A Case !?

[Aljubouri83]

A 42 years old female patient presented with attacks of severe throbbing headache with palpitation, & tightness in the chest. Her blood pressure during the attacks was 240/140 mmHg, & dropped to normal between the attacks. Discuss the Dx & medical Mx of this patient ??

Tough one, right ?
Waiting for your replies ...


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Ahmed A. Al-Jubouri

[mobic777]

hi


i think its a typical case of pheochromocytoma

its arare tumor of chromaffin tissue which secrets catecholamine
dx by measuring the vma in urine
and the hormons ( adrenaline ,nor ...,and dopamine )in the plasma

[mobic777]

also we should localise the tumor by abdominal ct scan

management
medical therapy is required for at least 6 weeks to prepare the p for surgery
the most ueful drug is alph bloker phenoxybenzamine(10_20mg oraly 6-8 houres)
if itproduses a marked tachcardia then betabloker (propanolol)
and then surgery but you should use sodium nitropossied and phentolamine to control hypertensive episode



i hope i am not wrong

i want to thankyou and god bless you

[Hour_Glass]

typical spells of pheochromcytoma

i would start by
1. ultrasound or CT for the adrenal glands looking for malignancy.
2.urine metnephrines level and VMA (vanillymandilec acid).

treatment surgical adrenalectomy



waiting for the feedback
Farah Baha

[Aljubouri83]

Both of U ( Dr. Fara7 & Dr. Mobic ) post the correct & accurate answer ..

هذولــــه أهـــل طــب بغــــداد

I think there is nothing more to add


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Ahmed A. Al-Jubouri

[Free Lancer]

Hi All ....

I couldnt diagnose the case ((cause halsana nija7it lil rabi3))...
But i could undestand the discussion and explanation of the case that has been said by both hour glass and mobic ..

Thank U Ahmed for this topic and the two previous ones ..... i really get
benifit from them ... KEEP ON ((DIAGNOSIS)) TOPICS MY FRIEND ...

Thanx Again...

[Aljubouri83]

An 18 years old man presented with shortness of breath of few hours duration, he gave a history of dark color urin, oliguria, nausia & vomitting for the preceding 2 days, he also gave a history of sore throat treated by antibiotics 2 weeks ago. O/E he had puffiness of the face & bilateral chest criptations up to the mid-zone on chest auscultation .. What is the most likely Dx ??



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Ahmed A. Al-Jubouri

[yezen]

Wella great job u r doing here Ahmed ...really great ..keep it up please..and guys let's help him and put cases and questions too ..I promise i will spare time specially for that ..

Concerning this one ...hmmm...It is a post streptococcus glomerulonephritis complicating an acute renal failure which causes a pulmonary oedema ..i think we had a similar one last year final exam..

The symptoms are due to the uraemia and the fluid overload..

salam ..

[Aljubouri83]

U R certainly right Dr. Yezen
But I didn't that they bring it last year ..

I'm happy that U like these subjects that I've put it in our forum, & I wish we all concentrate on the Medical side coz we are the doctors of the future ..

& I hope our STAGERS participate in solving these cases ..


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Ahmed A. Al-Jubouri

[Aljubouri83]

A 25 years old man sustained a bullet injury to the left leg causing a comminuted fracture of the Tibia; P.O.P. was applied as a treatment. 8 days later he presented with fever, cough, & haemoptysis with extreme SOB, O/E : temp. 38.5, P.R. 135/min, respiratory rate 39/min, centrally cyanosed, chest examination reveals some crepitation & ronchi with pleural rub over the right lower zone posteriorly.
What is the most probable diagnosis ?


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Ahmed A. Al-Jubouri