"CREST" syndrome

one of variant of scleroderma (other variants: eosinophilic fasciitis,Thibierge-Weissenbach syndrome)

• Calcinosis
• Raynaud's phenomenon
• oEsophageal dysmotility
• Sclerodactyly
• Telangiectasia

Diagnosis criteria for SLE

Any 4 of 11 criteria:

1. Malar rash
2. Discoid rash
3. Photosensivity
4. Oral ulcers
5. Arthritis - nonerosive arthritis
6. Serositis - Pleuritis,pericarditis
7. Renal impairment - proteinuria, cellular casts
8. Neurological involvement -seizures,psychosis
9. Haematological involvement - haemolytic anaemia, leukopenia, thrombocytopenia
10. Antinuclear antibody - 95%
11. Immunological disorder - positive LE cell, anti-DNA antibody, false-positive syphilitic serology

innocent murmur of baby :)

features of an innocent murmur - 4S
Soft
Systolic,
aSymptomatic
left Sternal edge

Addison's disease

Addison :

Autoimmune

DIC (meningococcus)

Destruction

Iatrogenic

Sarcodosis,granulomatous eg. TB histiomycosis

hypOtension/ hypOnatremia
Nelson's syndrome (post adrelectomy,increased ACTH)