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One Disease Daily
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Question of the week:
A 32-year-old woman with no notable medical history presents to the emergency department with pain in her back, left knee, and right ankle. She reports that the back pain began 3 weeks ago, frequently wakes her from sleep, is associated with stiffness in the morning, and improves with activity.
Her left knee and right ankle have become warm, swollen, and painful during the past week, impairing her ability to work. Naproxen at therapeutic levels provides only mild relief.
The patient also reports conjunctivitis and dysuria. She has multiple sexual partners who use condoms intermittently. She states that she does not experience fevers or rash.
Physical examination reveals moderate swelling in the left knee, warmth and redness of the right ankle, and tenderness at the right upper buttock.
Arthrocentesis of the knee effusion reveals cloudy synovial fluid containing 15,400 leukocytes per high-power field, with 85% neutrophils. Cultures of synovial fluid are negative.
Urine polymerase-chain-reaction testing is positive for Chlamydia trachomatis but negative for Neisseria gonorrhoeae.
Answer: Weed Pollen
Allergies in the late summer and early fall are most likely to be caused by weed pollen.
Allergic rhinitis is associated with nasal and ocular symptoms during times of allergen exposure. Weed pollen is most common in late summer and in the fall.
Tree pollen is the most prominent environmental allergen in the early spring.
Grass pollen is most common in the late spring into summer.
Cat and dog dander, as well as dust mites, are perennial allergens that cause symptoms year-round.
Question of the week:
A 36-year-old woman who lives in the United States presents for evaluation of nasal symptoms. She reports symptoms of rhinorrhea, nasal pruritus, and ocular pruritus that occur every year for 3 to 4 weeks in the late summer and early fall. She has a cat and a dog.
" Saying the product of the kidneys is urine is like saying the product of a factory is pollution. Urine is a by-product. The product is homeostasis "
- Joel Topf. MD.
Davidson principles and practice of medicine 23 edition 💜
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https://drive.google.com/file/d/1A-ehSwEP1cVdgSQsZzhEqRYKNrhVOXto/view?usp=drivesdk
Answer for the 👆🏻: Azithromycin + Indomethacin
Reactive arthritis (formerly known as Reiter syndrome) is a spondyloarthritis, which classically manifests as arthritis, urethritis, and conjunctivitis. Uveitis, fever, and other constitutional symptoms are also common features, as are acute pustular skin lesions known as keratoderma blennorrhagica.
However, in more than 50% of affected patients, extra-articular manifestations are absent. Joint involvement, typically oligoarticular and asymmetric, may involve the spine (most frequently the sacroiliac joints).
Causative pathogens include Chlamydia trachomatis and enteric bacteria, such as Salmonella, Shigella, Yersinia, Campylobacter, and Clostridioides difficile. Treatment involves eradicating the pathogen if there is evidence of ongoing infection, but in many cases, the precipitating infection has resolved before arthritis develops. In this patient, azithromycin treats the active chlamydial infection.
Nonsteroidal antiinflammatory drug (NSAID) therapy is the first choice for control of arthritis, and it is not uncommon for more than one NSAID to be tried in an attempt to find an effective agent.
Systemic or intra-articular glucocorticoids are indicated if NSAIDs are ineffective. Average disease duration is 3 to 6 months.
In the up to 20% of patients with reactive arthritis who have arthritis that persists beyond several months, disease-modifying antirheumatic drugs, such as methotrexate, can be considered.
Prolonged antibiotic treatment (with rifampin plus azithromycin or doxycycline) may benefit patients who have refractory, Chlamydia-induced reactive arthritis, particularly if there is evidence for persistence of bacteria in an attenuated form.
However, testing for such persistent infection by polymerase chain reaction of synovial tissue is not generally available.
Source: NEJM
Last reviewed Sep 2019. Last modified Jul 2019.
Common Nutritional Deficiencies Quiz by Medscape
https://reference.medscape.com/viewarticle/909390?src=wnl_fastquiz_190316_mscpref&uac=287655CV&impID=1907220&faf=1
Q: An otherwise healthy 9-year-old girl presented to the primary care clinic with a sore throat and fever. Her temperature was 38.5°C. Physical examination revealed swollen and tender cervical lymph nodes, an inflamed uvula, enlarged tonsils, and “doughnut” lesions on both the hard and soft palates. What is the underlying cause?
Читать полностью…To which one of the following allergens is this patient most likely to be sensitive?
public poll
Grass pollen – 68
👍👍👍👍👍👍👍 45%
Weed pollen – 55
👍👍👍👍👍👍 36%
Dust mites – 15
👍👍 10%
Cat or dog dander – 10
👍 7%
Tree pollen – 4
▫️ 3%
👥 152 people voted so far.
oral Intake of Vancomycin Vial
Indication
Pseudomembranous Colitis/Staphylococcal Enterocolitis
Dose : 125 mg/dose (q6hrs)
for 7-10 days
من ولايات امريكا الساحلية هية ولاية مين وولاية كاليفورنيا
ويتميز ساحل ولاية مين في الخارطة بانه ذات حافات متعرجة
عكس ساحل ولاية كاليفورنيا والتي تتميز بان ساحلها في الخارطة ذات حافات ملساء
هذا التشبيه يقتبس منه التفريق ب café au lait spot
حيث ان الcafe au lait spot
ذات الحواف الملساء والتي تشبه ساحل ولاية كاليفورنيا تكون في
مرض neurofibromatosis
اما ال café au lait spot
ذات الحواف المتعرجة والتي تشبه ساحل ولاية مين
يكون في مرض ال mccune albright syndrome
المقارنة اعلااااااااه
Complete package including links to download all the pdf books you will need in MBBS :-
Anatomy:
1--> KLM for Gross Anatomy
2--> Snell's Anatomy
3--> BD Churassia
4--> RJ Last
5--> Grey's Anatomy
6--> Langman Embryology
7--> KLM for Embryology
8--> BD For General Anatomy
9--> Dissector
10--> Di Fore Histology
11--> Junqueira's Histology
12--> Netter Atlas of human Aantomy
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LYV9KQ3lxY29FY28
Physiology:-
1--> Guyton
2--> Ganong
3--> Sheerwood
4--> Sembulingam
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LdXlCSjdZM214dEE
Biochemistry:-
1--> Harper
2--> Lippincott
3--> Chatterjea
4--> Satyanarayan
5--> Stryer
6--> MRS Biochemistry
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0Ld0o3WnhCR2VEczg
Pathology:-
1--> Big Robins
2--> Medium Robins
3--> Pathoma
4--> Goljan
5--> Harsh Mohan Pathology
6--> Atlas of Histopathology
7--> Levinson
8--> MRS microbiology
9--> Microbiology by Jacquelyn G. Black
10--> Color Atlas of Microbiology
11--> Kaplan Pathology
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LYkRYdjFrTm5MR0U
Pharmacology:-
1--> Big Katzung
2--> Mini Katzung
3--> Kaplan Review
4--> Lippincott
5--> Pocket Katzung
6--> Rang and Dale's Pharmacology
7--> Atlas of Pharmacology
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LMkE1UUVRZGwtTlU
Forensic Medicine:-
1--> Simpson's Forensics
2--> Krishan's Forensics
3--> Atlas of Autopsy
4--> Atlas of Forensic Medicine
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LQXVwOGoyWnFSV2s
Ophthalmology:-
1--> Jogi
2--> Jatoi
3--> Parson's Textbook of Eye
4--> Kanski
5--> AK Khurana
6--> Atlas of ophthalmology
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LOHc5WVZMdkJjX2M
Otorhinolaryngology:-
1--> Dhingra
2--> Logans Turner
3--> Color Atlas of Otorhinolaryngology
4--> Maqbool's Text Book of ENT
5--> Clinical Methods in ENT by PT Wakode
6--> ENT at a Glance
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LaDY2a0lFNDlfTGc
Community Medicine:-
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2--> Mahajan And Gupta Text Book of Community Medicine
3--> Bancroft's Text Book of Community Medicine
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0Lc1RCMml2NjhFNjA
Medicine:-
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2--> MTB Step 2 Ck
3--> Davidson Essentials
4--> Davidson Principals and practice
5--> Harrison's Internal Medicine
6--> Internal Medicine USMLE Nuggets
7--> Internal Medicine on call bt LANGE
8--> Oxfords Specialties
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LeEFJNG5TMlc4eWc
Surgery:-
1--> Bailey_love short practice of Surgery
2--> Churchill's pocketbook of Surgery
3--> Deja Review of surgery
4--> Farquharson's Textbook of Operative General Surgery
5--> Hamilton Bailey’s Physical Signs
6--> Oxford Handbook of Clinical Surgery
7--> Schwartz's Principles of Surgery
8--> Macleod's Clinical Examination
9--> Macleod's Clinical Diagnosis
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LRFpFSG5hZ1pVWkE
Obstetrics & Gynecology:-
1--> Case Discussions in Obstetrics and Gynecology
2--> Deja Review of Obstetrics Gynecology
3--> Obstetrics by Ten Teachers
4--> Gynaecology illustrated
5--> Gynaecology by Ten Teachers
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LMU1LRjFDa1FrbjA
Pediatrics:-
1--> Nelson Essentials of Pediatrics[
2--> Nelson Complete
3--> Pediatrics Review
Folder link--> https://drive.google.com/open?id=0B3WdpdsqpX0LUkdTQkVuNV92Yzg
1st Professional Books--> https://drive.google.com/open?id=0B3WdpdsqpX0Lay1HT1d5Yks5V0U
2nd Professional Books--> https://drive.google.com/open?id=0B3WdpdsqpX0LemtmYXpYMGlydVk
3rd Professional Books--> https://drive.google.com/open?id=0B3WdpdsqpX0LWmlCSHBpUFpPZU0
4th Professional Books--> https://drive.google.com/open?id=0B3WdpdsqpX0LbnJvUzk3NHRhWWc
One Link For All eBooks--> https://drive.google.com/open?id=0B3WdpdsqpX0LQW5tbWEtUmJJY0k
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