MedRophine Science 🕘 история названий (1)

The ECG shows sinus rhythm with normal axis and intervals. The two notable findings are 1) inferior Q-wave myocardial infarction (MI) of indeterminate age and 2) diffuse ST elevations in anterior and lateral leads, with PR deviations (up in aVR, down laterally) c/w with pericarditis. The story was of prior MI with pericarditis post-coronary artery bypass graft (CABG) surgery. If you know anyone who got this right (the first time), drop us a line so we can sign them up for a Cardiology Fellowship!

1. Clavicle (green) 2. Posterior rib (red) 3. Anterior rib (yellow) 4. Right costophrenic angle (purple) 5. Left costophrenic angle (pink) 6. Right hilum (containing the right hilar lymph nodes) (light blue) 7. Left hilum (containing the left hilar lymph nodes) (blue) 8. Lung apex ( pl . apices) (orange)

A fetus in the ninth week of pregnancy that was aborted along with the placenta in an ectopic pregnancy.

Balancing the safety and efficacy of antithrombotic agents in patients with gastrointestinal disorders is challenging because of the potential for interference with the absorption of antithrombotic drugs and for an increased risk of bleeding. In this Review, we address considerations for enteral antithrombotic therapy in patients with cardiovascular disease and gastrointestinal comorbidities. For those with gastrointestinal bleeding (GIB), we summarize a general scheme for risk stratification and clinical evidence on risk reduction approaches, such as limiting the use of concomitant medications that increase the risk of GIB and the potential utility of gastrointestinal protection strategies (such as proton pump inhibitors or histamine type 2 receptor antagonists). Furthermore, we summarize the best available evidence and potential gaps in our knowledge on tailoring antithrombotic therapy in patients with active or recent GIB and in those at high risk of GIB but without active or recent GIB.

Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B . Most cases occur in spring or winter. It is characterized by vomiting and confusion, rapidly evolving to seizures and coma. Hepatomegaly is common, but icterus is usually mild or absent. Laboratory testing reveals markedly elevated aminotransferase activity, increased prothrombin time, hyperammonemia, hypoglycemia, and metabolic acidosis . The liver and other visceral organs have marked steatosis, which may be evident on ultrasound or computed tomography (CT). Renal and cardiac failure may ensue. Increased ICP is an important contributor to the morbidity and mortality of Reye syndrome and should be managed accordingly.

The patient may have a complication of ABRS and needs urgent evaluation and management. Typically, evaluation is performed in the emergency department where urgent imaging and referral to an otolaryngologist can be obtained. For most patients, either computed tomography (CT) with contrast or magnetic resonance imaging (MRI) without and with contrast is appropriate for evaluating intraocular or intracranial complications. CT is generally preferred for the evaluation of bone erosion, while MRI can better differentiate abscesses from inflamed tissue. However, the selection of an imaging approach should also take into account the suspected complication, severity of illness, contraindications to the procedures or to use of contrast, and available imaging modalities and expertise. The otolaryngologist may obtain a sinus aspirate or endoscopic culture. Nasal cultures from blind swabs or purulent nasal secretions are not reliable and are not indicated. Additional evaluation, such as the need for a lumbar puncture for patients with suspected meningitis or infectious diseases consultation, should be individualized.

Rare but potentially severe or life-threatening complications can arise when bacterial infection extends from the sinuses into the orbit, central nervous system, or surrounding tissue. Some signs and symptoms of complications may be immediately apparent on physical examination, such as lethargy, toxic appearance, or altered mental status. Other findings may be subtle and require careful neurologic examination for detection. Features that suggest complications include: Unusually severe and persistent headache Periorbital edema, inflammation, or erythema Mental status changes Neck stiffness or other meningeal signs Proptosis Cranial nerve abnormalities Abnormal extraocular movements Ophthalmoplegia or pain with eye movement Vision changes (double vision or impaired vision) Signs of increased intracranial pressure (eg, nausea, vomiting, papilledema) UpToDate

📌The midwife hears the heartbeat of the future. There is nothing more challenging than bringing a baby in this world and you did it very well. 🌹Happy international Midewives day.

📌Longitudinal ultrasound of the right ovary shows a hemorrhagic cyst (arrows) with heterogeneous, lacelike internal architecture. When color Doppler is placed (image 2), flow is present within the periphery of the hemorrhagic cyst. Patients with a hemorrhagic ovarian cyst may present with acute onset of pain. On ultrasound the cyst can have lacelike internal architecture or a hyperechoic internal clot. Occasionally, a fluid fluid level is present. For small (<5 cm) hemorrhagic cysts ...

📌Calcified mesenteric lymph nodes Calcified mesenteric lymph nodes are a common incidental finding on abdominal radiographs. These are asymptomatic and can be ignored. Occasionally calcified lymph nodes overlie an area affected by pathological calcification. Comparison with old images, if available, and reference to the clinical context will help to determine the relevance of abdominal calcification.