XRAY of Various Lung Disease

Asbestosis	reticulonodular infiltrates in the lower lungs. bilateral pleural thickening, and diaphragmatlc calcifications with sparing of the costophrenlc angles     Sometimes honeycombing with cystic spaces surrounded by coarse interstitial infiltrates and small lung fields may be seen This usually indicates advanced disease
idiopathic pulmonary fibrosis (IPF).	Bilateral diffuse reticular or reticulonodular infiltrates predominately at the periphery     which rs a chronic prygressive interstitial lung disease of unknwwn etiology IPF is characterized by inflammation and fibrosis of the lung parenchyma
Copd / emphysema.	Flattening of the diaphragm increased retrosternal airspace, and a long narrow heart shadow indicates hyperinflation. which often is seen in patients with chronicInterstitial disease.
bronchioiltis obliterans organizing pneumonia (BOOP),	bronchial thickening, and patchy bilateral alveolar infiltrates which is a disease of unknown etiology characterized by the presence of bronchiolitis and chronic alveolitis
Silicosis	Multiple small nodules that are more prominent in the upper lung fields and calcification of the hiar lymph are seen in it is necessary to note that some findings in silicosis are nonspecific.   Calcification of the hilar lymph nodes. Particularly in the rim of the nodes (so-called eggshell calcification), is characteristic of silicosis, but eggshell calcifications may be seen in some other conditions. Such as sarcoidosis. histoplasmosis. and irradiation.

 

Mental retardation

Mild	55-69	6th grade, work in structured environment (assembly wokrer), independent
Moderate	35-54	2nd grade, daily living, shletered workshop
Sever	34-20	Basic care, simple tasks
Profound	<20	Constant supervision

 

Tetanus prophylaxis

 
 

 

I had problems remembering this table so i used this simple concept :

 
 

• TIG = only dirty , incomplete
• Td = Incomplete , Complete (Last dose >5 dirty, >10 clean)

Patellar Pain

• Osgood-Schlatter disease is a common cause of knee pain, particularly in adolescent male athletes
• During early adolescence (typically ages 13-14 for affected males, and ages 10-11 for affected females), there are periods of rapid growth in which the quadriceps tendon puts traction on the apophysis of the tibial tubercle where the patellar tendon inserts This traction apophysitis is worsened by sports that involve repetitive running. jumping, or kneeling, and it improves with rest
• Approximately one fourth of affected individuals have bilateral disease
• Radiographic findings are nonspecific and include anterior soft tissue swelling, lifting of tubercle from the shaft, and irregularity or fragmentation of the tubercle.
• Treatment consists of activity restriction, stretching exercises, and non-steroidal anti-inflammatory medications.

   
   

   
   

Prepatellar bursitis		Occurs with chronic irritation of the anterior knee.	Symptoms include pain with direct pressure and superficial swelling over the patella.
Patellar tendonitis		Overuse syndrome resulting from repetitive jumping or kicking Patients present with anterior knee pain after exercise.	point tenderness at the inferior pole of the patella
Tibial osteomyelitis		Bone infection, usually bacterial in origin Symptoms include pain. swelling, tenderness, and erythema,	Patients classically present with refusal to bear weight on the affected extrernity Systemic symptoms may also be present The pain from osteomyelitis does not remit with rest.
Patellofemoral stress syndrom		Overuse injury commonly seen in runners Patients present with anterior knee pain that worsens upon descending steps or hills	Pain is localized to the patella and radiographs do not demonstrate separation at the tibial tubercle.
Osgood-Schlatter disease		Traction apophysis of the tibial tubercle Radiographic findings include anterior soft tissue swelling, lifting of tubercle from the shaft, and irregularity or fragmentation of the tubercle.	On physical examination, there is edema and tenderness over the tibial tubercle A firm mass can sometimes be felt due to heterotopic bone formation. Pain can be reproduced by extending the knee against resistance.

 
 

Eating disorder

Anorexia nervosa		Most common in adolescent girls from affluent families The DSM-IV criteria for the diagnosis of anorexia nervosa include: 1) body weight at least 15% below normal weight, accompanied by a refusal to maintain body weight at normal levels; 2) amenorrhea for three months; 3) distortion of body image in which the individual news herself as obese, when she is in fact thin, and 4) fear of gaining weight or becoming fat despite being underweight.     To continue to lose weight, individuals suffering from anorexia nervosa will either: 1) fast and/or exercise (the restricting subtype), or 2) binge eat followed by laxative usage or induced vomtting (the binge and purge subtype).	On physical examination Emaciation. Lanugo (a fine downy body hair) on the back and abdomen T Enlarged parotids, dental enamel erosion, and scars or calluses on the hand from contact with the teeth. bradycardia, hypotension, hypothermia, and dry skin Electrolyte abnormalities secondary to vomiting are often discovered as well.
Eating disorder, not otherwise specified		is the correct diagnosis in patients whose eating disorder does not meet the criteria for specific conditions     (e.g., a patient who meets the criteria for anorexia nervosa but has regular menses).
Bulimia Nervosa		1) recurrent episodes of uncontrolled binge eating followed by feelings of extreme disgust or guitt 2) repeated compensatory behavior to prevent weight gain after binging (e.g. induced vomiting, laxative abuse, diuretic abuse, fasting, or excessive exercise); 3) binging episodes that occur at least twice per week over a three month period 4) normal or slightly above normal BMI; and 5) dissatisfaction with body weight and shape.     Precipitating factors for a binge-purge episode: high levels of anxiety, emotional tension, boredom, exhaustion, poor self-esteem, environmental cues about food and eating, alcohol use, substance abuse, and mood disorders.     Unlike patients wtth anorexia nervosa, patients with bulimia nervosa maintain a normal body weight and are not amenorrheic.	episodes of binge eating followed by feelings of disgust or guilt, repeated compensatory behawior to prevent weight gain after the binge (eg. induced vomtting, laxative abuse), and a     normal or slightly above normal BMl .

 

Anorexia nervosa is always associated with Amenorrhea + below normal weight Bulimia nervosa, in contrast, is associated with normal menses and body weight.