Blogeverywhere: 07/16/08

Common deformities in rheumatoid arthritis

Common deformities in rheumatoid arthritis are the Boutonniere deformity (Hyperflexion at the proximal interphalangeal joint with hyperextension at the distal interphalangeal joint), swan neck deformity (Hyperextension at the proximal interphalangeal joint, hyperflexion at the distal interphalangeal joint). The thumb may develop a "Z-thumb" deformity with fixed flexion and subluxation at the metacarpophalangeal joint, and hyperextension at the IP joint.

conus medullaris

The conus medullaris is the terminal end of the spinal cord. It occurs near lumbar nerves 1 (L1) and 2 (L2). After the spinal cord terminates, the spinal nerves continue as dangling nerves called the cauda equina. The upper end of the conus medullaris is usually not well defined.

Stages of NHL

The various stages of NHL (the Ann Arbor staging classification, developed for Hodgkin's lymphomas) are based on how far the cancer has spread throughout and beyond the lymphatic system, and whether constitutional symptoms (fever, night sweats, or weight loss) are present.

Stage I: "Stage I" indicates that the cancer is located in a single region, usually one lymph node and the surrounding area. Stage I often will not have outward symptoms.
Stage II: "Stage II" indicates that the cancer is located in two separate regions, an affected lymph node or organ within the lymphatic system and a second affected area, and that both affected areas are confined to one side of the diaphragm - that is, both are above the diaphragm, or both are below the diaphragm.
Stage III: "Stage III" indicates that the cancer has spread to both sides of the diaphragm, including one organ or area near the lymph nodes or the spleen.
Stage IV: "Stage IV" indicates that the cancer has spread beyond the lymphatic system and involves one or more major organs, possibly including the bone marrow or skin.

The absence of constitutional symptoms is denoted by adding an "A" to the stage; the presence is denoted by adding a "B" to the stage (hence the name B symptoms).

Staging in non-Hodgkin's lymphomas is far less significant in determining therapy than it is in Hodgkin's disease.

management of steven johnson syndrome

This are outlines of management of steven johnson syndrome given by a dermatologist from Ipoh GH:

1) Vital Sign monitoring
2) Withhold Offending drug
3) Adequate hydration
4) Strict I/O chart
5) Assess disease severity daily
6) Oral lesion: NaHCO3 gurgle 4hrly
Syrup nystatin 6hrly
7) Crusted lip lesion: use liquid parafin soak with gauze apply to lips for 10min 4hrly to soften the crust, then slowly remove it
8) Body and lim lesions: KMno4 wash to raw area 2-3x per day, normal saline bath bd then apply gerila cream to raw area after KMno4, aqueous cream 2hrly