Study 8100 #MedEd "flash-XCreations"- Reminders of topics to do a deeper study-dive. Zebra hoof-beats? Think Tyrannosaurus Rex 🦖Thanks 56,000!
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4 main drug classes linked to tendon injury/rupture, with Achilles tendon most frequently:
-Fluoroquinolone antibiotics — most well-established
-Corticosteroids (systemic or local injection)
-Statins (HMG-CoA reductase inhibitors)
-Aromatase inhibitors — more tendinopathy
Jun 12
Q::Which antibiotic can cause this injury❓
A. Doxycycline
B. Ciprofloxacin
C. Penicillin
D. Metronidazole
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C. Lovibond angle (hyponychial angle or profile angle) = angle between nail plate & proximal nail fold, normally less than 169°. In digital clubbing, angle increases to 180° or greater, reflecting loss of normal acute angle at the nail base & characteristic "floating nail" sign
Jun 12
Q// Which angle is increased in digital clubbing?
A. Carrying angle
B. Q angle
C. Lovibond angle
D. Cobb angle
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Hypothyroidism carpal tunnel syndrome -->
1. deposition of mucopolysaccharides (pseudomucinous material) within carpal tunnel and
2. swelling and thickening of synovial membranes surrounding the flexor tendons (tenosynovitis)
*Both increase pressure on median nerve
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Rovsing's sign --> Pressure on lower left quadrant of abdomen produces pain on lower right side; = Appendicitis with peritonitis (possible appendix leakage, rupture?)
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Cullen’s Sign - Bluish bruising or discoloration directly around umbilicus / belly button.
The other sign of pancreatitis: Grey Turner’s Sign - Bluish or purplish bruising on flanks (sides of waist or upper outer thigh)
Jun 10
A patient with severe pancreatitis suddenly developed bruising here
What deadly sign is this called?
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B. Common cold - Rhinorrhea in children MCC is viral upper respiratory infection (common cold)
A. HTN does not typically cause a runny nose
C. DM has increased thirst, urination, but not usually runny nose
D. Causes abd pain, nausea, and fever, not nasal symptoms
Jun 11
The most common cause of a runny nose in children is:
A. Hypertension
B. Common cold
C. Diabetes mellitus
D. Appendicitis
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Takayasu arteritis in kids s/s: hypertension (83%), bruits, reduced pulse, limb claudication, fever, malaise, wt loss, abdominal pain, headache, blurry vision, dizziness, elevated creatine; Arteries involved in kids - abdominal aorta, renal arteries
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B. Alcohol-related liver disease; Fixed flexion deformity of ring finger with palpable thickening of palmar fascia = Dupuytren's contracture (palmar fibromatosis); "manifestation of excess ETOH consumption rather than of cirrhosis", Men 60 y/o northern European descent
A fixed flexion deformity of the ring finger with palpable thickening of the palmar fascia is most commonly associated with:
A. Viral hepatitis
B. Alcohol-related liver disease
C. Wilson disease
D. Hemochromatosis
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Brudzinski's sign - Indicates meningeal irritation (meningitis or a subarachnoid hemorrhage MC); Neck is passively flexed, stretching inflamed meninges triggers involuntary reflex flexion of the hips to relieve tension
A child shows reflex hip flexion when the neck is passively flexed.
Which clinical sign is being demonstrated here?
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IV urogram & pyelogram w/ duplicated collecting system on left, with 2 separate ureters = Congenital left duplex collecting system with duplicated ureters, absent right; Can predispose to: recurrent UTIs, vesicoureteral reflux, obstruction/ureterocele and/or hydronephrosis
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Valproate - high teratogenic risk among antiepileptics (9–10%) associated with oral clefts, neural tube defects, cardiac defects, hypospadias, skeletal anomalies; B) Phenytoin = "fetal hydantoin syndrome" (nail/digit hypoplasia, cardiac defects); Safer: Lamotrigine, Levetiracetam
May 13
Which antiepileptic drug is most clearly associated with an increased risk of cleft lip?
· A) Valproate
· B) Phenytoin
· C) Lamotrigine
· D) Levetiracetam
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"bat-wing" (or "butterfly") CXR = bilateral, symmetric, perihilar alveolar opacities that spare lung periphery; MC Diff Dx: Cardiogenic pulmonary edema (PEd), volume overload / renal failure, pulmonary alveolar proteinosis, acute MI with flash PEd, acute valvular catastrophe
علامة "أجنحة الخفاش" هي علامة طبية مميزه لحالة مرضية طارئة وتستدعي التدخل السريع
التشخيص هو ؟
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Vit B12 (cobalamin): Cofactor for 2 enzymes: methionine synthase and L-methylmalonyl-CoA mutase --> Required for DNA synthesis, methylation, red blood cell formation, and myelin maintenance; Deficiency: Pernicious anemia, malabsorption, veganism, bacteria overgrowth
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Hurler syndrome (Mucopolysaccharidosis type I-H), worst form of MPS I = deficiency of lysosomal enzyme α-L-iduronidase (IDUA gene mutation); s/s: Coarse facial features, Corneal clouding, Intellectual disability, Hepatosplenomegaly, Short neck, gaped teeth, Macroglossia, etc.
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Valproic acid is most strongly associated with an increased risk of spina bifida when taken in early pregnancy; Overall major congenital malformation rate with valproic acid is approximately 9–10%, with a dose-dependent relationship
May 12
Which drug is associated with an increased risk of spina bifida if taken in early pregnancy?
A) Paracetamol
B) Valproic acid
C) Amoxicillin
D) Ibuprofen
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Niacinamide / nicotinic acid (niacin) / B3 = MC associated with med-induced acanthosis nigricans; Metformin is actually used to treat acanthosis nigricans by reducing insulin resistance and compensatory hyperinsulinemia
Which drug is most commonly associated with medication-induced acanthosis nigricans?
A. Metformin
B. Niacinamide
C. Isotretinoin
D. Spironolactone
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Meclizine (Antivert) is not an effective treatment for BPPV... neither short-term nor long-term. The most effective treatment for BPPV is the Epley maneuver (canalith repositioning), which achieves complete symptom resolution in 88% to 98% of patients (right/left approach)
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Relaxin = primary hormone during pregnancy that contributes to weakening of collagen fibers via upregulation of collagenase, downregulation of collagen synthesis, connective tissue remodeling; Others? Estrogen, cortisol, progesterone
Which hormone during pregnancy contributes to weakening of collagen fibers? 💥🤯
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Osteosarcoma of distal femur: Divergent spiculated ("sunburst") periosteal rxn, large soft tissue mass with mineralized osteoid matrix surrounding distal femoral metaphyseal area in distal femur; Diff Dx: Ewing sarcoma, Osteomyelitis with aggressive periostitis, Metastatic dz
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Pitting Edema...
Heart
Kidneys
Liver
Lungs (via pulmonary hypertension/cor pulmonale)
Lymphatic system
Venous system
Intestines/GI tract
Endocrine system
Skin/capillary endothelium (sepsis capillary leak)
Multiorgan failure/critical illness
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