بمناسبة العيد والكليجة🥳
Old age female, known case of HTN and IHD presented with 1 hour hx of chest pain, burning in nature, no radiation, associated with nausea without vomiting
This is inferior stemi with slow AF
والحجية مقتنعة الالم بسبب كليجة التمر ورفضت الprimary pci …

Females usually present with "atypical" symptoms of myocardial infarction, that's why you should always consider it when a female patient present like this.

Heard a patient once describing her MI as panic-attack like symptoms, and "عبالك مي حار ونزل على گلبي"

Also, had a patient with lumbar disc herniation describing his foot weakness as "رجلي ما تلزم الكاع"

This is the sort of things that cannot be learned except by experience and interacting with patients...
This experience is very essential so that you can translate the patient's description into the scientific, English nomenclature that we, as med students, are used to.

It's a rare condition, considered a paraneoplastic syndrome. About 80% of patients have an underlying malignancy (most commonly lung cancer). It can appear with other non-malignant conditions such as TB, pregnancy, and CREST syndrome.

Hyperintense thalami and basal ganglia. These findings are not very specific for WE, but they were found in this same patient.

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هاي جانت مريضة حامل بالثلث الثاني وعدها hyperemesis gravidarum. البرزنتيشن مالتها جان focal seizures وتصير وراها generalized. هالشي كلش uncommon بالنسبة للـ WE

Charcot-Marie-Tooth disease (CMT)

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It's the most common inherited neurological disorder. It's can be caused by many different genetic mutations and affects peripheral nerves either by disrupting axons or the myelin sheath

باختصار:

هذا عبارة عن مرض وراثي سببه خلل بأكثر من جين، أي واحد منها ممكن يؤدي للـ CMT. لهذا يقسمون المرض إلى هواي أنواع (أعتقد 7 أو أكثر، بس أغلبهن نادرات كلش)، كل نوع سببه خلل جيني مختلف عن البقية والـ clinical picture هم تكون مختلفة بدرجةٍ ما، بس عمومًا كلهم يشتركون بصفات محددة، ولهذا احنة نجمعهم كلهم ضمن مرض واحد هو الـ CMT.

المرض يؤدي إلى peripheral nerve weakness يكون مزيج من الـ sensory & motor. عادةً يبدي distally وبالطرف السفلي ويتقدم شوية شوية، لهذا البرزنتيشن الشائع هو foot drop وقوس القدم يكون مقوَّس أكثر من اللازم. بأغلب الأنواع، المرض ما رح يؤدي لشلل تام، بس ببعضها ممكن يزيد ويؤثر على التنفس.

The most common initial presentation of CMT is distal weakness and atrophy manifesting with foot drop and pes cavus (high-arched foot). Sensory symptoms are often present but tend to be less prominent in most CMT subtypes. Later in the course, foot deformities such as hammertoes and calf atrophy (leading to stork legs) ensue, along with hand weakness and atrophy.

Types of CMT
Before the advent of genetic testing, the disease was classified pathologically to:

• Type 1, or CMT1 (abnormal myelination) which is the most common type and accounts for about 70% of patients.

• Type 2, or CMT2 (dysfunctional axons) which accounts for about 12% to 30% of patients.

• Type 3, or CMT3, is an infantile-onset disease with mean age of presentation at 2 years.

• There are many other types but most of them are quite rare and have generally been found in few consanguineous families.