A 36 year-old male patient comes to your office seeking treatment for his opioid abuse and alcohol abuse. He is particularly interested in using naltrexone maintenance. His past medical history is significant for chronic Hepatitis C. His most recent alanine aminotransferase (ALT) level is 80 U/L and Aspartate aminotransferase (AST) level is 90 U/L. Regarding […]
Parental Consent for Minor Treatment A 15 year-old male comes to your office for the evaluation of dysuria in your office. He has recently become sexually active and fears a sexually transmitted infection( STI). His parents are divorced and live differently. He asks you not to inform them about his STI. What is the most […]
A 16 year-old male came to your office for the evaluation of a rash on his back and an abscess on his right thigh. He is also feeling frustrated, irritable and lost interest in activities he once enjoyed. His vital signs were Temp = 98.2 F, Blood pressure = 150/90 mm Hg, Pulse = 95/minute, […]
A mother brought her 3 year-old female child to your office for a wellness pediatric physical examination. Her past medical history is significant for normal developmental milestones. Of the following, what developmental milestones can you expect in this child? Correct Answer is A. At year 3, a child can ride a tricycle and can stack […]
Key Points Jarisch-Herxheimer reaction is a transient clinical phenomenon that usually occurs within 2 – 24 hours of antibiotic treatment of spirochete infections, including syphilis, leptospirosis, Lyme disease, and relapsing fever. -it is common in early syphilis, particularly in secondary syphilis, where it can occur in 70-80 % of cases Mechanism The breakdown of dying […]
Graft-versus-host disease (GVHD) Graft-versus-host disease (GVHD) is a life-threatening complication that can occur after certain stem cell or bone marrow transplants. -it is the primary cause of morbidity and mortality after hematopoietic cell transplantation -30 to 70 percent of transplant recipients develop GVHD Time course: Acute GVHD usually happens in the first 100 days after […]
IgG,IgM, IgA mediated Sensitization: ‘freely circulating’ soluble antigens elicit T and B cell activation Immunologic reaction: IgG or IgM antibodies bind with circulating antigens, form an immune complex and deposit in tissue. They activate complement cascade, attract neutrophils leading to the release of lysosomal enzymes and an inflammatory response in tissues. Typical Time of Onset: […]
A 3 year-old male is brought to your office for the evaluation of recurrent infections and persistent hunger, and not gaining weight. His mother reports that his medical history is significant for recurrent skin abscesses with staphylococcus aureus. Recently he started to complain about abdominal pain that starts one to two hours after a meal. […]
A 7 year-old male comes to your clinic with a large blister on his left foot. They come and disappear after a few days. Occasionally, he also develops swollen lips, swollen tongue, colicky abdominal pain with these blisters. Blisters are not itchy but slightly painful. These episodes come every few months and last for 1-2 […]
Key Points Granulomatosis with polyangiitis is a systemic necrotizing, mostly small vessel vasculitis of unknown etiology that manifests as granulomatous lesions of the upper respiratory tract, lungs and kidneys. -Formerly known as Wegener Granulomatosis, it was renamed because of the eponymous individual’s association with Nazism -GPA is the most common form of vasculitis to involve […]
