Интересные и познавательные клинические случаи из реальных практик! Медицинские кейсы публикуются в форме викторин, в которых можно проверить свои знания. На каждый кейс дается детальный разбор правильного ответа! Авторы канала - врачи :)
An ovarian cyst is a fluid-filled sac within the ovary. Often they cause no symptoms.
Ovarian cysts are common findings usually discovered incidentally on physical examination or imaging. Ovarian cysts can cause complications, including rupture, hemorrhage, and torsion, which are considered gynecological emergencies. Therefore, it is essential to promptly diagnose and treat them. Occasionally they may produce bloating, lower abdominal pain, or lower back pain. If the cyst either breaks open or causes twisting of the ovary, it may cause severe pain. This may result in vomiting or feeling faint, and even cause headaches.
Most ovarian cysts are related to ovulation, being either follicular cysts or corpus luteum cysts. Other types include cysts due to endometriosis, dermoid cysts, and cystadenomas. Many small cysts occur in both ovaries in polycystic ovary syndrome (PCOS). Rarely, cysts may be a form of ovarian cancer. The majority of cysts are harmless.
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Purple urine bag syndrome is a medical syndrome where purple discoloration of urine occurs in people with urinary catheters and co-existent urinary tract infection. Bacteria in the urine produce the enzyme indoxyl sulfatase. This converts indoxyl sulfate in the urine into the red and blue colored compounds indirubin and indigo. The most commonly implicated bacteria are Providencia stuartii, Providencia rettgeri, Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli, Morganella morganii, and Pseudomonas aeruginosa.
Tryptophan in the diet is metabolized by bacteria in the gastrointestinal tract to produce indole. Indole is absorbed into the blood by the intestine and passes to the liver. There, indole is converted to indoxyl sulfate, which is then excreted in the urine. In purple urine bag syndrome, bacteria that colonize the urinary catheter convert indoxyl sulfate to the colored compounds indirubin and indigo.
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Leprosy is a long-term infection by the bacteria Mycobacterium leprae or Mycobacterium lepromatosis. Infection can lead to damage of the nerves, respiratory tract, skin, and eyes. This nerve damage may result in a lack of ability to feel pain, which can lead to the loss of parts of a person's extremities from repeated injuries or infection through unnoticed wounds. An infected person may also experience muscle weakness and poor eyesight. Leprosy symptoms may begin within one year, but, for some people, symptoms may take 20 years or more to occur.
Leprosy is spread between people, although extensive contact is necessary. Leprosy has a low pathogenicity, and 95% of people who contract M. leprae do not develop the disease. Spread is thought to occur through a cough or contact with fluid from the nose of a person infected by leprosy. Genetic factors and immune function play a role in how easily a person catches the disease.
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Primary pleural hydatid cysts
The patient underwent thoracotomy and the findings of numerous cystic lesions within the pleura confirming the diagnosis of hydatid cysts.
Primary pleural hydatid cyst is a rare disease. It is defined as a hydatid cyst within or dependent of the pleural space that has not been produced by rupture from another location and/or does not appear simultaneously or is preceded by another cyst, liver or lung.
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A person with a two hour history of phlegmasia cerulea dolens
Phlegmasia cerulea dolens (PCD) is an uncommon severe form of lower extremity deep venous thrombosis (DVT) that obstructs blood outflow from a vein. PCD results from extensive thrombotic occlusion of extremity veins, most commonly an "iliofemoral" DVT of the iliac vein and/or common femoral vein. It is a medical emergency requiring immediate evaluation and treatment.
When a thrombus occludes an extremity vein, pressure backs up in the venous system leading plasma fluid to leak out into the interstitium of the affected limb. This increases the pressure of that limb compartment, which can collapse the arteries and lead to acute ischemia, gangrene, hypovolemia, and hemodynamic instability.
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A squamous-cell lung carcinoma developing in the bronchius
Squamous-cell carcinoma of the lung is a histologic type of non-small-cell lung carcinoma (NSCLC). It is the second most prevalent type of lung cancer after lung adenocarcinoma and it originates in the bronchi. Its tumor cells are characterized by a squamous appearance, similar to the one observed in epidermal cells. Squamous-cell carcinoma of the lung is strongly associated with tobacco smoking, more than any other forms of NSCLC.
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Cirrhosis of liver. Micro and macronodular cirrhosis
This image shows a coarsely tuberous liver cirrhosis. The 30-year-old male patient this was removed from received a healthy liver transplant and has been living for more than 10 years without any negative side effects. He had Wilson's Disease, one of the most frequent hereditary metabolic diseases. His liver was insufficiently capable of disposing of copper and accumulated it instead.
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Idiopathic interstitial fibrosis of the lungs
Idiopathic pulmonary fibrosis (IPF) is a serious chronic disease that affects the tissue surrounding the air sacs, or alveoli, in the lungs. This condition develops when that lung tissue becomes thick and stiff for unknown reasons. Over time, these changes can cause permanent scarring in the lungs, called fibrosis, that makes it progressively more difficult to breathe.
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Vocal cord polyp
Vocal cord polyps are benign lesions that are generally unilateral. Their shape can be classified as sessile or peduncular, and their histological characteristics as gelatinous or translucent, fibrous or organized, and angiomatous or hemorrhagic.
The origin of the vocal cord polyp is phonotraumatic. Other irritating processes, however, may contribute to the emergence of polyps, such as gastroesophageal reflux, smoking, aspiration of aggressive chemical substances, or intense respiratory activities. The main signs and symptoms in individuals with vocal fold polyps are hoarseness or breathiness and vocal fatigue. Surgery is normally adopted for vocal cord polyp. However, some recent studies demonstrated the importance of speech therapy as a primary treatment of polyps, with total or partial lesion regression, followed by surgery when the lesions are persistent or if the patients are dissatisfied with their vocal quality.
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Medullary thyroid carcinoma
Medullary thyroid cancer is a form of thyroid carcinoma which originates from the parafollicular cells (C cells), which produce the hormone calcitonin.
Medullary thyroid cancer produces calcitonin, and elevated calcitonin level is an essential feature of this tumor. Diagnosis is primarily performed via fine needle aspiration of the lesion of the thyroid to distinguish it from other types of thyroid lesions. Microscopic examination will show an amyloid stroma with hyperplasia of parafollicular cells. Surgery and radiation therapy have been the major treatments for medullary thyroid carcinoma.
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