What’s your differential diagnosis to explain the “strange behavior” of a patient with newly diagnosed HIV/AIDS?
Thank you Shirley for a great presentation on a young patient presenting with jaundice, AST 2552 and ALT >5000!
What’s the differential?
Thank you Dr. John Hollowed for an excellent presentation on acute promyelocytic leukemia
- APL accounts for 5-20% of AML cases
- Increased incidence in people with prior cytotoxic therapy
- Presents with complications of pancytopenia, weakness, fatigue, infections, increased bruising/bleeding, DIC
- Diagnosis: bone marrow analysis and confirmation with PCR, FISH, or cytogenic analysis
- Treatment is All-trans Retinoic Acid (ATRA)
Thank you Dr. Liza Buchbinder for an excellent presentation on Huntington’s Disease
- Etiology: Autosomal dominant; Drug induced (antipsychotics, estrogen containing); Endocrine (thyrotoxicosis, hyperglycemia); pregnancy (chorea gravidarum); streptococcal infection (Sydenham chorea); autoimmune (SLE, APLS); neurodegenerative d/o of basal ganglia.
- Associated w/ parkinsonism, impulsiveness, psychiatric disorders, and dementia.
- Treatment is symptomatic
Thank you Dr. Daniel Jimenez for an excellent presentation on TCA induced cardiotoxicity Teaching Points Clinical presentation: anticholinergic sx (urinary retention, constipation), CNS (seizures, coma), acidosis, arrythmias ECG: prolonged QRS/PR/QT --> predisposes for ventricular arrhythmias) Management: supportive care, benzos for seizures,…
Excellent morning report today with Thomas Vu on Neuropsychiatric Lupus! Take a look at on the latest review on neuropsychiatric SLE: Management of Neuropsychiatric Systemic Lupus Erythematosus: Current Approaches and Future Perspectives on PubMed
Thank you Dr. Brendan Cerk for an excellent presentation on neurocysticercosis presenting with new onset seizure
- Histoplasmosis is a common endemic mycosis, usually asymptomatic but occasionally results in severe illness
- Hematogenous dissemination occurs during the acute infection before cellular immunity develops
- Diagnosis: serum and urine antigen
- Treatment: itraconazole for 12 months, if CNS then liposomal amphotericin B for 4-6 weeks then itrazonazole for an additional 12 months
Thank you Dr. Rajat Suri for an excellent presentation on neurocysticercosis presenting with new onset seizure
- Initial treatment for seizure: IV lorazepam 0.1mg/kg –> IV fosphenytoin –> sedation/intubation
- Neurocysticercosis is caused by Taenia Solium
- Spreads hematogenously to the brain, liver, muscle
- Diagnosis: presentation+imaging. serum testing not reliable
- Treatment: dexamethasone, albendazole, anti-epileptic
Thank you Dr. Kirollos Zaki for an excellent presentation on UGIB from esophageal varices
- Management of GI bleed
- fluids, goal hg>7, plt >50, INR<1.5.
- protonix drip if UGIB, add octreotide drip if concern for variceal bleed
- variceal ligation: using banding, goal is within 12 hours
- sclerotherapy: usueally epi is used, similar results as ligation but high rebleeding risk
- Indications: active hemorrhage despite endoscopic treatment or recurrent bleed
Thank you Dr. Annie Belzowski for an excellent presentation of pulmonary squamous cell carcinoma complicated by pulmonary abscess
- Common causes of pulmonary abscess:
- Bacterial: Anaerobic bacteria, Pseudomonas aeruginosa, Mycobacteria
- Fungal: Aspergillus, Coccidioides, Histoplasma, Blastomyces, Cryptococcus
- Non-infectious: malignancy, embolism, vasculitis, scarcoidosis
- Clindamycin preferred agent, time course dependent on follow up imaging
- Common forms of lung cancer: adenocarcinoma (40%), small cell (15%), squamous cell (30%)