Visual Diagnosis Part 9
Isolated ulnar shaft fracture is also known as “nightstick fracture.” The injury occurred during an assault, where the patient raised his arm in self-defense. Healthcare provider should consider the possibility of elder abuse or intimate partner violence. Anterior wall myocardial infarction due to proximal LAD total occlusion. The De Winter T wave pattern represents a form of ST-segment elevation myocardial infarction (STEMI) involving the left anterior descending (LAD) artery, characterized by ST-segment depression with an upsloping morphology in the precordial leads, often accompanied by tall and peaked T waves. It is associated with a significant risk of complete occlusion of the artery and subsequent myocardial infarction if left untreated. Gouty arthritis usually involves the first metatarsophallengeal joint. The following medications can precipitate gout: Furosemide, Aspirin, Cyclosporine, Thiazide diuretics, Salicylates, Pyrazinamide, Levodopa, Alcohol, Chlorthalidone, and Ethambutol. High lateral wall STEMI with South African flag sign. The ECG Features of High Lateral Wall STEMI consist of ST elevation primarily localized to leads 1, aVL and V2, and reciprocal ST depression in inferior leads, most pronounced in lead 3. The South Africa Flag sign refers to ST elevation in leads 1, aVL and V2, with reciprocal changes best seen in leads 3 and aVF. Aortic dissection involving the ascending aorta. The intimal flap of the ascending aorta can be demonstrated by ultrasound in the suprasternal notch view using a cardiac probe. Acute epiglottitis The thumb sign is a rounded thickening of the epiglottic shadow on a lateral neck x-ray, giving it the appearance of an adult sized thumb. Digital HSV infection is also known as herpetic whitlow. Children with primary HSV-1 gingiva-stomatitis may develop herpetic whitlow associated with thumb and finger sucking. Addison's disease Addison's disease, also known as primary adrenal insufficiency, is a rare condition where the adrenal glands don't produce enough of the essential hormones cortisol and aldosterone. The most common etiology of Addison's disease is autoimmune destruction. Symptoms of Addison's disease include: Chronic fatigue, weakness, weight loss, muscle cramps, nausea and vomiting, hyperpigmentation, and low blood pressure. Diagnosis of Addison's disease include: Blood tests to measure cortisol and aldosterone levels, and ACTH stimulation test. Treatment of Addison's disease include: Lifelong hormone replacement therapy with cortisol and fludrocortisone, and management of underlying cause.
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