Anoscopy provides a very limited view of the lower portion of the rectum. A technique that provides a better view of the entire colon, like a colonoscopy, can allow you to see the extent of the mass and look for any additional masses that may also need to be resected.
He's had heat stroke for 2 days???? I get the elevated CK and body temp (all pointing to heatstroke), but the fact that he was a temp of 106 and has been symptomatic for 2 DAYS makes the whole heat stroke diagnosis weird to me.
Bed bugs themselves are not known to be carriers of illness, but they can leave itchy bites. The girl is likely to scratch these bites, abrade the skin, and thus increase the risk of a staph skin infection (since staph aureus is the most common skin infection pathogen)
I'm guessing that since this is hashimoto's that a biopsy of the thyroid would show the thyroid gland completely engulfed by attacking lymphocytes. Over time though, wouldn't the thyroid be completely destroyed and fibrotic?
The only infection on that list that you would even screen an otherwise healthy appearing individual is HepB. The others I would think you only check if the patient has a presentation that makes you suspect them, like EBV if they had signs of mono, or RSV if they had respiratory symptoms. At that point, they're no longer screening tests, but more diagnostic ones.
The patient's "bizarre" behavior has been occurring for the past year. He has only been treated for hypothyroidism with levothyroxine for 6 months. Since the bizarre behavior he was brought in about today predates him even starting on levothyroxine, the diagnosis is Schizophrenia (Hallucinations, >6 months).
I fell for the trap and went down the road of thinking his thyroid was being overrated, causing hyperthyroid induced psychosis, but after reading that the behavior predated it, it made it not the correct answer.
Bed bugs themselves are not known to be carriers of illness, but they can leave itchy bites. The girl is likely to scratch these bites, abrade the skin, and thus increase the risk of a staph skin infection (since staph aureus is the most common skin infection pathogen)
Not sure I am understanding this question - the patient got an NSAID for RA and this decreased her prostaglandins so she developed GERD... Doc added Misoprostol to counteract the decreased Prostaglandins I the gut and an adverse reaction of Misoprostol is diarrhea .. Correct?
The thing is, the spinothalamic tract crosses 2 vertebral levels up and then decussates at the anterior white commissure to get from the right to the left, so how do I know which vertebral level I'd be working on this guy?
The question stem is describing a mitochondrial disease, which commonly present with lactic acidosis. There is an increase in anaerobic forms of energy production (glycolysis). The mitochondria are faulty, so they canโt use the end product of glycolysis (pyruvate) in TCA. Instead pyruvate is shunted over and is used by LDH (lactate dehydrogenase) to generate pyruvate.
Aside: Recall that LDH uses NADH and generates NAD+. Deficiency of LDH can lead to loss of regeneration of NAD+ and inhibits glycolysis.
The patient's "bizarre" behavior has been occurring for the past year. He has only been treated for hypothyroidism with levothyroxine for 6 months. Since the bizarre behavior he was brought in about today predates him even starting on levothyroxine, the diagnosis is Schizophrenia (Hallucinations, >6 months).
I fell for the trap and went down the road of thinking his thyroid was being overrated, causing hyperthyroid induced psychosis, but after reading that the behavior predated it, it made it not the correct answer.