Archive for December, 2012

A 29-year-old woman has progressive gait disorder and dysmetria. Laboratory studies include a hematocrit of 55% and a routine urinalysis, which reveals excess protein and some RBCs in the urine. Urine culture is negative. The initial physical examination reveals an enlarged liver and spleen. Additional physical findings will most likely include which of the following?

a. A Kayser-Fleischer ring around the cornea

b. Hypopigmented (ash-leaf) spots on the trunk

c. Telangiectasias in the fundi on retinal examination

d. Bilateral hearing loss

e. Generalized hyporeflexia

the answer is below…

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Di Car Free Day (CFD) Malang, sahabat saya Praba membawa Danbo. mari saya share  beberapa foto dengan model: Danbo. Memotret menggunakan danbo sedikit tricky. Hal ini mungkin dikarenakan kita lebih fokus pada suasana untuk membentuk nuansa foto. Dan keterbatasan gerak danbo, tentunya.

Selamat menikmati…

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The stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

4,329 films were submitted to the 2012 Cannes Film Festival. This blog had 15,000 views in 2012. If each view were a film, this blog would power 3 Film Festivals

Click here to see the complete report.

A 7-year-old boy is taken by his parents to see a dermatologist. They have noticed nodules on his face and are concerned. The dermatologist tells them that their child has adenoma sebaceum. Adenoma sebaceum of the face is especially common with which of the following diseases?

a. Neurofibromatosis

b. Sturge-Weber syndrome

c. Tuberous sclerosis

d. Ataxia telangiectasia

e. Fragile X syndrome

the answer is below…

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Naaah, kali ini saya potret dua orang sedang bersepatu roda. Lumayan juga kan hasilnya? Menggunakan tripod memang agak menyulitkan untuk mengatur ketinggian, terutama saat saya menggunakan fixed lens. Tetapi setelah beberapa kali mencoba, hasilnya tidak terlalu mengecewakan.

Foto ini saya ambil saat sang adik berusaha meraih tangan kakaknya untuk menjaga keseimbangan.

Selamat menikmati dan saya tunggu kritiknya…

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A 67-year-old man who has smoked heavily for 45 years describes that with exertion, such as walking, he develops pain in his legs and a tingling sensation in his feet. X-rays of his spine reveal no abnormalities. Pain and weakness have become increasingly frequent over the course of several months. The pain and weakness described by the patient with exertion is probably a manifestation of which of the following?

a. Myotonia

b. Myokymia

c. Spinal claudication

d. Spondylolisthesis

e. Spondylolysis

the answer is below…

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A 19-year-old man goes swimming in an inland pond in Puerto Rico. Within a few days, he notices itching of his skin over several surfaces of his body. He is unconcerned until several weeks later when he develops lancinating pains extending down his legs and all of his toes. Over the course of just a few days, he develops paraparesis and problems with bladder and bowel control. Within one week, he is unable to stand and has severe urinary retention. Which of the following is the most appropriate plan of action on an emergency basis?

a. Initiate anticoagulation

b. Perform sensory-evoked potential testing

c. Order an MRI scan

d. Place a cervical collar

e. Perform spinal angiography

the answer is below…

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A myelogram is performed upon a patient with a subacute, worsening paraparesis. The cerebrospinal fluid (CSF) and myelogram are both unremarkable except for a slight increase in the CSF protein content. A computed tomography (CT) scan of the spine is unrevealing. Plain films of the spine are completely normal. An MRI of the lumbar cord with gadolinium reveals patchy enhancement at about the L4–L5 spinal cord level. Based on this information, which of the following is the most likely diagnosis?

a. An intraspinal hemorrhage

b. An extraparenchymal meningioma

c. An intraparenchymal ependymoma

d. A transverse myelitis

e. A syringomyelia

the answer is below…

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A 15-month-old boy is brought to the emergency room because of fever and a rash. Six hours earlier he was fine, except for tugging on his ears; another physician diagnosed otitis media and prescribed amoxicillin. During the interim period, the child has developed an erythematous rash on his face, trunk, and extremities. Some of the lesions, which are of variable size, do not blanch on pressure. The child is now very irritable, and he does not interact well with the examiner. Temperature is 39.5°C (103.1°F). He continues to have injected, immobile tympanic membranes, but you are concerned about his change in mental status. Which of the following is the most appropriate next step in the management of this infant?

a. Begin administration of intravenous ampicillin

b. Begin diphenhydramine

c. Discontinue administration of ampicillin and begin trimethoprim with sulfamethoxazole

d. Perform bilateral myringotomies

e. Perform a lumbar puncture

the answer is below…

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Ini adalah barisan curhat saya. Hehe… ketika saya harus menunggu supervisor untuk ujian di stase Ilmu Penyakit Dalam (IPD).

Stase IPD memiliki tiga linimasa. Linimasa pertama adalah empat minggu pertama disebut koass junior. Di waktu ini jaga adalah makanan sehari-hari. Linimasa kedua adalah empat minggu kedua disebut koass intermediate. Ini adalah masa bersantai dengan jaga yang tidak terlalu berat. Linimasa ketiga adalah empat minggu terakhir disebut koass senior. Masa-masa presentasi kasus (masing-masing kelompok harus menyediakan lima laporan kasus sesuai request pembimbing). Masa ini juga masa ujian.

Di masa koass senior ini pula biasanya dua minggu terakhir digunakan untuk ujian. Dan saya menjadi koass pertama yang ujian dengan dr. G, SpPD-KPTI. Senang sekali. Segera selesai dan menikmati masa-masa selesai koass IPD. Ternyata oh ternyata.

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