CASE – 7 HISTORY
A 34 year female patient came with complaints of
Attempted hanging 30 min back
Altered sensorium
MRI
INFERENCE
CORTICAL LAMINAR NECROSIS
DIAGNOSIS – HYPOXIC ISCHEMIC ENCEPHALOPATHY
THANK YOU