ティアニー先生 in 茅ヶ崎 2010年10月27日
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- いいね！0
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<Diagnosis> Diffuse large B cell lymphoma Stage IV-A
2010-10-27 08:27:30
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<<< Symptoms High Ca >>> ==> 1. constipation, 2 Polyuria 3. Mental status change <most cause is Malignancy>
2010-10-27 08:29:03
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<case conferrence> 53 yo M with altered mental status
2010-10-27 14:05:33
家庭医療WS＠東京５月８、９日
@kateiiryouWS
2weeks before admission, he got low grade fever37c. 1DBA, his fever up to 39c. day of admission, he was brought to ER
2010-10-27 14:11:15
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<can't understand news paper= high function disorder>> this is more likely Encephalitis than meningitis.
2010-10-27 14:13:53
家庭医療WS＠東京５月８、９日
@kateiiryouWS
In summer, the older people tend to got "hyperthermia (high temperature)", this is different from Fever.
2010-10-27 14:15:43
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<Normal body temperature change > highest on evening, lowest on morning
2010-10-27 14:22:33
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<PMH> DM (Type2), Cerebral bleeding <Meds> Multi-vitamin, Glibenclamide (SH) Tabbaco 20p/y , occational drinker, Allergy: cimetidine,
2010-10-27 14:24:50
家庭医療WS＠東京５月８、９日
@kateiiryouWS
Diabetes mellitus => could be cause of AMS (but usually no fever)
2010-10-27 14:28:03
家庭医療WS＠東京５月８、９日
@kateiiryouWS
Cerebral bleeding at 53yo is rare (Maybe we need to consider HTN, Trauma, AVM, Amiroidangiopathy)
2010-10-27 14:29:44
家庭医療WS＠東京５月８、９日
@kateiiryouWS
Question time ==> Onset is acute, (-) headache, motor/sensory disfunction
2010-10-27 14:36:33
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<Cimetidine> sometimes cause psychiatric symptom ==> http://pmj.bmj.com/content/58/681/415
2010-10-27 14:42:23
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<Question> No sick contact, No Travel abroad, No heart disease
2010-10-27 14:43:23
家庭医療WS＠東京５月８、９日
@kateiiryouWS
No character change, He is sexually active only to his wife.
2010-10-27 14:45:36
家庭医療WS＠東京５月８、９日
@kateiiryouWS
<From Dr. Aoki> If someone coming back from abroad, and got high fever, you need to consider "ウエストナイル熱" http://ow.ly/3022e
2010-10-27 14:47:00
家庭医療WS＠東京５月８、９日
@kateiiryouWS
GCS E4V4M6, only oriented to name. HEENT: normal, Neck: supple, Heart and Lung: normal, Abdomen: normal, Extremeties: normal
2010-10-27 14:49:42
家庭医療WS＠東京５月８、９日
@kateiiryouWS
Google search "Fever, disorientation, Alexia" ===> Herpes encephalitis, Pick disease....
2010-10-27 14:50:50
家庭医療WS＠東京５月８、９日
@kateiiryouWS
Pulse rate is very low ==> Typhoid fever, Yellow fever, Atypical Pneumonia, some type of tumor.
2010-10-27 14:52:14
家庭医療WS＠東京５月８、９日
@kateiiryouWS
青木先生 ＝＞ ９度で１１０番と覚える （３９度なら脈は１１０くらいあるはず） その他、レジオネラ、リケッチアも
2010-10-27 14:53:19
家庭医療WS＠東京５月８、９日
@kateiiryouWS
Cranial nerves:intact, No barre sign, Motor: normal, Sensory: only reduced vibration, DTR & Babinski: normal,
2010-10-27 14:54:20
家庭医療WS＠東京５月８、９日
@kateiiryouWS
Coordination: smooth (Finger to nose: terminal tremor) Gait: stable (leaning forward)
2010-10-27 14:56:16