PICTORIAL CMECITY PHYSICIAN MEET-

CHENNAI

K.M.JEYABALAJI

CASE-1 HISTORY

A 56 YEAR OLD MALE PATIENT PRESENTED WITH RECURRENT EPISODES OF MALENA FOR PAST 2 YEARS

CT ABDOMEN

CT ANGIOGRAM

OSLER RENDU WEBER SYNDROME

CURACAO CRITERIA

Spontaneous recurrent epistaxis

Multiple telangiectasias

Proven visceral AVM (lung, liver, brain, spine)

First-degree family member with HHT

CASE -2 HISTORY

A 28 year old male patient came to medical OP with complaints of

Abdominal pain for past 3 days

H/O similar episode on & off for past 2 years

INFERENCE

ERUPTIVE XANTHOMA,LIPEMIA RETINALIS

DIFFERENTIAL DIAGNOSIS:

HYPERTRIGLYCERIDEMIA SYNDROMES – TYPE 1 ,3, 5

DIAGNOSIS

HYPERTRIGLYCERIDEMIA TYPE I WITH PANCREATITIS

FREDRICKSON CLASSIFICATION

CASE – 3 HISTORY

A 26 YEARS OLD MALE PATIENT CAME WITH COMPLAINTS OF

COUGH WITH EXPECTORATION FOR PAST 3 MONTHS

DIFFICULTY IN BREATHING FOR PAST 2 MONTHS

RADIOGRAPHY

INFERENCECENTRAL BRONCHIECTASIS

DIFFERENTIAL DIAGNOSIS:

Allergic broncho pulmonary aspergillosis

Kartagener’s syndrome

young’s syndrome

Eosinophilic lung diease

CYSTICFIBROSIS

Autoimmune causes- RHEUMATOID ARTHRITIS

ABPA EXACERBATION:

worsening in clinical symptoms

new infiltrates in radiography

Serum Ig E levels going above twice the baseline

TREATEMENT:

Prednisone 0.5 mg/kg daily until resolution occurs is recommended. Resolution is achieved when symptoms improve, the infiltrate clears and IgE levels decrease by at least 35%. Steroids should be slowly taper over 3 to 6 months.

ITRACONAZOLE, VORICONAZOLE

CRITERIA

CASE – 4 HISTORY

A 46 YEAR OLD MALE PATIENT CAME WITH COMPLAINTS OF

UNSTEADYNESS WHILE WALKING

KNOWN ALCOHOLIC FOR PAST 13 YEARS

MRI

INFERENCE

EXTRA PONTINE MYELINOLYSIS

ALCOHOL INDUCED

DISRIBUTION:

MIDBRAIN

BASAL GANGLIA

CEREBELLUM

THALAMUS

DD

EPM

CEREBELLAR HEMORRHAGE

MULTIPLE SCLEROSIS

GLIOMA

CASE -5 HISTORY

A 45 YEAR OLD MALE PATIENT CAME WITH COMPLAINTS OF

PALPITATION , SHOSTNESS OF BREATH FOR PAST 2 MONTHS

ECHOCARDIOGRAM

FINDINGS

HYPER REFRACTILE SEPTUM , POSTERIOR WALL

SPECKLED PATTERN

HYPERTROPHIED SEPTUM, POSTERIOR WALL

FINDINGS SUGGESTIVE OF

AMYLOID HEART

CASE – 6 HISTORY

A 42 year old male patient referred from dermatology dept suspecting a systemic disease

FINDINGSHYPERPIGMENTED NONSCALY PLAQUE TYPE LEION IN RIGHT ARM

NODULES OF SIZE 3 mm IN ALA

MULTIPLE PAPULES IN BOTH CHEEKS

DIFFERENTIAL DIANOSIS

SARCOIDOSIS

CUTANEOUS TB

TUBERCULOID LEPROSY

CASE – 7 HISTORY

A 34 year female patient came with complaints of

Attempted hanging 30 min back

Altered sensorium

MRI

INFERENCE

CORTICAL LAMINAR NECROSIS

DIAGNOSIS – HYPOXIC ISCHEMIC ENCEPHALOPATHY

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