کانال کیس های پزشکی

خانم مسن با شکایت از تاول لترال پا به دنبال مصرف ناپروکسن با سابقه قبلی تاول در همان محل Dx: Bullous FDE

A 17-year-old girl presents to her pediatrician for a wellness visit. She currently feels well but is concerned that she has not experienced menarche. She reports to recently developing headaches and describes them as pulsating, occurring on the left side of her head, associated with nausea, and relieved by ibuprofen. She is part of the school’s rugby team and competitively lifts weights. She is currently sexually active and uses condoms infrequently. She denies using any forms of contraception or taking any medications. Her temperature is 98.6°F (37°C), blood pressure is 137/90 mmHg, pulse is 98/min, and respirations are 17/min. On physical exam, she has normal breast development and pubic hair is present. A pelvic exam is performed. A urine hCG test is negative. Which of the following is the best next step in management?

A 17-year-old girl presents to her pediatrician for a wellness visit. She currently feels well but is concerned that she has not experienced menarche. She reports to recently developing headaches and describes them as pulsating, occurring on the left side of her head, associated with nausea, and relieved by ibuprofen. She is part of the school’s rugby team and competitively lifts weights. She is currently sexually active and uses condoms infrequently. She denies using any forms of contraception or taking any medications. Her temperature is 98.6°F (37°C), blood pressure is 137/90 mmHg, pulse is 98/min, and respirations are 17/min. On physical exam, she has normal breast development and pubic hair is present. A pelvic exam is performed. A urine hCG test is negative. Which of the following is the best next step in management?

📋 Internal Medicine Case A 32-year-old African American woman presents to the clinic due to a 2-month history of a persistent dry cough, progressive exertional shortness of breath, and fatigue. She also reports painful, tender, raised reddish nodules over both anterior lower legs. Physical examination shows bilateral clear lungs with faint basilar crackles and tender, violaceous subcutaneous nodules along the pretibial regions bilaterally. Laboratory evaluation reveals a serum calcium level of 10.9 mg/dL. A posteroanterior chest radiograph demonstrates symmetric enlargement of the hilar silhouettes and mild reticular interstitial opacities.

✅داروهای که تست اسکرین ادراری متادون را به شکل کاذب مثبت میکنند!

A 23-year-old primigravid woman comes to the physician at 28 weeks' gestation for a prenatal visit. Over the past 2 months, she has developed a hoarse voice and facial hair. Her medications include iron and a multivitamin. The last fetal ultrasonography, performed at 21 weeks' gestation, was unremarkable. Vital signs are within normal limits. Examination shows facial acne and hirsutism. Pelvic examination shows clitoromegaly. The uterus is consistent in size with a 28-week gestation. There are bilateral adnexal masses present on palpation. Ultrasonography shows a single live intrauterine pregnancy consistent with a 28-week gestation and bilateral 6-cm solid, multinodular ovarian masses. Serum androgen levels are increased. Which of the following is the most appropriate next step in management?👇👇👇 🆔👉@IMC_Iran

📚 گایدلاین‌های پزشکی همه رشته‌ها، یکجا و دسته‌بندی‌شده یک وب‌سایت بسیار کاربردی برای پزشکان که گایدلاین‌های معتبر رشته‌ها و تخصص‌های مختلف پزشکی را به‌صورت منظم و دسته‌بندی‌شده گردآوری کرده و امکان جست‌وجوی سریع بر اساس موضوع و رشته را فراهم می‌کند. ورود به Guideline گروه کیس ریپورت @casemedicalstudy

A 48-year-old man presents to the emergency department with shortness of breath. He reports that 6 months ago he was able to walk several miles without stopping. Yesterday, he became short of breath walking from his bed to the bathroom. He also endorses worsening abdominal distension and leg swelling, which he reports is new from several months ago. The patient has a past medical history of hypertension and hyperlipidemia. On physical exam, the patient has moderate abdominal distension and pitting edema to the knee. Crackles are present at the bilateral bases. Laboratory testing reveals the following: Hemoglobin: 13.4 g/dL Mean corpuscular volume (MCV): 102 um^3 Leukocyte count: 11,200 /mm^3 with normal differential Platelet count: 256,000/mm^3 Serum: Na+: 137 mEq/L Cl-: 100 mEq/L K+: 4.2 mEq/L HCO3-: 25 mEq/L BUN: 18 mg/dL Glucose: 126 mg/dL Creatinine: 0.9 mg/dL Alkaline phosphatase: 88 U/L Aspartate aminotransferase (AST): 212 U/L Alanine aminotransferase (ALT): 104 U/L Which of the following is the best next step in management?

اقای میانسال با شکایت از اریتم جنرالیزه بدن که ابتدا از سر و نیم‌تنه فوقانی شروع شده و سپس کل بدن درگیر شده. در معاینه پاپولهای فولیکولار بدون خارش در زمینه اریتم قرمز نارنجی و وجود نواحی عدم‌ درگیری sparing دیده می شود/افزایش ضخامت پوست کف دست و پا را ذکر می کند Dx:Pityriasis rubra pilaris(PRP) Tx:Acitretin

📋 Dermatology Case A 48-year-old man presents to the clinic with an intensely pruritic rash on his wrists and shins that has persisted for 3 weeks. He has a history of intravenous drug use 20 years ago but no other medical conditions. Physical examination reveals multiple purple, shiny, flat-topped, polygonal papules on the flexor surface of both wrists and the anterior lower extremities. Fine white lacy lines are visible on the surface of the lesions. Examination of the oral cavity demonstrates a reticular white network on the buccal mucosa. Skin biopsy shows a band-like lymphocytic infiltrate at the dermoepidermal junction.

آبشار ترز در استان مازندران، بخش مرکزی شهرستان سوادکوه، دهستان لفور، در روستای قرآن تالار قرار گرفته است. این آبشار از شمال به قائم‌شهر، از جنوب به فیروزکوه، از شرق به دودانگه و ساری و از غرب به بابل می‌رسد. آبشار ترز سوادکوه، یک آبشار آهکی به شمار می‎رود و ۱۸ متر ارتفاع دارد. برای رسیدن به این آبشار باید تقریبا ۴۰ دقیقه پیاده‌روی کنید. در میانه راه عبور از داخل رودخانه و مناطق خیلی مرطوب را دارید که نیاز به کفش مناسب و چوب دستی دارید. در میانه راه آبشارهای کوچکتری هم مشاهده می‌کنید. بهترین زمان برای بازدید از این آبشار اردیبهشت تا اوایل مهرماه است. ☘️گروه رفاهی،تفریحی،گردشگری جامعه پزشکی :تجربه ، خاطره،حرفای خوب https://t.me/+60i4zjW2zrIxM2Nk ╚═══🍁🍂❤️