Hi! I’m Alireza Mohammadhosseini. M.D , Internal Medicine specialist from Tehran University of Medical Sciences. Here I share my simple and important cases, come and share your ideas!
Internal Medicine Cases pinned «Case number 31 A 44-year-old construction worker comes to the emergency department due to nausea and fatigue over the past 2 days. The patient strained his back at work 7 days ago. He was unable to move for several days and has been taking over-the-counter…»
Case number 31 A 44-year-old construction worker comes to the emergency department due to nausea and fatigue over the past 2 days. The patient strained his back at work 7 days ago. He was unable to move for several days and has been taking over-the-counter pain medications and applying hot packs. The patient still has significant back pain and limited mobility. He smokes 1 pack of cigarettes a day. The patient drinks alcohol daily and heavily on weekends. In addition, he uses intravenous heroin on occasion.
He was hospitalized for pneumonia 6 months ago and treated with intravenous antibiotics. Echocardiogram during that admission showed normal left ventricular systolic function, a mildly dilated right ventricle, and mild pulmonary hypertension.
Temperature is 37.2 C (99 F), blood pressure is 94/50 mm Hg, and pulse is 112/min. There is mild scleral icterus. Several needle tracks are seen on both forearms. No heart murmurs are present. The lungs are clear. There is no abdominal distension. Moderate right upper quadrant tenderness is present. The spleen is not palpable. There is no peripheral edema.
Laboratory results are as follows:
Serum chemistry Sodium 148 mEq/L Potassium 3.2 mEq/L Chloride 106 mEq/L Bicarbonate 22 mEq/L Blood urea nitrogen 27 mg/dL Creatinine 1.7 mg/dL Liver function studies Albumin 3.8 g/dL Bilirubin Total 3.2 mg/dL Direct 2.2 mg/dL Alkaline phosphatase 190 U/L Aspartate aminotransferase (SGOT) 3578 U/L Alanine aminotransferase (SGPT) 4235 U/L Coagulation studies International Normalized Ratio (INR) 1.7
Internal Medicine Cases pinned «Case number 30 A 21 y/o female came to the emergency ward with dyspnea, pruritis, fecal incontinence and lips bulging. She mentioned penicillin intramuscular injection in a clinic 10 minutes before her attendance. On physical examination, she was alert and…»
Case number 30 A 21 y/o female came to the emergency ward with dyspnea, pruritis, fecal incontinence and lips bulging. She mentioned penicillin intramuscular injection in a clinic 10 minutes before her attendance. On physical examination, she was alert and conscious but toxic. Generalized urticarial plaques and erythema were seen on the skin. Bilateral wheezing was detected on lung auscultation, and mild abdominal tenderness was present on periumbilical examination. BP 80/30 mmHg PR 110/min RR 26/min SPO2 85% room air T 37°C
Transthoracic echocardiogram showed no significant vegetation or other abnormalities. Blood culture was also positive for Methicillin Resistant Staphylococcus Aureus. The picture shows the patient's nail.
Case follow up Coincident with our presumption, Methicillin Resistant Staphylococcus Aureus grew up in sternoclavicular synovial fluid. Vancomycin was started as soon as possible. Regarding the patient's dyspnea and hypoxia, chest CT scan was done which showed bilateral nodules and round masses and bilateral multilobar pleural based lesions.
Urine analysis: SG 1025 WBC 0-1 RBC many Bacteria few Ep cell 1-2 Protein 3+ Nitrite negative
How can I read @internalmedcases without a Telegram account?
TGViewer shows the public web preview Telegram publishes for Internal Medicine Cases: recent posts, photos, videos and the subscriber count, with no app, login or account.
How many subscribers does Internal Medicine Cases have?
Internal Medicine Cases (@internalmedcases) has 3.73K subscribers on Telegram, refreshed roughly every 30 minutes.
Does Internal Medicine Cases know I viewed it here?
No. Public channel previews carry no viewer identity, and TGViewer has no accounts or tracking of what you look up.
