2 Dr. kadem

its seems u want 2 help all the members 2 enter amedical discussion..that is nice from u..

i suppose i put the link 4 every one read it..so its not private discussion..
any one want..can open the link..

thank u 4 ur opinion.

yes Heba, it is hypercalcemia but how would u relate polyuria and polydypsia to hypercalcemia, that is the question?

يعني سامر انته متجوز من تحشيشاتك
!!!!!!!!!!

Thanks doctor M
Yeah you're right, there are links. I suppose copying and pasting is harder than giving a link to another website... I see.

Anyway, all we're after is the benefit of the members, so thanks anyway.

Ha.. btw Samer
It's because of nephrogenic diabetes insipidus caused by hypercalcemia.

u r a 100% right kadum, and dude, thats what i was talking about; genuine answers not stolen

There was nothing stolen dude! we just had a hard time communicating with each other!

Hi there,
it's been along time since i participated here, since i finished exams , i brought u all a case and i wondered where should i put it "not wanting to open a new topic and get a rizala " since there's alot of topics of cases lately,
finally i saw that this topic is more generalized, i got this case by email from a site am a member in , and i thought it's interesting so am gonna add it here hope everyone will have benefit...Soo here it is:-



Back Pain in a 39-Year-Old Man from Guatemala


A 39-year-old Guatemalan man presents to the emergency department (ED) with severe and debilitating back pain. The patient had previously been evaluated by his primary care provider (PCP) for back pain approximately 3 weeks ago; additionally, he was seen in the ED about 1 week ago for his back pain. The patient's pain had started immediately after he caught a heavy bag of ice, and it has progressively worsened. On both his visit to his PCP and in the ED, the patient was diagnosed with musculoskeletal back pain, and he was discharged with a therapeutic regimen that included a nonsteroidal anti-inflammatory medication (ibuprofen). He was advised to follow-up with his PCP.

At today's presentation to the ED, the patient describes the pain as throbbing and diffuse throughout the lower back, with radiation to his left buttock and upper back. The pain is exacerbated by walking and relieved with rest. He denies having any associated lower-extremity numbness or paresthesias. He also denies any fevers, chills, or night sweats. The review of systems is negative for loss of bowel or bladder control, difficulty urinating, or constipation. The patient has no known chronic medical conditions. He smokes half of a pack of cigarettes daily. He is currently not taking any medications other than the prescribed ibuprofen, and he denies any intravenous (IV) drug abuse.

On physical examination, his temperature is 98.7°F (37.1°C), his pulse rate is 75 bpm, his blood pressure is 138/69 mm Hg, and his respiratory rate is 16 breaths/min. The head and neck examination is normal, and the lungs are clear to auscultation. The cardiac examination reveals normal S1 and S2 heart sounds, without any murmurs, rubs, or gallops. His abdomen is soft, nontender to palpation, and without any pulsatile masses. The rectal examination shows normal tone and brown, guaiac-negative stool. Mild tenderness to palpation is noted in the midline lower back, at the T11-L1 levels. There is no significant pain produced by flexion of the leg at the hip. He has normal strength and sensation in both lower extremities and no sensory level is noted. Normal reflexes are noted in his upper and lower extremities. His gait is antalgic but without ataxia.

An anteroposterior lumbar radiograph (Figure 1) is obtained and, based on the interpretation of the plain film, a magnetic resonance imaging (MRI) study of the spine (Figure 2) is obtained.

What is the diagnosis?

Hint: Look closely at T11.

is it :

1-Spinal cord hemorrhage
2- Epidural abscess secondary to tuberculous spondylitis "pott's disease"
3-Spinal malignant metastases
4-Epidural abscess secondary to pyogenic spondylitis





good luck

hi Safa nice to have u back,
nice case u have there
i think i will go with no.2

good luck all

Hi
thanks Ali,
you're exactly right Doctor , that's pott's disease..
i have a couple of questions more about it then i'll add sth abt the explanation..

Which of the following symptoms is not typically associated with Pott disease?

1- Back pain
2- Fever
3- Night sweats
4- Weight loss
5-Cough


Which of the following statements regarding Pott disease is false?

1-Surgery is not always recommended for treatment.
2- Magnetic resonance imaging (MRI) and computed tomography (CT) scans are both sensitive for and suggestive of the diagnosis.
3- It most commonly affects the cervical region.
4-The most serious complication of Pott disease is Pott paraplegia.
An elevated white blood cell count may only be present in 40% of cases.

good luck all