[Severe Falciparum Malaria]
1. Why ?
-- 1000000 death around the world
-- nearly all death from Falciparum
2. What is severe malaria?
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進醫院前的暑假要先閱讀完畢的兩個領域 --> Radiology 及ECG

常見Q&A
 Q1. 都是英文書,我擔心程度不好看很慢balabala,怎麼辦?
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[Keneth Kuo]

1974.7.7 (0)  born in Taipei
1978        (4)  遇見cello
1986      (12) 曼哈頓音樂學院先修部, 師從Marion Feldman
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1928.1.4 : born in Lawrence, Massachusetts -> NY city grow up
1942 (14): Drop out school
1944 (16): into US Navy 
1946 (18): discharge from US NAVY -> become profession boxer ->
1951 (23): University of Oklahoma 
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S. bovis

[Two No]
1. no valve abnormal (43%~72%)
2. no IV drug related
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remember:  ask  "from onset to recovery"

                                         seizure                        syncope
precipitating                   none                            Valsava, emotion, Hx of heart disease
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[2007]
1.  Norvasc
2.  Lipitor
3.  Diovan
4.  Plavix
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A day of Intern
[Morning]
1. to check: vital sign, lab data, ,PRN times
2. to see: chief complain relieve? Any complication? Tx response?
3. to reflection: Why else can I do? Is Tx appropriate?
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[clinical picture]
under 40 or 45 y/o, male, smoker, complain of digital/toe pain/ischemia

[Symptom]
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  • Mar 19 Wed 2008 23:10

  • MR



[S&S]

1. forward decrease -> low C.O -> fatigue / exertional dyspnea -> LV failure
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ECG

during exercise
1. ST depression (看J point後2格) 
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[Discolored of Nail Bed] ->In nail bed, therefore color is white/pink change
1. kidney: Lindsay nail (half and half nail)
                  a. proximal (40%~80%)-> white
                      distal ->red, pink, brown (depend on pressure)
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Brugada Syndrome

[epidemiology]
1. most Asian, japan~ 1%
2. male : female = 9 : 1
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[intro]
1. amebiasis: infected by E. histolytica 
2. infectied -> 90% -> asymptom
                         10% -> dysentery, liver abscess..etc
# free-living amebas
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[cirrhosis complication]
four major -- portal hypertension
1. EV bleeding 
2. hepati encephlopahty
3. hepatorenal syndrome
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