postdiagnoses

[postdiagnoses]

Provisional Diagnosis: gastroesophageal reflux disease (GERD or GORD if you spell it "oesophageal")

Clinical Notes: heartburn intensified by eating greasy food.

There are two muscular rings in your esophagus: one at the top and one at the bottom of your esophagus called the upper and lower esophageal sphincter respectively. The lower sphincter stops stomach acid from going up into your throat. If something happens to this sphincter, say the nerve controlling it is damaged or the muscle weakens, acid can splash into the esophagus, where there is less acid protection than in the stomach and cause damage. Repeated and chronic acid reflux can lead to changes in how cells grow, and if left untreated, increases risk of esophageal cancer.

Differential Diagnoses:

Angina/heart attack: any chest pain must be investigated for cardiac problems because even if unlikely, heart problems can become emergencies fast.

Achalasia: discomfort and gross-feeling sensations could be due to the opposite problem, where the lower esophageal sphincter clenches too tight and won't let food pass into the stomach. The swallowed food sits, festers, and gets nasty.

Recommendations:

ECG to rule out cardiac problems

Upper endoscopy: a health professional may use a small camera on a long narrow tool to look at the esophagus for signs of the problem.

Contrast swallow: an X-ray taken after swallowing a substance that shows up bright on X-ray shows the shape of the esophagus. Achalasia will appear as a pinched "bird's beak" appearance.

GERD is often managed with lifestyle changes (such as changing diet so the stomach produces less acid) and over-the-counter antacids first before proceeding with more aggressive treatment with medication

Medication options include H2 histamine blockers and proton pump inhibitors to stop the stomach from producing as much acid.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

[postdiagnoses]

Provisional Diagnosis: pneumoconiosis

Clinical Notes: exposure to fine particulate substances

Our lungs are good at taking care of themselves. Mucus can trap random things we inhale, and cilia keeps the mucus flowing up and out. If you've coughed up sputum when you're sick, it's your body's slain enemies turned into a paste! Some stuff though, is hard to clear. Very fine powders can cause inflammation and fibrosis, sort of like scarring. Most pneumoconioses are from workplace exposure; asbestosis (construction), silicosis (occupations with sandblasting), coal miner's lung, and berylliosis (aerospace manufacturing).

Differential Diagnoses:

Pneumonia: infections can also cause inflammation and fibrosis in the lung

Pulmonary oedema: thickening via fibrosis can be mistaken for fluid buildup in lungs. Make sure you know which it is (via X-ray)!

Smoking: also introduces foreign substances into lungs, and tar can stain lungs like in coal miner's lung.

Recommendations:

Take a full social history: occupation, hobbies, use of alcohol, smoking, other substances, possible exposure to pneumonia sources

Chest X-ray: pneumonias often have a characteristic pattern; lobar (in one lung lobe), bronchial (patches around the bronchioles), or interstitial (in the tissues inbetween). Pneumoconioses also have their patterns and chest X-ray can differentiate them.

Refer patient to @osha-official-2 for discussion of PPE, workers' rights, compensation for workplace injuries, and outreach to coworkers with similar exposure. Remember: advocating for patients is part of the job and a duty for healthcare providers!

There is no cure for pneumoconiosis. A lavage (rinsing out the lungs with saline while under anesthesia) can help remove some of the causing substance. Prognosis is poor once fibrosis sets in. Treatment is supportive; maximizing exercise tolerance and preserving lung function.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

lately been on a real powdered substance kick

[postdiagnoses]

This one is dark. Please read at your own discretion.

Provisional Diagnosis: Lesch-Nyhan Syndrome

Clinical Notes: rips across the body appearing to be caused by mouth.

Gout is the buildup of urate crystals, which eventually deposits in joints. This causes a swollen, red, warm, painful joint. These symptoms are usually the sign of infection, but gout is weird like that. There is also pseudogout which is a buildup of calcium pyrophosphate crystals. It used to be believed that gout was entirely due to eating foods high in purine (which gets metabolised into urate). Turns out it's more complex and also has genetic and other factors. While gout occurs in adults and has a lifestyle component, Lesch-Nyhan Syndrome is essentially a congenital type of gout. LNS is caused by a mutation that knocks out a key enzyme that recycles purines, which means all of it will become urate. LNS is distinctive and tragic because people are born with it and will begin biting and scratching everything, including themselves early in life. LNS patients often try to bite off their own fingers and lips, and have to be restrained to prevent them from injuring themselves.

Differential Diagnoses:

Gout: unlikely in a very young patient, but there is shared pathophysiology.

Rabies: although rabies is very distinctive in the foaming mouth and history of animal bite, it also can cause erratic, violent behavior

Recommendations:

Blood tests, looking at urate levels

Genetic testing can be used to confirm, but diagnosis can be made from history, examination, and blood tests.

Treatment is similar to gout: pain relief as needed, and allopurinol to reduce urate levels.

There is currently no treatment to reduce the self-mutilating behavior.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

i need more outfits that go with my muzzle

[postdiagnoses]

Provisional Diagnosis: Cushing Syndrome

Clinical Notes: high cortisol levels in female patient

A syndrome is a collection of signs and symptoms that often occur together, usually because of an underlying disease, but the syndrome isn't, linguistically speaking, the disease. Cushingoid symptoms include a large, round, often reddened face, rapid weight gain that deposits in the center of the body rather than the arms or legs, reddened stretch marks, and in women, can cause male-like hair growth, such as coarse facial hair (hirsutism) and menstrual disturbances.

Cushing's is the result of abnormally high levels of glucocorticoids, including cortisol, but don't worry. You can't stress your way into Cushing's. Cushing's is either from taking extra glucocorticoids like in medication or from a tumor that makes way too much.

Differential Diagnoses:

Polycystic ovarian disease: often presents similarly: heavy person with endocrine-y symptoms and menstrual changes, but from the other direction. In PCOD, obesity leads to the disease whereas in Cushing's, disease leads to weight gain

Type II Diabetes (or other metabolic syndrome): shares similar symptoms; insulin resistance, weight gain, and T2DM often happens alongside hypertension, which occurs in Cushing's.

There are a few tumors that produce cortisol. These may be the underlying cause.

Recommendations:

Blood tests to check hormone levels. There are lots of eneocrine-y things on the differential you'd want to check, such as cortisol, insulin, thyroid, estrogen, androgen

Discuss medical history, especially medication. If they are on a glucocorticoid this would likely be the culprit

If Cushing's is suspected, perform a dexamethasone test. Give dexamethasone, and if normal, cortisol levels should drop in response. If blood cortisol levels remain high, something is wrong and you should look for a tumor.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

babygirl your cortisol

[postdiagnoses]

Provisional Diagnosis: Obstructive pulmonary disease

Clinical Notes: lung diseases where not enough air gets to the lungs is classified as either restrictive (air can't get in, usually because something around the lungs prevents them from inflating) or obstructive (air can't get out). We've all heard of COPD, that thing you get when you smoke. COPD is Chronic (happens over time) Obstructive (air can't get out) Pulmonary (of the lungs) Disease. This happens because long-term irritation changes the texture of the alveoli. The alveoli are no longer elastic so they inflate but don't deflate like they're supposed to so air just kinda stays in. This case, however is not chronic. It's probably the first and only case of acute obstructive pulmonary disease.

Differential Diagnoses:

Emphysema: the permanent enlargement of alveoli. It's usually a consequence of COPD but can also occur in people with a genetic mutation of an enzyme that maintains lung texture

Recommendations:

Refer patient to plastic surgery for reattachment

Live laugh love: I hear you, and I would be mortified too were I in your shoes. I'm sure no one thinks worse of you, though. I'm sure you know your stuff, it's just a silly thing happened with a mannequin. Those courses can be kinda dry and I bet your class welcomed a little levity, but it's not at your expense. Whatever you're getting the CPR cert for, OP I know you're gonna rock at it.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

I SHOT THE HEAD OFF THE CPR MANNEQUIN WHAT THE HELL

[postdiagnoses]

Provisional Diagnosis: Systemic Lupus Erythematosus (SLE)

Clinical Notes: Female patient experiencing arthralgia, headache, abdominal pain, general malaise.

Systemic Lupus Erythematosus is an autoimmune disease, where the immune system incorrectly attacks the body. Women are more likely to get autoimmune diseases. It's not well understood why, but estrogen is implicated because low-estrogen people; men, post-menopausal women, and girls, have lower rates of autoimmune disease. SLE classically comes as an adult woman with fever, joint pain, and a characteristic butterfly shaped rash across the nose and cheeks. However SLE can affect people of any age or sex, and what it looks like can vary widely. It just depends what your immune system decides to go to war against. Gastrointestinal symptoms are less common, but still possible.

Differential Diagnoses:

Fibromyalgia also presents with generalized pain, and is also difficult to diagnose

Metastatic cancer because it has spread, and can manifest across many organs, can be the cause of fever and general malaise.

Rheumatoid arthritis is also autoimmune, can have widespread pain, and cause warmth, but often symptoms follow a recognizable pattern.

Recommendations: Because SLE is so variable, it is difficult to recognize and diagnose. Check the criteria table, which outlines possible symptoms and a point system for how suspicious for SLE it is.

Take a full history to get a full picture of symptoms and their onset.

Full examination to look for any relevant signs

Blood tests, including full blood count (the numbers and ratios of immune cells are useful for diagnosis) and antibodies (presence of certain antibodies is critical for diagnosis).

Urine tests to assess kidney function

If SLE, treatment depends on severity. Hydroxychloroquine is a common treatment, which can be combined with other treatment. Steroids and immune suppression can be used for more advanced disease.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

moodboard for cute girls 🤩

[postdiagnoses]

Woke up in the middle of the night thinking that calling diseases "chronic" is kinda funny like "you're taking so long to have this disease it's under the Lord of Time's purview now."

[postdiagnoses]

Provisional Diagnosis: obstructive sleep apnea (OSA)

Clinical Notes: Breathing is super important, but when you're asleep, you have less control over your breathing. (paramedics know that keeping the tongue from falling into unconscious people's throats is a big deal. It's crazy that the tongue can even go there, huh?) A person's trachea can collapse for many reasons (such as having a thicker neck or having an elongated face like in acromegaly) and when it does, they start to suffocate. When things get dire, their body wakes them up, and they breathe normally for a bit, fall asleep, and this repeats. This means they can't enter the deeper phases of the sleep cycle, so they don't get quality rest and are tired the next day.

Differential Diagnoses:

Sleep apnea can be classified by cause: obstructive sleep apnea is when the airway collapses whereas central sleep apnea is when the nervous system doesn't send signals for breathing, so you just... don't breathe.

Depression: one of the symptoms of depression is sleep changes. This is often either excessive or minimal sleep and they either sleep in late into the day or wake up absurdly early and/or are unable to fall asleep until late.

Recommendations:

Take a social history. Pay attention to sleep hygiene; habits around bedtime leading to good or bad sleep. Ask if partners or roommates notice that they snore. Loud snoring is a key sign of OSA

Check for conditions that may affect sleep such as acid reflux that may be exacerbated by being sideways

Assess patient's Epworth Sleepiness Scale to determine the degree that their condition is affecting them.

Refer patient for a sleep study (sleeping with sensors to detect sleep cycle, oxygen saturationz etc.)

If obstructive sleep apnea is the diagnosis, a CPAP machine may be used to force air into the airways while the patient sleeps.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

[postdiagnoses]

Provisional Diagnosis: upper respiratory tract infection, rhinovirus

Clinical Notes: Mucus is secreted by the respiratory tract, and serves a variety of roles, such as keeping the tissues from drying out. In response to what the body may fear is an infection, mucus production may increase. Mucus color may offer clues to the type and progress of infection. Mucus is normally clear, but may progress from opaque white to yellow to green as an infection gets more severe. Dark, brown or black mucus may be a sign of inhaled mold, ash, or coal.

Differential Diagnoses:

Adenovirus, seasonal flu, other viruses. Management is unlikely to be different for these organisms.

Allergic rhinitis: allergies may also cause a miserable torrent of mucus

Pneumonia

Recommendations:

Don proper PPE for personal safety; N95 mask, goggles, and explosive ordinance disposal suit

Take vital signs; temperature, pulse, blood pressure, respiration rate, oxygen saturation

Perform ear/nose/throat examination. Pay attention to tonsils, epiglottis, and vocal cords.

Auscultate (listen with stethoscope) to lungs. Note any crackles, wheezes, or other sounds.

For a viral upper respiratory infection, treatment is generally supportive: rest, proper hydration, electrolytes, and as tolerated, food. (notice traditional flu cures such as chicken noodle soup and rice congee deliver all three)

Advise proper hygiene and infection control measures to prevent any other members of the household from getting sick; isolation/quarantine, hand washing, wearing PPE.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

happy make a terrible comic day 2025 . I am 80% mucus today

[postdiagnoses]

Provisional Diagnosis: genital thrush

Clinical Notes: Thrush is caused by candida, a yeast-like fungus. Candida is a fairly common organism, and healthy bodies tend to keep it under control. A candida overgrowth is usually a sign of an underlying problem such as antibiotics wiping out your microbiome, stress, or poorly managed diabetes. Although it's not technically considered a sexually transmitted infection, it is an infection that can be transmitted by sexual contact.

Differential Diagnoses:

Contact dermatitis can also cause irritation, usually due to soaps, latex, or other products.

Tinea infection: another possible fungus

Skin conditions such as eczema or psoriasis could cause similar looking skin changes and irritation

STIs are also a possibility

Recommendations:

Obtain accurate history, especially social history. Recent changes to hygiene products could point to a contact dermatitis.

Examine groin. Observing details of any skin changes can differentiate skin conditions.

Run an STI panel to rule these conditions out

Consider sending a sample for culture if necessary

If fungal infection is confirmed, antifungal cream is a typical treatment.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

Is your entire name just a front so people call you puki (pooky) because you dont feel validated by your own partner?

My username predates the nickname pookie. Does the name "doktor schruum" have to do with the fact that physicians keep finding strange fungal infections on your testicles?

[postdiagnoses]

MY OVARIES!!!!!!

[postdiagnoses]

Provisional Diagnosis: temporomandibular joint (TMJ) dysfunction

Clinical Notes: the temporomandibular joint is where the jaw connects to the rest of the head. This joint can begin to have problems such as pain, clicking, locking, or grinding of the jaw when opening the jaw. Pain can radiate out to a headache or neck pain. TMJ dysfunction has multiple possible causes, including rheumatoid or osteoarthritis, stress-related clenching of the jaw, or... overuse injury.

Differential Diagnoses:

Headaches could also be primary headaches (migraine, tension headache, cluster headache)

TMJ dysfunction could also be secondary to rheumatoid or osteoarthritis

Recommendations:

Obtain a history from patient to check for ways the injury may have come about. Consider the possibility of underlying conditions.

Examine the jaw and surrounding anatomy

Most TMJ dysfunctions resolve with rest. Try to eat soft foods, avoid activities that work the jaw such as chewing gum and... rough XXL activities.

Consider imaging if necessary for diagnosis or management

Treatment with surgery is rare.

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

Enough of "Posting the same image of Beernox until the game comes out"

HAPPY XXL WOOFIA RELEASE DATE!!!

[postdiagnoses]

MY OVARIES!!!!!!

[postdiagnoses]

Provisional Diagnosis: jaundice

Clinical Notes: blood is red because of heme, a molecule with an iron atom at the center. As red blood cells get worn out, their parts are either recycled or broken down. When heme is broken down, it is converted to biliverdin (which is green) then to bilirubin (which is yellow). This typically happens in the liver but it is possible to fix liver enzymes onto a surface, usually done for laboratory sample containers, but I guess you could also do it to a goblet. Bilirubin is a normal thing to have as worn out red blood cells are constantly being recycled or degraded, but when there is more bilirubin than the body can break down, it builds up, turns skin and eyes yellow (or perhaps a golden color from a certain point of view). This is called jaundice.

Differential Diagnoses:

Conditions that cause faster than normal blood cell breakdown;

Liver damage; hepatitis, HIV, alcohol overconsumption, liver cirrhosis, Wilson's disease

Bile duct blockages; bile duct stones, strictures

Recommendations: jaundice is usually not the problem but a sign of a problem. Treating the underlying problem is the main priority.

Blood tests can give clues to what is happening in the liver and blood such as a full blood count to see if red blood cell populations are normal or not and liver function tests to see if it is working properly and if it is overworked.

A blood smear can show what blood cells look like and, if normal, rule out sickle cell disease and other anemias

Hepatitis antigen and antibody testing to see if patient has / had / was vaccinated for the different types of hepatitis.

Abdominal imaging to assess for bile duct blockage, cancers, fatty liver disease/cirrhosis, etc. Consider biopsy if imaging gives reason to investigate further.

If jaundice is particularly bad, consider light therapy (photons can break apart bilirubin)

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

At Every Coronation, Each Would-Be Monarch Is To Provide A Single Drop of Blood For The Goblet Of Divine Rights. If The Blood Stays Red, Their Reign Will Be Peaceful. If The Drop Turns Black, They Will Bring Tyranny And Ruin To The Kingdom…What Does It Mean When Your Blood Turns Gold?

[postdiagnoses]

Provisional Diagnosis: granulosa/thecal cell tumor

Clinical Notes: the main workers of the ovary are the granulosa and thecal cells. When they receive orders from their pituitary overlords in the form of lutenizing hormone (LH) and follicle stimulating hormone (FSH), the thecal cells produce androgens and pass them on to the granulosa cells to produce estrogen. If these cells seize the means of production and buck their overlords, this is called a granulosa thecal tumor. Being more efficient workers as independents than under bourgeois scrutiny, these cells produce more of their products: androgens and estrogen. Excess androgen may result in hirsutism; male-pattern hair growth and texture such as thicker, coarser facial hair, and virilization; development of male characteristics like deepening voice, shrinking breasts, and enlarged clitoris. Excess estrogen may cause breast enlargement, breast tenderness, and postmenopausal bleeding. How the contradictory symptoms play out (boob bigger or smaller? Heavier or lighter flow?) depends on age and other factors.

Differential Diagnoses:

Polycystic ovarian syndrome and polycystic ovarian disease (PCOS & PCOD) can also produce excess androgen and menstrual irregularity

Pituitary adenoma may result in excess LH or FSH and result in androgen or estrogen imbalance

Adrenal hyperplasia: the adrenals also produce androgen, and should be checked as a possible cause for hirsutism and virilization

Recommendations:

Vive la Revolution.

Blood tests to detect hormonal abnormalities (FSH, LH, androgen, estrogen)

Imaging to detect growths in the ovary, adrenals, or brain (pituitary)

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

MY OVARIES!!!!!!

[postdiagnoses]

Nowotice: youw cwanes awe decweasing.

Confuse a Gimmick Blog for 10s (1/1)

[postdiagnoses]

Provisional Diagnosis: benign prostatic hyperplasia (BPH)

Clinical Notes: symptom: incomplete bladder emptying, frequent urination, and other urinary symptoms often are caused by an enlarged prostate. The prostate is a gland in AMABs that produces some fluid components of semen. It wraps around the urethra for some reason, so if it enlarges, it can squeeze the urethra shut. This can cause difficulty peeing and symptoms like stopping peeing but the bladder isn't empty, having to go in and out of the bathroom and still feeling like you need to pee even after you stop, and a dribbling pee stream. Risk factors for BPH are testosterone (likely a reason trans women have lower rates of BPH) and age.

Differential Diagnoses:

prostate cancer: another way the prostate grows, but this time, it's cancerous.

Renal calculus (kidney stones): stones can cause blockages which can also cause irregular urinary symptoms

Recommendations:

History taking: ask about urinary symptoms, family history of cancer, etc.

Digital rectal exam to assess prostate. Consider following up with ultrasound.

If prostate is enlarged, biopsy to rule out prostate cancer

If BPH is confirmed, treatment is typically a 5α reductase inhibitor such as finasteride or dutasteride, which shrinks the prostate.

Surgery could also be considered to reduce the size of the prostate

Note: I'm not a health professional and this is not medical advice! If you have real concerns, please consult a real health professional and not a quirky sideblog!

pee

part 2 tomorrow

on the edge of my seat