l*h
发帖数: 4124 | 1 当时的医生说脑出血的可能性很低 所以说建议她生完孩子再做手术。
no matter whether it's an aneurysm or AVM, the timing of discovery made its
management tricky. i don't think many neurosurgeons would have acted
differently.
the diagnosis is simple, there is usually no use to do a second opinion.
what can others do with a surgical problem from far away? nothing.
she needs an endovascular neurosurgeon or neurointerventional radiologist,
depending on the specifics of the disease. |
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w******y
发帖数: 4871 | 2 just FYI,
Guidelines for the diagnosis of KD were established by Tomisaku Kawasaki in
1967. Diagnosis of KD according to these criteria requires the presence of
fever lasting ≥five days, combined with at least four of the five following
physical findings, without an alternative explanation (table 1) [1,36]:
搂 Bilateral bulbar conjunctival injection (picture 1)
搂 Oral mucous membrane changes, including injected or fissured lips (
picture 2), injected pharynx, or strawberry tongue (picture 3)
搂 ... 阅读全帖 |
|
x***x
发帖数: 416 | 3 More common: 可能的常见的问题:
1. Glaucoma;
2. after central retinal vein or artery occlusion;
3. ischemic optic neuropathy;
4. chronic optic neuritis;
5. chronic papilledema;
6. compression of the optic nerve, chiasm, or tract by a tumor or aneurysm;
7. traumatic optic neuropathy
这些对应的诊断应该不难, 需要:VF, NMR, Dilated Fundus pictures, imaging, etc.
Less common:
8. Syphilis, 查CRP等梅毒指标,
9. retinal degeneration (e.g., retinitis pigmentosa), Dilated Fundus picture
,一看就知道了,
10. toxic/metabolic optic neuropathy, 有... 阅读全帖 |
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i********n
发帖数: 171 | 4 send your CV if you think you are an expert in the field. [email protected]/* */
1. Curcumin-loaded Bioinspired Polymeric Nanosystem Enhances the Cell Cycle
Arrest and Cell Apoptosis in Colon Cancer Cells
2.Proliferation-enhancing effects of gastrodin on RSC96 Schwann cells by
regulating ERK1/2 and PI3K signaling pathways
3.MiR-489 suppresses proliferation and invasion of human bladder cancer
cells
4.Combination treatment with Rhizoma Paridis and Rhizoma Curcuma longa
extracts and 10-hydro... 阅读全帖 |
|
|
u***e
发帖数: 611 | 6 过劳不会导致脑溢血的，一般是aneurysm , 先天的。 |
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g*2
发帖数: 658 | 7 烟是一个坏东西，大致说几点 1）和很多肿瘤的发病有关，不光是大家都知道的肺癌，
还有一个预后非常差的胰腺癌，口腔食管的鳞状上皮癌等。 2）二手烟和小孩子的哮喘
，中耳炎，上呼吸道的经常感染有很大的关系。 3）对女性， 如果〉35岁+抽烟，是使
用避孕药OCP的禁忌症， 因为它在用会引起血栓。 4）曾经抽烟达100支的人，60岁以
后得腹主动脉瘤（abdominal aorta aneurysm）的风险大很多，所以在美国要用超声
ultrasound作screening. 5）还有如增加咽炎，肺炎的危险
所以能戒就戒，能减就减。 |
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d******e
发帖数: 2541 | 8 bless.
White or Black,stroke mostly due to thrombosis or blood vessel blocked,
Asian more caused bu vessel rupture.
of course some youg one can also have stroke, mostly from primary aneurysm
or 动脉血管瘤rupture....... |
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z*****k
发帖数: 600 | 9 中风就那几种病造成，高血压是瞒不住体检单的，老年动脉硬化也可以引起中风，但是
动脉硬化伴随有高血压也瞒不过，血栓多是血管内壁健康状况造成, 常见的有高胆固醇
史，体检单上有，Thrombosis平时会有严重头晕头痛症状，Aneurysm和不好办，在不做
专门的检查查不到，但这大概都是由脑外伤或遗传或tumor的所致。发生概率不是很大
。要是注意饮食，体检，适量的锻炼就行。其实健康人常年锻炼的血压都是偏低的，
有的非常低。当然中风不是唯一的风险。 |
|
l*y
发帖数: 21010 | 10 Gish - Not Crap
Siamese Dream - Not Crap, no fucking way.
Mellon Collie - Not Crap with a stack of waffles. Why the shit would anyone
record, like, "We Only Come Out At Night"? What the fuck, seriously?
Adore - Crap
Machina - MASSIVE CRAP MY GOD WHAT HAPPENED
Machina II - Not Crap! Was Corgan fucking conspiring to ruin his career or
something? Why didn't they release this shit! If you've heard the songs they
didn't record with Zwan, too, you wonder why the hell they recorded a lot
of the stuff t... 阅读全帖 |
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B********4
发帖数: 7156 | 11 多伦多的公交乘客拍下了公交职工开车发短信，买票睡觉的图片后，
The president of the TTC workers' union says it is “disturbing” that a
transit rider snapped a photo of what appears to be a sleeping ticket
collector instead of checking to see whether the worker was okay.
“The guy could have had a heart attack. He could've had an aneurysm. He
could have been a diabetic,” said Bob Kinnear, president of Amalgamated
Transit Union Local 113, which represents more than 9,000 TTC employees. “
Seventy-five per cent of them are down ther... 阅读全帖 |
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a********k
发帖数: 2273 | 12 Curr Opin Cardiol. 2013 May;28(3):290-6. doi: 10.1097/HCO.0b013e32835f0d55.
Genetics of abdominal aortic aneurysm.
a********[email protected]
包子一个。谢谢 |
|
l******8
发帖数: 1691 | 13 你说的脑瘤不是指一般的肿瘤吧，是指血管变形形成的弯曲的突起，就是aneurysm吧？
这个在破之前发现就好治，破了就麻烦大了，所以要快点做手术。你妈什么症状，有没
有出现思维混乱什么的，没有就说明还好，有出现就得赶紧马上做。这个不用开颅啊什
么的，就从腿上开个口用导管弄几个弹簧箍进去堵上就行了。
西医一般可靠的手术就用西医，西医没辙的事情才去找中医吧，好的中医挺难找的，不
好判断。 |
|
l******8
发帖数: 1691 | 14 你说的脑瘤不是指一般的肿瘤吧，是指血管变形形成的弯曲的突起，就是aneurysm吧？
这个在破之前发现就好治，破了就麻烦大了，所以要快点做手术。你妈什么症状，有没
有出现思维混乱什么的，没有就说明还好，有出现就得赶紧马上做。这个不用开颅啊什
么的，就从腿上开个口用导管弄几个弹簧箍进去堵上就行了。
西医一般可靠的手术就用西医，西医没辙的事情才去找中医吧，好的中医挺难找的，不
好判断。 |
|
w*******4
发帖数: 17 | 15 Pearls:
1. Treatment for rhabdomyolysis involves intravenous saline infusions to
maintain a high urine output and alkalization of urine with a target pH of 7
-8 to prevent myoglobin deposition.
2. Aortic dissecting aneurysm caused by degeneration of tunica media-cystic
medial necrosis.
3. Cardiac rupture most common 4-7 days post MI.; ventricular free wall
rupture leads to cardiac tamponade.
4. New onset serous discharge from a laparotomy wound should raise the
suspicion of wound dehiscence.
5. |
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L****n
发帖数: 12932 | 16 i have done a few of these cases--dissected aortic aneurysm repair.
anesthesia of course. all of them survived without major complication. seems
to me the success rate is higher than 50%. cheer up. |
|
a**e
发帖数: 5094 | 17 先占个坑，这些日子累死我了
这些日子出奇的忙,每天早上6点钟上班,晚上8,9点才走.我的junior才干了3天,就和我说,这3天过的感觉和一个月一样.不巧被fellow听到了,说"you are winning like a baby, do you want some milk?"
当了senior才发现当时做junior resident的日子有多么幸福.只要操心把自己的病人管好就行了.我当时junior转ICU的时候,两个senior都是非常棒的那种,自己多干活,还要护着我不要被fellow欺负到.当时自己眼里面也没有活,护士也不会找你干这干那,也没有medical student追着你问问题,时间总是一大把.现在的感觉就是上有老(attending,fellow),下有小(junior,student),既要帮fellow排忧解难,又要照顾到小的情绪,别让他们干得太苦了.我们每天下午wrap up round,本来是该fellow做的,结果这几天,每天都有iv/ia tPA+/-mechanical clot retrieval or SAH aneurysm coiling/ |
|
l*******8
发帖数: 1745 | 18 熬吧，neuro ICU一年几个月？我怎么觉得一定要和attending/fellow多学着点如何和
病人家属谈话尽早DNR+DNI
更重要呢。神啊，原谅我吧。
我说,这3天过的感觉和一个月
一样.不巧被fellow听到了,说"you are winning like a baby, do you want some
milk?"
管好就行了.我当时junior转ICU
的时候,两个senior都是非常棒的那种,自己多干活,还要护着我不要被fellow欺负到.当
时自己眼里面也没有活,护士
也不会找你干这干那,也没有medical student追着你问问题,时间总是一大把.现在的感
觉就是上有老
(attending,fellow),下有小(junior,student),既要帮fellow排忧解难,又要照顾到小
的情绪,别让他们干得太苦了.我们每
天下午wrap up round,本来是该fellow做的,结果这几天,每天都有iv/ia tPA+/-
mechanical clot retrieval or SA: H
aneurysm coiling/clipping的病人,a |
|
c*********r
发帖数: 541 | 19 看来科科有本难念的经阿。我本来还想上来哭诉我刚开始两周的悲惨遭遇，不过比你的
强度还是差一些。唯一不如你的就是大部分时候都要站一天。
对了，你帮我介绍一个北京的ms专家，email了你好几次也没有理我
我说,这3天过的感觉和一个月一样.不巧被fellow听到了,说"you are winning like a
baby, do you want some milk?"
管好就行了.我当时junior转ICU的时候,两个senior都是非常棒的那种,自己多干活,还
要护着我不要被fellow欺负到.当时自己眼里面也没有活,护士也不会找你干这干那,也
没有medical student追着你问问题,时间总是一大把.现在的感觉就是上有老(
attending,fellow),下有小(junior,student),既要帮fellow排忧解难,又要照顾到小的
情绪,别让他们干得太苦了.我们每天下午wrap up round,本来是该fellow做的,结果这
几天,每天都有iv/ia tPA+/-mechanical clot retrieval or SA: H aneurysm coili |
|
L********a
发帖数: 576 | 20 A 67-Year old man with alcoholism comes to the physician for a routine exam.
He has a 15-year history of poorly ocntrolled hypertension; he takes
hydrochlorothiazide and admits that he is not compliant with his drug
regimen. his blood pressure is 170/102 mmHg, unchanged from his last three
office visits. Funduscopic examination shows arteriovenous nicking and
tortuosity of the arteries. The patient is at greatest risk for which of the
following?
A) Aortic aneurysm
B) Glaucoma
C) Myocardial infar... 阅读全帖 |
|
h***a
发帖数: 312 | 21 Pt with blood group O undergoing operation for repair of aortic aneurysm..
mistakenly transfused with group A unit of packed rbcs.he goes into shock.a
blod sample is merkedly homolyzed.which of the following is the primary mech
for hemolysis?
1-action by properdin to cleave c3
2-action of c5-9 complex of complement
3-activation of factor 12
4-prod of c5a to stimulate phagocytosis
5-release of histamin by action of c5a |
|
N***a
发帖数: 149 | 22 MEDICAL ETHICS 137 cases:
________________________
1. A 25- year old mother refused immunization for her 2-month old son. The
social worker spoke to the mother. (Important for Board examination)
Next step in management: immunization should be given for the benefit of the
child.
2. A 30-year old mother refused surgery for suspected appendicitis for her 6
-year old daughter. The social worker spoke to the mother. (Important for
Board examination)
Next step in management: surgical removal of the ap... 阅读全帖 |
|
b****e
发帖数: 227 | 23
bruits
拿自己的听诊器bell试了试,在我和LG身上都没听到静脉杂音,呼吸音倒是很响.汗.
放狗搜搜,原来这个静脉杂音不是每个人都有的,年轻人里多见.
穷人的偶,NEJM的文献看不着,http://www.nejm.org/doi/full/10.1056/NEJM196209272671307
另外找一篇,
In a survey of 200 persons, ages 18 to 76, the incidence of normal cervical
venous hum was 47 per cent in young adults and 21 per cent in persons of
middle and older age, a group in whom it once was thought to be rare.
The importance of the hum is that it may be misinterpreted as caused by a
pathologic state such as an arteriovenous aneur... 阅读全帖 |
|
b*********m
发帖数: 92 | 24 没查到这个是什么器官的动脉瘤。
在此向大家请教！谢谢！ |
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z*****g
发帖数: 63 | 25 It is in the brain. Willie's circle. |
|
d********y
发帖数: 616 | 26 Heart & Blood Vessels
Flask-shaped / Pear-shaped / Leathe- bottle / Money-bag shaped heart -
Pericardial effusion
Boot-shaped heart / Coer-en-sabot - Fallot's tetralogy
Box shaped appearance - Tricuspid atresia
Jug Handle appearance - Primary pulmonary artery hypertension
"3" like appearance - Coarctation of Aorta
Egg on side appearance - Transposition of great vessels
Egg in cup appearance - Constrictive pericarditis
Snow-man heart - TAPVC (total anomalous pulmon... 阅读全帖 |
|
l******g
发帖数: 278 | 27 NBME form 4
1. A 22-year-old woman with asthma comes to the physician for a follow-up
examination. She feels well. She has been treated for six acute episodes of
wheezing and nonproductive cough during the past year; her last episode was
1 month ago. Her symptoms are exacerbated when she is outside during the
spring and fall. Current medications include an albuterol inhaler and
echinacea. She has smoked one-half pack of cigarettes daily for 5 years and
does not drink alcohol. She is employed in ... 阅读全帖 |
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b*****l
发帖数: 8603 | 28 2007年的，不知道你们说的是不是这个。祝好。
medical ethics more than hundred cases
Sep 24th, 2007, 12:17pm
1. A 25- year old mother refused immunization for her 2-month old son. The
social worker spoke to the mother. (Important for Board examination)
Next step in management: immunization should be given for the benefit of the
child.
2. A 30-year old mother refused surgery for suspected appendicitis for her 6
-year old daughter. The social worker spoke to the mother. (Important for
Board examination)
Next step in ma... 阅读全帖 |
|
e****0
发帖数: 678 | 29 • leukemia
ALL AML CLL
child adult elderly
BM lymphoblasts 25%myeloblasts
lab Lymphocyte 5000, mature-appearing cells
• Osgood-schlatters disease
Adolescent male athletes
Traction apophysitis—quadriceps tendon put the traction on the
apophysis of the tibial tubercle where patellar tendon inserts.
A firm mass =heterotopic bone formation
Pain can be reproduced by extending the kne... 阅读全帖 |
|
r*****1
发帖数: 805 | 30 My CCS protocol:
P.S.：多有重复，谨防遗漏，仅供参考。
Screening test: General—Lipid profile/ multi-vitamin; Elderly—DEXA scan&
Calcium& VitD/ Colonscopy or FOBT/ vaccination; F-- >18yo Pap smear; >50yo
Mammogram; reproductive age- folate; menopause- Lipid/DEXA/FOBT; M-- >50yo
PSA; sickle cell dz child-prophylaxis w penicillin till 5yo, CF-prophylaxis
w Abx
Prophylaxis: Pantoprazole, pneumatic compression stocking;
Acute abd w perforation: triple Abx- Gentamycin/ Ampicillin/
Metronidazole (口诀：阿扁举旗庆国庆)
E... 阅读全帖 |
|
z******8
发帖数: 844 | 31 ☆─────────────────────────────────────☆
rhcrc11 (Rebel) 于 (Thu May 15 00:13:42 2014, 美东) 提到:
Step3考场壮烈回来。第一天挺累人，最后一个block甚至做到有心无力状，看着题反应
不过来，导致来不及做完。非常没有信心能否通过。所以match之前先考Step3的童鞋，
需要考前调整生物钟，坚持锻炼，提高耐力。
MCQ没有资格说，CCS有一点小感受，拿出来分享下。大家请轻拍砖。
复习资料：
UW 52 online cases : 基础。最好复习早起找高手一起过一遍，尽快摸熟软件，进入
状态。第二遍找一位水平相近童鞋过一遍，不断总结protocol. 考前迅速做一遍，熟练
运用protocol.
UW 41 offline cases: 我当时和partner每个case仔细做一遍，虽然不像online有反馈
，但对练临床思维，补充protocol非常有帮助。最后考试与41 case有异曲同工之处，
遇到复杂case也不慌神。
CD 6 cases： 最后再熟悉下考试软件。与UW相近，但... 阅读全帖 |
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d*******g
发帖数: 150 | 32 应该是比较多的head trauma(motor vehicle accident,gunshot wound,stab wound
etc.), spinal cord injury. 有的时候可能会混一些别的比如SAH, ruptured
aneurysm etc. |
|
n**z
发帖数: 26 | 33 来自主题: Medicalpractice版 - a case what does NLF stand for? sorry for my stupid Q.
stoke should be the first on differential list, but not necessary the answer
.How about branchial plexus compression? spinal compression 2ndary to trauma?
the reason I think so is that this pt has sudden onset during physical
activity, if stoke, more likely to be bleeding secondary to HTN, or aneurysm
, which most time cause more dramatic change, instead limited to only one
upper extremity.
nothing specific would be seen on head CT if not stroke. i... 阅读全帖 |
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A*******s
发帖数: 9638 | 34 来自主题: Medicalpractice版 - a case If you don't take my advice, you will get killed in your residency. :)
My questions are:
1. Did you make the diagnosis on CXR or CT of the chest?
2. Did you give the TPA?
BTW, Do not use AAA for ascending aortic aneurysm. I know what you mean, but not the others. |
|
k********n
发帖数: 756 | 35 来自主题: Medicalpractice版 - a case NLF: nasolabial fold.
You are totally right. We were not sure about the facial weakness and were
thinking that the patient had something rather than stroke because of the
single limb weakness and significant pain in the elbow.
We did not expect the dissection. I went back after we saw the CT, he had no
pulse on right arm.
answer
trauma?
aneurysm |
|
s******t
发帖数: 579 | 36 MRA - to see aneurysm (hx of HTN) and any infarction (post-operational
stasis and embolization). |
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A*******s
发帖数: 9638 | 37 脑动脉血管瘤英文翻译: cerebral aneurysm
介入治疗: Endovascular Coiling
一般大学的神经外科都能做， 无所谓好不好。 |
|
|
f*********1
发帖数: 189 | 39 Re: 【征文活动】图文并茂，一天一个病例
响应futurehw and Aplusplus 提议
1. 70 y/o patient: incidental findings of RLL lung mass on CT during a work-
up for aortic aneurysm.
2. PET-CT:
4.0 cm consolidative mass in the lower lobe of the right lung (with SUVmax
17.4), suspicious for malignancy.
3. CT-guided biopsy: poorly differentiated NSCLC. |
|
h*****1
发帖数: 429 | 40 Update:
<1> Second brain CT: A second brain CT shows that the hemorrhagic shadow
shown in the first CT 4 weeks ago appeared not visible.
<2> The cause of the (ischemic) stroke remains unknown: He has not done
any MRI/MRA to establish a diagnosis of the acute stroke or to rule out
aneurysm/AVM, which makes worrisome.
It is true that he needs to talk to a neurosurgeon about it. However, the
hard part is that he is in China and he is now normal other than high blood
pressure. It would be very h... 阅读全帖 |
|
z****o
发帖数: 368 | 41 Pulsatile tinnitus. Possible reasons include carotid artery arteriosclerosis
or aneurysm, high jugular bulb. Need images to make the diagnosis, e.g.
thin slice CT with and without contrast. As for the slow heart rate, it may
or may not be related to the tinnitus. Need to see a doctor to make the
diagnosis.
建议看看primary医生，如果需要再转专科 |
|
A*******s
发帖数: 9638 | 42 Aneurysm surgery is a regular surgery for neurovascular surgeon in the U.S.
Not sure about China now. Complications may include seizures which can be
controlled with medications. Prognosis is good if surgery is successful. |
|
j****2
发帖数: 3211 | 43 老年人肚子跳不是首先怀疑AAA么？怎是环？？abdominal aortic aneurysm其中一个特
点不就是pulpable mass么？ |
|
L******i
发帖数: 124 | 44 Your dad need to go to emergency room for MRI. Sudden onset third cranial
nerve pulse with blown pupil, highly suspicious for aneurysm. You have to
rule out this immediately! |
|
J*********4
发帖数: 1274 | 45 https://www.youtube.com/watch?v=pmxAwNn8LJI
还有的情况是Cocaine Abuse，antiphospholipid syndrome, h/o radiation therapy,
或者小时候得过Kawasaki's disease 造成 coronary aneurysm.
Abuse anabolic steroids, and homocysteinemia 都是和年轻人MI有关？ 当然，还是
要拿小板凳来听专家的：） |
|
w*******y
发帖数: 60932 | 46 FYI
Just in case people have purchased these items.
Link:
http://www.peanutbutter.com/Recall.html
Unilever Announces Recall of
SkippyReduced Fat Peanut Butter Spread Due to Possible Health Risk
Limited Recall of 6 Best-If-Used-By Dates
FOR IMMEDIATE RELEASE March 4, 2011, Englewood Cliffs, NJ Unilever United
States, Inc. today announced a limited recall of SkippyReduced Fat Creamy
Peanut Butter Spread and SkippyReduced Fat Super Chunk Peanut Butter
Spread, because it may be contaminated with S... 阅读全帖 |
|
