WHAT IS LITHOTRIPSY

Melatonin and it`s uses

Melatonin is a hormone secreted by the pineal gland in the brain. It helps regulate other hormones and maintains the body's circadian rhythm. The circadian rhythm is .................

Read more.............>>

Vascular invasion: way to follicular thyroid carcinoma

There are 4 types of thyroid carcinoma: papillary, follicular, medullary, and anaplastic carcinoma. One of these types, follicular thyroid carcinoma, can look very much like a benign thyroid adenoma. Both follicular carcinoma and thyroid adenoma are composed of follicles (resembling normal thyroid follicles).

The only way to tell apart follicular thyroid carcinoma (which is malignant) from thyroid adenoma (which is benign) is to take out the entire nodule and examine the entire thing very carefully. If you see tumor cells invading the capsule, or if you see them within vessels (as in the photo above), that means it’s follicular carcinoma. Malignant tumor cells invade; benign ones do not.

Classification of Wound by Sterility

The Centers for Disease Control and Prevention (CDC) “Guidelines for prevention of surgical site infection” identifies four surgical wound classifications.

CLASS I: CLEAN WOUNDS

* an uninfected surgical wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tracts are not entered.
* clean wounds are primarily closed and, if necessary, drained with closed drainage.
* Surgical wound incisions that are made after nonpenetrating (ie, blunt) trauma should be included in this category if they meet the criteria.

CLASS II: CLEAN-CONTAMINATED WOUNDS

* a surgical wound in which the respiratory, alimentary, genital, or urinary tracts are entered under controlled conditions and without unusual contamination.
* Specifically, surgical procedures involving the biliary tract, appendix, vagina, and oropharynx are included in this category, provided no evidence of infection is encountered and no major break in technique occurs.

CLASS III: CONTAMINATED WOUNDS

* open, fresh, accidental wounds.
* surgical procedures in which a major break in sterile technique occurs (eg, open cardiac massage) or there is gross spillage from the gastrointestinal tract and incisions in which acute, nonpurulent inflammation is encountered are included in this category.

CLASS IV: DIRTY OR INFECTED WOUNDS

* old traumatic wounds with retained or devitalized tissue and those that involve existing clinical infection or perforated viscera.
* This definition suggests that the organisms causing postoperative infection were present in the wound before the surgical procedure.

A 41-year-old woman presents with amenorrhea for 9 mo.She is found to have a prolactin secreting pituitary adenoma. Laboratory data reveals a serum calcium level of 12.0 mg/dL and hypoglycemia (serum glucose of 49 mg/dL). Which of the following is the most likely diagnosis?

• a.MEN 1 syndrome
• b.MEN 2A syndrome
• c.MEN 2B syndrome
• d.Sipple syndrome

The answer is (a).  The patient most likely has multiple endocrine neoplasia or MEN 1(Wermer syndrome), an autosomal dominant disorder, consisting of tumors of the Pancreas, Pituitary, and Parathyroid gland (PPP).
MEN 2A(Sipple syndrome) consists of Pheochromocytoma, hyperParathyroidism, and medullary carcinoma of the Thyroid (PPT). Patients with MEN 2B syndrome present with Pheochromocytoma, Neuromas, and medullary carcinoma of the Thyroid (PNT).

AMC Handbook of Clinical Assessment

This book provides unique problem-based self-learning exercises to aid preparation for clinical assessment.

Self-test clinical competency tasks with performance guidelines and commentaries cover all domains and disciplines for the medical graduate about to enter internship.
The publication covers:
*Communication Skills
*Clinical consulting skills
*Ethics & The Law
*More that 150 self-assessment tasks and performance guidelines
*8 complete trial examinations for self-testing

GET IT HERE