Steem Medics,
#AIR-CLINIC ROCKS! It’s good to be back with another interesting episode of Online Ward rounds, a special programme for medics on the blockchain. It is a part of @Air-Clinic's sub-project, SMSI (steem medics support initiative). We are sure you had a great time during the Last episode. For those that missed the show, here is a link to the third edition
ATTENDANCE REGISTER (LAST WEEK).
These are the steem medics that graced our grand rounds last week:
- Dr. @Nairadaddy (a GP)
- Dr. @Antigenx (a GP),
- Dr. @Thelovejunkie (a practicing dentist),
- Dr. @Elvigia (a practicing ENT Surgeon)
- Dr. @Omaqiin (a general practitioner),
- Dr. @Endopediatria (pediatric endocrinologist and special guest),
- @Drqamranbashir(a GP),
- @tamala (a Health coach),
You all made our second episode a success. We appreciate your contributions.
@air-clinic specially appreciates Dr. @Endopediatria
Thank you for honoring our invite. It was great having you on the show. We also Learned from you
Here is a quick summary for last weeks cases
Case 1 Highlights
The Diagnosis for this was Pyloric Stenosis
Case 2 Highlights
The Diagnosis for that case is G6PD Deficiency.
Case 3 Highlights
Ectopic Thyroid** is the provisional Diagnosis, The management is controversial. Dr. @Endopediatria would throw more light into this case.
FOR THIS WEEK , HERE ARE THE CASES FOR YOU TO ATTEMPT.
Case 1
A 54-year-old Female develops a mild fever, malaise, and ear pain. 3 days later, she develops multiple painful vesicles over her ear canal and external auditory meatus.
- What is your diagnosis? (And what is the basis for making your diagnosis?)
- What are your DDx?
- How would you work up this patient?
- How would you manage this patient?
Case 2
A 32-year-old boxer presents with a headache, drowsiness, seizures, and a rising blood pressure
- What is your diagnosis? And what is the basis for making the diagnosis?
- What are your DDx
- How would you work up the patient?
- What are your management modalities for this case?
Remember to approach these cases from your professional point of view.
BENEFITS OF SMSI
- As the name implies this is strictly to assist steem medics on their steemit journey.
- Support will be in the form of community of mutual interests.
- Qualification verification to improve the quality of steem healthcare.
- Upvotes and post -curation for verified members.
- Get part of the rewards for participating in Online Ward rounds.
- Engaging discussions will be held intermittently to listen to our individual journey on the path of health.
- Problem-solving and family bonding.
TETE-A-TETE (INTERVIEW SEGMENT):
*For this week’s TETE-A-TETE segment, meet our guest... - Dr. @Elvigia (a practicing ENT Surgeon)
Tell us about yourself
My name is Elvigia Adams, I´m an otolaryngologist, I also have a doctorate in education. I teach future otorhinolaryngologists in Barquisimeto, Venezuela. I love my family and my profession. I am married to a gynecologist and I have two teenage daughters, the oldest of whom has Down syndrome.
Why you love @air-clinic
I love the air clinic because I have met very interesting people. We can discuss clinical cases and know different points of view for the treatment and clinical management. It is also a wonderful space to help people from different parts of the planet.
Hight and low point on steemit
The experience in this social network has been very pleasant, it has allowed me to know and share virtually, with countless cultures, occupations, very talented people.
Challenges/survival story in your specialty
I did my postgraduate studies far from my family. Those three years were very difficult for me and for them. I lost 10 kilograms during the first year of graduate school. However, the experience was enriching from every point of view and made us stronger as a family. I am Venezuelan and we are not really having a good time in the health sector. There is a shortage of medicines, medical supplies and many good and dear colleagues have left the country.
Motivation to study your career.
When I was little, my mom often took care of people or relatives in my house and even paid her expenses. So I decided to be a doctor to help people too. The main motivation to be an otolaryngologist is that I wanted to have a beautiful and delicate surgical specialty for a woman. Today I know I'm not wrong.
Final words
Medicine is a wonderful way to help people. Sometimes we forget our family for a few hours, but we must maintain a balance in our roles. There will always be patients who challenge our knowledge, but that is the good thing about being a doctor. You will keep studying and looking for new things in the wonderful medical world.
OTHER INITIATIVES THAT "Steem-Medics" WILL BENEFIT FROM.
#AIR-CURIE: is an initiative powered by @Air-Clinic aimed at finding and rewarding quality medical posts. We also submit to giant curators who may further reward posts.
#Leading-HEALTH-TALKS: every true health professional/student desires to share their knowledge of medicine and the human body with others. We engage #steem medics in the affairs of @Air-Clinic.You get the opportunity to share knowledge according to your interests and specialty*.
- All interested Steem Medics who would love to be a part of this support initiative should join @Air-Clinic on DISCORD.
See link here: https://discord.gg/rqded5m
Don’t forget to share your interesting case with us; it may be used for a review in our next episode.
We are here for your health!
This article was compiled by @antigenx for @air-clinic
KINDLY UPVOTE & RESTEEM TO REACH MORE MEDICS.
KINDLY UPVOTE & RESTEEM TO REACH MORE MEDICS.
Hey common, where are all the other medical personnels on Steemit, you all should kindly come join ward rounds, it's very educative. Let's tell someone to tell someone.
Kudos @air-clinic
Woops! We are into another week already?.
Case 1 looks quite interesting. It could be Otitis Externa 2o to Herpes Zoster due to the painful vesicles. I don't know whether the age and sex are significant. Clinical diagnosis should nail it though viral pcr of lesion may suffice.
Acyclovir should come in handy.
Case 2: I'm thinking of hypertensive emergency. Would have said concussion if it was during the boxing game. It may also be a CVA or TIA depending on duration.
In the management, you don't want to rapidly crash the bp. You taper the dose of hydrallazine and monitor bp continuously.
Hey Dr. @Elvigia,
Nice having you on the show today. It's wonderful how your mom has inspired you to study medicine.
Cheers dear!
I think in case 2 h/o being a boxer needs some attention. I would go for concussion rather than htn Em.
Thank you @nairadaddy. Yes, my mother was my inspiration to study medicine.
I think it is very important to try to balance our personal and professional roles, although it is not always easy.
@nairadaddy, we have indeed reached the fourth episode. We are waxing stronger and stronger and impacting knowledge
@nairadaddy I so agree with you on case 1 as Herpes zoster as that was what popped up in mind also considering the glossopahrygeal nerve which takes it course behind the ear. Yes, acyclovir is best.
@elvigia, thanks for your interview, so inspiring. I love you already. Xoxo
Educated
Case 1
My dx is herpes zoster oticus.
(May be Ramsay hunt syndrome-old age seems pointing towards that but history is too short to be sure about that- no h/o facial weakness and not past h/o chickenpox infec)
Basis:-H/o of pain, fever and typical feature of vesicles on aud cnal and ext aud meatus.
DDX:- Acute otitis media , otitis externa, myringitis bullosa. Ramsay hunt syndrome.
Work up:- Usually History, auditory function tests and otoscopic examination suffice.
However sometimes typanometry, vesical fluid examination or diagnostic imaging to rule out complications may be required.
Treatment:- Analgesics and Antivirals.
I have chnaged my dx from myringitis bullosa to herpes zoster because in hurry i though there is h/o TM membrane involvement also.
Very detailed approach @drqamranbashir
Thanks @air-clinic, for the opportunity. I love you.
Case I
The first thing to think about is a viral herpes zoster infection, due to the presence of vesicles in the ear and external auditory meatus.
It is more common in immunosuppressed patients.
This patient must be aware that he does not develop a facial paralysis, in which case it would be a Ramsay Hunt syndrome. Other complications include hearing loss, vertigo, nystagmus and involvement of other cranial nerves, mainly the V-pair.
The treatment is based on antivirals such as acyclovir, in the first 72 hours anti-inflammatory and steroids.
Case 2
I can think of a serious traumatic brain injury, related to his profession, because he is a boxer, he may have received a strong punch to the head that probably generated a hemorrhage or even a cranial fracture and that's why he would have a headache, convulsions and altered consciousness .
This patient must be hospitalized and have a CT scan of the skull or a Nuclear Magnetic Resonance to evaluate if surgery is required.
This is a lovely read, i love beautiful approach you came up with each diagnosis.
Thanks you for the interview. I hope you feel good
Today i am better and much stronger, never knew acute Gastroenteritis was that bad lol, i had a one on one experience and I can pass any clinical exam on it now. Hehehe
Case 1 It could be otic herpes zoster.
Dx clinical, excluding others, history of varicella.
Tx Antiviral and analgesics
Case 2 We have to rule out subdural hematoma or intracranial hemorrhage. TC is mandatory
You could check my last post with images of ectopic thyroid case in last week discussion
@endopediatria, would check it out. Lovely input from you here..
excelente initiative, also is educative, thanks to the doctors and @air-clinic
U are welcome @romanc93, you can pick up one or two useful information here that might come in handy someday .
I agree with the diagnosis of herpes zooster for case 1
For case 2 I'm thinking of subdural hematoma (because of patient's profession and even age) with differential of heamorrhagic CVA.
CT scan will pinpoint the diagnosis. Complete blood count and coagulation profile i will also do.
Treatment of subdural hematoma could be conservative (with serial CT, analgesics, anticoagulants) or surgical(Craniotomy and evacuation) depending on size of the hematoma, pressure effect, presence of focal neurological signs and clinical state of the patients.
I think the patient would do well after your detailed plan for management . lovely input dear.
I agree with the diagnosis of herpes zooster for case 1
For case 2 I'm thinking of subdural hematoma (because of patient's profession and even age) with differential of heamorrhagic CVA.
CT scan will pinpoint the diagnosis. Complete blood count and coagulation profile i will also do.
Treatment of subdural hematoma could be conservative (with serial CT, analgesics, anticoagulants) or surgical(Craniotomy and evacuation) depending on size of the hematoma, pressure effect, presence of focal neurological signs and clinical state of the patients.