long case แปลก สัส สัส

Question 1

Hypertension in young

แบ่งได้จากอะไรบ้าง

Answer 1

1. ยา
2. Renal
3. Vascular
4. Endo
   5 pulmo
5. Cardio

Question 2

Htn in young

ยา

Answer 2

Steroid
ชะเอม
NSAID
Coccaine

Question 3

Htn in young

Renal

Answer 3

ADPK
PCOS
Glomerular- protenuria edema
Tubular - distal RTN

Question 4

Htn young

Vascular

Answer 4

RAS
PAN
Scleroderma

Doppler utz
MRA
Spiral CT

Question 5

Htn in young

Endo

Answer 5

1. Pheochromocytoma
2. Cushing
3. Aldosterone
4. Acromegally
5. Hypo hyper thyroid

Question 6

Htn in young

Pulmo

Answer 6

Pulmo HTN

OSA

Question 7

Htn in young

Cardio

Answer 7

Takayasu

Coarctation(NF1, turner)

Question 8

Opthal

Cc มองไม่เห็น sudden
Central retinal vein occlusion

Answer 8

Hyper coag> protein CS, ATT, homocysteine, APAS, MM(rauolaux,serum EP)
DIC
PNH

Question 9

Opthal

ตาตกเห็นภาพซ้อน 1 ข้าง
Opthalmoplegia cn3,4,6

Cavernous sinus thrombosis

Dx
tumor(cranio, meningio),

vascular(fistular, PCA aneyrysm) ,

infect(mucocele, abscess, herpes,mucor, syphilis),

autoimmune(wg) eosinophil, sacoid, pseudo tumir

Answer 9

Infiltrate-AMl
Infect
Granulomatous- tolisa hunt( painful weakeye weak muscle

Question 10

Chronic Diarrhea

Answer 10

1. ro bloody> malignancy, infection(tb CMV Amebic shigella), IBD (uc>crohn)
2. Watery? Secretory? Small bowel(ออกเยอะ)
3. Infect- TB, MAC, Parasite,CMV, Protozoa, Crypto
4. Inflame- IBD, Colitis
5. Malabsorption- Pancreatitis, sprue
6. Hormone - hyperthyroid, addison
7. Neoplasm + ตับโต wt liss - colon Ca
8. Drug colchicine

Question 11

Vomiting

Answer 11

1. R/o drug - ATB chemo digoxin OCP
2. แยก other uremia(ตับ?ไต?), preg(ท้องโตนมคัดตึง),กินสารอะไรไปไหม ethanol
3. Intraperitoneum(GI)
   Obstruction, infection, inflam(Panc, Appendicitis, hepatitis, biliary colic), Motor(gastroparesis, functional)
4. Extraprritoneal(non GI)
   Brain > abscess, Ca, hemorrhage, hydrocephalus
   Cardio > MI
   Ear> motion sickness, lybrintitia

Question 12

Spleenomegally

แยกเป็นขาอะไรได้บ้าง

Answer 12

Hemato- nononco- thal

Infection- leshmianiasis, TB, EBV, Malaria, thyphoid, HIV, Histo, Schistomiasis

Cancer - lymphoma, Hairy cell, CLL, AML, PV

Portal- cirrhosis hepatic splenic vein thrombosis

Systemic- amyloid, sarcoid, SLE, RA(felty syndrome)

Metabolic(young)- gaucher, POEMS(polyneuro organomegally endocrine monoclonal skin)