Scaphoid Fracture

Gross Pathology Micro Pathology Treatment During anti-Gulf War protests in Ohio, a 23-year-old man was forcefully dragged away by the arm because he was blocking the entrance to the meeting. While in the police car on the way to headquarters, he complained of pain in the shoulder and inability to move his arm. Pain in shoulder, deformity (lack of normal rounded contour of shoulder), and inability to move arm depression easily palpable under acromion humeral head palpable through axilla, After...

Cardiac Tamponade

Micro Pathology Treatment Discussion An 18-year-old white male is found during a military physical to have high blood pressure. The patient denies a history of any major illness. VS BP in arms significantly greater than BP in legs (BP right arm 180 110, left arm 190 110 BP in legs 110 70). PE femoral pulses diminished and delayed harsh systolic ejection murmur heard between shoulder blades. CXR may demonstrate rib notching (due to collateral circulation through intercostal arteries)...

Lymphatic Metastasis Of Lung Cancer

A 63-year-old woman who is a heavy smoker comes to the emergency room with severe swelling on the right side of the neck, arm, and face (compression of superior vena cava) together with severe pain in the right arm. The swelling has gotten progressively worse over the past several months. In addition, her voice has become hoarse over the same period of time (the recurrent laryngeal nerve is paralyzed due to compression by the tumor). Reduced radial pulse on right side (arterial flow is blocked...

Portal Hypertension

ID CC A 58-year-old obese man presents for an evaluation of a lump in the anal area of tbree days' duration, causing acute, constant pain that increases during dcfccation. HPI He is a smoker with a chronic cough and is overweight. He also .suffers from prostatic hyperplasia that forccs him to strain in order to initiate micturition. PE Patient walks very slowly with both legs apart and sits down in chair sideways external rectal exam reveals presence of a rounded, 3-cm, purple mass in the anal...

Astrocytoma

Micro Pathology Treatment Discussion A 45-year-old diabetic male comes to the emergency room fearing that he has had a stroke he complains of inability to move the right side of his lace and cannot blink his right eye or seal his lips (lesion of C.N VII - facial nerve). The previous night, his wife noticed that he was sleeping with his right eye open and that the right side of his face was drooping. That morning, the patient could not stop drooling on the right side of his mouth. He has not...

Tracheoesophageal Fistula

Labs Imaging Gross Pathology Micro Pathology Treatment A 12-week-old male infant is brought to the hospital for evaluation of recurrent oral thrush and URIs. The child had seizures (due to hypocalcemia) shortly after birth. His mother is an IV drug user. Full-term infant jittery increased muscle tone oral thrush midfacial hypoplasia. Hypocalcemia T-cell count markedly low. CXR absent thymic shadow. Transplant of an immature fetal thymus treat opportunistic infections irradiation of blood...

Perforated Gastric Ulcer

A 47-year-old male is brought by ambulance to the emergency room vomiting copious amounts of blood ( He has a history of heavy alcoholism he has gotten drunk at least three times a week for many years. VS tachycardia (HR 103) hypotension (BP 90 40) (due to hypovolemia) no fever. PE marked pallor thin, wasted, delirious man with strong alcohol smell on breath pupils reactive and equal enlargement of parotid glands no focal neurologic signs abdomen enlarged due to ascitic fluid spider angiomas...

Tonsillitis

Micro Pathology Treatment Discussion A 35-year-old woman is brought to the emergency room by ambulance because of the sudden appcarancc of severe retrosternal pain with radiation to the back and abdomen along with dyspnea the pain appeared after vigorous vomiting. She suffers from episodes of binge eating and self-induced vomiting ( BULIMIA). VS tachycardia (HR 110) mild hypotension (BP 100 65) no fever. PE in acute distress complains of severe chest pain no heart murmurs left lung field...

Tabes Dorsalis

Gross Pathology Micro Pathology Treatment A 55-year-old woman complains of intermittent bouts of excruciating stabbing pain on the left side of her face between the upper lip and lower eyelid region covered by the maxillary branch of CN V the pain is so severe that the patient has considered suicide. She first experienced this pain two months ago, while she was chewing gum. She also reports that cold drafts trigger the attacks. HEENT exam normal no lymphadenopathy found no neurologic...

Thyroglossal Duct Cyst

Gross Pathology Micro Pathology Treatment A 10-year-old boy is brought to the pediatrician complaining of high fever, sore throat, earache, swollen glands, and productive, greenish-white, blood-tinged sputum. His mother states that the boy has had recurrent bouts of sore throat several times a year for the past five years, each time treated effectively with antibiotics. Mouth partially open swollen pharyngeal tonsil obstructs nasopharyngeal isthmus tonsils markedly enlarged, hyperemic, and...

Straddle Injury

Gross Paitioiogy Micro Pathology Treatment A 42-year-old female on the gynecology ward complains of a dull, aching pain on her left flank as well as nausea and vomiting on her third postoperative day the intern notices that the patient has also been oliguric overnight. She recently underwent a total abdominal hysterectomy due to large uterine fibroids. VS low-grade fever normotension. PE patient well hydrated no pallor noted surgical wound is midline infraumbilical dressing noted to be wet with...