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全部话题 - 话题: lesions
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w****u
发帖数: 1078
1
How about this one
Manuscript ID JICR-2014-0190, entitled "Activated conventional T-cells are
present in Langerhans Cell Histiocytosis lesions despite the presence of
immune suppressive cytokines." I have yet to hear from you about this.
what is your name and email address?
thanks
f******g
发帖数: 1003
2
老的T细胞如果不被新生取代的话,容易生成tumor。
Cell competition is a tumour suppressor mechanism in the thymus
Cell competition is an emerging principle underlying selection for cellular
fitness during development and disease. Competition may be relevant for
cancer, but an experimental link between defects in competition and
tumorigenesis is elusive. In the thymus, T lymphocytes develop from
precursors that are constantly replaced by bone-marrow-derived progenitors.
Here we show that in mice this turnover is regula... 阅读全帖
r*****m
发帖数: 3619
3
来自主题: Biology版 - Wang Jun这么狠了吗?
Results: 46
Select item 25597018
1.
Exome-wide Sequencing Shows Low Mutation Rates and Identifies Novel Mutated
Genes in Seminomas.
Cutcutache I, Suzuki Y, Tan IB, Ramgopal S, Zhang S, Ramnarayanan K, Gan A,
Lee HH, Tay ST, Ooi A, Ong CK, Bolthouse JT, Lane BR, Anema JG, Kahnoski RJ,
Tan P, Teh BT, Rozen SG.
Eur Urol. 2015 Jan 14. pii: S0302-2838(14)01396-7. doi: 10.1016/j.eururo.
2014.12.040. [Epub ahead of print]
PMID: 25597018 [PubMed - as supplied by publisher] Free Article
Related citations... 阅读全帖
m********2
发帖数: 317
4
来自主题: Biology版 - 借人气也问个crispr相关的问题
Nat Biotechnol. 2014 Sep;32(9):941-6. doi: 10.1038/nbt.2951. Epub 2014 Jun
22.
Generation of mouse models of myeloid malignancy with combinatorial genetic
lesions using CRISPR-Cas9 genome editing.
有同学用过这篇文章提到过的质粒吗?
我用了,但是不workwork,包病毒的时候能看到293T细胞全部绿了,但是收集的病毒
titer非常非常低,根本不能重复文章中的转染效率。
m********2
发帖数: 317
5
来自主题: Biology版 - 借人气也问个crispr相关的问题
Nat Biotechnol. 2014 Sep;32(9):941-6. doi: 10.1038/nbt.2951. Epub 2014 Jun
22.
Generation of mouse models of myeloid malignancy with combinatorial genetic
lesions using CRISPR-Cas9 genome editing.
给通讯作者写信问了,然后第一作者的回复是这样的:
for the original virus we have been using standard calcium phosphate
transfection wit plasmid ratios of 6:10:1.5 (all ug per 10 cm dish) for
vector:psPAX2:pMD2.G.
The virus was collected at around 24-28h and 36-40h post transfection and
concentrated 50-100x with ultrazentrifuga... 阅读全帖
y*****g
发帖数: 40
6
来自主题: Biology版 - 貌似张生的爆料靠谱
再看看这篇文章,应该就是爆料里张生家争共一未遂的那篇:
Ito HT, Zhang SJ, Witter MP, Moser EI, Moser MB. (2015). "A prefrontal-
thalamo-hippocampal circuit for goal-directed spatial navigation." Nature
522(7554): 50-55.
Contributions
H.T.I., E.I.M. and M.-B.M. designed the experiment. S.-J.Z. made all viral
constructs. M.P.W. advised on location of electrodes and lesions, H.T.I.
performed all experiments and analyses. H.T.I., E.I.M. and M.-B.M. wrote the
manuscript after discussion among all authors. M.-B.M. and E.I.M.
sup... 阅读全帖

发帖数: 1
7
对肖氏手术的盖棺论定 http://fangzhouzi.baijia.baidu.com/article/440220
——评肖传国的弥天大谎和胡舒立的“新闻专业主义”
十几年前,原华中科技大学教授肖传国在国外声称其发明的“肖氏反射弧手术”能够治
愈脊柱裂(脊膜膨出)和截瘫患者的大小便失禁,成功率高达85%,是中国各大医院都
在做的常规手术,引起了美国、德国、丹麦等国外一些医生的兴趣,2005年起开始在肖
传国的指导下做肖氏手术临床试验。2010年,我和方玄昌因为揭露肖氏手术骗人的实质
,遭到肖传国雇凶袭击,轰动一时,也引起国外医学界对肖氏手术的怀疑。但当时国外
肖氏手术临床试验已经启动。近年来这些试验的长期随访结果陆续发表,都证明了肖氏
手术没有效果(文献1、2),只有肖传国在美国最早、最密切的合作者密歇根州
Beaumont医院的Peters小组报告脊膜膨出患儿有部分人的排尿功能术后有所改善,能少
量排尿,但是除了一人其他人都漏尿(文献3),这与肖传国声称的术后能够完全自主
控制排尿的说法显然不符,以致Peters小组疑惑是不是中国的手术“成功标准”和美国
的不一样。随后,美国... 阅读全帖

发帖数: 1
8
来自主题: Biology版 - DNA damage FPG assay请教
最近做一个DNA damage的实验,就是用H2O2来诱导Hek细胞基因组oxidative damage;
然后用FPG这种能识别8-oxoG的酶来切,被切的基因组位点会产生nick,阻碍PCR
polymerase,基于这样的原理做qPCR定量来研究某段序列对于oxidative damage的反
应。
好像这种做法比较少见,大部分DNA damage的研究都是global的。但也有很好的先例比
如:
http://www.nature.com/nature/journal/v429/n6994/abs/nature02661.html
这篇经典的Nature 文章
我按照这篇文章的做法,把genomic DNA进行FPG overnight digestion (DNA+FPG+Neb
buffer+BSA),同时也做了mock control(DNA+水+Neb buffer+BSA),然后qPCR发现
Ct如下:
DNA:25
DNA+FPG+buffer:28
DNA+水+buffer: 28
让我惊讶的是,相比于纯DNA,mock control的DNA+水+buffe... 阅读全帖
h*****a
发帖数: 1295
9
来自主题: Chemistry版 - paper help (with link) thanks!
http://www.sciencedirect.com/science/article/pii/00142999879065
Nitrous oxide analgesia: partial antagonism by naloxone and total reversal
after periaqueductal gray lesions in the rat
John Zuniga, Shirley Joseph, Karl Knigge
The Neuroendocrine Unit, University of Rochester, Rochester, NY 14642, U.S.A
.
w******e
发帖数: 953
10
Journal of Dental Research
Volume 76, Issue 9, 1997, Pages 1587-1595
Remineralization of enamel subsurface lesions by casein phosphopeptide-
stabilized calcium phosphate solutions (Article)
Reynolds, E.C.
Biochemistry and Molecular Biology Unit, School of Dental Science,
University of Melbourne, 711 Elizabeth St., Melbourne, Vic. 3000, Australia
b*******y
发帖数: 4
11
The projected starting date is August 2015; this date may be postponed for a
few months if needed. The major focus of the Li laboratory is to use
chemical biology means to understand the reactivity of nucleotide damages.
Research projects include: (1) to elucidate the formation and repair of a
thymine photo-dimer, 5-thyminyl-5,6-dihydrothymine, i.e. the spore
photoproduct (SP), and (2) to understand the stability of DNA lesions such
as 5,6-dihydro-2ʹ-deoxyuridine (dHdU) and 5,6-dihydroxy-5,... 阅读全帖
w******e
发帖数: 953
12
来自主题: Chemistry版 - please down load this paper for me! thanks!
Gen Dent. 1997 May-Jun;45(3):254-60; quiz 265-6.
Guidelines for the restoration of Class V lesions.
w******e
发帖数: 953
13
Clinical Oral Investigations
February 2012, Volume 16, Issue 1, pp 129-137
Date: 08 Oct 2010
A 13-year clinical evaluation of two three-step etch-and-rinse adhesives in
non-carious class-V lesions
c******r
发帖数: 889
14
这倒是真的。前列腺癌是这么个比例。北大一院(北医第一附属医院)泌尿科切前列腺
肥大,几个病例里就有一个病理切片看到癌变的,号称一刀癌。估计其实比例还要高,
因为切片很多时候会没cover到小的癌变lesion.
不过,别害怕。前列腺癌是非常slow progress的。通常不等他症状发作,其他病,心
血管啊什么的,就把人要了命了。
M*****8
发帖数: 17722
15
来自主题: ChineseMed版 - 关于中医与肿瘤的治疗

西医最拿手的就是玩标题游戏,定义游戏。
不明白的病变组织,就用"lesion"一字带过,
虽然毫无信息或内容,但忽悠外行没问题。
因为要制造神圣权威形象,才能财源广进。
如果多数癌症化疗后存活率只有半年,
估计西医就会定义“痊愈”为三个月。
还会大言不惭地鼓吹这就是“痊愈”。
这世界愚蠢的人是占绝大多数。
崇洋媚外的群体里,比例还会是特别高。
文凭学位改变不了愚蠢没自信没主见的人。
x*****n
发帖数: 4
16
Two job vacancies (a research fellow and a software engineer) are now
available at the Biomedical Imaging Lab http://www.sbic.a-star.edu.sg/research/bil/index.php, Singapore Bio-Imaging Consortium, Agency for Science Technology and Research, Singapore.
Research fellow:
Job description
a. Study and develop algorithms for fast and accurate automatic segmentation
and modeling of 3D anatomic structures (vessel, liver) and lesions (liver
tumor) from biomedical images (CTA and MRA).
b. Cooperate wit
K**********n
发帖数: 1197
17
来自主题: EE版 - 版上有人懂这个技术没?
学术界珍稀有限的原版外文资料,
Remote Mind Control Technology

Reprinted from SECRET AND SUPPRESSED: BANNED IDEAS AND HIDDEN
HISTORY, edited by Jim Keith, $12.95, available from
1-800-680-INET.
There had been an ongoing controversy over health effects of electromagnetic
fields (EMF) for years (e.g., extremely low frequency radiation and the
Navy's Project Seafarer; emissions of high power lines and video display
terminals; radar and other military and industrial sources of radio
frequencies and micr... 阅读全帖
k**********n
发帖数: 438
18
来自主题: MedicalCareer版 - JDJ - An interesting question in Step 1
☆─────────────────────────────────────☆
JDJ (小兔乖乖) 于 (Mon Jul 21 02:34:52 2008) 提到:
HIV positive patient, CD4 count<200, presents with bloody diarrhea.
Colonoscopy showed reddish lesions with crypt abscesses.
What is the associated pathology?
1. adenocarcinoma
2. Kaposi's sarcoma
☆─────────────────────────────────────☆
soaplover (Ha) 于 (Mon Jul 21 02:40:55 2008) 提到:
interesting...2?
☆─────────────────────────────────────☆
magua08 (麦地麻瓜~回归) 于 (Mon Jul 21 03:09:29 2008) 提到:
it's int
d******a
发帖数: 127
19
来自主题: MedicalCareer版 - an interesting case
85 yo WM w/no significant PMH presented in ER for AMS. CC: I can't move my
right leg between the pedals and don't feel good. His wife stated that he
has been pretty healthy and still drives everyday. ER CT w/o contrast was
negative. Vitals: NL; PE: Nothing significant. Patient had Brain MRI which
showed multiple small lesions B/L in the basal ganglia. What is the
diagnosis?
l*********e
发帖数: 158
20
来自主题: MedicalCareer版 - an interesting case
I am a vegetable bird, so I don't care to google and guess and be totally
wrong.
"When confronted with a MRI pattern showing bilateral basal
ganglia lesions, the differential diagnosis includes hypoxic injury
[6], mitochondrial disease [7], vasculitis [8], carbon monoxide
intoxication [9], hypoglycemia [10], extrapontinemyelinolysis [11],
Wilson’s disease [12], Creutzfeldt–Jakob disease [13], and deep
venous thrombosis [14]."
So I guess deep venous thrombosis, and I guess lacunar stroke.
http://
d******a
发帖数: 127
21
来自主题: MedicalCareer版 - an interesting case
>>>"When confronted with a MRI pattern showing bilateral basal
ganglia lesions, the differential diagnosis includes hypoxic injury
[6], mitochondrial disease [7], vasculitis [8], carbon monoxide
intoxication [9], hypoglycemia [10], extrapontinemyelinolysis [11],
Wilson’s disease [12], Creutzfeldt–Jakob disease [13], and deep
venous thrombosis [14]."
Very nice! What is the diagnosis?
As a physician, the most important thing is that you try to get the history
and do physical by yourself.
l*********e
发帖数: 158
22
来自主题: MedicalCareer版 - an interesting case
I guess; Sitting - Deep Venous Thrombosis in the lower limb -Patent foramen
ovale- stroke in deep penetrating arteries that arises directly from the
constituents of the Circle of Willis, cerebellar arteries, and basilar
artery that irrigate posterior limb of the internal capsule-descending
corticospinal tracts- hemiplegia? How can the bilateral lesions happen with
one side of symptoms?
d******a
发帖数: 127
23
来自主题: MedicalCareer版 - an interesting case
lotusconnie got the answer based on "a MRI pattern showing bilateral basal
ganglia lesions".
His wife stated that he has been pretty healthy and still drives everyday.
It is unusual that a 85 yo male drives daily. When we asked more details, pt
's wife states that her husband loved driving so much and he was driving his
car hours everyday for fun. But his a was an very old 1980's car. After
further investigation, this patient suffered from chronic carbon monoxide
poisoning. This is a very unique
a**s
发帖数: 177
24
我孩3岁了,走路一直不太稳,似乎左腿有些跛,但两腿绝对一般长。
最近去做了X-ray,这是检查报告:
Only AP and frog leg positions were obtained. There is widening of the
femoral acetabular joint space on the left. Could this be secondary to joint
effusion or possible mild dislocation? Additionally especially seen on the
frontal projection the epiphysis of the left femur is considerably smaller
of uncertain etiology. Has there been prior trauma to account for this
finding? No osteolytic or osteoblastic lesion is seen. The sacroiliac joints
app
a*********f
发帖数: 101
25
来自主题: MedicalCareer版 - neuroanatomy: horizontal gaze lesion question
kaplan anatomy notes (2006-2007) Page385:
损伤left frontal eye field 或者right PPRF,两眼都不能同时右视.为什么只有损伤
left frontal eye field以后,双眼会slow drift to left? PPRF损伤不会有这一现象
吗?
3nx.
a*********f
发帖数: 101
26
来自主题: MedicalCareer版 - neuroanatomy: horizontal gaze lesion question
抱歉,我看书不仔细。我当时只留意了示意图(确实少了左向箭头)。但注解里面写了
会drift to the left. 谢谢你的回复。

or
m***d
发帖数: 441
27
来自主题: MedicalCareer版 - 发道题娱乐一下 (step1)
multiple enhancing lesions, Toxoplasma gondii?
f*****w
发帖数: 1451
28
来自主题: MedicalCareer版 - 私人诊所OB第一天
真有意思阿,我觉得孕妇不觉得自己是病人吧,而且心情比较好。妇科病人本身可能就
有一种羞耻感,所以更不愿意让男学生在旁边了。
我今天是亲手做了一次妇科检查,带我的医生让我自己做了pap,pelvic exam,病人很活
跃,很开朗,还主动提出要不要做肛查,结果带我的医生很少做过,就问我坐不做,我
说俺在中国经常作,她就让我做了。结果看我做完,大跌眼镜,大叫,“You really
did it!”。今天比较好玩的就是这个了。其他时候基本也都是僵硬微笑的站在一旁,不
过感觉脸部肌肉稍微松驰了一些。
哦,还让我给一个病人用 nitrogen liquid去身上的皮肤lesion,可惜我胆怯,不敢使
劲砰,结果医生变拿过去刷刷刷就喷好了,自己懊悔半天,下次要是还有机会一定不能
再那么胆怯了。

夫都在observe
情,然后给我一
书。每次看病
赶紧记下来,没
的公式,一
所之前医生已经
生的效率极高,
L********8
发帖数: 248
29
来自主题: MedicalCareer版 - 请教逆风mm和其他内分泌专家
On call now, cannot input more.
Agree with Againstwind and Hemocell. Pt has totol thyroidectomy with neck LN
dissection with pathology confirmed advanced thyroid cancer, most likely
follicular cancer. Pt may has parathyoid injury or removal during surgery
causing low PTH, which is very common for such surgery. Post-op therapy
involves thyroid hormone supplement and I131 treatment for this stage of
cancer. Thyroid hormone reduces TSH, to some extension, inhibiting
metastatic lesion growth. Remnan
b*****8
发帖数: 59
30
来自主题: MedicalCareer版 - CK in 1 week, please help NBME2 qs, thanks!
3-21. A previously healthy 85-year-old man has had abdominal distention,
decreased caliber of stools, and decreased appetite over the past 2 weeks
and a 9-kg (20-lb) weight loss over the past 3 months. On sigmoidoscopy, he
is found to have a constricting adenocarcinoma of the sigmoid colon; imaging
studies show three 1-cm metastases to the liver. Which of the following is
the most appropriate next step in management?
C) Chemotherapy
In kaplan note, a single liver metastatic lesion is surgical re
n***8
发帖数: 634
31
来自主题: MedicalCareer版 - CK in 1 week, please help NBME2 qs, thanks!
This is what I think , the Correct answer is E.
On FA : "1. Resect of the 1st lesion." is the number 1 in Treatment.
a*****s
发帖数: 838
32
来自主题: MedicalCareer版 - NBME form 2 question discussion
Please help!
block 2 question 34
A 52yo man is found to have hypertension during a routine examination. A sys
tolic bruit is heard over the lft renal artery. Angiography shows a discrete
95% obstructive lesion within the left renal artery; the right renal artery
is normal. The right kidney is 11cm, and the left is 8.5cm. Which of the fo
llowing describes the most likely response to the treatment?
A) Decresed plasma renin activity and decreased serum angiotensin I concentr
ation following adminis
z****o
发帖数: 368
33
来自主题: MedicalCareer版 - NBME step1 form2 题目讨论
A 48-year-old man comes to his physician because his wife noticed that his
right pupil is "small." Physical examination shows that the right pupil is
constricted and does not react to light. His left pupil is normal. These
findings are most likely due to a lesion involving which of the following
structures on the right?
A) Cervical spinal cord
B) Frontal eye fields
C) Lateral geniculate nucleus
D) Optic tract
E) Visual cortex
你的选择?麻烦再简单说一下原因。多谢
s*******d
发帖数: 1079
34
来自主题: MedicalCareer版 - confused---a neuro question
A patient's left eye looked funny.The left upper lid appeared higher than on
the right.His pupil was larger on the left than on the right.What single
lesion may account for this?
e******8
发帖数: 319
35
来自主题: MedicalCareer版 - 记录自己的USMLE复习过程
Thanks kaye, I feel better now. Last month, our mice were housed in a small
animal room where close to our imaging room, I am the one who should check
the mice everyday. I didn't go to check them after I lost my ID, I thought I
has been excute all the mice, I have no need to check them. But my friend put some
tumor born mice in there after imaging and didn't tell me, we have a rule,
the last one who collect the imaging will excute the mice. You can image
what happened on these mice. The tumor g... 阅读全帖
D*****l
发帖数: 554
36
来自主题: MedicalCareer版 - Extract text from UW Q Bank
UW Qbank is a great one. How to make notes from UW? I am lazy and hate
typing. I use TopOCR software and then copy/paste into my word document.
Do you have a better way to do this? If so, please let me know.
The following is the example I just did.
The inner walls of the lesion are most likely lined with:
O A. Glycogen-rich cuboidal epithelium
O B. Columnar mucinous epithelium
O C. Atypical cells forming papillary projections
~ O D. Fibrous and granulation tissue
X O E. Endothelial cells
This C... 阅读全帖
d****y
发帖数: 2180
37
来自主题: MedicalCareer版 - STEP 1 NBME form 4 block 2 q 22
I think the answer is C- Right abducens nerve.
Lesion of cranial nerves VI produces ipsilateral lateral rectus palsy.
H: left abducens nerve.
A, F: oculomotor nerve
B, G: trochlea nerve
D, I: CN VIII
E, J: accessory nerve.
V*****G
发帖数: 337
38
来自主题: MedicalCareer版 - a case today
看来该问用药历史,是否服用抗精神病用药。可能这是楼主想考的吧。不过这vaginal bleeding是不是就不管了?这毕竟是主诉呀.
Oculogyric crisis (OGC) is the name of a dystonic reaction to certain drugs
and/or medical conditions. The term "Oculogyric" refers to rotating of
eyeballs,
Causes
Drugs that can trigger an oculogyric crisis include neuroleptics (such as
olanzapine),[2] amantadine,[citation needed] benzodiazepines,[citation
needed] carbamazepine, chloroquine, cisplatin, diazoxide, influenza vaccine,
[citation needed] levodopa,[citation needed] li... 阅读全帖
A*******s
发帖数: 9638
39
来自主题: MedicalCareer版 - 一道CCS题目
I will never do a LP without a scan(CT or MRI) in practice.
It does not matter if ICP high or not. As long as the 4th ventricule is open
, you can go ahead for LP. In fact, we always see high opening pressures in
meningitis patients. For pseudotumor cerebri, the opening pressure is also
high. We tap them all the time.
However, if there is a space occupying lesion like tumor on the scan, do not
tap them without checking with NSG.
w******n
发帖数: 88
40
来自主题: MedicalCareer版 - 问一个STEP3 NBME的问题
22. A 28-year-old African-American woman comes to the office because of
low back pain and decreased urine output. She is a semiprofessional
basketball player and she is married. She had one pregnancy 12 years ago
that was uncomplicated and resulted in vaginal delivery of a term female
neonate. Medications include oral contraceptive pills and a corticosteroid
inhaler for asthma. She is 182 cm (6 ft) tall and weighs 88 kg (195 lb).
Physical examination is normal except for a palpable lower abdomin... 阅读全帖
A*G
发帖数: 256
41
来自主题: MedicalCareer版 - 妈妈的肺癌seek 2nd openion thx!
(左上肺叶肿块,左下肺叶肿块) (Mass at left superior lung lobe, and left
lower lung lobe)
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。Well differentiated adenocarcinoma, mainly bronchioloalveolar (
BAC), tumor size:1.5*1.0*0.8cm & 1.0*0.6*0.8cm,locally invaded to visceral
pleural.
未见明确脉管内癌拴及神经侵犯。There is no tumor emboli and no perineural invasion.
(左上肺叶后段肿块)可见部分肺泡扩张,符合肺气肿改变。另见部分区肺泡上皮不典
型增生伴癌变,病灶大小φ 0.5cm。
(mass at left superior lobe posterior lung segment) There are some alveolar inflation, ... 阅读全帖
n*****n
发帖数: 119
42
来自主题: MedicalCareer版 - 住院病历的英汉对照
别处看到的,觉得还不错,不排除有些拼写错误~
POMR (Problem-Oriented Medical Records)表格式住院病历
Biographical data:
一般项目:
Name Age Sex Marital status Nativity Race
姓名 年龄 性别 婚否 籍贯 民族
Occupation Date of admission Informant History
职业 入院日期 病史叙述者 病史
Chief complaint
主诉
History of present illness
现病史
Past history
既往史:
Previous health status: well ordinary bad Infectious diseases
平素健康状况: 良好 一般 较差 传染病史
Immunizations Allergies: N Y clinical manifestation
预防接种史 过敏史 无 有 临床表现
allergen: Trauma: Surgery:
过敏原 外伤... 阅读全帖
L********r
发帖数: 37
43
来自主题: MedicalCareer版 - CK NBME 2 Block 4 - Q 11
11. A 2-day-old newborn is brought to the physician because of a
generalized rash for 6 hours. The newborn is active, alert, and feeding
well. His temperature is 36.9 C (98.4 F). Examination shows a rash
consisting of numerous white and pale yellow papules with a large base of
macular erythema over the trunk and extremities. Wright's stain of
scrapings from the lesions shows eosinophils. Which of the following is
the most appropriate next step in management?
A) Reassurance
B) Topical corticoster... 阅读全帖
x*******8
发帖数: 68
44
来自主题: MedicalCareer版 - CK NBME form 3 4-9& 4-14 11/19
2nd one
3-14
A 67 year old woman is brought to the ED because of the inability move the
right side of her body since awakening this morning.. she has type 2
diabetes mellitus. Her blood pressure is 170/95. Exaniation shows dysarthric
speech, but language function is normal. Cranial nerves are intact except
for moderate weakness of the right low face. She is unable to move the right
upper or lower extremities. Sensation is intact. There is hyperreflexia of
the right upper and lower extremities. A... 阅读全帖
m****d
发帖数: 156
45
来自主题: MedicalCareer版 - CS closure
My rule of thumb: I would spend as long as I can on closure. The purpose of
closure is to confirm that you got everything right from patient; you have
some but not definitive idea on what's going on ; and you have plan what to
do next based on current clues. Do mention any workup if it helps to justify
your judgement: say you need do rectal exam because you suspect colon
lesion, you need do brain function study(auditory evoked potential) for the
cause of hearing loss. In fact, more goal-oriented... 阅读全帖
b***r
发帖数: 40
46
来自主题: MedicalCareer版 - 病历翻译——跪求帮助
尝试翻译了一下出院小结部分,大家多指教~
Discharge summary:
Date of Admission:2012-1-4
Date of Operation:2012-1-10
Date of Discharge:2012-1-29
1-year old female with acute awareness of complete vision loss,OU.
Exam:
General:well-appear
CN:unremarkable. no physical findings
Visual Acuity: NLP,OU
Pupil: 3mm, no light perception,OU (NLP-->3mm?)
MRI brain: irregular T1 and T2 signals in intrasellar and suprasellar.CE MRI
showed no apparent enhanced lesions.
Admitting diagnosis: Sellar occupying disease, probabaly a mal... 阅读全帖
e******e
发帖数: 364
47
来自主题: MedicalCareer版 - help step 3 NBME form 1 question
20. A 58-year-old woman comes to the office for follow-up of fibromyalgia.
You had been treating her for the past several years for nonspecific
muscular aches and pains. In the past you noted that occasionally the pain
could be reproduced on physical examination by applying pressure to certain
muscles; however, these trigger points seemed to change on each physical
examination. Fibromyalgia was diagnosed 3 months ago and amitriptyline
therapy was started at that time. At a follow-up visit 3 week... 阅读全帖
z**********4
发帖数: 467
48
This problem could be caused by (1) Prolactinoma (2) Pituitary gland stalk
lesion. Remember the hypothalamus has negative control over prolactintrophic
cells in the anterior pituitary gland. If the stalk is injuried, the
prolactin will oversecret which might mimic prolactinoma....
h*******r
发帖数: 182
49
Question: why TSH is at normal level while T4 is low in this patient?
Low T4 will lead to increase of TRH, which stimulates TSH and prolactin. In
the presence of stalk lesion, TSH and prolactin cannot be increased by TRH.
Prolactinoma will cause amenorrhea, but should not change TRH and TSH levels.
So prolactinoma should not be considered even given in the options.

prolactintrophic
i**********d
发帖数: 853
50
十分感谢各位的解答!!
我还有一个困惑:如果是stalk lesion,那么LH和FSH会释放减少,这可以解释她没有
月经;
但既然LH和FSH减少,雌激素和孕激素也会分泌减少,如何解释“vaginal mucosa
is pink and moist”,以及“cervical mucus is consistent with the
proliferative phase”?
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