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Arthrocentesis (synovial fluid analysis)
04/08/17 - The synovial fluid is examined for physical characteristics (color, viscosity), chemistry (glucose, protein, uric acid) and microscopy (white blood cell counts, differential count, gram stain). Physical characteristics A normal sample of synovial fluid is usually straw colored and clear. A cloudy sample may indicate the presence of bacteria, white blood…

Homologous recombination and sequence homology
04/05/17 - Definition Sequence homology (or similarity) occurs when different segments of DNA or protein have similar sequences. This indicates that the two segments evolved (divergently) from a common ancestor (shared ancestry). This is important in the field of bioinformatics by allowing us to identify the presence of putative genes in a…

BRCA mutation testing
04/01/17 - Because genetic tests are associated with potential risks including psychological, financial, legal, social and medical risks, it is critical that candidates undergo pre-test evaluation of genetic risk by a board-certified genetic counselor as well as post-test counseling to review the results as well as the options. Unfortunately, despite an increase…

Acute diarrhea
03/31/17 - Definitions Inflammatory/invasive diarrhea (dysentery) Diarrhea +inflammatory signs (blood, mucus, fever) suggests infection of the large bowel. Common organisms: CHEESSY Severe diarrhea Diarrhea + hypovolemia, passage of ≥ 6 unformed stools per day, need for hospitalization. Acute diarrhea >Diarrhea of ≤ 2 weeks duration. Most cases of acute diarrhea are infectious…

Acute diarrhea (inflammatory/invasive) mnemonics
03/29/17 - CHEESSY Campylobacter jejuni Hemorrhagic E.coli Enteroinvasive E.coli Entameoba histolytica Salmonella (lactose negative/flagellar motility) Shigella (lactose negative/shigella toxin) Yersenia emterocolitica

Felty’s Syndrome mnemonics
03/29/17 - Felty’s Syndrome Felty’s syndrome is the arthritis in which the spleen can be felty!

Editorial Policy & Author Guidelines
03/27/17 - The target audience and scope Submitted articles should be written in academic writing style. Articles should be engaging, accessible, and informative to a general physician readership. This includes practicing physicians, researchers, health care administrators, med students and residents, and policymakers, among others. This may require more explanation on your part…

Acute dyspnea (shortness of breath)
03/24/17 - 1. Acute dyspnea Acute dyspnea is shortness of breath that lasts between hours to days and is always an alarm symptom that requires prompt attention. A chest x-ray is requested to rule out respiratory, cardiac and mediastinal disease. If the patient is unable to complete a full sentence without pausing…

Diverticulitis
01/13/16 - Diverticulosis usually involves the large intestine or colon, and in rare cases, the small intestine. Clinical picture Diverticulitis presents with left lower quadrant pain. This is accompanied with fever, tenderness and increased white blood counts. Depending on its location it may be associated with nausea, diarrhea or constipation. Some patients…

Zenker diverticulum
01/13/16 - Clinical picture Zenker diverticulum usually occurs with older age and presents regurgitation of undigested food, bad breath and oropharyngeal dysphagia mainly to solids. The diagnosis is confirmed by barium studies. Endoscopy and nasogastric tubes are contraindicated due to risk of pharyngeal perforation. Treatment Treatment is with surgical resection of the…

Diffuse esophageal spasm
01/13/16 - Clinical picture Patients present with intermittent chest pain (due to spasm) that is not associated with exertion and bears no relation to food. There is intermittent esophageal dysphagia to both solids and fluids that does not progress. Barium studies show corkscrew esophagus during the time of an attack. Manometric studies…

Dysphagia
01/13/16 - Dysphagia should differentiated from odynophagia (is the term applied to painful swallowing) as well as from globus hystericus (a sensation of a lump in the throat & is not associated with deglutition or regurge). Warning signs Age above 50 years, weight loss, hematemesis are concerning for malignancy. As is progressive…

Hypercholesterolemia
01/12/16 - Causes There is a number of secondary causes for high cholesterol: Diabetes mellitus and syndrome X Kidney disease (nephrotic syndrome) Hypothyroidism Classification Classically, hypercholesterolemia is categorised by its appearance on lipoprotein electrophoresis by the Fredrickson classification. Type I: high chylomicrons Type II: Type IIa: high LDL Type IIb: high LDL…

Pregnancy test
01/12/16 - Pregnancy tests measure the levels of hCG in the blood or urine to indicate the presence or absence of a fertilized egg. In particular, most pregnancy tests employ an antibody that is specific to the β-subunit of hCG (βhCG). This is important so that tests do not make false positives…

Ebola Outbreak Highlights Struggle for Science in Africa and Inequalities in Global Health Research
11/13/14 - This article was first published on The Huffington Post by Dr. Tamer M. Fouad, M.D. Republished on Doctors Lounge with permission.

NCCN and Proventys Collaborate to Provide Point of Care Access to Guidelines
07/26/10 - Collaboration Integrates Evidence-Based Medicine and Innovative Decision Support Technologies, Providing Clinicians Access to the NCCN Guidelines at the Point of Care.

NCCN Launches Free NCCN Guidelines Mobile App for iPhone and Android
06/16/10 - The National Comprehensive Cancer Network® (NCCN®) goes mobile with the launch of free NCCN Guidelines Clinical Practice Guidelines in Oncology (NCCN Guidelines™) apps for iPhone and Android. These apps provide registered users of NCCN.org mobile access to the NCCN Guidelines™.

Parkinsonism
04/03/10 - Etiology and classification 1. 1ry idiopathic Parkinsonism Parkinson’s disease Juvenile Parkinsonism   2. Secondary (aquired, symptomatic) Parkinsonism: Infectious: post-encephalitic Drugs: neuroleptics, reserpine, tetrabenazine, lithium, flunarizine, cinnarizine. Toxins: ethanol, methanol, CO, Hg. Vascular: multi-infarct, hypotensive shock. Trauma: pugilistic encephalopathy. Other: parathyroid abnormalities, hypothyroidism, hepatocerebral degeneration, brain tumour, normal pressure hydrocephalus, syringomesenchephalia.…

Migraine
04/03/10 - Types Classic Site: unilateral starts temporal. Chronic pain headache can occur at any time of the day, but usually not during the period of concentration (rather when relaxing). Throbbing. Neurological manifestations in the form of hemianopia / paresthesias precede the characteristic headache in opposite side (4 phases) Patient prefers to…

Ulnar palsy
04/03/10 - The cubital tunnel is in this region commonly referred to as the ‘funny bone’, the area where the ulnar nerve crosses the elbow joint. The wrist is made up of a number of small bones. Two of these bones and their associated ligaments form a canal that runs through the…

Trigeminal neuralgia
04/03/10 - The eetiology of trigeminal neuralgia is obscure and could be due to diabetes, Herpes zoster or alcohol. Manifestations When the onset of this disease occurs after 50 years it usually reflects a vascular compression by a tortuous artery at the base of the brain. If the onset occurs in younger…

Transient global amnesia
04/03/10 - Causes Temporary vascular insufficiency to hippocampus or its thalamic connections. There are many theories as to how this can happen: A result of a migraine attacks: The most compelling evidence in favor of the migraine theory is that patients who suffer from a TGA event have a slightly higher incidence…

Transient Ischemic Attack (TIA)
04/03/10 - Symptoms TIA symptoms, which usually occur suddenly, are similar to those of stroke but do not last as long. Most symptoms of a TIA disappear within an hour, although they may persist for up to 24 hours. Symptoms can include: numbness or weakness in the face, arm, or leg, especially…

Cervical outlet and thoracic outlet syndrome
04/03/10 - Symptoms The most frequent complaints are numbness and tingling in the fingers; pain in the neck, shoulder, and arm; headaches in the back of the head; weakness of the arm and dropping things from the hand; worsening of the symptoms when elevating the arm to do such things as comb…

Tension type headache
04/03/10 - Sense of pressure or tightness in the head, rather than pain, occasionaly throbbing. However, its intensity changes. Occaisionally relieved by tight band. Tension headache variants TMJ syndrome, post-traumatic headaches, depressive headaches, atypical fascial pain, conversion equivalent.

Temporal arteritis
04/03/10 - Clinical suspicion New, severe, sustained, steady or throbbing headache most often located in the temporal region of the scalp and accompanied by a tender, nodular, or incompressible artery in the area. Head pain also may affect the masseter or sterno-cleidomastoid muscles, occasionally as the chief symptom. Associated symptoms may include…

Tardive dyskinesia
04/03/10 - Clinical presentation Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Rapid movements of the arms, legs, and trunk may also occur. Impaired movements of the fingers may appear…

Progressive supranuclear palsy
04/03/10 - It is an uncommon condition, however it is the commonest form of Parkinsonism plus. It affects patients in their middle age / older Manifestations: Parkinson - like rigidity, no tremor Loss of postural reflexes Postural dystonia increased on extension of the head. Progressive external ophthalmoplegia 1st to voluntary conjugate vertical…

Stroke
04/03/10 - Overview The ischemic stroke is usually caused by atherosclerosis (hardening) of blood vessels, embolus (a piece of blood clot originating from atherosclerotic plaque or heart) or small artery disease (the occlusion of small cerebral vessels by the influence of such presumed factors as diabetes mellitus, elevated blood lipid levels, hypertension…

Status epilepticus
04/03/10 - There is continuous seizure activity with no recovery between successive tonic-clonic seizures. This is a life threatening condition and emergency medical assistance should be called immediately if this is suspected. A tonic-clonic seizure lasting longer than 5 minutes (or two minutes longer than the usual seizures for a given epileptic)…

Spondylosis
04/03/10 - Manifestations Usually no manifestations. Nerve root compression or spinal cord compression may result in symptoms and signs of herniated discs) Diagnosis Magnetic Resonance Imaging is very useful in its diagnosis. Treatment 1st choice soft collar leading to cervical traction and neck stabilization. If condition progresses surgery may be required.

Sciatica
04/03/10 - Causes of sciatica The most common cause of sciatica is a “slipped disc” (a herniated disc in the spine). Other conditions that can cause or aggravate sciatica include roughening and enlarging of the vertebrae, tension in the piriformis muscle, infections, and tumors. Symptoms and signs The pain is usually shooting…

Psychogenic memory impairment
04/03/10 - Manifestations Can cause antero (near)/ retrograde (far) memory impairment. A block in time is removed leaving memory before and after intact. Emotionally enforced memories are often forgotten. Self may be denied and insight (the knowledge that one is psychologically ill) is absent Treatment Unfortunately there is no drug cure for…

Postural Tachycardia Syndrome
04/03/10 - Causes Causes of POTS usually are not identified in individual patients. Reversible causes such as low blood volume should be ruled out. Symptoms Symptoms include rapid heartbeat, lightheadedness with prolonged standing, headache, chronic fatigue, chest pain, and other nonspecific complaints. Treatment Treatment of POTS depends upon the severity of the…

Parkinson’s disease
04/03/10 - The disease is a progressive movement disorder of the extrapyramidal system, which controls and adjusts communication between neurons in the brain and muscles in the human body. Etiology The cause of Parkinson’s disease is not known. Geneticists have since 1997 found nine different specific genetic defects, each of which causes…

Olivopontocerebellar degeneration (OPCD)
04/03/10 - Pathologically the most common denominator in this category is degenerative changes in the pons, olive and cerebellum. The condition in the 40-60 (as early as 20) age group. There is no sexual predilection. The condition is autosomal dominant. Clinical suspicion Patient presents with any combination of the following dysfunctions: Cerebellar…

Narcolepsy
04/03/10 - The etiology is unknown, however genetic predisposition, aberrant neurophysiological mechanisms of REM have been postulated. Diagnosis 4 criteria are required for the diagnosis of narcolepsy: sleep attacks, cataplexy, sleep paralysis, hypnagogic states. Treatment Treatment is of limited value; methylphenidate, amphetamines, MAO inhibitors.

Myasthenia gravis
04/03/10 - Acetylcholine is a chemical substance that sustains muscle contraction by stimulating the muscle fibers by binding to its receptors. The immunologic reaction against these receptors and consecutive damage of the neuromuscular endplate give rise to deficient stimulation of muscle fibers. Patients frequently present with restricted movements of eye muscles and…

Multi-infarct dementia
04/03/10 - Risk factors include hypertension, diabetes, hyperlipidemia. Manifestations include episodes of focal neurological worsening, less commonly progressive amnesia and dementia.

Multiple sclerosis
04/03/10 - Epidemiology The prevalence of multiple sclerosis (MS) is approximately 350,000 cases in the United States and more than 2.5 million worldwide. There are at least 10,000 newly diagnosed cases of MS annually. In northern Europe, continental North America, and Australasia, about one of every 1000 citizens suffers from multiple sclerosis,…

Motor neuron disease
04/03/10 - Characteristically, sensory changes and cerebellar dysfunction are absent. Motor Neurone Disease (MND) is a term used to cover a number of illnesses of the motor neurone. Amyotrophic Lateral Sclerosis (ALS), Progressive Muscular Atrophy (PMA), Progressive Bulbar Palsy (PBP) and Progessive Lateral Sclerosis (PLS) are all types of MND. MND is…

Meningitis
04/03/10 - Meningitis is usually caused by the infectious disorders of the neighboring structures (sinuses, mastoid cells of ear etc.). Major bacteria that cause meningitis are Streptococcus pneumoniae, Haemophilus influenzae, staphylococcus and meningococcus. Symptoms and diagnosis The classical symptoms of meningitis are headache, neck stiffness and photophobia (the trio are called “meningism”).…

Progressive hydrocephalic dementia
04/03/10 - The disease usually affects patients > 55yrs old. Manifestations Moderate dementia. Pyramidal and cerebellar manifestations. Treatment Surgical ventricular shunting.

Huntington’s disease
04/03/10 - Clinical suspicion The presence of progressive chorea (basal ganglia) in the presence of behavioral changes and dementia (frontal lobe). Diagnosis CT / MRI in fully developed cases shows atrophy especially of basal ganglia. Treatment The treatment aims mainly at symptomatic relief of patients. Serpasil 1-2 mg tds and chlorpromazine 100…

Herniated cervical or lumbar discs
04/03/10 - Clinical manifestations Pain: herniated disc by itself usually does not cause any pain. Pain occurs when the membrane on the outside of the spinal cord or spinal nerves is irritated. Pain or numbness may occur in the area of the body to which the nerve travels. For example, a herniated…

Guillain-Barre syndrome
04/03/10 - Guillain-Barre syndrome is an Inflammatory or immune polyneuropathy. Demylination occurs due to antimyelin - antiganglioside Antibody. It is the most common immune mediated polyneuropathy. Affects young or middle aged individuals with no sexual predilection. Other risk factors include mild respiratory or GIT infection or Hodgkin’s disease and surgery. Clinical suspicion…

Glossopharyngeal neuralgia
04/03/10 - The disease can be associated sometimes with brief cardiac slowing or arrest during attack. Treatment Carbamazepine is the drug of choice. If this fails surgical sectioning of the glossopharyngeal nerve roots in the post fossa may be indicated.

Facial hemispasm
04/03/10 - Manifestations Unilateral, recurring, rapid, locally migrating twitches of bundles of facial muscles most often occurring around the eye or mouth. Initially intermittent in bursts of minutes to an hour or so but often becomes continuous. Sensory changes are lacking and most examples reflect the compression of the facial nerve at…

Epilepsy
04/03/10 - Definitions Epileptic seizure: An episodic, uncontrollable, abnormal motor, sensory or psychological behavior caused by abnormal electrochemical activity in the cerebrum. Epilepsy: A chronic condition characterized by repetitive seizures. Types of seizures Reactive seizure: Occur in predisposed patients a variety of sensory stimuli can precipitate reflex epilepsy. E.g. video games (valproic…

Diabetic neuropathy
04/03/10 - Diabetic polyneuropathies Rapidly reversible physiologic dysfunction associated with hyperglycemia Symmetric polyneuropathy Sensorimotor neuropathy “Small-fiber” neuropathy, with autonomic dysfunction, reduced pain sensibility, spontaneous burning pain         Diabetic mononeuropathies and plexopathies Diabetic third nerve palsy Diabetic fourth nerve palsy Diabetic truncal neuropathy Diabetic lumbosacral plexopathy Diagnosis Electrodiagnostic studies (usually…
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