d*******n
发帖数: 1 | 1 很长一段时间（一年多）一直觉得嘴里发甜。血糖等各项指标一直正常。家庭医生推荐
了耳鼻喉科医生，医生建议做个脑部的MRI.做完后医生看过了报告后说脑部没什么异常
。 不知道有没有必要再找脑神经科的医生看一下？ 报告如下。小时侯得过鼻窦炎，出
国后就没什么症状了。平时有时候会有头疼，主要集中在脑门部位。喝杯咖啡，或者睡
一觉就没事了。
谢谢
Technique Used: .
MRI of the Brain Without & With Contrast: Axial DWI, sagittal T1, Sag 3D
FLAIR, axial SWI, Axial
T2 and FLAIR; Following an injection of 8.5ml Optimark: Coronal T2 and
Sagittal 3D T1 MPRAGE.
Reformat: axial, coronal, and sagittal T1 post contrast.
Symptoms: .
Altered taste described as sweet.
Body: .
MRI of the... 阅读全帖 |
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s********p
发帖数: 1319 | 2 水晶好认真——听诊比我仔细得多！
主动脉瓣狭窄（AS）向颈部传导，我们的注意力，应该多放在胸骨右缘第二肋间，在心
脏听诊方面，那里的杂音和心音的改变比较明显（详细情况见图，说明）。这是和单纯
动脉粥样硬化（Arthroscleroses, AS）所致颈动脉狭窄所导致的Carotid bruits收缩
期杂音的主要鉴别要点。
单纯动脉粥样硬化（Arthroscleroses, AS）所致颈动脉狭窄时，听到carotid bruits
收缩期吹风样杂音的时候，心脏本身的杂音和心音变化并不明显。此时，“Duplex
ultrasound imaging provides a direct, noninvasive means of assessing both
the anatomical characteristics of peripheral arteries and the functional
significance of arterial stenoses.”
此外，颈部听诊时还有个连续的静脉杂音，见图2。
不知道说清楚没有？
等我Step 12 考完后，一同和XDJM们探讨些... 阅读全帖 |
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e****0
发帖数: 678 | 3 Class Three
NEJM-09/13/2012
Fractional flow reserve-guided PCI versus Medical therapy in stable coronary
disease
##Conclusion
In patients with stable coronary artery disease and functionally significant
stenoses, FFR-guided PCI plus the best available medical therapy, as
compared with the best available medical therapy alone, decreased the need
for urgent revascularization.
In patients with stenosis that were not functionally significant, the best
available medical therapy alone results in an ex... 阅读全帖 |
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g****y
发帖数: 34 | 4 68 y/o woman has 1 year history of severe ab pain after meals. also has an
unintentional 20lb weight los. pain is relieved when she decreases the
amount of food she eats. p/e shows soft, nontender abdomen and abdominal
bruit. pedal pulses diminished. which artery is stenosed?
greater pancreatic
hepatic
right gastric
superior mesenteric
supraduodenal |
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A*******s
发帖数: 9638 | 5 大家在学习过程中， 肯定看到很多有趣的，经典的临床综合症。 希望大家每人贡献一
个case， 图文并茂， 奖励办法由futurehw公布。
我开个头： Bow hunter's syndrome
It is named after how a bow hunter's who usually turn their head
significantly to shoot the bow and arrow. Bow Hunter's syndrome is a
condition where the contralateral vertebral artery is stenosed, compressed,
or occluded. Since the vertebral arteries supply blood to the posterior
portion of the cranium, then patients are going to have issues with sight,
vertigo and occasions of syncope. When the co... 阅读全帖 |
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L****n
发帖数: 12932 | 6 ----For medically treated patients with 70% to 99% stenoses, there was a
significantly increased risk of outcome events.----！！！ During the 3-year
follow-up, risk of ipsilateral stroke and perioperative death was 10.3% for
patients who had surgery and 16.8% for patients treated without surgery.
Risk of death due to carotid endarterectomy or stroke from any cause during
follow-up was 12.3% for surgical patients and 21.9% for nonsurgical patients
. |
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L****n
发帖数: 12932 | 7 闲话少说， i believe in evidence based medicine. I've shown reference to the
possibility of TIA presents as loss of consciousness, as well as study that
better long term outcome of CEA compare to conservative treatment in a
severely stenosed carotid artery (even if 1% better is 1% better), i have
yet to see any reference point the other way. Can you provide reference
support your argument pertain to:
1) this patient's loss of consciousness CAN'T POSSIBLY result from carotid
stenosis? this patient ac... 阅读全帖 |
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