Eaton-Lambert syndrome?,”Eaton-Lambert syndrome is associated with small cell carcinoma of the lung, and results from autoantibodies directed against the voltage-gated calcium channels i the presynaptic motor nerve terminal. Look at a patient’s history, especially for smoking, weight loss, and physical exam findings, like proximal muscle weakness, malaise, lung mass

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Central retinal artery occlusion secondary to embolism?,”PlPainless loss of monocular vision is the usual presenting symptom. Embolism of the retinal artery is the most common cause of ocular stroke. CRAO is an ophthalmologic emergency. A delay in treatment may result in permanent loss of vision. Immediate intervention includes ocular massage

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Hyperthyroidism?,”Plasma TSH is the best initial diagnostic test for patients with suspected hyperthyroidism. Almost all patients with hyperthyroidism have low TSH concentrations due to appropriate suppression by high serum T3/T4 concentrations. If the plasma TSH level is low, free plasma T4 should be measured, and if this is elevated, the diagnosis of clinical hyperthyroidism is established. A 24-hour thyroid radioiodine uptake and scan should be done to differentiate Grave’s hyperthyroidism from other causes. In the management of patients with hyperthyroidism

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Tricyclic antidepressant (TCA) overdose?,”TCA overdose can have central nervous system toxicity )eg, sedation, seizures, coma), anticholinergic toxicity (eg, hyperthermia, dilated pupils, intestinal ileus, urinary retention), and cardiac toxicity. Cardiac toxicity causes most death in TCA overdose. Sodium bicarb is used to treat cardiac toxicity, which is characterized by prolonged QRS duration and ventricular arrhythmias. Sodium bicarb increases serum pH and extracellular sodium

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Fibromuscular dysplasia?,”FD is a noninflammatory and nonatherosclerotic condition that presents most commonly in women age 15-50. The condition affects primarily the renal arteries and causes hypertension. Involvement of the cerebrovascular arteries (eg, carotid, vertebral) can cause symptoms of brain ischemia (eg, transient ischemic attack, amaurosis fugax, stroke) or nonspecific symptoms (eg, headache, pulsatile tinnitus, dizziness). Patients with renal artery involvement usually develop hypertension. Diagnosis is usually confirmed with noninvasive imaging (CT angiography of the abdomen or duplex U/S). FMD decreases perfusion to the kidneys

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