Forwarded from Quick Notes
Radiological features of Rheumatoid Arthritis:
(LESS):
L: Loss of joint space
E: Erosions
S: Soft tissue swelling
S: Soft bones (osteopenia).
#Rheumatology
#Medicine
(LESS):
L: Loss of joint space
E: Erosions
S: Soft tissue swelling
S: Soft bones (osteopenia).
#Rheumatology
#Medicine
Forwarded from Quick Notes
Gleason Grade of Carcinoma Prostate
(1–5)is asfollows:
1.Small uniform glands
2.More stroma between glands
3.Distinctly infiltrative margins
4.Irregular masses of neoplastic glands
5.Only occasional gland formation (undifferentiated).
#Surgery
(1–5)is asfollows:
1.Small uniform glands
2.More stroma between glands
3.Distinctly infiltrative margins
4.Irregular masses of neoplastic glands
5.Only occasional gland formation (undifferentiated).
#Surgery
•Indications of surgical treatment in case of closed depressed skull fracture:
1-If it's larger than one inch.
2-If it compresses an important area as motor area.
3-Results in cosmetic deformity.
4-Overlies air sinuses.
-Compound depressed : needs operative treatment.
#Surgery
1-If it's larger than one inch.
2-If it compresses an important area as motor area.
3-Results in cosmetic deformity.
4-Overlies air sinuses.
-Compound depressed : needs operative treatment.
#Surgery
Ortolani’s test:
-This test defects hips that are already dislocated
- The baby’s thighs are held with the thumbs medially and the fingers resting on the greater trochanters; the hips are then flexed to 90°, which should normally be a smooth movement.
-In the presence of dysplasia or dislocation, there is resistance that is overcome when pressure is applied to the greater trochanter. There is a soft clunk as the hip is reduced.
#Surgery
-This test defects hips that are already dislocated
- The baby’s thighs are held with the thumbs medially and the fingers resting on the greater trochanters; the hips are then flexed to 90°, which should normally be a smooth movement.
-In the presence of dysplasia or dislocation, there is resistance that is overcome when pressure is applied to the greater trochanter. There is a soft clunk as the hip is reduced.
#Surgery
Barlow test:
-This test detects an unstable but located hip!
-A physical examination maneuver used to evaluate developmental dysplasia of hip.
-The child's hips are placed in 90° of flexion and the examiner adducts the leg and applies downward pressure.
-A palpable clunk represents a subluxation of the examined hip (positive barlow sign).
#Surgery
-This test detects an unstable but located hip!
-A physical examination maneuver used to evaluate developmental dysplasia of hip.
-The child's hips are placed in 90° of flexion and the examiner adducts the leg and applies downward pressure.
-A palpable clunk represents a subluxation of the examined hip (positive barlow sign).
#Surgery
Functions of Spleen:
1-Response to antigenic challenge—by secreting antibodies like IgM, tuftin, opsonins, properdin, interferons.
2-Destruction or correction of abnormal cells like old RBCs, target cells, siderocytes, spherocytes or removal of inclusion bodies or parasites from the RBCs by culling and pitting.
3-Phagocytosis of foreign substances.
4-As platelet reservoir.
5-Erythrocyte production:
-In fetal life, it is an important site of RBC production till 5th month of gestation.
-In adults erythropoiesis in spleen. occurs only if marrow production is inadequate, e.g. in myelofibrosis.
6-Iron reutilisation.
#Surgery
1-Response to antigenic challenge—by secreting antibodies like IgM, tuftin, opsonins, properdin, interferons.
2-Destruction or correction of abnormal cells like old RBCs, target cells, siderocytes, spherocytes or removal of inclusion bodies or parasites from the RBCs by culling and pitting.
3-Phagocytosis of foreign substances.
4-As platelet reservoir.
5-Erythrocyte production:
-In fetal life, it is an important site of RBC production till 5th month of gestation.
-In adults erythropoiesis in spleen. occurs only if marrow production is inadequate, e.g. in myelofibrosis.
6-Iron reutilisation.
#Surgery
Plain X-ray abdomen findings in Spleen Trauma:
1-Obliteration of splenic outline
2-Obliteration of psoas shadow (most important feature)
3-Indentation of fundic gas shadow
4-Fracture of lower ribs
5-Elevation of left side of diaphragm
6-Free fluid in the abdomen between coils of intestine.
#Surgery
1-Obliteration of splenic outline
2-Obliteration of psoas shadow (most important feature)
3-Indentation of fundic gas shadow
4-Fracture of lower ribs
5-Elevation of left side of diaphragm
6-Free fluid in the abdomen between coils of intestine.
#Surgery
Trendelenburg test:
-Patient in standing position and asked to lift one leg; the pelvis should remain level but if falls or dips inferiorly on the side of the raised leg, this is indicative of abductor muscle weakness on side of standing leg.
#Surgery
-Patient in standing position and asked to lift one leg; the pelvis should remain level but if falls or dips inferiorly on the side of the raised leg, this is indicative of abductor muscle weakness on side of standing leg.
#Surgery
Legg- Calve- Perthes disease:
-Unknown pathophysiology
-It's idiopathic osteonecrosis of femoral head; typically presents at age 4–8 years.
#Surgery
-Unknown pathophysiology
-It's idiopathic osteonecrosis of femoral head; typically presents at age 4–8 years.
#Surgery
Developmental dysplasia of the hip;:
-Abnormal hip development resulting in laxity, subluxation, or dislocation of the. hip; initial instability/laxity of the. hip results in malposition-ing of the femoral head in the developing acetabulum and incomplete formation of the hip socket; dysplasia can lead to gradual dislocation, difficulty with ambulation, degenerative arthritis, and pain.
#Surgery
-Abnormal hip development resulting in laxity, subluxation, or dislocation of the. hip; initial instability/laxity of the. hip results in malposition-ing of the femoral head in the developing acetabulum and incomplete formation of the hip socket; dysplasia can lead to gradual dislocation, difficulty with ambulation, degenerative arthritis, and pain.
#Surgery
Developmental dysplasia of the hip X-ray:
- Subluxation or dislocation of the femoral head from the acetabulum;. difficult to assess on x-ray in infants, for which ultrasound is typically used.
#Surgery
- Subluxation or dislocation of the femoral head from the acetabulum;. difficult to assess on x-ray in infants, for which ultrasound is typically used.
#Surgery
Spread of HCC:
-Lymphatic spread: It can spread to other part of liver through lymphatics within the liver, to the lymph nodes in the porta hepatis and other abdominal lymph nodes later. Often spread occurs directly to cisterna chyli.
-Blood spread: To lungs, bones and adrenals often can occur.
-Direct infiltration: To diaphragm and neighbouring structures.
#Surgery
-Lymphatic spread: It can spread to other part of liver through lymphatics within the liver, to the lymph nodes in the porta hepatis and other abdominal lymph nodes later. Often spread occurs directly to cisterna chyli.
-Blood spread: To lungs, bones and adrenals often can occur.
-Direct infiltration: To diaphragm and neighbouring structures.
#Surgery
Latent tetany:
-With serum calcium 7 – 9 mg/dl; signs:
1)Chevostek sign:
Tapping the facial nerve in front of the ear → twitch of the mouth.
2)Trouseau sign:
Inflation of sphygmomanometer cuff over the arm above systolic pressure for 3 min → carpal spasm.
3)Peroneal sign:
Tapping of the peroneal nerve o dorsiflexion + abduction of the foot.
4)Erb’s sign:
Motor nerve can be stimulated by low current.
#Surgery
-With serum calcium 7 – 9 mg/dl; signs:
1)Chevostek sign:
Tapping the facial nerve in front of the ear → twitch of the mouth.
2)Trouseau sign:
Inflation of sphygmomanometer cuff over the arm above systolic pressure for 3 min → carpal spasm.
3)Peroneal sign:
Tapping of the peroneal nerve o dorsiflexion + abduction of the foot.
4)Erb’s sign:
Motor nerve can be stimulated by low current.
#Surgery
Manifest Tetany:
-With serum calcium < 7 mg/dl ; manifested by :
1. Carpo pedal spasm:
- Flexion of the wrist & metacarpophalangeal joints
- Extended interphalangeal joints
- Flexed adducted thumb.
- Plantar flexion & inversion of the feet
2. Laryngeal spasm (laryngismus stridulous): stridor is afebrile & recurrent.
3. Convulsions.
#Surgery
-With serum calcium < 7 mg/dl ; manifested by :
1. Carpo pedal spasm:
- Flexion of the wrist & metacarpophalangeal joints
- Extended interphalangeal joints
- Flexed adducted thumb.
- Plantar flexion & inversion of the feet
2. Laryngeal spasm (laryngismus stridulous): stridor is afebrile & recurrent.
3. Convulsions.
#Surgery
Radiologic X-ray findings in Rickets:
Active rickets:
The lower ends show:
- Broadening ; widening of the distal end of the metaphysis
-Cupping or concavity ; metaphysis changes from a convex or flat surface to a more concave surface
- Metaphysis loses its sharp border ( Fraying )
-Wide joint space.
The shaft shows:
-Rarefaction o p bone density
-May be green stick fracture.
-May be deformities.
#Surgery
Active rickets:
The lower ends show:
- Broadening ; widening of the distal end of the metaphysis
-Cupping or concavity ; metaphysis changes from a convex or flat surface to a more concave surface
- Metaphysis loses its sharp border ( Fraying )
-Wide joint space.
The shaft shows:
-Rarefaction o p bone density
-May be green stick fracture.
-May be deformities.
#Surgery
b. Healing rickets:
-Usually seen 2 weeks of vitamin D therapy
-The lower ends shows white concave continuous line at ZPC
- Less evident features of rickets
c. Healed rickets:
-Usually seen 4-6 weeks of vitamin D therapy
- The lower ends show straight continuous line at ZPC.
- No features of active rickets.
#Surgery
-Usually seen 2 weeks of vitamin D therapy
-The lower ends shows white concave continuous line at ZPC
- Less evident features of rickets
c. Healed rickets:
-Usually seen 4-6 weeks of vitamin D therapy
- The lower ends show straight continuous line at ZPC.
- No features of active rickets.
#Surgery
Forwarded from د. طه حسين درقم
- Choledochal cyst:(types)
type I: dilatation of CBD
Ia-->cystic.
Ib-->saccular.
Ic-->fusiform.
type II: Choledochal diverticle.
type III: Choledochocele.
type IVa: Dilatation of extra & intra hepatic biliary ducts.
type IVb: Dilatation of multiple sections of extrahepatic duct.
type V: Caroli's syndrome.
- Congenital extrahepatic biliary atresia (types):
type I: atretic CBD.
type IIA: atretic CHD.
type IIB: atretic CBD and CHD.
type III: atretic CBD, CHD, RHD&LHD
Klatskin tumour is classified as 4 types—
I: Just at or below the confluence;
II: At the confluence.
III: at the confluence extending
along the RHD.
IV: at the confluence extending along the LHD.
Mirizzi syndrome:-
Type I : Compression of CBD without lumen narrowing.
Type II : Compression causing CBD lumen narrowing.
Type III : Compression causing CBD wall necrosis.
Type IV : Cholecysto-choledochal fistula.
type I: dilatation of CBD
Ia-->cystic.
Ib-->saccular.
Ic-->fusiform.
type II: Choledochal diverticle.
type III: Choledochocele.
type IVa: Dilatation of extra & intra hepatic biliary ducts.
type IVb: Dilatation of multiple sections of extrahepatic duct.
type V: Caroli's syndrome.
- Congenital extrahepatic biliary atresia (types):
type I: atretic CBD.
type IIA: atretic CHD.
type IIB: atretic CBD and CHD.
type III: atretic CBD, CHD, RHD&LHD
Klatskin tumour is classified as 4 types—
I: Just at or below the confluence;
II: At the confluence.
III: at the confluence extending
along the RHD.
IV: at the confluence extending along the LHD.
Mirizzi syndrome:-
Type I : Compression of CBD without lumen narrowing.
Type II : Compression causing CBD lumen narrowing.
Type III : Compression causing CBD wall necrosis.
Type IV : Cholecysto-choledochal fistula.
Forwarded from Suleiman Al-Mashramh
☝️
Compare between epidural and subdural hematoma?
Compare between epidural and subdural hematoma?