This patient was suffering from chronic elephantiasis!
He presented to the ER with chest pain and dyspnea, suffering from cardiac failure.
Chronic lymphedema (Elephantiasis nostras verrucosa) is an exaggerated form of secondary nonfilarial lymphedema that causes progressive cutaneous hypertrophy.
The term elephantiasis describes a body part that becomes enlarged and disfigured due to edema and fibrosis of the skin.
Conditions that block lymphatic drainage can induce lymphedema, including neoplasms, trauma, radiation treatment, congestive heart failure, obesity, hypothyroidism, chronic venous stasis, and filarial infection.
It can lead to severe disfiguration of body parts with gravity-dependent blood flow, especially the lower extremities.
Clinically, it begins at the dorsal aspect of the foot and progresses to the proximal parts of the limbs. In the beginning, the lesion presents as mild and persistent pitting edema. Later, the affected area loses its elasticity and eventually has a hypertrophic, verrucose, cobblestone-like appearance.
The pathogenesis is still unclear. It is conceivable that first the lymphatic channels are damaged and blocked due to one or more of the above-mentioned conditions, and excessive protein-rich fluid accumulates in the dermis and subcutaneous tissues. Second, the protein-rich fluid decreases oxygen tension and might decrease the immunity of the skin. Third, poor immunity increases the skin’s susceptibility to infection by micro-organisms. Finally, there is swelling, fibrosis, and disfiguration of the affected areas. Hence, a vicious cycle begins, as the underlying conditions predispose the skin to microbial infections.
In this case, patient denied having traveled to a tropical area, and blood smear for microfilaria was negative. However, he presented with several medical conditions, including congestive heart failure, partial deep vein thrombosis, and morbid obesity. These conditions can cause poor venous and lymphatic circulation. In addition, the patient had several episodes of soft tissue infection bilaterally in his lower limbs. It induced fibrosis of the soft tissue and worsened the already deteriorating lymphatic drainage.
#医学生Medic[超话]##medicaltalks#
He presented to the ER with chest pain and dyspnea, suffering from cardiac failure.
Chronic lymphedema (Elephantiasis nostras verrucosa) is an exaggerated form of secondary nonfilarial lymphedema that causes progressive cutaneous hypertrophy.
The term elephantiasis describes a body part that becomes enlarged and disfigured due to edema and fibrosis of the skin.
Conditions that block lymphatic drainage can induce lymphedema, including neoplasms, trauma, radiation treatment, congestive heart failure, obesity, hypothyroidism, chronic venous stasis, and filarial infection.
It can lead to severe disfiguration of body parts with gravity-dependent blood flow, especially the lower extremities.
Clinically, it begins at the dorsal aspect of the foot and progresses to the proximal parts of the limbs. In the beginning, the lesion presents as mild and persistent pitting edema. Later, the affected area loses its elasticity and eventually has a hypertrophic, verrucose, cobblestone-like appearance.
The pathogenesis is still unclear. It is conceivable that first the lymphatic channels are damaged and blocked due to one or more of the above-mentioned conditions, and excessive protein-rich fluid accumulates in the dermis and subcutaneous tissues. Second, the protein-rich fluid decreases oxygen tension and might decrease the immunity of the skin. Third, poor immunity increases the skin’s susceptibility to infection by micro-organisms. Finally, there is swelling, fibrosis, and disfiguration of the affected areas. Hence, a vicious cycle begins, as the underlying conditions predispose the skin to microbial infections.
In this case, patient denied having traveled to a tropical area, and blood smear for microfilaria was negative. However, he presented with several medical conditions, including congestive heart failure, partial deep vein thrombosis, and morbid obesity. These conditions can cause poor venous and lymphatic circulation. In addition, the patient had several episodes of soft tissue infection bilaterally in his lower limbs. It induced fibrosis of the soft tissue and worsened the already deteriorating lymphatic drainage.
#医学生Medic[超话]##medicaltalks#
#EEA晨读# day22-6.12
Those who take responsibility for their
/ðəʊz/ /hu/ /teɪk/ /rɪspɑnsəˈbɪləti/ /fɚ/ /ðer/
life and are wanting to move on
/laɪf/ /ənd/ /ɑr/ /ˈwɑntɪŋ/ /tə/ /muv/ /ɑn/
and put the past behind them are
/ənd/ /pʊt/ /ðə/ /pæst/ /bɪˈhaɪnd/ /ðəm/ /ɑr/
much more likely to gain freedom,
/mʌtʃ/ /mɔr/ /ˈlaɪkli/ /tu/ /ɡeɪn/ /ˈfridəm/
success and happiness.
/səkˈses/ /ənd/ /ˈhæpinɪs/.
Those who take responsibility for their
/ðəʊz/ /hu/ /teɪk/ /rɪspɑnsəˈbɪləti/ /fɚ/ /ðer/
life and are wanting to move on
/laɪf/ /ənd/ /ɑr/ /ˈwɑntɪŋ/ /tə/ /muv/ /ɑn/
and put the past behind them are
/ənd/ /pʊt/ /ðə/ /pæst/ /bɪˈhaɪnd/ /ðəm/ /ɑr/
much more likely to gain freedom,
/mʌtʃ/ /mɔr/ /ˈlaɪkli/ /tu/ /ɡeɪn/ /ˈfridəm/
success and happiness.
/səkˈses/ /ənd/ /ˈhæpinɪs/.
成果汇报+两份浮力
图1⃣️是50天之前立下的FLAG，今天来汇报成果啦~我在网易☁️课堂上买了《赵铁夫讲单词》，这位东北赵老师，也是有点幽默，从语言学（大概）的角度讲了单词的构成、转化和来源，帮助大家找单词的规律。
高中时候的英文老师经常让我们——“to be a good 蒙er”……当时觉得只是语感方面的培养，现在想想单词也该包括在内，一旦掌握了规律，很多单词即便不认识也可以凭借经验猜出其基本含义。我本来就挺喜欢英文的，现在是认真地觉得单词本身很有趣。举个课程中印象超级深刻的例子——Brexit，英国脱欧。其实就是Br+exit：British exit or Britain exiting from the EU.这样分解下来，想记不住也是挺难。（顺便推荐小伙伴去看一下本尼牺牲发际线主演的《脱欧：无理之战》，帮助观众还原英国脱欧的一部分真相。）
东北赵老师讲起单词真的有一套，听课过程中大概记了三四十页的笔记，个人觉得都是精华，有一点值得注意的是：单词该背还是要背的，不是说学了课程就可以靠猜单词走天下了，老师讲的是规律和方法，我们学的是举一反三的技巧和能力。师傅领进门，修行在个人呀~
除了英文课程之外，平台上面还有诸如：办公软件、个人管理、读书、健身、经济、设计、影视处理等很多方面的课程可选。别的课程我还没有体验过，不过单词课效果良好，其他的应该差不了~这里也准备了一个小小的购课优惠浮力，放在评论里面啦~有兴趣的小伙伴们可以试一试，购买课程有优惠哦~
PS：我真的觉得课程很不错，但这篇确实是一个推广（如此耿直.JPG），所以我自己也准备了一个浮力。会在儿童节当天抽一位转发的小伙伴，送一本《挪威的森林》，可能随机掉落一些专属小纸条，毕竟我也没什么别的好送……总之，希望小伙伴们喜欢！
ʟᴏᴠᴇ ᴜ ᴀʟʟ[小仙女] https://t.cn/Ai97VP6F
图1⃣️是50天之前立下的FLAG，今天来汇报成果啦~我在网易☁️课堂上买了《赵铁夫讲单词》，这位东北赵老师，也是有点幽默，从语言学（大概）的角度讲了单词的构成、转化和来源，帮助大家找单词的规律。
高中时候的英文老师经常让我们——“to be a good 蒙er”……当时觉得只是语感方面的培养，现在想想单词也该包括在内，一旦掌握了规律，很多单词即便不认识也可以凭借经验猜出其基本含义。我本来就挺喜欢英文的，现在是认真地觉得单词本身很有趣。举个课程中印象超级深刻的例子——Brexit，英国脱欧。其实就是Br+exit：British exit or Britain exiting from the EU.这样分解下来，想记不住也是挺难。（顺便推荐小伙伴去看一下本尼牺牲发际线主演的《脱欧：无理之战》，帮助观众还原英国脱欧的一部分真相。）
东北赵老师讲起单词真的有一套，听课过程中大概记了三四十页的笔记，个人觉得都是精华，有一点值得注意的是：单词该背还是要背的，不是说学了课程就可以靠猜单词走天下了，老师讲的是规律和方法，我们学的是举一反三的技巧和能力。师傅领进门，修行在个人呀~
除了英文课程之外，平台上面还有诸如：办公软件、个人管理、读书、健身、经济、设计、影视处理等很多方面的课程可选。别的课程我还没有体验过，不过单词课效果良好，其他的应该差不了~这里也准备了一个小小的购课优惠浮力，放在评论里面啦~有兴趣的小伙伴们可以试一试，购买课程有优惠哦~
PS：我真的觉得课程很不错，但这篇确实是一个推广（如此耿直.JPG），所以我自己也准备了一个浮力。会在儿童节当天抽一位转发的小伙伴，送一本《挪威的森林》，可能随机掉落一些专属小纸条，毕竟我也没什么别的好送……总之，希望小伙伴们喜欢！
ʟᴏᴠᴇ ᴜ ᴀʟʟ[小仙女] https://t.cn/Ai97VP6F
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