Tuesday, December 7, 2010

Exostosis in external auditory canal

Exostosis: The 1st Picture demonstrates bony ingrowths which have encroached upon the external auditory canal. Normal ear is shown for comparisno.

An osteochondroma or exostosis is a bony projection of the surface of a bone capped by cartilage.

It is the second most common benign primary bone tumour after non-ossifying fibromata.

This condition affects males and females equally in their first decade, and usually found in the lower femur, upper tibia and upper humerus i.e. the metaphysis of long bone.

The condition can be single or multiple, the later is associated with a 20% rate of malignancy, compared to less than 1% in the presence of a solitary tumour.

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Manual of Neonatal Care (Spiral Manual Series)

This Spiral(R) Manual provides a practical approach to the diagnosis and medical management of newborns. Chapters cover maternal, fetal, and neonatal problems and common neonatal procedures. An outline format provides quick access to a large amount of information, and the outline headings are standardized in this edition. The updated coverage includes new information on fetal assessment, survival of premature infants, and perinatal asphyxia and new guidelines on neonatal jaundice. The popular appendices include effects of maternal drugs on the fetus, maternal medications during lactation, and NICU medication guidelines. A neonatal dosing chart and intubation/sedation guidelines appear on the inside covers.

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Anatomy, Histology, and Cell Biology PreTest Self-Assessment and Review, Third Edition (PreTest Basic Science)

This one-of-a-kind test prep guide helps you to test your knowledge of essential anatomy, histology and cell biology concepts for the USMLE Step 1; practice with 500 USMLE Step 1-style questions with referenced answers; review explanations for right and wrong answers;and build confidence, skills, and knowledge.

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Anatomical Considerations of Abdominal aorta in Ultrasound

The abdominal aorta is entirely a retroperitoneal structure. It begins at the aortic hiatus of the diaphragm at approximately the 12th thoracic vertebrae and courses anterior to the spine before bifurcating into the common iliac arteries. The inferior vena cava (IVC) courses to the right of the abdominal aorta and may be confused for the abdominal aorta by novice sonologists. The psoas muscle and kidney are posterior-lateral to the abdominal aorta on the left side............

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Branches of the abdominal aorta and inferior vena cava. SMA = superior mesenteric artery.......

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Angioedema caused by angiotensin-converting enzyme (ACE) inhibitor

Swollen tongue caused by angiotensin-converting enzyme (ACE) inhibitor-associated

Angioedema is a clinical diagnosis. If the patient presents with the characteristic swelling of the
mouth, lips, tongue, or pharynx and is also taking an ACE inhibitor, the diagnosis should be highly suspected.

Clinical Complication:
Airway compromise secondary to swelling of the tongue, uvula, soft palate, and larynx is a common and potentially life-threatening complication of ACE inhibitor-associated angioedema.

Management : Patients with impending airway compromise require the immediate establishment of a definitive airway. Those with less severe findings need early medical management with intravenous (IV) antihistamines, steroids, and subcutaneous epinephrine. After discontinuation of the ACE inhibitor and administration of the appropriate medications, most cases of ACE inhibitor-induced angioedema resolve within 12 to 48 hours.2 However, this angioedema can proceed rapidly to life-threatening airway closure and must be treated as a serious emergency.

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Rule of 2 of Diverticulum

Meckel's diverticulum details :
  • 2 inches long.
  • 2 feet from end of ileum.
  • 2 times more common in men.
  • 2% occurrence in population.
  • 2 types of tissues may be present.
· Note : "di-" means "two", so diverticulum is the thing with all the twos.

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Lymphoma; a common cause of Intussusception above 6 years

An 8 year old is seen in the emergency room secondary to abdominal pain. Further evaluation confirms the presence of intussusception. The most likely precipitating cause is

  • A) colon polyp
  • B) Meckel's diverticulum
  • C) lymphoma
  • D) parasite infection
  • E) foreign body

The answer is ( C ).
Intussusception is the most common cause of intestinal obstruction in the first 2 years of life. It is more common in males than in females. In most cases (85%) the cause is not apparent. Associated conditions that can result in intussusception include polyps, Meckel's diverticulum, Henoch–Schönlein purpura, lymphoma, lipoma, parasites, foreign bodies, and viral enteritis with hypertrophy of Peyer patches.

Intussusception of the small intestine occurs in patients with celiac disease and cystic fibrosis—related to the bulk of stool in the terminal ileum. Henoch–Schönlein purpura may also cause isolated small-bowel intussusception. In children older than 6 years, lymphoma is the most common cause. Intermittent small-bowel intussusception is a rare cause of recurrent abdominal pain.

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