MRCP Paces DR Ahmed Eliiwa

cases by dr ahmed eliwa 10 hours
starting from :- 25 minutes discussion of acromegaly,,, patient might ask for

facial feature concern, u cud refer them to plastic surgeon, visceral changes
may not be reversible, diabetes melitius,
mohammad misbah 27 minutes :- mis ahlam 42 old, neck swelling for your
kind care for hix taking :good eve i m dr salah, i m here to discuss with your your discuss your lcinical
condition i have informed about your nek swelling , is that right, tell me more
about it, is painful or not ? anyshortness of breath, swallowing difficulty,
lump in other body parts, do u feel u r hot more than usual , lost weight,
intolerant to cold, or gained weight. how is ur periods, any eye problem, any
itching in your body,
whats your job , i m teacher does it affect your job , i live with my husband,
do u smoke , do u drink alcohol, past medical hx of any other medical
disease, no other similar condition in family. mother was diag with ca in
gland, i m sorry to hear about it,
i want to examine the patient, sweating palmer erythema, clubbing, pulse is
normal, shoulder movement no muscle weakness, swelling in front of the
neck, i want to see movement of thyroid whether it moves , there is no
tenderness but multiple nodules in thyorid, these are soft nodules, no reternal
extension, with percussion, any lymph nodes, eye examination, lid lag ,
opthalmoplegia , all are normal.
in lower limb edema , reflex are normal ,
all other system is normal
whats ur concern is
whats going on with me
is it cancer
i m glad to hear ur concern, you have multinodulder goiter, it does not look
like cancer , i shall do blood test,
is it cancer , its a possiblilty no loss of body weight, no lump nodes, but its
our differntial diagnoses.
no other concern. so ur case is mutinoduler goiter
cbc liver function coagulation, thyroid scan, blood tests, what are indications
of thyroid biopsy i dont know
u took good hx , fine needle aspiration, 1 cm u will take , identify physical

finding, 24/28 marks
can we do first do hot or cold nodule any nodule is more than one cm, if its
less than we can do isotope scan to see its hot or cold to decide biopsy.
38.23 seconds , new case from same doctor :- 28 year old marwa, with
headache with blurring of vision for your care
good ev mis marwa, i m dr sala, from hospitakl i m here to discuss about
your....i got from ur gp
where is site of headache, front of headache, is it morning or evening , its
always there, any body temperature, any sickness, if u grade this headache
to 5. its associated with lacrmination or sneezing, associated with leg or limb,
pins and needles, any hx of falling down, tell me more about blurring of
vision, its started with headache or before, its continous , blurring of vision is
in last one month, its unilateral or bilateral, its both sides, night vision is ok,
no double vision, no pain in arm,
mis marwa can u tell me about diabetes or htn, taking any medicines ? what
about ur cycsle its regular, any oral contraceptive pills, mis marwa are u
smomker , u drink alcohol, no , any mouth sores, down below sores, u r
married yes i m , u have kids , yes , no hx of miscarriage , any hx of blood
clot , any one in your family has same condition.
i will examine patient :- i will examine her neurologically, examine the
fundus , blurring of disc, biltaeral vision is blurred.
my concern is : my vision will be lost completely, i appreciate your concern,
after ur hx and exmaination , ur electrical wriing in nerve, we will do brain
picture, we can take fluid in your back, increased pressure inside your back.
is there any treatment for this condition :- ? if its a blood clot , we can give u
mecine which will make it right, we will estrogen pills,
cavernous sinus thrombosis , there is bilateral papliedema, urgent ct, or mri
whats treatmnt for this condition :- if its cavernous thrombosos we will do
antithrombolsys, if high cranial pressure, acetazolamide and stop estrogen.
in pic there is optic atrophy , it could be increasesd intracranial presure :he missed ,
we have to ask for weight gain.
if u ask for night vision , ask for colour vision, in optic neuritis its lost or
impaired .
i will send you to opthalmology, but we will first do imagining in ur brain. we
will take take sampling fro your back it cud used for tratment or investigation.

MRCP Paces DR Ahmed Eliiwa

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cases by dr ahmed eliwa 10 hours

starting from :- 25 minutes discussion of acromegaly,,, patient might ask for

u took good hx , fine needle aspiration, 1 cm u will take , identify physical

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