FAS

Fetal alcohol syndrome.

clinical features- facial dysmorphology,growth retardation,mental deficiency/emotional instability.

anatomic findings-microcephaly,epicanthal folds,short palpebral fissure,maxillary hypoplasia,thin upper lips,micrognathia,poorly developed philtrum,septal defects of heart.

IQ below 85

short memory spans,impulsiveness,emotional instability.







(pic from wikipedia.)

Folic Acid

Folic acid have been shown to reduce the incidence of neural tube defects by lowering plasma levels of homocysteine.
Homocysteine is a teratogen for CNS and heart.
women with reduced activity of 5,10-methylenetetrahydrofolate reductase exhibit elevated levels of homocystein and are at risk for bearing children with neural tube and other birth defects.

false positive syphilis in SLE

why do patients with SLE have positive VDRL and RPR tests for syphilis?

40-50% SLE patients have anti-phospholipid antibodies,which often reach with cardiolipin antigen used as reagent in serologic test for syphilis. the cross-reactivity cause false positive syphilis test in SLE patients.

"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)