Dr. Gomathi

Surgery Resident | Managing with p̶i̶l̶l̶s̶ scalpels | Sunset enthusiast | ரௌத்திரம் பழகு
📋Sharing clinical cases & daily quizzes to inspire learning #MedEd

[Dr. Gomathi @Drgomathi_tn]

Stop sitting at the table where they speak ill about others because when you get up,
you are "the topic."

[Dr. Gomathi @Drgomathi_tn]

@IhabFathiSulima I guess Congenital Granular Cell Epulis (CGCE),aka Neumann's tumor.

[Dr. Gomathi @Drgomathi_tn]

@Indian__doctor His cassette lectures were of great use for many of the Doctors during the learning phase. You will be missed. Rest in peace Dr. Ghanshyam Vaidya sir.🕯️

[Dr. Gomathi @Drgomathi_tn]

@SomeShitILike Henoch-Schonlein Purpura (HSP/IgA vasculitis) presents with typical hive-like rash,abdominal pain &hematuria. Labs will be showing mild anemia,leucocytosis,high CRP & NORMAL platelet count.

[Dr. Gomathi @Drgomathi_tn]

The coagulogram of this patient shows increased
Prothrombin time & Activated Partial Thromboplastin time
with Platelet count of 1.2 L/mm³. What's the diagnosis?

A Henoch-Schonlein Purpura
B Acute ITP
C DIC
#MedTwitter #medicine #Clinical #MedEd #Medical #Health #pathology

[Dr. Gomathi @Drgomathi_tn]

@AdityaBurje Right!🌟 Petechiae along with the lab findings suggest a diagnosis of DIC. Elevated D-dimer levels are also seen. What are the treatment options for this patient?

[Dr. Gomathi @Drgomathi_tn]

@Shashankk0007 Good!🏆 aka Consumption Coagulopathy where PT/aPTT are elevated with low platelet count & fibrinogen levels due to extensive clot formation.

[Dr. Gomathi @Drgomathi_tn]

3/n
In Japanese Encephalitis, Bubonic Plague & Hydatid Cyst,humans are the dead-end hosts i.e.,humans don't act as reservoirs for reinfection of the animal/insect hosts.

🚳Their lifecycles are shown below👇

[Dr. Gomathi @Drgomathi_tn]

Which is not a human dead-end disease?
#MedTwitter #MedEd #medicine #infectiousdiseases #Clinical #Health #Medical

[Dr. Gomathi @Drgomathi_tn]

2/n
Answer: Leishmaniasis ✅

-transmitted by the bite of infected female phlebotomine sand flies

Human infection➡️ Parasitemia➡️ infected blood🩸sucked up by the Sandfly➡️ transmitted to others

Rx: topical Paromomycin,Imiquimod,oral Pentamidine

[Dr. Gomathi @Drgomathi_tn]

@AbhayChillarge Awesome!👏🌟 a rare sclerodermiform syndrome where the fascia becomes thick & inflamed with an eosinophilic infiltrate; treated with steroids & phototherapy.

[Dr. Gomathi @Drgomathi_tn]

68 yo M,painful skin tightening &swelling of his arms& legs ×8 months. The symptoms had progressed on Glucocorticoids &MTX. O/E: symmetric woody induration of the trunk,arms & legs; dimpled appearance; elbow contractures. What's the diagnosis?
#MedTwitter #Clinical #Rheumatology

[Dr. Gomathi @Drgomathi_tn]

@hitmanogo Serum Electrophoresis (for M proteim spike) is even recommended as the preliminary test for the suspected cases of Multiple Myeloma. It is uncommon to see a symptomatic MM patient with normal SPEP.
https://t.co/db4jp8Lx2M

[Dr. Gomathi @Drgomathi_tn]

Spot Diagnosis.💀
A 65 yo male patient p/w mild dyspnea,upper respiratory infection; H/O weight loss present. The skull xray& bone marrow trephination picture is shown below. What's the diagnosis?
#MedTwitter #medicine #MedEd #Clinical #radiology #hematology #Health

[Dr. Gomathi @Drgomathi_tn]

@mikias52530213 The reasons for unimproved symptoms despite MTX Rx may be due to:
-delay in the diagnosis time >6 months
-remission case with disability
-failure to respond with persistent active disease

[Dr. Gomathi @Drgomathi_tn]

@kyle_kevz Good!👍 Systemic Sclerosis affects the skin whereas here you can see the "Groove sign" (linear indentations &puckering) which is a heeding sign of Eosinophilic Fasciitis (early variant of Scleroderma) s/o fascia involvement,esp. along the course of veins.

[Dr. Gomathi @Drgomathi_tn]

@schowardjd @MithuRheum Nice. Thanks for sharing :)

[Dr. Gomathi @Drgomathi_tn]

@schowardjd Excellent!👏🏆 As the name says, Eosinophilic Fasciitis affects the fascia giving the "Groove sign" -linear depressions along the medial aspect of both arms especially upon elevation when the superficial veins collapse.

[Dr. Gomathi @Drgomathi_tn]

@naagarsaurabh Excellent question!👏 Vit C (ascorbic acid) intake in *high* doses is fatal in G6PD deficient cases. Because,Vit C➡️ increases the production of Hydrogen Peroxide,a potent oxidizer➡️ damages the G6PD deficient RBCs➡️ acute hemolytic reaction➡️ death
https://t.co/PSrudyxAcg.

[Dr. Gomathi @Drgomathi_tn]

A 67 yo male p/w abdominal pain over the past few days,fever,nausea,anorexia,brown urine,yellow sclerae& skin.He reported ingesting the below shown legume, 3 days ago. What is the missing enzyme in this patient?
#MedTwitter #medicine #Medaed #medicalstudents #MedEd #hematology

[Dr. Gomathi @Drgomathi_tn]

@celeebu Awesome!🌟 The CRAB is now SLiM CRAB!🦀 These are the Myeloma defining events which helps to diagnose Multiple Myeloma.

[Dr. Gomathi @Drgomathi_tn]

@matthewbstoker Great pic!👍 Additionally, M-band seen on serum Electrophoresis also helps to arrive at the diagnosis.

[Dr. Gomathi @Drgomathi_tn]

@mikias52530213 Good!👏🏆 Lytic lesions of the skull and bone marrow biopsy showing multiple plasma cells,increased rouleaux formation of RBCs & a few denatured cells are s/o Multiple Myeloma.

[Dr. Gomathi @Drgomathi_tn]

@dr_sapiosexual Correct!👏 Diffuse small lytic lesions (radiolucencies) giving a classical "Pepper pot" skull appearance seen in MM.