J.M. 21 y/o female cc: scalp mass. History of Present Illness Slowly enlarging, firm, occasionaly tender mass on R parietoocipital area (3x3cm) Consult.

Slides:

Advertisements

Similar presentations

Preeti Prerna M. Vaswani

Advertisements

General Data E. V. 15/M Single Sampaloc, Manila Roman Catholic.

History of Present Illness 9 months Terminal pain during urination UTI – cefuroxime 250mg/5mL BIDx7 days 6 months Fever and loss of appetite; U/A - WBC:

Chicco, sorry sa late ppt.. Not sure if anung ilalagay kong PE if on admission or PE ni martin. So nilagay ko na lang pareho.. Hindi ko din nilagay lahat.

PE on Admission Conscious, coherent, not in cardiorespiratory distress Vital Signs –BP: 130/80 - ok na ba to, o kailangan pang pababain –HR: 88, regular.

General Data R.G. 2 years 4 months (May 22, 2008) Male Filipino Roman Catholic Sampaloc, Manila Informant: Mother Reliability: Good.

MEDICAL HISTORY U.S. 28 year old male, catholic, married, born on May 6, 1981, works as a tricycle driver since 2001, residing in Caloocan City with wife.

Upper GI Bleeding Case 2 Alonzo, Amaro, Amolenda, Anacta, Andal.

General Data C.D. Age/Sex/Status: 81/F/Widow Address: San Miguel, Manila Date of birth: May 19, 1929 Place of birth: Manila Occupation: Unemployed Religion:

Brugada Group 6 Ateneo School of Medicine and Public Health.

Jerry V. Pua MD 2nd year Resident

Alonzo.Amaro.Amolenda Anacta.Andal. Beginning Data  Male, 45 year old  Chief Complain: Severe Abdominal Pain.

Case Conference February 1, 2011 Geronimo RE, Go CM, Go CK, Go F, Go MR.

Objective To present a case of a Hemophagocytic Lymphohistiocytosis (HLH)

ER Con DRAFT. General data L.A 14 month old Female Filipino Roman Catholic Quezon City.

General Data Name: Y.F. Age & Gender: 67/Female Civil Status: Widow Occupation: Housewife Chief Complaint: Left neck pain.

Physical Examination On admission Upon PE General Survey Vital Signs

TRAUMA. PATIENT DATA N.H 53/M Married Filipino Roman Catholic Pasig city.

Approach to a patient with cough B4 – Dr. Remedios Coronel Garcia, Garcia, Garzon, Gaspar, Gatchalian, Gaw, Geraldoy, Geronimo, Geronimo Geronimo, Go,

Head and Neck, Eyes, Ears, Nose, & Throat

Approach to a Patient with Cough B4 – Dr. Remedios Coronel Garcia, Garcia, Garzon, Gaspar, Gatchalian, Gaw, Geraldoy, Geronimo, Geronimo Geronimo, Go,

General Information S.A. 21 y/o female Single, unemployed Born April 5, 1988 Resident of Laloma City Chief complaint: Left flank pain for 1 day.

Approach to a Patient with Diabetic Foot

Infiltrating Ductal Carcinoma & Man

Admission Conference Clk. Kirsten Diane Dy. General Data U.S. 28 y/o Male Married Filipino Tricycle driver Roman Catholic Quezon City Date of Admission:

MAKATI MEDICAL CENTER DEPARTMENT OF MEDICINE MEDICAL GRANDROUNDS

Pediatric Orthopedic Conditions Block 5A January 6, 2010.

ADMISSION CONFERENCE Patricia Amolenda. General Data A.B. 18 month old/female Roman Catholic DOA: March 27, 2011.

PHYSICAL EXAMINATION.

Epigastric Stab Wounds

CLINICOPATHOLOGIC CONFERENCE GROUP 8 Cabal, Cabrera, Cachola, Cajucom, Callang, Cantor, Chen, Chu, Co, Cuenca-Cajucom, De Jesus, Delos Reyes.

Dengue Fever with Warning Signs. Objectives To identify warning signs seen in Dengue Fever To manage a case of Dengue Fever with warning signs.

Patient History  TO  14 year old male  Lives in Palau  Right-handed  Informant: Patient, good reliability Chief Complaint: Wrist Injury.

Pediatric Diagnosis Observation –Eye contact –Establish rapport with the parents & the child History taking –Investigation –Asking “relevant” questions.

General Data Name: Y.F. Age & Gender: 67/Female Civil Status: Widow Occupation: Housewife Chief Complaint: Left neck pain.

 28 y/o, Female  Chief Complaint: Dyspnea 3 days PTA Underwent dental procedures 2 days PTA Productive cough with yellowish sputum accompanied by colds.

 This is a case of M.T, 37 year-old female, married, Christian, right-handed, from Malate, Manila who came in due to stiffening and pain in the neck.

Inguinoscrotal mass Case Presentation. Objectives To present the history and physical examination of a patient presenting with inguinoscrotal mass To.

ALCARAZ, ALLEGRE, ALMORA, ALONZO, AMARO, AMOLENDA, ANACTA, ANDAL, ANG, J.

A Case of N.E. 16 y.o Male cc: fever x 3 days

Admitting Conference 217 – E Clerk YUMUL, ARVIN R.

GS III Preceptorials January 28, 2012 Block 10a. General Data 55 y.o. Male Farmer Roman Catholic Lubang Island, Occidental Mindoro Chief Complaint: RUQ.

Maria Febi C. Billones January 13,  R.Q.  61 y/o  Female  Married  Bicutan.

Presented by: GAW, Gem Minnie Mae GO, Stephanie M. GONZALES, Alexander II.

GENERAL DATA  M.R.  34 years old/Female/Single  Right handed  Place of Birth: Oriental Mindoro  Roman Catholic  Fish vendor  Quezon City  Date.

 IR  45 years old, female  Right handed  Manila  Chief complaint: purulent discharge from surgical wound.

Surgical Pathology Conference 一般外科 : CR 吳柏鋼 / VS. 張耀仁

CASE CONFERENCE Ang, Kevin Aningalan, Arvin Antonio, Aby Aramburo, Jan Cruel, Anna.

 J.Y.  13 y/o Female  Single  Filipino  Roman Catholic  from Butuan City, Agusan del Norte.

1. What is your clinical impression?. Differential Diagnosis TB adenopathyLymphoma Lymphadenitis from aphthous ulcer Metastatic carcinoma from oral cavity.

Daguman, Emmanuel II Dadgardoust, Persia. Case 2  45 y/o  male  c/c: severe abdominal pain.

Approach to a Patient with Productive Cough and Fever B4 – Dr. Remedios Coronel Garcia, Garcia, Garzon, Gaspar, Gatchalian, Gaw, Geraldoy, Geronimo, Geronimo.

History and PE Fiona Javelosa. The Curious Case of John Dick Group 3 Clinical Clerk Batch 2012 SY

What is your clinical impression? What are the differential diagnosis?

호흡 곤란을 주소로 내원한 44 세 여자 환자 호흡기 내과 R1 이지훈 / Prof. 박명재.

 J.Y.  13 y/o Female  Single  Filipino  Roman Catholic  from Butuan City, Agusan del Norte.

1 MGR 내분비 대사 내과 R2 황연희. 2 주소 전신적인 무기력증 발병시기 : 약 7 개월 전 현병력 특이 병력과 약물 복용력 없는 62 세 여자 환자로 7 개월 전부터 쉽게 지치고, 일상생활 유지 못할 정도로 전신 무기력감 지속되어 건강검진 시행 받았으며 당시 혈청.

건강 검진에서 발견된 위선종 73/M 소화기 내과 R 3 김혁 / Prof. 장영운 MGR.

Polygrandular Autoimmune Syndrome 내분비대사 내과 R1 권성진.

MGR - case R2. 유정선 / Prof. 정재헌. Case 송 O 섭 M/67 Adm date: Chief complaint Left neck mass o/s) 15 일전 Present illness 67/M, 2009.

Case Presentation Jung Hyun Seo Department of Internal Medicine Catholic University of Daegu School of Medicine School of Medicine.

High Risk Conference Clerk Emman Carlo R. Evangelista.

Part 1 Final. The Curious Case of John Dick Group 3 Clinical Clerk Batch 2012 SY

A Case of Hemiparesis.

Presented by Int. 楊為傑 Int. 吳建霆

Arm Injury A Case Discussion

Emergency Case Conference

II. The Family CP A. Introduction.

Case Presentation M. S. 13 y.o., male Toril, Davao City

General data T. E. 39 year old Male Catholic From Mandaluyong City

Presentation transcript:

J.M. 21 y/o female cc: scalp mass

History of Present Illness Slowly enlarging, firm, occasionaly tender mass on R parietoocipital area (3x3cm) Consult – A: Hemangioma – P: Excision 14 years PTA

ADMISSION 2 mos PTA Recurrence of slowly enlarging mass (5x5cm) Consult at UST OPD – Scalp X Ray – Ultrasound of neck

(-) HPN (-) DM (-) HPV infection (-) Asthma (-) Allergies (-) PTB

Mixed diet Nonsmoker Not an alcoholic beverage drinker

(+) HPN – mother (+) DM – grandfather (-) Asthma (-) CA

(-) weight loss, weakness, fatigue (-) Headache, dizziness, blurring of vision (-) hearing loss, aural discharge, tinnitus (-) epistaxis, nasal discharge, sinusitis (-) hoarseness, mouth sores, dysphagia (-) dyspnea, cough

Conscious, coherent, ambulatory, not in distress BP: 120/80 PR 80bpm RR 18cpm T 36.5°C Wt. 60 kg Ht. 162cm Warm moist skin, no active dermatoses Pink palpebral conjunctivae, anicteric sclerae No naso-aural discharge, non-congested turbinates, non-tender sinus, buccal mucosa, tonsils not enlarged, no bleeding gums Supple neck, (-) palpable cervical Lymph Nodes, no thyromegaly

Symmetric on chest expansion, (-) retractions, lungs resonant, clear breath sounds Adynamic precordium, AB 5 th LICS MCL, S1>S2 at the apex, S2>S1 at the base, no murmurs Flat abdomen, no organomegaly, (-) rebound tenderness, no masses (-) pallor, clubbing, petechiae, ecchymoses Pulses ++ on all extremities

Admitting Impression Soft tissue tumor to consider recurrent hemangioma vs. granuloma

Merkel’s Cell Carcinoma Classified as a neuroendocrine malignancy of the skin. Cutaneous small cell undifferentiated carcinoma Incidence of 1200 per year in the US Mortality rate of 33 % National Cancer Institute. Fact Sheet MERKEL’S CARCINOMA Merkel Cell Carcinoma: More Deathsbut Still No Pathway to Blame Bianca Lemos and Paul Nghiem. Journal of Investigative Dermatology (2007)

Discussion Merkel’s cells located in the basal layer of the epidermis. Grossly, the primary tumor presents as a small, red, pink, or blue-violet, non-ulcerated, painless, intradermal nodular mass often located in sun-exposed areas of the skin such as the head and neck

Discussion Neuroendocrine markers – Neuron-specific enolase – Chromogranin – Synaptopysin Merkel cell carcinoma, Virve Koljonen. World Journal of Surgical Oncology 2006

American Joint Committee on Cancer Stage I (primary lesion ≤ 2 cm) Stage II (primary lesion > 2 cm). Stage III (nodal involvement) Stage IV disease (metastatic)

Prognosis Aggressive course with reported overall 5-year survival rates ranging from 30% to 64%. Survival after a diagnosis of MCC is highly dependent on the stage at presentation. 90 percent of recurrences occurring within three years of diagnosis Merkel Cell Carcinoma: A Case Report and Literature Review. Oncology. Medical Journal of Islamic World Academy of Sciences 15:3, 91-94, 2005