Saturday, 19 June 2010

exam question



examin this patient's arms and legs and arms and discuss your findings.

on examination this patient has symemetrical weakness and wasting in the proximal muscles.the patient is unable to rise from squating position.there is no other neurological signs.
the diagnosis is proximal myopathy.

what are the causes of proximal myopathy?
what is Gower's sign?
what is diabetes amyotrophy?

Tuesday, 8 June 2010

Pseudoxanthoma elasticum




Chicken skin neck, axilla
Test:Punch bipsy – van Gieson stain shows fragmentation elastic tissue
Extensions.
Examine peripheral pulses
Fundus for angioid streaks
Complications: upper GI haemorrhage, visual loss, MI, stroke, claudication, miral valve prolapse, renovascular hypertension

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Saturday, 27 February 2010

hemodialysis Vs peritoneal dialysis

RENAL REPLACEMENT THERAPY
Haemodialysis:
blood from the patient is pumped through an array of semipermeable membranes (the dialyser, often called an 'artificial kidney') which bring the blood into close contact with dialysate, flowing countercurrent to the blood.

Peritoneal dialysis:
Peritoneal dialysis utilizes the peritoneal membrane as a semipermeable membrane, avoiding the need for extracorporeal circulation of blood. This is a very simple, low-technology treatment compared to haemodialysis.

hemodialysis requires patient to stick to a schedule and go to a facility to have the treatment while peritoneal dialsis can be done at home, at the time that's best for patient.
hemodialysis give superior electrolyte control but require more time travilling.
peroteneal dialysis have greater risk of infection and the process need to be performed 3 times a day.