Loading ...
Sorry, an error occurred while loading the content.

Fw: Medical Videos Lectures and Clinical Examination Videos

Expand Messages
  • Emil Doru Steopan
      Doru Steopan ... From: Medical Osce To: emildoru_steopan@yahoo.com Sent: Saturday, January 12, 2013 3:09 PM Subject: Medical Videos
    Message 1 of 64 , Jan 13, 2013
    • 0 Attachment
      *:-? thinking
       
      Doru Steopan

      ----- Forwarded Message -----
      From: Medical Osce <joolyusa2@...>
      To: emildoru_steopan@...
      Sent: Saturday, January 12, 2013 3:09 PM
      Subject: Medical Videos Lectures and Clinical Examination Videos

      Medical Osce

      Medical Videos Lectures and Clinical Examination Videos

      Link to Medical Osce

      Posted: 12 Jan 2013 05:06 AM PST
      What is the most likely diagnosis in this 36-year-old woman with chronic renal failure?
       
      Question
      A woman presented with painless, subcutaneous nodules that had developed during the previous 5 months on her buttocks, shoulders, and left wrist
      What is the most likely diagnosis in this 36-year-old woman with chronic renal failure?
      Lipoma
      Osteitis fibrosa
      Osteosarcoma
      Fistula
      Calcinosis
       
      Show Correct.Answer

      Correct Answer : Calcinosis
      Explanation :
      CalcinosisTumoral calcinosis is characterized by soft-tissue calcium and phosphate deposits which are most commonly due to chronic renal failure. These nodules resolved after parathyroidectomy.
      Her medical history was notable for glomerulonephritis leading to dialysis at 14 years of age. She later underwent transplantation of a kidney from a deceased donor; the transplant failed, and for the 3 years since, the patient has been undergoing peritoneal dialysis. A plain film of her left wrist showed numerous lobulated, septated calcific masses (Panel B). Laboratory tests revealed severe secondary hyperparathyroidism, with a calcium level of 10.5 mg per deciliter (2.6 mmol per liter) (normal range, 8.4 to 10.2 [2.1 to 2.6]), a phosphate level of 6.4 mg per deciliter (2.1 mmol per liter) (normal range, 2.7 to 4.5 [0.9 to 1.5]), an alkaline phosphatase level of 458 U per liter (normal range, 40 to 120), and a parathyroid hormone level of more than 2000 pg per milliliter (normal range, 15 to 65). Attempts to suppress the parathyroid hormone level with the use of medication were unsuccessful. Three months after a partial parathyroidectomy to remove a 4-g left hyperplastic inferior gland, there was complete resolution of the subcutaneous nodules, including those in the wrist (Panels C and D). Laboratory values improved considerably: calcium level, 9.8 mg per deciliter (2.5 mmol per liter); phosphate level, 5.4 mg per deciliter (1.7 mmol per liter); and parathyroid hormone level, 177 pg per milliliter. Tumoral calcinosis is characterized by soft-tissue calcium and phosphate deposits, which are most commonly due to chronic renal failure.

       
      Created by USMLE PlAB MCQ
      This posting includes an audio/video/photo media file: Download Now
      Posted: 12 Jan 2013 04:02 AM PST
      This patient reported bleeding gums
       
      Question
      This patient reported bleeding gums. What is the diagnosis?
      Acromegaly
      Dermatomyositis
      Monocytic leukemia
      Periodontitis
      Scurvy
       
      "Show" "Correct.Answer"

      Correct answer : Dermatomyositis
      Explanation
      Examination of the mouth reveals markedly dilated capillaries in the attached gingiva, with bushy loop formations that spread over the lower teeth. These areas reflect the vasculopathy associated with dermatomyositis, particularly in its juvenile form.
      Dermatomyositisthis  16-year-old girl with long-standing juvenile dermatomyositis had an illness marked by intermittent clinical flares, including increased muscle weakness, joint contractures, photosensitive rashes, and dysphagia, despite treatment with multiple immunosuppressive drugs. At presentation, Gottron’s papules, a heliotrope rash, and periungual capillary changes were visible, including dilated and tortuous blood vessels with areas of atrophy, telangiectases, and bushy loop formation along the fingernail bed (Panel A, arrows). The patient reported having had bleeding gums that had not responded to traditional dental treatment. Close examination of the mouth revealed markedly dilated capillaries in the attached gingiva, with bushy loop formations that spread over the lower teeth .These areas reflect the vasculopathy associated with dermatomyositis, particularly in its juvenile form. Periungual capillary changes have been reported frequently in patients with juvenile dermatomyositis, whereas the accompanying gingival changes are often present but not frequently recognized. Periungual capillary changes correlate with underlying disease activity, particularly in the skin, and persistent abnormalities are associated with a long course of illness.

      Created by USMLE PlAB MCQ
      The post test appeared first on Medical Osce.
      This posting includes an audio/video/photo media file: Download Now
      Posted: 12 Jan 2013 02:56 AM PST
      A 46-year-old woman had an enlarging, tender, draining nodule on the upper arm
      Question
      A 46-year-old woman had an enlarging, tender, draining nodule on the upper arm. Prior treatment consisting of hot compresses and a course of oral antibiotics had had no effect. The patient had no other symptoms or findings, and the results of routine blood studies were normal
      What is the diagnosis?
      Cutaneous leishmaniasis
      Cutaneous larva migrans
      Epidermoid cyst
      Furuncular myiasis
      Tungiasis
       
      Show Correct.Answer

      Correct Answer : Furuncular myiasis
      Explanation :
       larva (approximately 2 cm long) (Panel B) emerged from the lesion spontaneouslyThe image shows a human botfly larva (Dermatobia hominis) emerging from an inflamed nodule on the patient’s upper arm. Cutaneous leishmaniasis, cutaneous larva migrans, epidermoid cyst, and tungiasis have distinct appearances.
      She had traveled to southern Mexico six weeks earlier for an archaeological dig. During her clinic visit, a human botfly larva (Dermatobia hominis) began to emerge from the nodule. The traditional treatment in areas where myiasis is endemic (Mexico and South and Central America) is occlusion of the furuncular punctum with pork fat to stimulate extrusion of the larva. Neither the pork-fat treatment nor surgical treatment with a cruciate excision and gentle extraction of the larva was required in this patient, because the larva (approximately 2 cm long) (Panel B) emerged from the lesion spontaneously. The female botfly deposits her eggs on the legs or body of an insect or tick. The patient presumably was infected when bitten by such an insect or tick. At the time of the bite, the botfly eggs hatch, and the larvae quickly burrow into the host’s skin. Within days, the host’s immune response causes the development of an inflamed furuncle. The larva has characteristic black, backward-pointing spines that anchor it in the host’s skin and make removal difficult.

       
      Created by USMLE PlAB MCQ
      This posting includes an audio/video/photo media file: Download Now
      Posted: 12 Jan 2013 01:53 AM PST
      A 14 months old baby presented with a lesion on her abdomen
       
      1.What is the lesion?
      2.What is your management?
       
       
      Created by USMLE PlAB MCQ
      This posting includes an audio/video/photo media file: Download Now
      Posted: 12 Jan 2013 12:52 AM PST
      man presented with a long-standing history of sinusitis
      3 weeks of frontal headache
      63-year-old man presented with a long-standing history of sinusitis and 3 weeks of frontal headache. The physical examination was unremarkable. The alkaline phosphatase level was elevated at 434 IU per liter (upper limit of the normal range, 129). The serum calcium level was within normal limits
       
      Comment about his Radiographic findings?
      What are the  DDx ?
      What is the Rx for headache ?
      Created by USMLE PlAB MCQ
      This posting includes an audio/video/photo media file: Download Now
      Posted: 11 Jan 2013 11:51 PM PST
      A 34-year-old woman presented to her primary care physician with vulvar pruritus
       
      Question
      A 34-year-old woman presented to her primary care physician with vulvar pruritus, which she reported having had for several months.
      What is the diagnosis?
      Behçet’s syndrome
      Lichen simplex chronicus
      Condyloma acuminatum
      Lichen sclerosus
      Vestibular papillomatosis
       
      Show Correct.Answer

      Correct Answer : Vestibular papillomatosis
      Explanation :
      These shiny, soft, linearly arrayed papules are the typical presentation of vestibular papillomatosis, a variant of vestibular mucosa commonly mistaken for genital warts
      A diagnosis of condyloma on the vulvae was made, and the patient was referred for treatment. Many flesh-colored, soft pearly papules, which were 1 to 2 mm in diameter, with some grouped and some discrete, were observed on the inner aspects of her labia minora. These papules were linearly distributed and symmetrically located along both inner sides of the vulvae (arrows). Grouped projections on the right inner labium minus were easily separated from each other on examination. The shiny, soft, linearly arrayed papules are the typical presentation of vestibular papillomatosis, a variant of vestibular mucosa commonly mistaken for genital warts. Clinically, genital warts, or condyloma, are not confined to the vestibule. Filiform or cauliflower projections of condyloma tend to fuse at the base. When 5% acetic acid is applied to condyloma acuminatum, a whitening typically occurs; with vestibular papillomatosis, there is usually no whitening. Vestibular papillomatosis is a normal vulvar anatomical condition that can be seen as the female counterpart of male pearly penile papules. A correct diagnosis of vestibular papillomatosis prevents unnecessary concern and laboratory tests.

       
      Created by USMLE PlAB MCQ
      This posting includes an audio/video/photo media file: Download Now
      Posted: 11 Jan 2013 08:29 PM PST
      image
       
      Question
      An 83-year-old man was being treated for diabetes mellitus, hypertension, and ischemic heart disease.  What is the diagnosis?
      Pancreatic pseudocyst
      Duodenal torsion
      Cholangiocarcinoma
      Gallbladder lipomatosis
      Emphysematous cholecystitis
       
      Show Correct.Answer

      Correct Answer : Emphysematous cholecystitis
      Explanation :
      showed air (arrow) in the upper right quadrant.The computed tomogram shows an air-fluid level in the lumen of a dilated gallbladder and gas within the gallbladder wall. These findings suggest emphysematous cholecystitis.
      Cholelithiasis had previously been detected by abdominal ultrasonography. After drinking alcohol at home, the patient had acute abdominal pain. Plain-film radiography of the abdomen (Panel A) showed air (arrow) in the upper right quadrant. After antibiotic therapy, cholecystectomy and drainage were performed. Clostridium perfringens was isolated from the culture of drained biliary fluid. The patient recovered uneventfully.

       
      Created by USMLE PlAB MCQ
      This posting includes an audio/video/photo media file: Download Now
      Posted: 11 Jan 2013 07:17 PM PST
      A 26-year-old malnourished woman presented with a 4-day history of mouth pain and a 3-month history of fatigue, general malaise, and palpitations.
      Question
      A 26-year-old malnourished woman presented with a 4-day history of mouth pain and a 3-month history of fatigue, general malaise, and palpitations.
      What is the most likely diagnosis?
      End-stage renal disease
      Graves’ disease
      Iron deficiency
      Pseudohypoparathyroidism
      Sarcoidosis
       
      Show Correct.Answer

      Correct answer : Iron deficiency
      Explanation :
      There is pallor of the nail beds, as well as koilonychia (spoon-shaped nails). Though koilonychia can be present in other diseases, together these findings are most suggestive of iron-deficiency anemia.

       
      Created by USMLE PlAB MCQ
      This posting includes an audio/video/photo media file: Download Now
      Posted: 11 Jan 2013 06:13 PM PST
      A 56-year-old woman with hypertension presented with a sudden onset of painless impaired vision in the right eye.
      Question
      A 56-year-old woman with hypertension presented with a sudden onset of painless impaired vision in the right eye. On the previous day, she had undergone cardiac catheterization for evaluation of hypertensive emergency (chest pain and blood pressure of 235/110 mm Hg) with mild troponin elevation.
      What is the diagnosis?
      Central retinal vein occlusion
      Cholesterol embolism
      Retinoschisis
      Temporal arteritis
      Toxoplasmosis
       
      Show Correct.Answer

      Correct Answer : Cholesterol embolism
      Explanation :
      The image demonstrates cholesterol emboli with surrounding white lucency representing retinal edema. Fluorescein angiography confirmed occlusion of the cilioretinal artery with nonperfusion of the tissue bed in the hypofluorescent areas. Cholesterol emboli are crystals that are released in the arterial bloodstream from ulcerated or disrupted atherosclerotic plaques and can be an initial sign of vascular disease.

       
      Created by USMLE PlAB MCQ
      This posting includes an audio/video/photo media file: Download Now
      Posted: 11 Jan 2013 05:08 PM PST
      What is this genetic disorder ?
      What is your diagnosis ?
      Created by USMLE PlAB MCQ
      The post What is this genetic disorder ? appeared first on Medical Osce.
      This posting includes an audio/video/photo media file: Download Now
    • Emil Doru Steopan
        Doru Steopan ... From:  Subject: Medical Videos Lectures and Clinical Examination Videos Medical Osce Medical Videos Lectures and Clinical Examination
      Message 64 of 64 , May 14, 2013
      • 0 Attachment
        *:) happy
         
        Doru Steopan

        ----- Forwarded Message -----
        From: 
        Subject: Medical Videos Lectures and Clinical Examination Videos

        Medical Osce

        Medical Videos Lectures and Clinical Examination Videos

        Link to Medical Osce

        Posted: 13 May 2013 10:14 PM PDT
        Woman with dyspnea and dysphagia
         
        A 67-year-old woman presented with a 6-month history of dyspnea and dysphagia, What is the diagnosis?
        Coarctation of the aorta
        Lung cancer
        Pneumothorax
        Rib fracture
        Substernal goiter
         
        Show Correct.Answer

        Correct Answer : Substernal goiter
        Explanation :
        The chest radiograph demonstrates tracheal deviation. Ultrasonography of the neck revealed a large goiter with the right lobe extending into the anterior superior mediastinum

        Created by USMLE PlAB MCQ
         
        Created by USMLE PlAB MCQ
        This posting includes an audio/video/photo media file: Download Now
        Posted: 13 May 2013 09:06 PM PDT
        A 56-year-old female presented with cough, a weight loss of 27 kg over a period of 6 months, and diffuse bone pain.
         
        Question
        A 56-year-old female presented with cough, a weight loss of 27 kg over a period of 6 months, and diffuse bone pain.
        What diagnosis accounts for the combination of findings on the bone scan?
        Adverse effect of chronic glucocorticoids
        Mastocytosis
        Metastatic lung cancer
        Osteomalacia with fracture
        Paget’s disease
         
        Show Correct.Answer

         Metastatic lung cancerCorrect answer : Metastatic lung cancer
        Explanation :
        The bone scan shows areas of uptake consistent with metastases as well as diffuse linear uptake in the femoral and tibial bones, consistent with hypertrophic pulmonary osteoarthropathy. Examination of specimens obtained by CT-guided biopsy of an 11-cm right lung mass was consistent with large-cell adenocarcinoma. Hypertrophic pulmonary osteoarthropathy is most frequently associated with lung and gastric carcinomas.

        Created by USMLE PlAB MCQ
         
        Created by USMLE PlAB MCQ
        This posting includes an audio/video/photo media file: Download Now
        Posted: 13 May 2013 07:50 PM PDT
        image
        Question
        A 36-year-old woman with mild mental retardation presented for evaluation of recurrent seizures, which she reported having had since childhood. What is the diagnosis?
        Condylomata lata
        Neurofibromatosis type 1
        Keloid
        von Hippel-Lindau disease
        Tuberous sclerosis
         
        Show Correct.Answer

        Correct Answers : Tuberous sclerosis
        Explanation :
        Periungual fibromas Periungual fibromas such as those in the image are typical in adults with tuberous sclerosis. This patient had tuberous sclerosis
        Tuberous sclerosis is a congenital disease characterised by hamartomatous lesions in the skin, nervous system and internal organs, principally heart and kidney.
        It is dominantly inherited but many cases result from new mutations.
        The most frequent presentation is a triad of:
        • adenoma sebaceum:
          • actually an angiofibroma with passive involvement of sebaceous glands
        • epilepsy
        • mental retardation

        Created by USMLE PlAB MCQ
        Created by USMLE PlAB MCQ
        The post What is the diagnosis? appeared first on Medical Osce.
        This posting includes an audio/video/photo media file: Download Now
        Posted: 13 May 2013 06:43 PM PDT
        A 70-year-old woman was referred by her general practitioner
        Question
        A 70-year-old woman was referred by her general practitioner for evaluation of an ulcerative lesion on her lower right leg
        What is the most likely diagnosis?
        Chronic venous insufficiency
        Reiter syndrome
        Gunshot wound
        Chronic renal failure
        Pseudohypoparathyroidism
         
        Show Correct.Answer

        Correct Answer :  Chronic venous insufficiency
        Explanation :
        Chronic venous insufficiencyChronic venous insufficiency may be accompanied by subcutaneous calcifications. These calcifications are often discovered by chance on plain radiographs.
        She had worn compression stockings for several years because of bilateral recurrent ulcers caused by venous stasis. Chronic venous insufficiency was seen on duplex ultrasonography. The patient had no other associated illnesses and had normal levels of C-reactive protein, parathyroid hormone, calcium, phosphorus, serum creatinine, and 25-hydroxycholecalciferol. Chronic venous insufficiency may be accompanied by subcutaneous calcifications. These calcifications are often discovered by chance on plain radiographs (Panel B, arrows) or on ultrasonographic examination of the soft tissues and must be distinguished from calcification of the arterial or venous walls and phleboliths. The patient underwent venous stripping, curettage of the ulcer, and compression therapy; she was subsequently lost to follow-up.

        Created by USMLE PlAB MCQ
         
        Created by USMLE PlAB MCQ
        This posting includes an audio/video/photo media file: Download Now
        Posted: 13 May 2013 05:35 PM PDT
        image
        Question
        Movement, bathing, and exercise triggered pain in this patient’s right hand. What is the most likely diagnosis?
        Brachial plexus injury
        Erythromelalgia
        Frostbite
        Raynaud phenomenon
        Subclavian artery stenosis
        Created by USMLE PlAB MCQ
        Posted: 13 May 2013 04:30 PM PDT
        This 68-year-old woman presented with hair growth and a sore furrowed tongue.
         
        Question
        A 68-year-old woman requested medical attention for a sudden increase in hair growth that she had noticed 11 months earlier. She had lost more than 30 kg during this same period. Physical examination revealed fine lanugo hair all over her face  and body  and a deeply furrowed tongue, which caused a burning sensation  What is the most likely diagnosis?
        Cushing’s syndrome
        Prophyria cutanea tarda
        Paraneoplastic disorder
        Acromegaly
        Polycystic ovarian syndrome
         
        Show Correct.Answer

        Correct Answer :  Paraneoplastic disorder
        Explanation :
        Acquired hypertrichosis lanuginosa is a rare disorder of abnormal and excessive growth of fine lanugo hair, most often associated with an internal malignancy

        Created by USMLE PlAB MCQ
         
        Created by USMLE PlAB MCQ
        This posting includes an audio/video/photo media file: Download Now
        Posted: 13 May 2013 03:29 PM PDT
         
        A 16-year-old, blonde-haired patient was evaluated for a new band of lighter-colored hair
         
         
        Question
        A 16-year-old, blonde-haired patient was evaluated for a new band of lighter-colored hair located approximately 3 cm from the scalp. The patient first noted the change in hair color 1 week after returning from a 2-week vacation in Costa Rica,
        What medication is most likely to be responsible for the finding in this woman’s hair?
        Carbamazepine
        Chloroquine
        Danazol
        Desipramine
        Verapamil
         
        Show Correct.Answer

        Correct Answer : Chloroquine
        Explanation :
        Hair hypopigmentation is a rare but reversible side effect of chloroquine. Although most cases occur after 3 consecutive months of treatment, rapid onset is also possible.
        which she took chloroquine phosphate for malaria prophylaxis. Instead of taking 500 mg weekly, the recommended dose for prophylaxis, the patient took 500 mg of chloroquine phosphate daily, starting 1 week before the trip, during the 2 weeks in Costa Rica, and for 1 week after returning home. She had taken the first dose 3.5 months before presentation. Hair hypopigmentation is a rare but reversible side effect of chloroquine. Although most cases occur after 3 consecutive months of treatment with daily doses of more than 500 mg of the drug, rapid onset is also possible.

        Created by USMLE PlAB MCQ
         
        Created by USMLE PlAB MCQ
        This posting includes an audio/video/photo media file: Download Now
        Posted: 13 May 2013 02:20 PM PDT
        A 61-year-old man presented for evaluation of increasing abdominal pain
         
         
        Question
        A 61-year-old man presented for evaluation of increasing abdominal pain of eight months’ duration. Basophilic stippling was evident on a blood smear. What is the most likely diagnosis?
        Acute myelogenous leukemia
        Chronic lead poisoning
        Beta-thallasemia
        Megaloblastic anemia
        Sickle cell anemia
         
        Show Correct.Answer

        Chronic lead poisoningCorrect Answer :  Chronic lead poisoning
        Explanation :
        Chronic lead poisoning was the diagnosis in this case. Lead poisoning is associated with abdominal pain, blue discoloration of the gums, and basophilic stippling.
        The patient reported having worked in a lead-smelting company for the past 30 years. The physical examination showed a bluish discoloration of the gums (Panel A). The blood level of lead was 130 μg per deciliter (6.3 μmol per liter [reference range, <20 [1.0 μmol per liter]). His hemoglobin level was 11.5 mg per deciliter, and basophilic stippling was evident in some erythrocytes on a blood smear stained with May–Grunwald–Giesma stain (Panel B). The patient was given a diagnosis of chronic lead poisoning and treated with edetate calcium disodium for 10 days and with 2,3-dimercapto-1-propanesulfonic acid sodium (Dimaval) for 4 weeks. His abdominal pain resolved, and at three months, the blood level of lead was 50 μg per deciliter (2.4 μmol per liter). At follow-up two years later, he remained asymptomatic and his blood lead level was 38 μg per deciliter (1.8 μmol per liter). The reaction of circulating lead with sulfur ions released by oral microbial activity may cause the deposition of lead sulfide at the interface of the teeth and gums, referred to as Burton’s line.

        Created by USMLE PlAB MCQ
         
        Created by USMLE PlAB MCQ
        This posting includes an audio/video/photo media file: Download Now
        Posted: 13 May 2013 01:11 PM PDT
        Which one of the following medications is most characteristically associated with the illustrated finding?
        Question
        An 80-year-old woman presented with longitudinal dark pigmentation of the nails .Which one of the following medications is most characteristically associated with the illustrated finding?
        Alendronate
        Carbamazepine
        Imatinib
        Ropinirole
        Zidovudine
         
        Show Correct.Answer

        Correct Answers : Zidovudine
        Explanation :
        Longitudinal melanonychia, or longitudinal dark pigmentation of the nails is characteristically associated with use of the medications zidovudine, hydroxyurea, minocycline, doxorubicin, and cyclophosphamide

        Created by USMLE PlAB MCQ
         
        Created by USMLE PlAB MCQ
        This posting includes an audio/video/photo media file: Download Now
        Posted: 13 May 2013 12:03 PM PDT
        A 4-year-old girl presented to the hospital with progressive abdominal pain
         
        Question
        A 4-year-old girl presented to the hospital with progressive abdominal pain and distention after a 1-week history of watery diarrhea. The physical examination showed a body temperature of 36.2°C, a distended abdomen, hypoactive bowel sounds, and diffuse tenderness without rebound pain. The laboratory evaluation revealed a white-cell count of 5000 per cubic millimeter, with 63% segmented neutrophils,
        What is the diagnosis?
        Ankylosing spondylitis
        Ascending cholangitis
        Intestinal obstruction
        Pancreatitis
        Perforation of a viscus
         
        Show Correct.Answer

        Perforation of a viscusCorrect Answer : Perforation of a viscus
        Explanations :
        The plain-film radiograph of the abdomen shows several signs of free intraperitoneal gas. These include air accumulation in the right upper quadrant; the falciform-ligament sign, visible as a longitudinal linear density on the ventral surface of the liver; the ligamentum teres sign, visible as a linear density running along the inferior edge of the falciform ligament; and the visualization of air on both sides of the bowel wall. The patient had a perforated cecum.

        Created by USMLE PlAB MCQ
         
        Created by USMLE PlAB MCQ
        This posting includes an audio/video/photo media file: Download Now
      Your message has been successfully submitted and would be delivered to recipients shortly.