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Case study ҡ POL/PBL Case ʹ ͧ discuss ҹ

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Dominic
l2aphael
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Case study ҡ POL/PBL Case ʹ ͧ discuss ҹ Empty Case study ҡ POL/PBL Case ʹ ͧ discuss ҹ

ตั้งหัวข้อ  l2aphael Tue Feb 26, 2008 9:19 am

Case study ҡ POL/PBL Case ʹ ͧ discuss ҹ Clip_i11


⨷ѭ
ӻһШ͹



ѵ: ҧǨӻ 25 һ֡ᾷͧШ͹ 7 ͹ ˹ѡ 8 š 6 ͹ Ǣ鹺dz˹ҡԴѧࡵ Ѻ͹ҹ Ш͹͹ 1-2 ͹

ŵǨҧ: ˹ѡ 80 Kg ٧ 155 cm Ǣ鹺dz˹Ҽҡ ˹Ǵ鹺ҧ к蹻
ŵǨҧͧԺѵԡ: Fasting blood sugar ; Thyroid function test ; Serum prolactin ; Urine pregnancy test = negative; Free serum testosterone = 110 ng/dl (20-80 ng/dl); Serum LH = 20 IU/L (5 - 20 IU/L); Serum FSH = 6 IU/L (4.7-21.5 IU/L)



ŵǨ§٧(Ultrasound): اӨӹǹҡѧ (polycystic ovary) ѧٻ ҧ蹻

ѡ: ѧҡѺԹԨ ᾷй͡ѧ Ѻзҹ dian-35 (ҤԴԴ)
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ตั้งหัวข้อ  Dominic Tue Feb 26, 2008 10:39 pm

555 Laughing Laughing PBL ѧͶҨ

POL ç

ʴѹ ͹ѺѡѺ Embarassed Embarassed ѹ͡
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ตั้งหัวข้อ  l2aphael Wed Feb 27, 2008 5:35 am

............. ѭҳͺѺҡŢҹ¡ - -" discuss ҹ˹¤Һ ͧ Թ๪ ˹
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ตั้งหัวข้อ  Min Jung Hoe Wed Feb 27, 2008 6:25 am

ҡ ҧὧҺ ҡ͡ѹç ͹ὧ
silent ˹Թ silent
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ตั้งหัวข้อ  HNOONNON Wed Feb 27, 2008 8:27 am

PCOD
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ตั้งหัวข้อ  Ⱦ. Wed Feb 27, 2008 8:39 am

The Losses in Lulu's Legs

Lulu is a previously well, 39-year-old woman, who has noted increasing weakness in her legs over the past month. She is now unable to walk without assistance. One year ago, she noted paresthesias in her feet which have gradually worsened. More recently, she has had tingling in her hands. She has had no back or neck pain. However, she has noted increasing urinary urgency, and had been incontinent on 2 occasions.

Examination reveals a normal mental status and cranial nerves. Arm strength is normal. The legs are stiff and moderately to severely weak: she is able to stand from a sitting position only with assistance. Her gait is also stiff, narrow-based, and unsteady, and she tends to circumduct her legs. When she closes her eyes, she topples forward. Light touch and pain perception are normal, but both joint position sense and vibratory sensation are diminished in the arms and legs. Deep tendon reflexes are increased in the arms and at the knees, but are absent at the ankles. Plantar responses are extensor bilaterally.

Ⱦ.
ผู้มาเยือน


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ตั้งหัวข้อ  Dominic Wed Feb 27, 2008 8:29 pm

...ҹһСԴ͡

˹໹ŧ
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ตั้งหัวข้อ  l2aphael Thu Feb 28, 2008 5:40 am

Ⱦ ѡ ͪ lulu - -" lulu'=
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ตั้งหัวข้อ  Min Jung Hoe Sun Mar 02, 2008 3:14 am

cherry ὧԤѺ ͡ͺǹ
˭ԧ͵ͧ ٫ alien

ҡ ѧçա cheers
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ตั้งหัวข้อ  aodz Sun Mar 02, 2008 3:30 am

ҹ2÷Ѵ騺Ρҹ
ͧҿ

POL ѹԴҡǧҢй

դӶ͹ ҡҡС ӵͺѹ Դͧ͡ 4 ventricle ҧҧ abducen nucleus ˹ facial nucleus (ҹҹ) ҹ˹ҫҧ ҹ ǤѹԴ㹡š CN 6 ״͡2ҧ

Դ ˵ءҹ ͡ҡӵͺ. ͡Դcortexͧͧ˭

Ъ˹¤Һ

ѧçա^^ Exclamation
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ตั้งหัวข้อ  Min Jung Hoe Wed Mar 05, 2008 6:28 am

͡ ʹҧѴ
...ѧçա
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ตั้งหัวข้อ  l2aphael Fri Mar 07, 2008 8:01 pm


LH ++FSH++
Theca CellsGranulosa Cells
AndrogenEstrogen

Theca Cells Ե Androgen ¡áе鹨ҡ LH ¹ٻ Estrogen Granulosa Calls

Case դԴ Theca Cells Ե Androgen ҡԴ FSH ӼԴ ¹ Androgen >>>>> Estrogen ŧ ռŷ Estrogen

1. Polycystic Ovary >>>> Estrogen Follicle ԭԺ Follicular phase ԭ Ͷ֧ǧ Shift day ҡ Estrogen öԴ Ovulation նاӵҧ
2. Դ Menstruation Դ ͧҡ 赡Դ Thyroid Hormone ռšѺԴ Menstruation ͧաõǨ Thyroid Hormone 觷¡ԹԨ㹡õǨ ˵Դҡ Estrogen
3. Դ ˹ѡ ͧҡԴԢͧ Hormone


Dian-35

Estrogen >>>> õչШѺѺ Steroid Hormone >>>> Androgen йŧ >>>>> Androgen Ŵ
Ŵ Progesterone >>>> Ŵ LH ǡе Theca cells Ŵŧռŵ͡ҧ Androgen Androgen Ŵŧ


*** õǨ Prolactin ҨռҨҡ >>> ä觢ͧ Estrogen ҹҹռŷдѺͧ Prolactin ٧
ѺõǨ FBS з㹡ҧἹǷҧ㹡ѡբ
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ตั้งหัวข้อ  l2aphael Fri Mar 07, 2008 8:28 pm

FRIEDRICH's ATAXIA

ԴšѺԴԴԷ cerebellum and the posterior tracts of the spinal cord
˵آͧþ Areflexia ͧ knee and ankle Դ extensor plantars ҨҡüԴԢͧüҧ upper and lower motor neurone lesion, Դ÷ posterior columns and lateral columns 觼šз corticospinal and posterior spinocerebellar tracts / dorsal roots and peripheral nerves < ҧҨ Myelin > ŧ / Purkinje cell ѧ atrophy ͧ dentate nucleus cerebellum / Muscles ˹

The clinical features of Friedreich's ataxia Сͺ


  • males and females equally affected



  • an ataxic gait is an early sign:

    • upper limbs become ataxic in the later stages, often with an intention tremor
    • dysarthria is usually a late feature
    </LI>



  • features of corticospinal tract involvement:

    • limb weakness
    • absent abdominal reflexes
    • extensor plantars
    </LI>



  • features of posterior column involvement:

    • loss of vibration and joint position sense in the extremities
    </LI>



  • dorsal root and peripheral nerve involvement:

    • loss of lower limb reflexes: ankle before knee
    • axonal sensory peripheral neuropathy
    </LI>



  • musculoskeletal abnormalities present in 80% of cases - pes cavus and kyphoscoliosis



  • cardiomyopathy with resultant cardiac failure or dysrhythmias



  • nystagmus is common; optic atrophy and retinitis pigmentosa may occur



  • diabetes mellitus occurs in 10%



  • no mental retardation
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ตั้งหัวข้อ  Admin Sun Mar 09, 2008 9:24 pm

شʹ l2aphael

Ǩоŧ
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ตั้งหัวข้อ  l2aphael Mon Mar 10, 2008 9:44 am

A 47-year-old man is brought to the emergency department by local law enforcement personnel. The man is thin, undernourished, somnolent, and clearly intoxicated. Other indicators, such as a lack of personal hygiene, suggest that the man's condition has been long term. When the physician asks the man his name and where he live, the man give a nonsensical response.

ҡ⨷ҧ ¤ѧǹҨä/Դ
¡ҹ discuss ˹ ա 3 ѹ ҵͺ
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ตั้งหัวข้อ  l2aphael Thu Mar 13, 2008 9:59 pm

ҡ¹ǹ ͹ ˧
Korsakoff syndrome

繡ҡ÷Сͺ - Memory loss
- Confabulation < >
- Amnesia
- Dementia
㹼äѧ

Korsakoffs syndrome/Amnestic confabulatory syndrome
ҡùԴҡâҴԵԹ B1 äѧ ԴмѡлԴè¡ͧ͵ͺӶ٤Ҩ (confabulation)
աͧ neuron mamillary bodies
There are six major symptoms of Korsakoff's syndrome:
1.Anterograde amnesia
2.Retrograde amnesia, severe memory loss
3.Confabulation
4.Meager content in conversation
5.lack of insight
6.Apathy - the patients lose interest in things quickly and generally appear indifferent to change.
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ตั้งหัวข้อ  HNOONNON Fri Mar 14, 2008 6:31 am

bounce bounce bounce

ŧ ҵͺءҷԵ
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ตั้งหัวข้อ  l2aphael Sat Mar 15, 2008 9:08 pm

presents to her family physician with intermittent headache and the complaint that she can't see in her left eye. The examination reveals that the woman is blind in her left eye. When a light is shined into her left eye there is no direct or consensual pupillary light reflex. Magnetic resonance angiography shows a large aneurysm at the origin of the ophthalmic artery.

ҡͤҧ ҨԴ lesion شԴͧ vessel?
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ตั้งหัวข้อ  HNOONNON Tue Mar 18, 2008 6:27 am

cavernous
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ตั้งหัวข้อ  l2aphael Tue Mar 18, 2008 6:55 am

Internal Carotid dzǹ origin ͧ ophthalmic a. ҡ ҢҧվҸҾͧ Distal ҢҧǡоҸҾл ҧҨԴ Homonymous hemianopia ҹç ᢹͧѹ§ Visual radiation
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ตั้งหัวข้อ  HNOONNON Wed Mar 19, 2008 12:13 am

ͺԴԴź -1 ṹ



鹷§
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ตั้งหัวข้อ  l2aphael Wed Mar 19, 2008 2:08 am

A 70-year-old woman is brought to the emergency department by member of the volunteer fire department of small town. She primarily complains of weakness. The examination reveals a hemiplegia involving the left upper and lower extremities , sensory losses < pain , temp. sensations, proprioception > on the left side of the body and face , and a visual deficit in both eyes. The MRI show an area of infarction consistent with the territory served by the .............. <<< 1 >>>......................

Which of the following visual deficits is seen in this woman? <<< 2 >>>
A. Left homonymous hemianopsia
B. Left nasal hemianopia
C. Left superior quadrantanopia
D. Right homonymous hemianopsia
E. Right superior quadrantanopia



ͺ 1 2
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ตั้งหัวข้อ  Admin Wed Mar 26, 2008 1:11 pm




ҵͺѹ













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ตั้งหัวข้อ  Min Jung Hoe Mon Jun 30, 2008 1:02 am

ºѧ
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