Dr. Suraj Baidya

Doctor ⚕️
Evidence over opinion |
Off duty on ucl matchdays⚽

[Dr. Suraj Baidya @OPDDiaries]

A patient came for “itching.”

Not eczema.
Not allergy.
Not a skin disease.

The itching became unbearable after hot showers.

A CBC revealed the real diagnosis.

What was it?

[Dr. Suraj Baidya @OPDDiaries]

✅ Answer: B) Epidural hematoma

Bonus: The lucid interval.
This classic pattern occurs when bleeding from the middle meningeal artery slowly expands after a head injury. The patient may appear completely normal for hours before rapidly deteriorating due to rising intracranial pressure.

CT-
Biconvex (lentiform), lens-shaped hyperdense collection.
Does NOT cross suture lines.

[Dr. Suraj Baidya @OPDDiaries]

Everyone fears a brain bleed.

But which type can occur after a seemingly minor head injury and leave the patient “perfectly normal” before suddenly collapsing?

A) Subarachnoid hemorrhage
B) Epidural hematoma
C) Intracerebral hemorrhage
D) Lacunar stroke

Bonus: What is the famous term for this temporary recovery period?

[Dr. Suraj Baidya @OPDDiaries]

@Doctors_GUILD Yes. You are correct 💯

[Dr. Suraj Baidya @OPDDiaries]

@kiddiewise_ Very clearly explained Dr Yonni. Thank you 👏

[Dr. Suraj Baidya @OPDDiaries]

@modernHealthMe Usual interstitial pneumonia (UIP)

[Dr. Suraj Baidya @OPDDiaries]

@NurseDan__ A perfect answer I was looking for👏.Thank you @NurseDan__

[Dr. Suraj Baidya @OPDDiaries]

@DocPriyamMD @Chiragrx07 ✅ Acute Motor Axonal Neuropathy (AMAN)

While AIDP (Acute Inflammatory Demyelinating Polyneuropathy) is the most common variant in Western countries, AMAN is relatively more common in India and other parts of Asia.

It is associated with high titres of GM1 , Gd1a

[Dr. Suraj Baidya @OPDDiaries]

Diagnosis- Guillain-Barré syndrome

A classic example of ascending paralysis, often triggered by a recent gastrointestinal infection, particularly Campylobacter infection.
Deep tendon reflexes are typically absent or markedly reduced (areflexia). Respiratory failure can occur if the diaphragm becomes involved.

Can anyone tell me the most common variant in India ?

[Dr. Suraj Baidya @OPDDiaries]

Answer: B. Smoking

Smoking is the single most important risk factor for bladder cancer. Tobacco smoke contains carcinogens that are absorbed into the bloodstream and concentrated in the urine, where they repeatedly contact the bladder lining and can trigger malignant changes.

Smokers have about a 2 to 4 times higher risk of developing bladder cancer compared with non-smokers.

[Dr. Suraj Baidya @OPDDiaries]

@Chiragrx07 It's an infantometer used to measure length of infants. It is used for children upto 2 years. After that shift to stadiometer.

[Dr. Suraj Baidya @OPDDiaries]

@DrNovinoTailor Absolutely correct 💯

[Dr. Suraj Baidya @OPDDiaries]

A young patient presents with numbness in the limbs.

Neurological workup is confusing.

Blood tests reveal HDL levels that are nearly absent.

Then you look in the mouth and see
this.

What's the first diagnosis that comes to your mind?

[Dr. Suraj Baidya @OPDDiaries]

@zaidheartsci Correct 💯

[Dr. Suraj Baidya @OPDDiaries]

@zebrahoofbeat Tangier disease is named after Tangier Island, a small island in the Chesapeake Bay.

The disease was first discovered in 1961 in a boy from Tangier Island.

[Dr. Suraj Baidya @OPDDiaries]

@ajlkfad2333 Perfectly answered. Thank you 👏

[Dr. Suraj Baidya @OPDDiaries]

@thediabetes_doc C. Ace inhibitors-

They:

* Dilate the efferent arteriole of the glomerulus
* Reduce intraglomerular pressure
* Decrease proteinuria
* Slow progression of chronic kidney disease and diabetic nephropathy.

[Dr. Suraj Baidya @OPDDiaries]

@thediabetes_doc I think it is c. poor glycemic control

[Dr. Suraj Baidya @OPDDiaries]

@NdibeSamue86933 Congratulations

[Dr. Suraj Baidya @OPDDiaries]

Answer: Peutz-Jeghers Syndrome

-Autosomal dominant disorder caused by mutation of the STK11 (LKB1) tumor suppressor gene.

-Characterized by hamartomatous GI polyps and dark pigmented spots on the lips, oral mucosa, and fingers.(perioral melanosis)

-Can cause recurrent intussusception, abdominal pain, and GI bleeding.

-Associated with a significantly increased risk of pancreatic(100x), colorectal, gastric, breast, ovarian, and testicular cancers.

🚨 Never ignore the freckles: They may be signaling a lifetime risk of multiple cancers.

[Dr. Suraj Baidya @OPDDiaries]

16-year-old boy presents with recurrent abdominal pain.

On examination, multiple dark brown spots are seen around his lips and inside his mouth.

A few months later, he develops acute abdominal pain and vomiting due to intestinal intussusception.

What is the most likely diagnosis?

🚨Bonus: Which gene mutation is classically associated with this condition ?

[Dr. Suraj Baidya @OPDDiaries]

Answer- Acute intermittent porphyria.

Affected enzyme- porphobilinogen deaminase
Accumulation of porphobilinogen, ALA

The triad nobody connects:
• Severe, unexplained abdominal pain
• Neuropsychiatric symptoms (anxiety, hallucinations)
• Autonomic instability (tachycardia, hypertension)

The clue: Purple urine when exposed to light.

It is precipitated by CYP inducers, alcohol, starvation

Treatment - hemin and glucose

If you see abdominal pain + "psychiatric" symptoms in a young woman, think porphyria.

Tag someone who needs to see this and follow for more 🧵

[Dr. Suraj Baidya @OPDDiaries]

Guess the diagnosis.

28 years female. 3 years of "IBS" and "anxiety."
No GI doctor found a cause.
Then a nurse made a mistake that cracked the case.
What is it?
Drop your answers below👇

Clue 1:
Recurrent, severe abdominal pain. Hospitalized multiple times.
Colonoscopy, CT, MRI: all normal.
Diagnosed as "functional."

Clue 2:
During flares, she also gets:
• Tachycardia
• Hypertension
• Panic attacks
• Peripheral neuropathy
SSRIs did nothing.

Clue 3:
A nurse left her Foley bag on the windowsill.
The urine turned dark purple in the sunlight.

[Dr. Suraj Baidya @OPDDiaries]

@albertoortegana Ischemic stroke as CT is negative for hemorrhage
To confirm we have to do diffusion weighted MRI

[Dr. Suraj Baidya @OPDDiaries]

@kuldeep90380039 @Heyyanyaa Let's connect