Monday, October 11, 2010

Heart sounds in normal

Keratosis pilaris

An 18 year old presents to your office complaining of a sandpaper-like rash that affects his upper outer arms. He is otherwise healthy and has no other symptoms. The most likely diagnosis is?
  • A) scarlet fever
  • B) infectious mononucleosis
  • C) keratosis pilaris
  • D) seborrheic dermatitis
  • E) psoriasis

 The answer is: (C). (Keratosis pilaris) 
Keratosis pilaris is defined as hyperkeratotic follicular papules on the extensor surface of the upper arms or upper anterior thighs and occasionally on the malar area of the face. It may be associated with atopy and dry skin.
A sandpaper-like feel is noted in these isolated areas. The condition is considered benign and is treated with topical lactic acid cream or lotion. Lesions that are associated with the face typically resolve at puberty.

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Handbook of Dermatology: A Practical Manual320 pages Publisher: Wiley-Blackwell; 1 edit

320 pages
Publisher: Wiley-Blackwell; 1 edition (April 27, 2009)
Language: English
ISBN-10: 1405181109
ISBN-13: 978-1405181105

Because dermatology is a complex visual specialty that mixes medical and surgical approaches to management, trainees need fast access to a wide range of material. This concise new reference uses tables, algorithms, protocols, guidelines, and staging and scoring systems to present succinct guidance on best-practice patient care. Structured around three components -- medical, surgical, and pharmacological -- the book consolidates the core Board exam information residents most often look up. Handbook of Dermatology: A Practical Manual was road-tested as it was developed to ensure usefulness for dermatology residents, dermatologists, and family physicians.

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Counting Ribs in CT Scan by Clavicle


Counting Ribs on CT Scan by Clavicle



In 1990, Bhalla et al presented a useful method for counting ribs on CT scans in which the bilateral clavicles were used as anatomic landmarks. The first step was to identify the first rib on the axial image that demonstrated the medial third of the clavicle (the Figure below). Bhalla et al also used the costovertebral articulation as a landmark for counting vertebral bodies.
Rib counting at CT with the clavicle as an anatomic landmark. Axial CT scan shows the medial third of the clavicle (*) and the relative position of the first two ribs (1, 2).

Identifying the first rib in relation to the clavicles is easy and precise; however, counting ribs from the clavicles is tedious for middle and lower rib lesions. Furthermore, counting thoracic vertebrae may be imprecise owing to partial volume effect.

Other methods: We can also use the xiphoid process, or the sternal angle as an anatomic landmark to determine the precise location of the ribs.

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Characteristic pityriasis alba

Pityriasis alba is a term derived from the words scaly (pityriasis) and white (alba).

Alba Pityriasis is a common skin disease mark by round or oval, finely scaling patches without ..................

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