" Potter Syndrome"

Do u remember the story of Harry Potter.. not my fav though... but just to used his dear name.. POTTER...

Potter syndrome or also known as Potter sequence with classic triad:
1. CLUBBED hand or leg
2. PULMONARY HYPOPLASIA

3. CRANIAL abnormality

fetus wid clubbed limbs and potter facies

this happen due to OLIGOHYDROAMION... which main course of oligohydroamnion is BRA(Bilateral Renal Agenesis)...

usually it is detected only at second trimester which lead to poorer prognosis..

get the slight idea...
few remark:
according to AFI( Amniotic Fluid Index)
normal =8-18
oligo~ <5 or 6
poly~ >20 to 24

Spalding sign

Spalding sign is an obstettric Ultrasonography sign which show overlaping of cranial bone in the uterine cavity .
what does it mean?? Its a passport to IUFD( intrauterine fetal death)

normal cephalic without overlapping 

overlapping of fetal cranial bone.

Dukes Criteria for IE

 a bit about Dukes Criteria .
Major :
Little scarry bug
•  viridans streptococci, Streptococcus bovis, or HACEK group , or
•  community-acquired Staphylococcus aureus or enterococci, in the absence of a primary focus

 

on the Heart  what is seen ?

• perivascular abcess
• prosthethic valve
• valvular regurgitation.. newly formed...

Minor criteria ..

Clinical SiGN 

Osler Nodules

 Flat, painless, erythematous lesions 

-roth spot
-splinter H/r






IE, risk factor for old age patient, drug abuse-narcotic IV,  went to OT( tooth extraction, tonsilectomy, obs n gyne procedures and etc), Prosthetic Valve Replacement, Cardiac Transplant....

IE onset with Fever followed with Chille.
Aneamic Syndrome : pallor, asthernic, fatigue and weakness. Why? huporegeneration anemia ( blood analysis may show leococytopenia).. due to Bone marrow suppression .. which later lead to Spleenomegaly.. compensatory .

IE morphology in echocardiogram commonly is vegetation and perforation of valve.. most common is aourtic valve( diff diagnose with RF=>Mitral Valve)

                                                              vegetation of aoutic valve lealet 

main target organ of damage for  IE is heart .. infective endocardial surface...

enuf for today... sambung esok ... heheheheh

Chilaiditi syndrome

Chilaiditi Syndrome is transposition of a loop of large intestine (usually transverse colon) in between the diaphragm and the liver.
also known as 

•  interpositio hepatodiaphragmatica,
•  subphrenic displacement of the colon,
•  subphrenic interposition syndrome and
•  pseudopneumoperitoneum.

triad for CS is, abdominal pain, volvulus and shortness of breath..

on X-ray, classically u will find , gas in the right hemidiagphragma always misdiagnose with pneumoperitoneum...

 A small crescent of air can be seen under the right part of the diaphragm

gas between liver and diaphragmrugal 

rugal folds within the gas suggesting that it is within bowel and not free

COD:a long and mobile colon (dolichocolon), chronic lung disease such as emphysema, or liver problems such as cirrhosis and ascites. 

Cardiac Cachexic Syndrome.... wow

Cardiac Cachexia (CC) syndrome, is a complication of CHF(Congestive Heart Failure)
I didnt know this, until i start reading my Harrison's
it is a sign of bad prognosis. and related to age, sex , LV ejection fraction and exercise capacity.

it happen when generalized lose of body lean mass, tissues, fat and skeletal. Therefore, patient is weak and very weak, asthenic syndrome.
pathogenesis: neorohumoral and immunologic disbalance.

• increase amount of norepineprine,epinephrine, cortisol, renin-angiontensin aldosteron system activation 
• and increase plasma inflamatory cytokines that is TNF-a.

increase of above mentioned lead to catabolic imbalance n metabolic imbalance and later lead to wasting...

so that about it lah... the cascade that bring to dead end= CC...

siapa suka makan ice batu...

PAGOPHAGIA

it is a compulsive consumption of ice or iced drink. 

related with IDA( iron deficiency aneamia) , it is said chewing ice may give a good ease 

toward the iron deficient.

It is also somehow ease the glossitis pain such in PVS(Plummer Vinson Syndrome).

may compensate the

pay attention... OA

 do u see what i c...

 

on the pointed arrow, what is seen is osteophyte

what is osteophye? it is a bone projection which appear in along together with the joint..so its a bad thing lah..

where it cause a deformity. as seen in the x-ray.

  see this is due to present of osteophyte in the last segment of the finger.. 

medically it is known as Distal Inter Phalanges.  .. DIP..

if the deformity of finger present at this part it is known as : HEBEDEN'S NODES

if it the deformity occur at the base of the finger. Which is also known as Proximal Inter Phalanger aka PIP.

as seen in the picture. this is called : Bouchard's Nodes.