Comments on: Situaţii reale UMF

By: bruno

bruno — Thu, 28 Jul 2011 06:24:23 +0000

@alexxx de la ce iti vine @XXX, mie imi e clar ca acolo iti sunt toate gandurile fitzele si pretentziile -dar ai uitat sa spui ca postezi ds tine

By: bruno

bruno — Thu, 28 Jul 2011 06:22:58 +0000

N-am mai vizitat de mult siteurile tale Andrei, dar imi pare bine ca nu te-ai lasat si ca ai continuat sa transmiti chair daca nu cu aceeasi frenezie din anii preclinici/ Am dat un search din alt motiv si am regasit asta si mi-am adus aminte de MARELE SI INTELIGENTUL CERCETATOR @Andrei C si m-am uitat sa vad daca in nesimtzirea lu si-a cerut scuzele de rigoare pt ca a inceput sa jicneasca in baza unor vanturi trase de un “prieten” al domnieis ale. Nimic.
Adica doar ne-a tratat cu SUPERIORITATEA LUI DE MARE CERCETATOR SI NE-A IGONARAT: “Este ultimul post (adica nu mai revin la ce am scris). Va urez succes pe viitor.”
Foarte urat domnule foarte urat si acum pot sa ti-o spun si mai franc pentru ca nu mai sunt atat de mic k in 2008, dar tu cum esti?
Respect pentru cei care merita! Sper ca nu se lasa loviti de comentarii si prostii si rautati
@Ghost ai dreptate si nu e niciodata prea tarziu sa recunosti un adevar. Brav tie!

By: Appendicitis

Appendicitis — Mon, 30 Aug 2010 17:27:07 +0000

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By: Ghost

Ghost — Fri, 02 Jan 2009 13:53:01 +0000

Sper ca nu m-am trezit prea tarziu in legatura cu subiectul asta…
Am citit cateva reply-uri din cele de mai sus si ce scria pe site si in documente.
Si mi se pare imposibil sa poti sa spui ceva impotriva domnului profesor. Mai ales daca ai avut sansa nemaipomenita sa faci cursuri si laboratoare cu dumnealui.
Eu nu am fost un student prea bun….dar de la un curs tinut de domnul profesor retineam mult mai mult comparativ cu alte cursuri ale altor profesori. Pentru ca punea intrebari si ne explica, nu ne dicta… Si mai primeam si cursul pe mail !!! Unde ati mai vazut asa ceva ??!?!?!
Pe langa treaba foarte buna pe care o facea cu studentii la cursuri, la laboratoare, mai investea timp si energie si in cercul de microbiologie – exact cum le place studentilor: moka !
Plus ca titlurile pe care le detine ( M.D., Ph.D., M.P.H. ) il obliga la inca alte nu-stiu-cate activitati. Si daca mai pui ca are si familie, te intrebi de ce a mai scris si a pus documentele acelea pe trionline ! Alt timp, alta energie…
Cred ca motivatiile au fost diverse….si multe.
Domnul profesor este foarte deosebit si eu cred ca in mijlocul acestui vartej de activitati impletit cu nemultumiri si jigniri de-ale unor studenti/colegi, dumnealui rezista datorita unui “lucru”: Dumnezeu.
ok… “TCB”
Sorin Ghost

By: Mircea Ioan Popa

Mircea Ioan Popa — Wed, 19 Nov 2008 20:06:33 +0000

1. @Costin
Primele cazuri au aparut pe site-ul “cercului”. Participanti, foarte putini. Nici macar tu.
O sa mai incercam.
Case no. 1
A 48-year-old man presents for the evaluation of a 2-month old history of upper abdominal pain associated with nausea. It is made worse when he drinks coffee, soda or alcohol. He has taken multiple over-the-counter antacid medications that provide temporary relief. He admits to a 20-pack-year smoking history and drinking one or two alcoholic beverages a week but denies significant use of nonsteroidal anti-inflammatory drugs (NSAIDSs). His general physical examination is notable for epigastric tenderness without the presence of masses, rebound tenderness or guarding. A rectal examination reveals his stool to be heme positive. A complete blood count (CBC) shows a mild hypochromic, microcytic anemia. He is referred to a gastroenterologist for an upper GI endoscopy, which shows diffuse gastritis and a gastric ulcer.
1. What organism is most likely to be visualized on histologic evaluation of a gastric biopsy specimen?
The organism likely to be visualized is Helicobacter pylori.
2. Besides microscopic evaluation, what other clinical test may provide a rapid detection of this organism?
The urease test – H. pylori uses this enzyme to convert urea into ammonia and carbon dioxide. This chemical reaction is the basis of the rapid urea breath test for diagnosis of H. pylori. The increased ammonia produced by this reaction neutralizes gastric acid, which allows the organism to survive the normally harsh environment and damages to gastric mucosa.
3. What two factors facilitate this organism’s ability to colonize the stomach?
Blockage of acid production by a bacterial acid-inhibitory protein and neutralization of acid by ammonia produced by urease activity.
Comprehension question:
A 45-year-old man presents to the hospital vomiting blood. He is diagnosed with a perforated peptic ulcer. The causative agent discovered by gastric biopsy is a spiral gram-negative bacillus. What other long-term complications could this organism cause if not treated?
Skin ulcers
Esophageal varices
Gastric MALT lymphomas
Colon cancers
Correct answer: C. Gastric MALT lymphomas
H. pylori is the causative agent of type B gastritis, peptic ulcers, gastric adenocarcinoma and gastric MALT B cell lymphomas.
Case no. 2
A 50-year-old man, a recent immigrant from Vietnam, is brought to the emergency room with a cough productive of bloody sputum. He first noticed a cough approximately 2 months ago, but there was not much sputum. In the past several days his sputum production has increased and become mixed with blood. He reports having lost approximately 15 lb in this time frame as well. He also notes that he’s had drenching night sweats 2 or 3 nights a week for the past month. He has a 50-pack-year smoking history but no other medical history. He came to the US from Vietnam 7 months ago. On examination he is a thin, frail-appearing male. His vital signs are normal. His head and neck exam is normal. He has no palpable adenopathy in his neck or axilla. His lung exam is notable only for decreased breath sounds diffusely. A chest x-ray shows a cavitary infiltrate of the left upper lobe.
1. What type of organism is likely to be seen on Gram stain of a sputum sample?
Mycobacterium tuberculosis – appear as colorless (”ghost”) cells.
2. What technique of staining is most commonly used to identify this organism?
Acid-fast staining
3. What is the histologic characteristic of Langhans cells?
Langhans cells are multinucleated giant cells of fused macrophages.
M. tuberculosis is spread from person to person via aerosolized respiratory droplets that travel to the terminal airways. The bacteria are phagocytized by alveolar macrophages but inhibit destruction by the phagosome and proceed to replicate. Circulating macrophages are attracted to the site of infection and create multinucleated giant cells, composed of fused macrophages called Langhans cells. Extrapulmonary sites are infected through the spread of infected macrophages via lymphatic or hematogenous dissemination.
Case no. 3
While on call on a Saturday in July, you receive a call from the mother of a 15-year-old man who developed the acute onset of nausea, vomiting and diarrhea shortly after returning from an outdoor party that was held at the home of a friend. At the party, a picnic lunch of hamburgers, hot dogs, potato salad, baked beans and lemonade was served. The food was served on an outdoor picnic table and the guests were free to eat at any time during the party. None of the food tasted spoiled or tainted. His symptoms started abruptly about an hour after he returned home, which was approximately 4 hours after he had eaten. He currently is unable to keep down anything. He does not have a fever and has not passed any blood in his stool or vomitus. Prior to calling you, your patient’s mother spoke with the hostess of the party, who said that she had heard from three other guests who became ill with similar symptoms.
What organism is most likely to cause this patient’s illness?
Staphylococcus aureus
Your patient’s mother requests that you call in a prescription for an antibiotic to treat the infection. What is your response?
The correct response would be: No, the gastroenteritis is caused by a preformed toxin, not by the ingested Staphylococci, therefore antibiotic therapy would be of no help.
Comprehension questions:
1. Short incubation food poisoning, caused by ingestion of preformed enterotoxin, is caused by which bacteria listed below?
Staphylococcus aureus
Staphylococcus epidermidis
Enterococus faecalis
Streptococcus pneumoniae
Streptococcus pyogenes
Correct answer: A. Staphylococcus aureus. Of the options given the best answer is A., as a result of enterotoxin production in food. None of the other strains listed produce enterotoxins that result in short-term gastroenteritis.
2. A 12-year-old girl was playing soccer when she began to limp. She has pain in her right leg and right upper thigh. Her temperature is 38.9şC. X-ray of the femur reveals that the periosteum is eroded, suggestive of osteomyelitis. Blood culture yields Gram-positive bacteria. The most likely etiologic agent is which of the following?
Listeria monocytogenes
Salmonella enteritidis
Staphylococcus aureus
Staphylococcus saprophyticus
Streptococcus pneumoniae
Correct answer: C. Staphylococci, especially S. epidermidis, are normal flora of the human skin and respiratory and gastrointestinal tracts. Nasal carriage of S. aureus, the pathogen, occurs in 20-50 percent of humans. Abscesses are the typical lesion of S. aureus. From any one focus, organisms may enter the bloodstream and lymphatics to spread to other parts of the body. In osteomyelitis, the primary focus is generally in a terminal blood vessel of the metaphysic of a long bone, which may lead to necrosis of bone and chronic suppuration. Staphylococcus saprophyticus is usually a nonpathogenic normal flora organism. Listeria is usually transmitted in unpasteurized dairy products, whereas Salmonella pneumoniae is primarily intestinal. Streptococcus pneumoniae is primarily a respiratory pathogen, although it is an important central nervous system pathogen in children.

By: Mircea Ioan Popa

Mircea Ioan Popa — Thu, 13 Nov 2008 11:13:28 +0000

Costin,
Daca vrei, inscrie-te pe site-ul “cercului de microbiologie”. Acolo sunt deja 144 persoane inscrise si va fi mai usor si mai corect de utilizat ca “locatie” pentru ideea ta.
Adresa este – health.groups.yahoo.com/group/cerc_microbiologie_UMF/
Toate cele bune.

By: Costin

Costin — Thu, 13 Nov 2008 10:57:05 +0000

Multumesc domnului profesor ca a raspuns.Vad insa ca nu a mai postat nimeni ca ar vrea “sa participe”.Asteptam in continuare sa va inscrieti;).

By: Mircea Ioan Popa

Mircea Ioan Popa — Tue, 11 Nov 2008 18:23:32 +0000

Costin,
Multumesc pentru propunere.
Sunt inca in toiul unei conferinte pe care am organizat-o, dar incepand cu ziua de luni am sa ma gandesc la modul in care sa pun in aplicare ceea ce ai spus.
Eu cred ca meritati; este important sa credeti si voi aceasta.
Toate cele bune.

By: Costin

Costin — Mon, 10 Nov 2008 21:26:01 +0000

Pentru ca stiu ca domnul profesor mai citeste cand are timp mesajele noastre am sa va propus si voua, si dumnealui daca vrea, poate si crede ca meritam…..sa se mai joace putin cu noi…asa ca in anul 2…Sa ne dea un pacient…iar noi…stim ce avem de facut….ne stoarcem mintea, cautam prin cartea dumnealui(ii multumesc pe aceasta cale pentru cartea minunata pe care a scos-o – editia a doua)…gasim ce are pacientul iar la sfarsit domnul profesor va posta in calitate de coleg al nostru un raspuns…numai ca vom sti ca acela e cu siguanta raspunsul corect.Sa premiem cu cate 100 de puncte primul raspuns corect, 60 al doilea, 40 al treilea si cate 20 de puncte toate celelalte.De ce asa…?Pentru ca celelalte raspunsuri, mai putin primul, au o sursa in plus de inspiratie si prin urmare n-ar fi corect sa primeasca acelasi numar de puncte.Astfel cred ca vor fi si mai multi cei care vor posta aici.Daca sistemul de notare credeti ca nu e corect, il vom lasa pe domnul profesor sa acorde puncte dupa cum crede dumnealui, bine-nteles daca este de acord sa intre in jocul nostru.Sau in jocul meu..pentru ca nu stiu (inca) daca ar mai fi si altii interesati sa se joace.

By: Monica Oana

Monica Oana — Thu, 06 Nov 2008 17:20:41 +0000

E incredibil cum de fiecare dată când eşti pus în faţa unei alegeri de tipul a face bine / a face rău, e atât de greu sa faci binele, doar ce satisfacţie vei avea?!. Mai bine începi să spui minciunele…Că doar din asta se trăieşte în zilele noastre. Îmi pare nespus de rău pentru confuziile (ne)voite de mai sus. De exemplu – eu am făcut cursul cu dna. prof. Debeleac iar la LP am avut norocul sa-l “prind” de vreo două ori pe dl. prof. Popa şi NU, nu am stat numai 15-20 minute. Ne-a ţinut chiar cât trebuie pentru un LP şi a fost tare frumos. Am zis asta şi voi repeta de fiecare dată: domnul Profesor întotdeauna a reuşit să ne facă să vedem clar pentru ce anume ne străduim atâta şi, mai ales, ne-a pus destule cărămizi la baza temeliei noastre mediciniste.
Şi DA, dl. Profesor ne este ca un părinte. Îndrăznesc şi eu să spun asta. De câte ori am apelat la dumnealui pentru alte probleme (în special de sănătate), întotdeauna mi-a răspuns şi m-a ajutat enorm atât cu sfaturi cât şi cu faptul că m-a direcţionat către oamenii care mă puteau ajuta pe mai departe. Şi asta folosindu-mă de numele şi imaginea dumnealui. Voi fi întotdeauna recunoscătoare domnului Profesor pentru acest mare ajutor. Ca să nu mai vorbim de faptul că de fiecare dată îmi răspunde la nenumăratele întrebări mai ales că acum sunt în anul III – este un lucru mare şi minunat să ai un îndrumător într-ale medicinei.
Noi vom continua să-l susţinem pe dl. Profesor. Dumnealui nu este în niciun fel ceea ce aţi îndrugat domniile voastre (mă refer la cei de pe la început) mai sus. Poate vă veţi da seama odată de greşeală numai că deja e cam târziu.