OOPS LIFE IS SO BORING AT THE SAME TIME SO THRILLING
WAITING FOR FURTHER EXPERINCES
Friday, August 26, 2011
Friday, January 21, 2011
A teenaged girl complains of pain in knee on climbing stairs and on getting up after sitting for a long time. What is the probable diagnosis?
A. Chondromalacia patellae
B. Plica syndrome
C. Bipartite patella
D. Patello-femoral osteoarthritis
ans:chondromalacia patella
Plica Syndrome (also known as Synovial Plica Syndrome) occurs when the plica (an extension of the protective synovial capsule of the knee) becomes irritated or inflamed.
Presentation and pathophysiology
This inflammation is typically caused by the plica being caught on the femur, or pinched between the femur and the patella. The most common location of plica tissue is along the medial (inside) side of the knee. The plica can tether the patella to the femur, be located between the femur and patella, or be located along the femoral condyle. If the plicae tethers the patella to the femoral condyle, the symptoms may cause it to be mistaken for Patello-femoral Syndrome. Because of this similarity in symptoms, Plica Syndrome is frequently misdiagnosed as Patello-femoral Syndrome. Diagnosis is often complicated by the thin structures of plicae, fenestrated septum or unfenestrated septum all being too fine to resolve well even in MRI.
The plica themselves are remnants of the fetal stage of development where the knee is divided into three compartments. The plica normally diminish in size during the second trimester of fetal development, as the three compartments develop into the synovial capsule. In adults, they normally exist as sleeves of tissue called synovial folds. The plica are usually harmless and unobtrusive; Plica Syndrome only occurs when the synovial capsule becomes irritated, which thickens the plica themselves (making them prone to irritation/inflammation, or being caught on the femur).
A. Chondromalacia patellae
B. Plica syndrome
C. Bipartite patella
D. Patello-femoral osteoarthritis
ans:chondromalacia patella
Plica Syndrome (also known as Synovial Plica Syndrome) occurs when the plica (an extension of the protective synovial capsule of the knee) becomes irritated or inflamed.
Presentation and pathophysiology
This inflammation is typically caused by the plica being caught on the femur, or pinched between the femur and the patella. The most common location of plica tissue is along the medial (inside) side of the knee. The plica can tether the patella to the femur, be located between the femur and patella, or be located along the femoral condyle. If the plicae tethers the patella to the femoral condyle, the symptoms may cause it to be mistaken for Patello-femoral Syndrome. Because of this similarity in symptoms, Plica Syndrome is frequently misdiagnosed as Patello-femoral Syndrome. Diagnosis is often complicated by the thin structures of plicae, fenestrated septum or unfenestrated septum all being too fine to resolve well even in MRI.
The plica themselves are remnants of the fetal stage of development where the knee is divided into three compartments. The plica normally diminish in size during the second trimester of fetal development, as the three compartments develop into the synovial capsule. In adults, they normally exist as sleeves of tissue called synovial folds. The plica are usually harmless and unobtrusive; Plica Syndrome only occurs when the synovial capsule becomes irritated, which thickens the plica themselves (making them prone to irritation/inflammation, or being caught on the femur).
Which of the following antihypertensive drugs is contraindicated in a patient on Lithium in order to prevent toxicity?
A. Clonidine
B. Beta blockers
C. Calcium channel blockers
D. Diuretics
ans: diuretics it increases lithium toxicity
DRUG INTERACTIONS: Non-steroidal anti-inflammatory drugs (NSAIDs), [for example, ibuprofen , naproxen , indomethacin, nabumetone, diclofenac , ketorolac , reduce the kidney's ability to eliminate lithium and lead to elevated levels of lithium in the blood and lithium side effects. Blood concentrations of lithium may need to be measured for 4 to 7 days after an NSAID is either added or stopped during lithium therapy. Aspirin and sulindac do not appear to affect lithium concentrations in the blood.
Diuretics should be used cautiously in patients receiving lithium. Diuretics that act at the distal renal tubule, [for example, hydrochlorothiazide, spironolactone triamterene , can increase blood concentrations of lithium. Diuretics that act at the proximal tubule, [for example, acetazolamide (Diamox)], are more likely to reduce blood concentrations of lithium. Diuretics such as furosemide and bumetanide may have no affect on lithium concentrations in blood.
A. Clonidine
B. Beta blockers
C. Calcium channel blockers
D. Diuretics
ans: diuretics it increases lithium toxicity
DRUG INTERACTIONS: Non-steroidal anti-inflammatory drugs (NSAIDs), [for example, ibuprofen , naproxen , indomethacin, nabumetone, diclofenac , ketorolac , reduce the kidney's ability to eliminate lithium and lead to elevated levels of lithium in the blood and lithium side effects. Blood concentrations of lithium may need to be measured for 4 to 7 days after an NSAID is either added or stopped during lithium therapy. Aspirin and sulindac do not appear to affect lithium concentrations in the blood.
Diuretics should be used cautiously in patients receiving lithium. Diuretics that act at the distal renal tubule, [for example, hydrochlorothiazide, spironolactone triamterene , can increase blood concentrations of lithium. Diuretics that act at the proximal tubule, [for example, acetazolamide (Diamox)], are more likely to reduce blood concentrations of lithium. Diuretics such as furosemide and bumetanide may have no affect on lithium concentrations in blood.
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