Uncle-Ralph's Medicine

Uncle-Ralph's Medicine

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04/10/2024

When I ask you on the major ward round what the cause of anemia in this would be? I want you to Navigate like this

Evaluation of Anemia

09/08/2024

Something you will be asked randomly on a Major ward round in OB/GYN

12/03/2022

Plummer-Vinson syndrome

We bet you haven't seen anything like this before: associated with mutilans rheumatoid arthritis.In Arthritis mutilans, a patient's fingers become shortened by arthritis, and the shortening may become severe enough that the hand looks paw-like, with the first deformity occurring at the interphalangeal and metacarpophalangeal joints. The excess skin from the shortening of the phalanx bones becomes folded transversely, as if retracted into one another like opera glasses, hence the description la main en lorgnette. As the condition worsens, luxation, phalangeal and metacarpal bone absorption, and skeletal architecture loss in the fingers occurs.Arthritis mutilans occurs mainly in patients with psoriasis and rarely advanced rheumatoid arthritis, but can occur independently.The hallmark feature of rheumatoid arthritis (RA) is persistent symmetric polyarthritis (synovitis) that affects the hands and feet, although any joint lined by a synovial membrane may be involved. The severity of RA may fluctuate over time, but chronic RA most commonly results in the progressive development of various degrees of joint destruction, deformity, and a significant decline in functional status. Extra-articular involvement of organs such as the skin, heart, lungs, and eyes can also be significant.The most important possible etiological factor is iron deficiency. Other possible factors include malnutrition, genetic predisposition or autoimmune processes. Plummer-Vinson syndrome can be treated effectively with iron supplementation and mechanical dilation. Since Plummer-Vinson syndrome is associated with an increased risk of squamous cell carcinoma of the pharynx and the esophagus, the patients should be followed closely.

Source: https://medizzy.com/feed/1077518

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