Doctoremia
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A doctor remains a student until his last breath. The moment he stops learning, he truly begins to die
إظهار المزيد6 419
المشتركون
-124 ساعات
-57 أيام
-1830 أيام
أرشيف المشاركات
6 419
ECG of left main disease.. st elevation in aVR and ST depression in multiple leads... লেফট মেইন ডিজিজের ফেইট খুবই খারাপ।
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The Storm in the Breath: A history of asthma or severe airway hyperreactivity 🌬️.
- The Red Tide: High eosinophilia (present in both the blood and invading the tissues) 🩸.
- The Dragon's Hoard: Elevated serum IgE levels 🐉.
- The Scars of Bronchiectasis: Specifically, central bronchiectasis, carving out the airways 🏗️.
- The Precipitating Storm Clouds: Fleeting pulmonary infiltrates (the "clouds" visible on a chest X-ray or CT) ☁️.
The truth you seek is clear. This classic pentad reveals the grand diagnosis: Allergic Bronchopulmonary Aspergillosis (ABPA) 🩺.
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Behold the warrior whose breath is a storm, whose blood swells with the red tide of eosinophilia, and whose IgE levels rise like a dragon's hoard! Does the lung bear the scars of bronchiectasis? Does the IgE precipitate like storm clouds? What is the diagnosis, O seeker of truth?
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✅In chronic pancreatitis,which types of malabsorption develop in the most advance cases?
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SBA SERIES 🛑:
প্রশ্নটা এমনিতে খেয়াল করলে মনে হবে যহেতু acidosis আছে এটা maybe due to metformin induced lactic acidosis এর কারণে হচ্ছে। যেহেতু পেশেন্ট মেটফরমিন নেয়।
কিন্তু একটা প্যাচ দিয়ে দিয়েছে।সেটা হচ্ছে এখানে Anion gap calculate করতে হবে।
এখানে ক্যালকুলেশন করলে normal anion gap আসে।
(Na+k) -(hoc3+Cl)
10 এর মতো আসে।
আমরা জানি normal anion gap 16+- (4)
ডেভিডসনে দেখবেন lactic acidosis সহ ,বাকি সব কিটোএসিডোসিস হচ্ছে HAGMA..
high anion gap metabolic acidosis..
তাহলে উত্তর অবশ্যই lactic acidosis না।।
খেয়াল করবেন পেশেন্ট acetazolamide খাচ্ছে। এর মানে proximal tubule এ carbonic anhydrase কাজ করতে পারছেনা।
ঠিকমতো bicarbonate ion reabsorption হচ্ছেনা।bicarbonate loss হচ্ছে।
এবং বডিতে acidosis হচ্ছে।
acetazolamide induced acidosis হচ্ছে proximal renal tubular acidosis.. এটা normal anion gap..
এটাই উত্তর।
Doctoremia
Dr Tamim
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Which one gives adaptive immune response
1.Defensins
2.Ig A
3.Sub Epithelial cell
4.Epithelial cell
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C. difficile in a pt with no antibiotic exposure in the last 3 months: think community-acquired from proton pump inhibitors.
PPIs increase gastric pH, allowing C. diff spores to survive the stomach. The relative risk of CDI with PPI use is similar to low-risk antibiotics like cephalosporins.
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A 25-year-old woman with ulcerative colitis develops worsening bloody diarrhea despite high-dose IV corticosteroids. CRP is 60 mg/L. Stool test is positive for a viral pathogen known to cause steroid-refractory colitis.
Which pathogen is most likely?
A. Rotavirus
B. Norovirus
C. Cytomegalovirus
D. Adenovirus
E. Enterovirus
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🛑obesity can cause decrease BNP levels,leading to a false negative for heart failure screening
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woman with Pulmonary hypertension should avoid becoming pregnant due to very high mortality levels
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