Forwarded from AAS Medical Notes (Mohammed Sadoon)
A young female is presented with a skin rash. Initially to start with redness in the oral cavity and over lips to develop edematous and erythema with burning sensation then spread symmetrical on the extensor surface of distal extremities especially upper limbs. The patient mentioned hx of polycystic ovarian cyst and drugs(Metronidazole and Ciprofloxacin).
O/E showed target lesions or bullseye and skin involvement less than 10% and the trunk is spared. No other mucosal surface involvement. The nikolsky sign is negative.
Dx
Ddx
Tx?
🤔🤔
O/E showed target lesions or bullseye and skin involvement less than 10% and the trunk is spared. No other mucosal surface involvement. The nikolsky sign is negative.
Dx
Ddx
Tx?
🤔🤔
AAS Medical Notes
A young female is presented with a skin rash. Initially to start with redness in the oral cavity and over lips to develop edematous and erythema with burning sensation then spread symmetrical on the extensor surface of distal extremities especially upper limbs.…
Erythema multiforme (EM):
• It is usually triggered as an immune reaction to herpes simplex virus (HSV) infection but can be caused by a drug.
• Target lesions and lesions on the palms and soles can be relatively specific findings. These lesions are usually not pruritic.
• Diagnosis is clinical, and biopsy is usually not necessary.
• Treat erythema multiforme supportively and consider prophylactic antiviral drugs if HSV is the suspected cause and recurrences are frequent. (The use of corticosteroids is controversial).
• It is usually triggered as an immune reaction to herpes simplex virus (HSV) infection but can be caused by a drug.
• Target lesions and lesions on the palms and soles can be relatively specific findings. These lesions are usually not pruritic.
• Diagnosis is clinical, and biopsy is usually not necessary.
• Treat erythema multiforme supportively and consider prophylactic antiviral drugs if HSV is the suspected cause and recurrences are frequent. (The use of corticosteroids is controversial).
AAS Medical Notes
A young female is presented with a skin rash. Initially to start with redness in the oral cavity and over lips to develop edematous and erythema with burning sensation then spread symmetrical on the extensor surface of distal extremities especially upper limbs.…
Stevens-Johnson syndrome (SJS) & Toxic epidermal necrolysis (TEN):
• Drugs cause > 50% of SJS and up to 95% of TEN cases, but infection, vaccination, and graft-vs-host disease are also potential causes.
• Confirm the diagnosis by biopsy (showing necrotic epithelium) if clinical characteristics (eg, target lesions progressing to bullae, ocular and mucous membrane involvement, positive Nikolsky sign, desquamation in sheets) are inconclusive.
• Early treatment decreases the often high mortality rate.
• Except for mild cases, treat SJS/TEN in a burn unit and with intensive supportive care.
• Consult ophthalmology if the eyes are affected.
• Consider cyclosporine and possibly plasmapheresis for severe cases.
• Drugs cause > 50% of SJS and up to 95% of TEN cases, but infection, vaccination, and graft-vs-host disease are also potential causes.
• Confirm the diagnosis by biopsy (showing necrotic epithelium) if clinical characteristics (eg, target lesions progressing to bullae, ocular and mucous membrane involvement, positive Nikolsky sign, desquamation in sheets) are inconclusive.
• Early treatment decreases the often high mortality rate.
• Except for mild cases, treat SJS/TEN in a burn unit and with intensive supportive care.
• Consult ophthalmology if the eyes are affected.
• Consider cyclosporine and possibly plasmapheresis for severe cases.
AAS Medical Notes
A young female is presented with a skin rash. Initially to start with redness in the oral cavity and over lips to develop edematous and erythema with burning sensation then spread symmetrical on the extensor surface of distal extremities especially upper limbs.…
I think this is more likely to be EM than SJS, because Nikolsky sign is -ve, the lesions are raised (SJS lesions are macular), and the trunk is not affected.
Forwarded from The Zombie Club (Haidar A. Fahad)
Anterior cerebral artery (ACA) &
Posterior cerebral artery (PCA)
Posterior cerebral artery (PCA)
Patients with unstable pelvic fractures are severely hemodynamically unstable. It is rare to see a stable pelvic fracture causing hemodynamic instability.
Therefore, if a patient has a stable fracture yet he is hemodynamically unstable, search for the cause elsewhere, such as the abdomen, the chest, or the lower limbs.
Therefore, if a patient has a stable fracture yet he is hemodynamically unstable, search for the cause elsewhere, such as the abdomen, the chest, or the lower limbs.
The mortality due to pelvic trauma is approximately 9%, yet it increases to 50% if the patient is hemodynamically unstable at presentation.
Lab Rats In Lab Coats
Cerebral palsy (CP)
It's an umbrella term for the neurodevelopmental disorders that cause motor problems. Most of the cases have their etiology prenatally (rarely postnatally), and are caused by things like infections, hypoxia, and head trauma. They are only rarely due to genetic mutations.
It is classified according to its effect on the motor system:
• Spastic (pyramidal), due to lesions in the upper motor neurons of the pyramidal system. It has many subtypes, like spastic hemiplegic, and diplegic CP.
• Dyskinetic (extrapyramidal), due to lesions in the basal ganglia leading to symptoms such as chorea and dyskinesia.
• Ataxic, due to cerebellar problems.
It is classified according to its effect on the motor system:
• Spastic (pyramidal), due to lesions in the upper motor neurons of the pyramidal system. It has many subtypes, like spastic hemiplegic, and diplegic CP.
• Dyskinetic (extrapyramidal), due to lesions in the basal ganglia leading to symptoms such as chorea and dyskinesia.
• Ataxic, due to cerebellar problems.