MedClips

Causes Cushing's syndrome is a syndrome characterized by hypertension, fatigability, weakness, sexual dysfunction, striae, edema, osteoporosis, and truncal obesity of chronic glucocorticoid (cortisol). Cushing's syndrome is the cause of exogenous origin of cushing's syndrome caused by drugs such as glucocorticoid. The next is cushing's syndrome of endogenous origin. ACUT-dependent pituitary adenoma, cushing's disease, is a microadenoma of less than 10 mm mostly over 90%. It may also be caused by ectopic ACTH secretion. This may be caused by SCLC, thymoma, pancreatic islet cell tumor, MTC, and pheochromocytoma, which induces hypersecretion of ACTH at the origin, not the pituitary gland. ACTH independent causes are adrenal neoplasm and adrenal nodular hyperplasia. Adrenal neoplasm is usually unilateral, 8-10% of adenoma, and 8-10% of carcinoma. Therefore, it must be distinguished, and if it is uncertain as to the imaging test, postoperative biopsy is essential. It i...

Causes The causes of primary adrenocortical insufficiency can be divided into the following five categories; Gland destruction (chronic & acute), impaired hormone production, ACTH-blocking antibodies, mutation of ACTH receptor gene, adrenal hypoplasia congenital. More than 90% of both glands must be destroyed before adrenal insufficiency develops. The most common cause of gland destruction is tuberculosis infection in Korea, and the most common cause of gland destruction is caused by autoimmune among idiopathic atrophy. This autoimmune destruction is due to cytotoxic T lymphocyte. Other causes of gland destruction include surgical removal, tuberculosis, infection with fungi and viruses, hemorrhagic infarction due to anticoagulation, and invasion of the tumor. Secondary adrenocortical insufficiency is a disease that lacks ACTH in the pituitary. Therefore, hypothyroid-pituitary disease-induced hypopituitarism, exogenous steroids, or endogenous steroids produced by tumors may cause...

The febrile illness, for which clinically clear etiology is not known, is often referred to as the Fever of unknown origin (FUO), but the use of the term is not clearly defined. Most febrile illness comes about before diagnosis, or before showing any characteristic findings that may lead to diagnosis. In the end, FUO is a persistent febrile illness that does not establish etiology even though it uses intensive evaluation and diagnostic tools. Causes The most common causes of FUO are infection, neoplasm, connective tissue disease, miscellaneous disease, and undiagnosed condition. First, there may be a number of infectious agents such as abscess, endocarditis, tuberculosis, and extrapulmonary tuberculosis is one of the most common causes of FUO. Malignant lymphoma is the most common cause of neoplasm, and hematologic malignancies, solid tumors, and benign tumors may be the cause of FUO. Noninfectious inflammatory disease is also a common cause of FUO, other than miscellaneous conditio...

Causes There are three major causes of Thrombocytopenia. First, there is a decrease in bone marrow production. If there is a problem in bone narrow, factors such as BM failure, adverse effect of drug, and BM infiltration can be considered. The second is splenic sequestration by splenomegaly. One-third of the platelets usually pass through the liver and spleen, and splenomegaly can increase this amount, reducing the number of platelets in the peripheral blood. Liver cirrhosis, leukemia, splenic vein thrombosis, and portal hypertension may cause splenomegaly. Finally, when platelet destruction increases, thrombocytopenia may occur, which can be further divided into immune destruction and non-immune destruction. Immunologic thrombocytopenia is caused by the removal of monocytes from the spleen of the pletelets that bind the antibody, immune complexes, and complement. The most common cause is infection and autoimmune diseases such as drug, ITP and SLE can also be induced. Non-immunologic ...

Hemoptysis refers to the bleeding that occurs in the lower extremities and should be differentiated from bleeding from the donor nasopharynx and gastrointestinal tract. It is important to distinguish between hemoptysis and hematemesis. Hemoptysis is bright red or rust, pH is alkaline. Usually accompanied by a cough, mixed with blood in the phlegm, frothy mucus can be seen if you see a hemoptysis. Chest pain may also accompany. On the other hand, blood clots may show crimson or brown with a coffee-ground appearance and may contain food waste. It has an acidic pH, followed by nausea and vomitting. Causes The most common causes of hemoptysis in children are respiratory infections, foreign body aspiration, and bronchiectasis. Bronchiectasis is most common in children with cystic fibrosis. Tuberculosis is the cause of bacterial infection and histoplasmosis, coccidioidomycosis, invasive pulmonary aspergillosis, aspergilloma, and stachybotrys atra are the causes of fungal infection. Trache...

A respiratory infection is the first suspicious symptom when it comes to symptoms of runny nose, cough, sputum and shortness of breath in infants and young children. The most common causative agent is a virus, which causes a cold, nasal congestion, rhinorrhea, throat injection, and cough. Viral respiratory infections are largely divided into upper respiratory infections and lower respiratory infections. Upper respiratory tract infection The infection usually involves the nose and the larynx and is accompanied by a mild or no fever. Croup is a typical disease. It is the most prevalent at 3 to 5 months of age and 2 years of age and is known to be more prevalent in men. In addition, family history is often seen. Parainfluenza was the most common causative organism, and RSV, adenovirus, and influenza were the most common causative organisms of the viral croup. In the bacterial croup, hemophilus influenza was the main causative organism. However, vaccine was developed and Moraxella catar...

Causes & Symptoms When we look at viral meningitis, symptoms are similar to bacterial meningitis, but they are usually much weaker. Neurological symptoms may be relatively low or absent. However, in neonates, herpes simplex virus meningitis is associated with a higher risk of severe systemic diseases such as pneumonia, hepatitis, and myocarditis. When infected with enteroviruses (poliovirus, coxsackievirus, echovirus, numbered enteroviruses), which are the most common cause of viral meningitis, sudden fever of 38 ~ 40 ℃ occurs in more than half of cases. In addition, if the child has symptoms such as conjunctivitis, pharyngitis, rash, and wrist disease, enterovirus may be suspected. Herpes simplex virus, arbovirus, lymphocytic choriomeningitis virus, influenza virus, and mumps virus. Diagnosis The Bacterial Meningitis Score (BMS) can be used to predict if the cause is due to the virus. CSF pleocytosis (WBC count ≥10 cells / μL for CSF) In children who have not received antibiot...

Meningitis is largely divided into viral meningitis (most common) and bacterial meningitis. If it is bacterial, it is a medical emergency, so rapid diagnosis and treatment are needed. Without treatment, mortality is close to 100%. Neurological sequelae may also remain. Because bacterial meningitis is more severe than viral meningitis and has a poor prognosis, it is very important to differentiate between these two. First, let's look at bacterial meningitis. Causes Streptococcus pneumonia, Neisseria meningitidis, and Haemophilus influenza (decreased by preventive vaccine) are the main causative agents. Group B streptococcus is the most common causative organism in infants 1 month to 3 months of age. Neisseria meningitidis is the most common cause among children and adolescents aged 10 to 19 years. Symptoms Symptoms include fever, nausea, vomiting, anorexia and meningeal signs (headache, back pain, neck stiffness). However, because of nonspecific symptoms, all of these symptoms...

Stevens-Johnson syndrome is a serious skin disorder characterized by extensive necrosis and deprivation of the epidermis, usually caused by drugs. Stevens-Johnson syndrome is a relatively minor disease, which refers to the deprivation of less than 10% of the total body surface area. When more than 30% of the total body surface area is deprived, it is called a toxic epidermal necrosis. Causes The most common cause of Stevens-Johnson syndrome is medication. In general, allopurinol, aromatic anticonvulsant, antibacterial sulfonamide, lamotrigine, Nevirapine, and NSAIDs are thought to be the causative drugs. Especially in children, drugs such as antibacterial sulfonamide, phenobarbital, carbamazepine, lamotrigine and acetaminophen have been reported. Stevens-Johnson syndrome is common in infections of mycoplasma pneumonia and cytomegalovirus infection. Vaccination, systemic disease, contrast agent, chemical exposure, herbal medicines and food are also known to cause Stevens-Johnson synd...

Community acquired pneumonia is a leading cause of death in children under five in developing countries and accounts for 29% of all deaths worldwide for children under five years of age. The incidence of pneumonia is ten times higher in developing countries than in developed countries. Between 1939 and 1996 in the United States, children's pneumonia mortality declined by 97%. Haemophilus influenza type b (Hib) has been one of the major causes of bacterial pneumonia, but it has been reduced by the introduction of vaccines, which is thought to have decreased with the expansion of medical insurance for antibiotics, vaccines and children. Causes Most cases of pneumonia are caused by microbial infections, but food, gastric acid, foreign body aspiration, and hypersensitivity reactions are the noninfective causes. It is difficult to find the cause of pneumonia in individual patients. First, lung tissue biopsy is so invasive that it is rarely performed. 2) Sputum does not show the cause...

Cellulitis is a skin infection that occurs when bacteria enter through a breach in the skin barrier. Celulitis is characterized by skin erythema, edema, and warmth. Cellulitis involves the deeper dermis and subcutaneous fat. Cellulitis is frequently found in middle-aged and elderly people, and incidence is 200 cases per 100,000 patient years. The predisposing factors of cellulitis include wound-like trauma, inflammation, original skin infections such as tinea pedis, varicella, edema, and the like. Causes The most common cellulitis pathogen is beta-hemolytic streptococci and S. aureus. In one study, 73% of beta-hemolytic streptococci were admitted to 179 nonpurulent cellulitis. The response rate of the beta-lactam antibiotic was 96%. Less common pathogens include H. influenza, clostridia, non-spore forming anaerobes, pneumococcus, and meningococcus. Symptoms Patients with cellulitis usually indolent the development of symptoms and gradually develop a localized symptom over the cou...

Causes The definition of neonatal thrombocytopenia is defined as 150,000 / μL or less, and 1 to 2% may occur in normal children, but most of them have few symptoms and severely decrease to less than 50,000 in some cases. Most causes are classified according to the timing of platelet reduction. Placental dysfunction (preeclampsia, intrauterine growth retardation, etc.) and perinatal history of early onset occurring within 72 hours of birth. It may be considered a perinatal infection (eg E. coli, GBS, Haemophilus infuenzae), DIC, homologous immunity, autoimmune, congenital infection, thrombosis, metabolic disease, hereditary congenital disease and Kasabach-Merritt syndrome. Late onset after 72 hours of birth may be caused by delayed onset sepsis, neonatal necrotizing enteritis, congenital infection, metabolic disease, autoimmune, hereditary congenital disease.  Immune thrombocytopenia is largely autoimmune and allogeneic. Autoimmunity is the case when an anti-platelet antibody is ...

Causes The risk factors for perinatal asphyxia can be divided into three categories: prenatal, delivery, and postnatal. Risk factors for uterine pregnancy include maternal hypotension, maternal hypotension, maternal respiratory and cardiovascular disease, fetal congenital anomalies, and premature infants. The risk factors for labor are dystocia, fetal rotation, abnormal placenta, placental exfoliation, And hypotension. Postpartum risk factors include severe pulmonary disease of the newborn, severe recurrent apnea, congenital heart disease, patent ductus arteriosus with cardiac insufficiency, sepsis with cardiovascular collapse, persistent fetal circulation. The risk factors for normal birth and delivery are usually 90% of the perinatal asphyxia. Perinatal asphyxia can be diagnosed by satisfying all four of the following criteria. ① Severe metabolic or mixed acidemia due to arterial blood gas test, ② Apgar scores continuously 0 to 3 even after 5 minutes of birth, ③ Neurological sympto...

The IUGR and the SGA are interrelated and actually mixed, but not synonymous. IUGR is defined as the case where the growth of the fetus is inhibited by various causes and is defined as the case where the expected weight of the fetus according to the gestational age is less than the 10th percentile. On the other hand, SGA means that the birth weight of newborn when birth is below the 10th percentile of body weight distribution according to gestational age. Therefore, even if IUGR was present, it may not be the SGA depending on the timing and degree of its occurrence. IUGR is observed in 3-10% of total pregnancies and in 20% of still babies. Placenta dysfunction is the most common cause, with congenital infection (10%), chromosomal abnormalities and other genetic diseases accounting for 5-15%. Factors related to IUGR can be divided into maternal related factors, placental factors, and fetal factors. Maternal side factors include experience with drug use, malnutrition, hypoxia, hypertensi...

Causes One of the most important diseases in infant infections is pneumonia. In developed countries, mortality and morbidity due to neonatal pneumonia is high. In developed countries, incidence is 1% in full term infants, ill infant in normal weight, and incidence in 10% in low birth weight infants. Neonatal pneumonia can be divided into early onset and late onset, and in the case of congenital pneumonia, early onset. Early-onset pneumonia acquires pathogens from the mother within three days of birth through the following three pathways: If the infected amniotic fluid is aspirated from the uterus, the pathogen is transmitted through the placenta, or the infant is aspirated during vaginal organism during or immediately after birth.  Congenital pneumonia can be a bacterial or a virus. Bacterial pneumonia causes inflammation of pleura or infiltration or destruction of bronchopulmonary tissue. Viral pneumonia is mainly caused by interstitial pneumonia. The main cause is bacteria, amo...

In patients with leukemia, chemotherapy induces bone marrow suppression and causes the majority of patients to develop Neutropenia. Because these patients have much immune function, serious infections can be seen without any symptoms other than fever have. These infections can go on rapidly and can pose a life threat to your patients, so you should be familiar with Neutropenic fever. Definition Neutropenic fever is defined as Neutropenic fever when Fever and Neutropenia are simultaneously present. Fever can be diagnosed as Fever when the body temperature above 38 degrees Celsius lasts for more than 1 hour (different standard for each hospital) and Neutropenia when ANC is below 1500. Symptoms & Causes Even patients with the same neuroprotective fever have different risks, but the risk is assessed differently depending on the patient's condition and situation. At this time, the MASCC (Multinational Association for Supportive Care in Cancer) is the score. 5 points each when...

Syncope can be defined as loss of consciousness and muscle strength for a short time. Syncope features fast onset, short duration, spontaneous recovery. In most cases syncope is caused by a temporary decrease in blood flow to the brain due to low blood pressure. Loss of consciousness (LOC) may precede pre-existing symptoms, such as lightheadedness, sweating, pale skin, blurred vision, nausea, and vomiting. Syncope causes are cardiogenic, neurocardiogenic, and orthostatic hypotension. Among these, neurocardiogenic is the most common, and vasovagal syncope is the most common among young people. This occurs when vasodilation or an inappropriate decrease in heart rate occurs. It can also occur when the carotid sinus is under pressure. Cardiac syncope is the most serious condition requiring treatment. In this case, there is abnormal heart rhythm, heart valves or heart muscle, pulmonary embolism or aortic dissection. Syncope due to orthostatic hypotension is caused by a sudden decrease in b...

There are many symptoms in the breast, and it is important to distinguish between the typical symptoms and the diseases that can occur. If mass is present, it should be confirmed whether it is malignant. If there is firm, less circumscribed, and fixed characteristic in promotion, possibility of malignancy is great. When pain occurs, it is not related to cancer, and may be caused by premenstrual symptoms, fibrocystic changes, excessive caffeine intake, and the like. In the case of cyst formation, there are cases such as galactocele, which can be distinguished and treated by fine needle aspiration. Skin dimpling is the result of the shortening of the cooper's ligament, which is a sensitive, specific sign indicating underlying cancer. Erythema is a characteristic of inflammatory breast cancer and may be accompanied by peau d'orange findings. Carcinoma cell embolism is a phenomenon that the lymphatic duct of the dermis is clogged and edema of the skin occurs. In the case of nipple ...

Diarrhea is defined as a condition in which the number of bowel movements is more than four times a day and the amount of feces is more than 200 g per day. In cases of diarrhea, chronic diarrhea lasting more than 4 weeks and acute diarrhea less than 1 to 2 weeks are defined as diarrhea. There are caustic diarrhea and fecal incontinence which should be distinguished from diarrhea. Caustic diarrhea defecates more than 3 ~ 4 times a day, but total defecation is in the normal range. It is caused by irritable bowel syndrome, rectalitis and hyperthyroidism. Fecal incontinence can not be controlled voluntarily due to anomalous rectal or pelvic muscle abnormalities, so the bowel movement itself will not exceed 200g, regardless of the patient's intent. The most common causes of acute diarrhea are infections and drugs caused by pathogenic organisms. The causes of chronic diarrhea are very diverse and include irritable bowel syndrome, drug-induced diarrhea, inflammatory bowel disease, pos...

The liver abscess can be divided into pyogenic liver abscess and amebic liver abscess. The patient's diagnosis of pyogenic liver abscess accounts for about 85% of liver abscesses in the United States. The path / cause of the infection is as follows. 1) Biliary tract (most common): Cholangitis / Acute cholecystitis -> Ascending infection 2) Portal vein: Diverticulitis / Appendicitis 3) Abdominal trauma: penetrating wound / 4) Immune decline due to chronic diseases The causative organism varies according to the infection route. Usually E. coli is the main causative organism. If it is infected through the biliary tract, K. pneumoniae, enterococci, etc. may be suspected in addition to E. coli. In case of hematogenous spread, S. aureus and streptococci Can be. Candida spp. Can be suspected if liver abscess is found at the time of recovery of neutropenia in patients under chemotherapy. The clinical manifestations of pyogenic liver abscess include Fever (m / c), RUQ abdominal...