Eye Spy
Matters of the Heart
Are you Kidney-ing Me?
Derm, that itches!
100
Conjunctivitis
100
48 yo p/w N/V. Medical history is significant for hypertension, tobacco use, and hyperlipidemia. VSS.
Laboratory studies are notable for an elevated initial serum troponin I level.
An electrocardiogram shows 3-mm ST-segment elevations in leads II, III, and aVF. A chest radiograph is normal.
The patient is administered aspirin, clopidogrel, and a bolus of heparin. Transport to the nearest hospital capable of percutaneous coronary intervention would take 4 hours.
Now what?
Give thrombolytic therapy.
100
Intracranial aneurysms, hepatic cysts (80%), abdominal hernias, and mitral valve prolapse
100
Allergic Contact Dermatitis
200
Acute Angle Closure Glaucoma
200
Procainamide
200
50yo F w/ CAD, PVD, HTN p/w left sided abdominal bruit.
BP: 180/90, despite 4 agents.
Diagnosis? Treatment?
Renal Artery Stenosis
Txt w/ ACE-inh/ARB
200
Tinea Corporis
300
Papilledema
300
Adenosine
300
45yo female recently started on orlistat p/w flank pain.
What kind of stone?
Diet?
Calcium Oxalate
Low salt, low oxalate
300
Squamous Cell Carcinoma
400
Macular Degeneration
400
78yo p/w palpitations, worsening fatigue, and exercise intolerance. Two months ago, he was diagnosed with atrial flutter and is s/p cardioversion to NSR. EKG shows recurrent atrial flutter, avg ventricular rate of 69/min. Medical history is significant for hypertension and coronary artery disease. Medications are warfarin, metoprolol, lisinopril, low-dose aspirin, and atorvastatin.
VSS.
What's the next best step?
Catheter Ablation
400
p-ANCA w/ nasal polyps, rhinitis, sinusitis, peripheral eosinophilia, with migratory pulmonary infiltrates
Churg Strauss (Eosinohilic Granulomatosis w/ polyangiitis)
Txt w/ steroids if mild; cyclophosphamide with more severe disease
400
Scabies (Sarcoptes scabiei)
500
Diabetic Retinopathy
500
Atrial Myxoma
500
25yo w/ history of Lupus p/w 4 week hx of swelling of the legs, weight gain and SOB. VSS.
C3, C4 - low
Creatinine - 1
ESR - 68
Anti-smith; anti-dsDNA Ab - positive
U/A - 3+ protein, no RBCs, no WBCs, no casts
Urine protein: 6000 mg/24 hr
Need kidney biopsy to see the extend of renal involvement!
Lupus nephritis
High dose IV Steroids and aggressive immunosuppressive therapy
500
Porphyria Cutanea Tarda