w********n
发帖数: 202 | 1 41. A 49-year-old woman is admitted to the hospitalbecause of renal failure.
She has had episodes of flank pain over thepast 20 years. She has also had
nocturia 2 to 3 times nightly for 10years. Her blood pressure is 160/100 mm
Hg. Examination shows palemucous membranes. A mass is palpated in the right
flank. Which of thefollowing is the most likely diagnosis?
A) Horseshoe kidney
B) Nephrolithiasis
C) Papillary necrosis
D) Polycystic kidney disease
E) Renal cell carcinoma
How about E |
|
d*******e
发帖数: 89 | 2 D is better.
How could renal cell carcinoma have such a long history and cause renal
failure. |
|
w********n
发帖数: 202 | 3 3. Over the past 4 years, a 40-year-old woman hashad increasing episodes of
loss of urine and difficulty emptying herbladder. She has had no dysuria.
She has a 30-year history of type 1diabetes mellitus. She weighs 66 kg (145
lb) and is 175 cm (69 in) tall. Pelvic examination shows a moderate
cystocele. Postvoidingcatheterization yields 700 mL of clear urine. Which of
the following is the mostlikely cause of the patient's genitourinary
symptoms?
A) Carcinoma of the bladder
B) Detrusor instabilit |
|
a*********d
发帖数: 2763 | 4 yeah, 周末了周末了，来灌水。
六区，是甲状腺手术中用的颈部分区，舌骨，颈动脉鞘和无名动脉围成的区域，是分化
型甲状腺癌最容易转移的地方，所以一般都会进行六区淋巴结清除和病理。这个要请外
科的同学们来说了，我就不班门弄斧了。
分化型甲状腺癌的治疗，是根据肿瘤大小，局部转移的程度，病理类型，还有病人的年
龄和家族史来决定的，跟免疫组化的关系不大。
拿这个例子来说，肿瘤大于1cm,是符合术后I131治疗的，术后应该服用高于常剂量的甲
状腺素，抑制TSH，然后follow thyroidglobulin和颈部超声,而不是follow
calcitonin，我觉得这点上我很困惑。如果不是medullary carcinoma，跟本不用查
calcitonin的。是不是有什么特别的原因？
不过呢，说来说去还是这句话，病人我们没有见过，网上传来传去的消息容易出差错，
而且会引起不必要的误解和医患关系紧张。如果真的有疑问不妨去其他医院再看看。你
在上海的话（宝山，新华，所以我assume），瑞金医院的内分泌科是很有名的，可以去
挂个专家门诊咨询一下。
good luck |
|
a*********d
发帖数: 2763 | 5 楼上好像也是搞内分泌的哈。请你不要专家专家地，搞得我很受不了，呵呵，我是第一
年fellow而已，还不过是刚刚上路的新手。
我觉得这件事情本身就非常不make sense，如果病理已经明确诊断是follicular
carcinoma，本身就不应该查calcitonin，多抽血，多花钱，很好玩么。除非是临床上
发现有什么线索引起对诊断的怀疑。但是如果是这样的话，就不应该让病接受
radioactive iodine治疗。
我们在这里都是不能做出任何结论的，无非造成病人的压力和医患关系紧张。 |
|
h******l
发帖数: 238 | 6 您这个猜测因素也太多了吧，把病人都吓死了，不过比较符合内科主任查房的习惯:)
我个人意见，六区淋巴结看到甲状腺组织，这个估计不是滤泡癌，很可能是乳头样癌的滤泡型(follicular variant of papillary thyroid carcinoma)，这个类型病理诊断很难，搞错的可能性比较大。甲状腺肿瘤应该先做细胞学诊断，如果排除乳头状癌，不应该做淋巴结清扫。这个病人做了淋巴结清扫，而且乳头状癌的几个免疫染色都是阳性的，不知道为什么诊断滤泡癌。Tumor marker 这个就是赚钱，没啥好讨论的。
病人男性女性，年龄多大，这些比其他因素都重要。分子病理分析几个癌基因突变对确定类型有帮助，对治疗方案也有帮助，不过美国也只有少数几个会诊中心能做。 |
|
d****y
发帖数: 2180 | 7 我第1个反应就是carcinoma，不过看了图后觉得这个肿块不象那么恶性的。
刚好在看RRP，查了一个Gastrointestinal disorders,嘿嘿，有个图跟这个几乎一样，
是D; Tubular adenoma. |
|
d****y
发帖数: 2180 | 8 Adenocarcinoma: crater-like(象火山口的）, reddish, irregularly-shaped tumor
Tubular adenoma: most common polyp, the head of the stalked polyp has a
lobulated, mushroom-like appearance.
This is consitent with the figure presented in the question. The stalk of
the polyp is just under the mushroom-like head.
The adenoma has a great chance to develop into maglinant carcinoma since the
adenoma >2cm. |
|
d******g
发帖数: 40 | 9 restless70 is right. Iressa is one kind of chem therapy for non-small cell
carcinoma.
Morphiner: please search some paper or ask Doctors for more information. For
my limit understanding and information, Iressa won't treat any cancer,
except for relief the symptoms. So good luck and use internet information
wisely(the info you got from me :D) |
|
h***a
发帖数: 312 | 10 1. During an experiment, the following data are obtained from an
anesthetized dog:
Mean glomerular capillary hydrostatic pressure (HPGC) 45 mmHg
Mean Bowman space hydrostatic pressure (HPBS) 12 mmHg
Mean glomerular capillary oncotic pressure (piGC) 23 mmHg
Mean Bowman space oncotic pressure (piBS) 0 mmHg
Coefficient of filtration (Kf) 3.0 (mL/min)/mmHg
Renal Blood Flow 200 mL/min
Hematocrit 40%
Filtration Fraction 25%
An IV infusion of AngII is administered for 60 minutes. Which of the
fol... 阅读全帖 |
|
k**********n
发帖数: 438 | 11 Date/Time: Sunday, May 22th, 2011 9:30 am - 5:30 pm
Location: Sheraton Hotel, 135-20 39th Ave Queens, New York, NY 11354
Chinese Medical graduates Symposium will be concurrent with ACAP Gala, now open for registration:
https://spreadsheets.google.com/viewform?hl=en&formkey=
dFcxSHNsQ3E2WW4ySGZ0Zm91c3J6U0E6MQ&theme=
0AX42CRMsmRFbUy1mM2E0N2Q3Ny0zZWM4LTQ5YWMtODFhOC04NmUyNTU5MmQ2ZDg&ifq
9:00 am – 9:05 am Welcome Remarks
Dr. Jianjun Zhang, Resident, Long Island Jewish Medical Center
09:05 am... 阅读全帖 |
|
a******3
发帖数: 1017 | 12 To LZ:
babysteps她们有个申请医学院的club,你可以去看看。
To: carcinoma
CMG已经医学院毕业了，你申请这边医学院人家会收你吗？还有，你已经可以直接考试
了，为啥还要费劲费钱费时间去读这边得医学院呢，赫赫。
CMG效率高的可有一两年就搞定考版match的，当然大多数人花更长的时间，但也远不需
要超过10年吧～～～ |
|
l**x
发帖数: 296 | 13 III score 8 is high grade, not good
Low grade: score 3-5
Intermediate grade: score 6,7
High grade: score 8,9
This is histological grading of invasive ductal carcinoma of breast, based on tubular formation, mitotic count, and nuclear grade.
The link is about cancer staging, which means how extensive the tumor is involved, eg if there is axillary lymph node involved, if there's distant metastasis. |
|
g******p
发帖数: 111 | 14 Update:
I attended an webinar by NCCN on adjuvant therapy for NSCLC pts and asked the case. The presenter is leaning towards using adjuvant chemo therapy. I am still collecting more openion on this. My mom will have first first follow up CT in Aug. I guess (guess only) if obvious disease progression were seen, chemo should be used. I still have the hope that if she can rest well and build up her immuine system, she will be able to keep the cancer in check.
Also I put together my mom's diagnosis ... 阅读全帖 |
|
p********r
发帖数: 147 | 15 以下是翻译：
part 1:
（左上肺叶肿块，左下肺叶肿块)
高分化腺癌，以细支气管肺泡癌为主，肿块大小分别为1.5*1.0*0.8cm和1.0*0.6*0.8cm
，局部累犯脏层胸膜。未见明确脉管内癌拴及神经侵犯。
(1) left upper lobe and left lower lobe (lobectomy):
- well differentiated adenocarcinoma (1.5 cm, 1.0 cm respectively), with
predominantly bronchioalveolar pattern
- The carcinoma focally invades visceral pleura
- No definitive evidence of lymphovascular invasion or perineural
invasion
part 2:
left upper lobe, posterior segment (segmentectomy):
- foal atypical adenomatoid... 阅读全帖 |
|
a******8
发帖数: 231 | 16 15. A 60-year-old woman is undergoing surgical excision of a renal cell
carcinoma thrombus that extends in to the right renal vein. During the
procedure, the vena cava is temporarily occluded above the renal veins.
Increased venous pressure is most likely to be noted in which of the
following veins during the period of occlusion?
A) External iliac
B) Hepatic
C) Inferior mesenteric
D) Portal
E) Splenic
23. A 35-year-old woman is brought to the emergency department after having
a stroke. Evaluatio... 阅读全帖 |
|
L********r
发帖数: 37 | 17 Actually, I have the answer key, but I don't understand them.
Could you explain all the questions?
Thanks.
carcinoma
.
lobe
these |
|
h**s
发帖数: 1757 | 18 What do u wanna take? B?
1) T3 N0 M0 epidermoid carcinoma. This means he had no metastasis at the
very beginning.
2)smoking history
so primary has more possibility. |
|
h**s
发帖数: 1757 | 19 A)Bronchioalveolar carcinoma of the lung
this pathology is lung adenocarcinoma which does not relate with smoking. |
|
z*******6
发帖数: 353 | 20 OFC is caused by primary hyperparathyroidism. Common causes include
parathyroid adenoma/carcinoma. then hopefully it would make sense for you. |
|
h**s
发帖数: 1757 | 21 A(2): group leader:startover11
earth6 (headache)
abighappy (快乐的种子)
zhchchllp (zhchchllp)
pindolol (pindolol)
pathhunter (hunter)
kayatcan (kk)
ducklingdong (gaga)
sabrina99923 (sabrina)
followyou (yoyo)
chengc1234 (cat)
nmw1978 (nmw)
xnm2009 (xnm2009)
doczwqx (doczwqx)
labzhlg (labzhlg)
carcinoma1 (carcinoma)
luckysharp (luckysharp)
sunnyaspen (sunnyaspen)
hkhkl (hkhkl) |
|
h***o
发帖数: 350 | 22 乳腺癌的病理诊断会有可能出错吗？临床表现和B-超是breast cyst, but pathology
reports said it was invasive ductual carcinoma (IDC), grade 3. 手术后病理:
tumor (IDC) 5cm, Sentinel lymph node negative. Is it common for a big size
tumor with negative lymph node? need to examine another lymph node?
Thank you |
|
d********y
发帖数: 616 | 23 Heart & Blood Vessels
Flask-shaped / Pear-shaped / Leathe- bottle / Money-bag shaped heart -
Pericardial effusion
Boot-shaped heart / Coer-en-sabot - Fallot's tetralogy
Box shaped appearance - Tricuspid atresia
Jug Handle appearance - Primary pulmonary artery hypertension
"3" like appearance - Coarctation of Aorta
Egg on side appearance - Transposition of great vessels
Egg in cup appearance - Constrictive pericarditis
Snow-man heart - TAPVC (total anomalous pulmon... 阅读全帖 |
|
e***y
发帖数: 4307 | 24 【 以下文字转载自 Medicine 讨论区 】
发信人: eeguy (ILYF), 信区: Medicine
标 题: 求助，老婆的甲状腺癌可能复发了
发信站: BBS 未名空间站 (Mon Sep 24 00:52:36 2012, 美东)
年初曾经发帖咨询过，当时的帖子在这里：http://www.mitbbs.com/article_t0/Medicine/31238469.html
老婆今年28岁，二月在UCSF确诊是papillary thyroid carcinoma，四月做了total
thyroidectomy，冷冻切片符合papillary，但是是diffuse sclerosing variant比较
aggressive，而且是moderately differentiated，所以当时已经知道复发的可能性很
大。七月份做了RAI，剂量是100 millicuries。RAI后的全身PET scan没有发现I-131
uptake，TSH在0.1左右，但是因为thyroglobulin antibody (TgAb)非常高（>3000），
所以thyrogl... 阅读全帖 |
|
z*****o
发帖数: 37 | 25 A 56-year-od woman has recently diagnosed carcinoma of the breast. An x-ray
of the chest shows a tumor next to the right side of the heart. An enhanced
CT scan with the tumor invading the pericardium is shown.Which of the
following structures is most likely involved.
A. Coronary sinus
B. Greater splanchinic vein
C.Right phrenic nerve
D.Right Vagus nerve
E.Thoracic duct
我的选择是D， 但错了。正确答案是C. 能请哪位高手给个详细的解释吗？图这里粘贴
不出来。 |
|
|
|
|
t********o
发帖数: 228 | 29 leukoplakia:
Due to chronic stimulation, such as smoking. Depends on the size and
morphology on laryngoscopy. May need biopsy to rule out carcinoma in situ.
If it is very small, can monitor it by periodic laryngoscopy. Narrow band
image may also be helpful. Meanwhile, stop smoking; if have GERD, start PPI
and change life style such as no food 4 h prior to bedtime, take PPIs, no
smoking, no coffee and tea, et al.
There are not really meds for leukoplakia.
If the patient is using steroid inhaler,... 阅读全帖 |
|
yf
发帖数: 272 | 30 http://jop.ascopubs.org/content/early/2013/03/26/JOP.2012.00081
Perspective
Practicing Western Oncology in Shanghai, China: One
Group’s Experience
By David H. Garfield, MD, Harold Brenner, MD, FRCR (Lond), and Lucy Lu, RN
ProMed Cancer Centers–Shanghai, Shanghai, People’s Republic of China
In October 2011, we—David H. Garfield, MD, medical oncologist,
United States; Harold Jacob Brenner, MD, FRCR,
radiation oncologist, Israel; and Lucy Lu, oncology nurse,
Shanghai, China—were part of a group tha... 阅读全帖 |
|
J*********4
发帖数: 1274 | 31
.
nose
====
赞一下楼上专业!
1。不要觉得跟医生聊的好就应该给减免费用。在诊所里打个针啥的，如保险没cover,
银子会没的。跟哪个诊所真的没关系。
2。死皮可能是Actinic Keratosis, bowen's Disease, seborretic keratosis,Basal
cell carcinoma,.....必须看皮科，活检才能诊断-注意：费用很多哦 |
|
h*******y
发帖数: 1220 | 32 Steps are:
1. Low dose dex (sensitive but not specific) to exclude; if (-), stop; if (+
):
2. 24 h cortisol / urine (expensive but specific); if (-): look for other
reasons such as stress...; if (+):
3. High dose dex:
positive: adrenal or puituitary adenoma
--high ACTH = pituitary = MRI;
--low ACTH = adenoma of adrenal gland;
Negative high dose = small cell carcinoma (high ACTH) or adrenal Ca (low
ACTH). |
|
i*****r
发帖数: 265 | 33 帮个朋友问的，57岁，下面是病理报告：
Examination Findings
Specimen of right breast mass 4X2X3CM was sent for inspection. A grey nodule
with size of 2.5X2CM was found in the section. Endoscope finding: The tumor
cells were in nest shape and glandular tube. The cells arranged solidly and
grew invasively. Nuclear fission was easy to see, and nuclear atypia was
obvious. No cancer metastasis was found in the 3 pieces of lymph nodes in
the right paracardial region for inspection.
ER(++70%) PR(-) P35(++75%) C-erbB-... 阅读全帖 |
|
U******u
发帖数: 5829 | 34 发信人: USMedEdu (US_CMGs), 信区: Pre_Resident_Club
标 题: Summary for externship with Dr. He's program
发信站: BBS 未名空间站 (Thu Sep 10 01:07:41 2015, 美东)
Summary for externship with Dr. He's program
CHZ
It was a difficult decision for me to have an externship in New York
this summer. I had to leave work without payment, and I am also the
only person earning money for my family. However, I believe it was
very important for me, a truly old CMG, to have the special training
from Dr. He, a medical education s... 阅读全帖 |
|
U******u
发帖数: 5829 | 35 发信人: USMedEdu (US_CMGs), 信区: Pre_Resident_Club
标 题: Summary for externship with Dr. He's program
发信站: BBS 未名空间站 (Thu Sep 10 01:07:41 2015, 美东)
Summary for externship with Dr. He's program
CHZ
It was a difficult decision for me to have an externship in New York
this summer. I had to leave work without payment, and I am also the
only person earning money for my family. However, I believe it was
very important for me, a truly old CMG, to have the special training
from Dr. He, a medical education s... 阅读全帖 |
|
w*s
发帖数: 25 | 36 etiology of hepatocellular carcinoma:
Aflatoxin
HBV infection
HCV infection
detailed reason is unknown |
|
c*******3
发帖数: 48 | 37 Yamamoto T, Uenishi T, Ogawa M, et al.
Immunohistologic attempt to find carcinogenesis from hepatic progenitor cell
in hepatocellular carcinoma
DIGESTIVE SURGERY 22 (5): 364-370 2005
N***********[email protected] |
|
M*****e
发帖数: 1827 | 38 avastin
Metastatic Colorectal Cancer
AVASTIN, in combination with intravenous 5-fluorouracil–based chemotherapy,
is indicated for first- or second-line treatment of patients with metastati
c carcinoma of the colon or rectum.
，我 |
|
s********d
发帖数: 103 | 39 Alnylam and Ascletis collaborate to develop ALN-VSP for liver cancers in
China
US RNAi therapeutics specialties Alnylam Pharmaceuticals (Nasdaq: ALNY) and
Ascletis Pharmaceuticals, a privately held US-China joint venture
pharmaceutical company, have formed a strategic collaboration for the
development of ALN-VSP, a first-in-class, systemically delivered RNAi
therapeutic for the treatment of liver cancers including hepatocellular
carcinoma (HCC), a significant area of unmet need in China.
This co... 阅读全帖 |
|
发帖数: 1 | 40 您好，我的朋友是生物统计方向的master，她有很多publication和审稿的经验。她在
德州西南医学中心做computation biologist。以下是她的信息
name: Uthra Balaji
email: [email protected]/* */
如果有合适的审稿机会可以发给她吗？多谢您！！
Publication:
1. Metabolic Reprogramming of Pancreatic Cancer Mediated by CDK4/6
Inhibition Elicits Unique Vulnerabilities. Jorge Franco, Uthra Balaji,
Elizabeth Freinkman, Agnieszka K. Witkiewicz, Erik S. Knudsen, Cell Reports
2016.
2. Whole-exome sequencing of pancreatic cancer defines genetic diversity and
therapeutic targets. Agnie... 阅读全帖 |
|
发帖数: 1 | 41 您好，我的朋友是生物统计方向的master，她有很多publication和审稿的经验。她在
德州西南医学中心做computation biologist。以下是她的信息
name: Uthra Balaji
email: [email protected]/* */
如果有合适的审稿机会可以发给她吗？多谢您！！
Publication:
1. Metabolic Reprogramming of Pancreatic Cancer Mediated by CDK4/6
Inhibition Elicits Unique Vulnerabilities. Jorge Franco, Uthra Balaji,
Elizabeth Freinkman, Agnieszka K. Witkiewicz, Erik S. Knudsen, Cell Reports
2016.
2. Whole-exome sequencing of pancreatic cancer defines genetic diversity and
therapeutic targets. Agnie... 阅读全帖 |
|
C*****D
发帖数: 1299 | 42 Moderately differentiated invasive squamous cell carcinoma of cervix, with
the depth of invasion > 2/3.
Angiolymphatic invasion identified. Margins negative.
Leimyoma, adenomyosis.Proliferative endometrium
Vagina and bilateral fallopian tubes negative for neoplasm.
All lymph nodes negative for malignancy.
I think your report may not be accurate from my point of view. Better have
someone re-look the slides. |
|
C*****D
发帖数: 1299 | 43 Moderately differentiated invasive squamous cell carcinoma of cervix, with
the depth of invasion > 2/3.
Angiolymphatic invasion identified. Margins negative.
Leimyoma, adenomyosis.Proliferative endometrium
Vagina and bilateral fallopian tubes negative for neoplasm.
All lymph nodes negative for malignancy.
I think your report may not be accurate from my point of view. Better have
someone re-look the slides. |
|
x****z
发帖数: 1 | 44 今年5月份，妈妈确诊得了这个病（乳腺浸润性微乳头状癌），通过网络找到本坛，希
望能找到对妈妈病情有帮助的治疗方案。先谢谢大家。
==
确诊后医生使用的治疗方案是：先做4次CEF化疗，然后进行手术，再进行2次加强化疗
。但是前三次CEF化疗做完后，肿瘤没有什么改变，医生决定提前做手术并暗示CEF常规
化疗方案不敏感的话，手术后的化疗也是满足病人与家属的心理，实际效果很微。大量
的搜索关于这个（乳腺浸润性微乳头状癌）的资料后，几乎绝望！！
==
这个星期妈妈将要进行手术，5月份确诊的时候，肿瘤穿刺的结果是：“镜下为乳腺浸
润性导管癌3级，部分呈浸润性微乳头状癌改变。”淋巴穿刺结果没有转移，全身骨扫
描也没有转移。第三次化疗B超显示肿瘤大小没有明显变化，而淋巴却有转移的可能，
决定提前手术。
==
肿瘤位于右乳九点钟方向，左乳无异常，手术处理的话，采用什么方案会对整个病情及
后续的治疗较好呢？
CEF对这个IMPC没有效果，有没有最新的记录对这个IMPC有缓解的药物？
免疫组化：ER 40%（+）、PR 50%（+）、CerbB-2（-）、P53（+）、E-cadherin(+)、
COX-... 阅读全帖 |
|
I****a
发帖数: 407 | 45 There is nothing wrong to go for surgery now. The treatment after that
depends on what they find during the surgery. If she has high risk disease
then adjuvant chemotherapy would be recommended, a regimen containing either
Taxol or Texetere would be better given her lack of response with CEF. |
|
I****a
发帖数: 407 | 46 Sorry, the report does not apply to your 外公. It is for patient who has
anatomically resectable liver cancer but does not have enough liver reserve
to tolerate the surgery. Aside from Sarafenib,there is no real good way to
treat metastatic hepatocellular carcinoma. |
|
V**y
发帖数: 788 | 47 1st thing I would think is endometrial carcinoma. |
|
f******y
发帖数: 73 | 48 yes, you can consider this therapy, if the tumor is less than 8 cm.
if the tumer is larger. 易复发 after transplant
肝癌肝移植进展最新综述（Ronald W Busuttil）
Liver transplantation for hepatocellular carcinoma: an update |
|
I****a
发帖数: 407 | 49 radiation for sure with low dose chemotherapy as radiation senstizer.
surgery for squamous cell carcinoma is controversial after chemoradiation so
it might not needed. |
|
b******a
发帖数: 704 | 50 Happy Chinese New Year!
Here is what I recently read online. Very interesting topic from MAYO CLINIC !
PUBLIC HEALTH RELEVANCE: Clear cell renal cell carcinoma (ccRCC) is the most
lethal form of kidney malignancy, killing nearly 13,000 patients annually.
Current treatment options for metastatic ccRCC are limited as evident in 2
year survival rates of 10-20%. Advancing ccRCC patient care centers around
several areas including better methods for identifying patients at high risk
for metastatic rel... 阅读全帖 |
|
