Browsing all posts in Fast Facts.

Purpura fulminans as severe complication of meningococcal infection

Purpura fulminans
It is a severe condition due to meningococcal sepsis, it occurs in 15 to 25% of those patients with meningococcemia.
The clinical picture is as follows: acute onset of cutaneous hemorrhage and necrosis secondary to vascular thrombosis and disseminated intravascular coagulation. Often there is pain followed by petechiae. Ecchymoses develop and evolve into painful [...]

Six Symptoms You Don’t Want To Ignore

Yesterday at Health-Hack.com they made a list of six of the most evident symptoms of some serious illness, via WebMD:
From WebMD:
1. If you have unexplained weight loss and/or loss of appetite, you may have a serious underlying medical illness.
2. Slurred speech, paralysis, weakness, tingling, burning pains, numbness, [...]

Costochondritis (Tietze’s syndrome)

I’ve been asked –and consulted- about “rare chest pain” in several times. I could notice that people is always worried about any kind of chest pain because the fear of suffer a heart attack or a pulmonary problem. Chest pain is one of the most common symptoms that require medical attention. You –as physician- should [...]

Insulinoma & Whipple triad - Surgery (update)

Insulinoma
Insulinoma is the most common functioning tumor of the pancreas, and affected patients present a tableau of symptoms referable to hypoglycemia (symptoms of catecholamine release), mental confusion and obtundation. Many patients have symptoms for years. Some have been greatly troubled by emotional instability and fits of rage, often followed by somnolence.
Incidence: This tumors are so [...]

Thrombosed Hemorrhoid

Thrombosed external hemorrhoids often occurs in grade III-IV internal hemorrhoids, and can cause excruciating pain, and patients will often present acutely. In such cases, surgical evacuation of the hemorrhoid can produce immediate relief.
The treatment of choice is hemorrhoidectomy with partial lateral internal sphincterotomy, which consists in incised the mucosa on each side of the hemorrhoid [...]

A rare thoracic tumor

50 y/o male with a history of one year with respiratory symptoms, he was diagnosed treated at Guatemala where he lives. Now he comes to Mexico City seeking for a second opinion and other options of therapy. At the physical examination he is well, has diminished breath sounds and just sinus tachycardia. [...]

New AACE guideline to achieve glycemic goals

Via AACE from J Davidson, P Jellinger, L Blonde, H Lebovitz, C Parkin (2005):

The new position statement is this: Even if the initial A1C is from 6 to 7%, you should start pharmacotherapy.
This aggressive treatment has proved that mortality diminishes considerably.

Regards,
Jon Mikel Iñarritu, M.D.

technorati tags: diabetes, diabetes mellitus, A1C, AACE guidelines, guidelines, pharmacotherapy, medicina, [...]

Open Fractures Classification and its clinical manifestations

Open fractures are surgical emergencies because of its complications (soft tissue damage, infection, hemorrhage).
We at emergency department need a classification system that it is intented to determine the degree of that damage.
We have to make a rapid (also a good) interrogation of lession mechanisms (what, when,  where, who, associated lessions). REMEMBER: If a low-grade open [...]

Cardiac Tamponade

Physical findings & Clinical Presentation:
• Severeconstant pleuritic pain that localizes over the anterior chest and may radiateto arms and back; it is differentiated from myocardial ischemia, becausethe pain intensifies with inspiration and is relieved by sittingup and leaning forward.• Pericardial friction rub is best heard with patientupright and leaningforward and by pressing the stethoscope firmly [...]

Horrible: Child abuse

Another case of Child abuse was shown today on TV news.
It seems that we can’t stop this and some parents preffer to remain in silence rather than to speak out loud about this impunity.
I think it is time to recognize this cases and report them to the authorities. So today’s matter is to know the [...]

Concern about appearence

24-year-old male comes to you with the chief complaint that his nose is too big to the point of being hideous. He has been avoiding contact with others and has left his studies.
The patient states that his nose is a constant embarrassment to him and he would like it surgically reduced. He tells the physician [...]