SudaMediCa, The Sudanese Medical Community

to be continued
.

the scenario is as the following, this pt was cushinoid (drug induced) presented with adrenal insufeciency( explain hyponateremia, hyperkalemia, shock but hyperglycemia was odd thing here) induced by stress which was acute pancreatitis here(explain hyperglycemia, hypocalcemia, abd pain, SIRS), two c...

congratulations

thuraiaibrahim wrote:Dd:_
Admission's
Pancrea titis
Cause of hyper glycemia..drug induced
.ca!!!

very nice i will discuss the case later when return from work , serum lipase was 2896

this is a real case 50 female not DM or htn, living renal transplant for 3rd time on prograf, cellcept, hostacortin 10, history three years ago of CMV infection for which she recieved gancyclovir base line creat 2.3 presented to other hospital 3days ago with orthostatic hypotention, hyponateremia 10...

in our case we attributed the swelling to hypersensitivity due to analgesic given for the patient due to chest pain after patient falls, but it proved to be as this case here.

this is a case from BMJ, i but it because we saw a case looks like this one and was misdiagnosed for up to 2 days.

A 49 year old woman presented to the emergency department with facial swelling (fig 1). She had fallen four days previously, striking her back on a large piece of concrete. After picking herself up she proceeded with her normal activities. The morning after the fall she awoke with swelling of the a...

Progestin withdrawal challenge

MRI of the pituitary gland

(B) Chlamydia

a similar case scenario in MRCP exam but cause here was hypothermia, this people asks the right questions A 55-year-old homeless male was found stuporous and smelling of alcohol. Observations in the emergency department reveal a core temperature of 34°C, a pulse of 50 bpm and blood pressure of 116/8...

c) Methotrexate

VANCOMYCIN i think

this is the ecg of this case
notice prolonged QT more than 600 m.second
also inverted T waves with U waves in lead V2-6 .
depressed ST segment V5,6 (can occur with severe hypokalemia)

We should ask for history of: vomiting, diarrhea, poly urea, diuretics, laxative abuse, licorice ingestion.CKD,urinary divertion,git surgeries.DM,HTN this pt gave a history of licorice ingestion examination: BP,Pulse, volume status, muscle weakness. pt was htn in hypokalemia we have 3 tools: - Blood...

liver enzymes can rise in rhabdomyolisis specially ast, also raised creat without much raised urea occur in rhabdo due to release of creatinine from damaged muscles. in the setting of hypokalemia " Potassium release from muscle cells during exercise normally mediates vasodilation and an appropr...

alt 300 -ast 700 creat: 6 urea: 90 k 1.2 this is the clues
we suspected rhabdomyolisis we ordered cpk
14000
mostly hypokalemia induced rhapdomyolisis.
now we need workup for hypokalemia

we will search for the cause for hypokalemia next but first what was the cause of renal failure review the laps closely.

of course cloride in urine is important here but was not done

i was told it was low but i dont remember the number but giving this a met alkalosis anion gap is of no good.

she has a metabolic alkalosis Hco3 was 41

59 female known htn not diabetic no other medical disorder, known normal kidney function, was on atenolol. one week ago she developed weakness in her both l.l., she gone to other doctor who gave here just multivitamins. today she presented to us with just generalized weakness, no signs of lateraliza...

A 75-year-old man with type 2 diabetes and hypothyroidism underwent bilateral total knee replacement at our hospital. His functional capacity had been moderately limited by knee pain, but he could easily climb one flight of stairs without symptoms. His medications at that time included levothyroxine...

SudaMediCa wrote:please use the voting to answer

sorry i didn't noticed it first time

1.d) Plasma protein concentration so its decrease cause edema.
2.c) Chloride this is the major anion extracellular.
3.d) Is mainly due to Na+ salts the major cation extracellular.
4.d) Hypertonic NaCl as urea is ineffective osmolol.

venous ulcer and pt used minocycline for long time mostly causing grey pigmentation of skin esp in elderly