Precision Clinical Medicine

Out now: The December issue of Precision Clinical Medicine (Vol 8, Issue 4) is live! 🔬 This issue explores: 📉 New guidelines for obesity management 🤖 AI’s impact on the future of endocrinology 🧬 CRISPR-based prime editing 🎗️ HER2-ultralow breast cancer research Full issue here: bit.ly/4r5BAFs

@modernHealthMe Pellagra Pellagra is a systemic condition caused by Vitamin B3 (niacin) deficiency. It is characterized by the "four Ds": Dermatitis (specifically Casal’s necklace rash), Diarrhea, and Dementia, with untreated cases leading to Death. Source: @NIH

Patient with diarrhoea and memory loss. Diagnosis??

LDCT screening reduces lung cancer mortality by 20%. New advances in molecular pathology and AI-assisted imaging are further refining early diagnosis and personalized care. academic.oup.com/pcm/article/8/…

Systemic Amyloidosis. Amyloid fibrils deposit in small blood vessel walls, increasing capillary fragility. This leads to bilateral periorbital ecchymosis (raccoon eyes) or "pinch purpura." These symptoms can be triggered by minor trauma or pressure-increasing activities like sneezing, coughing, or the Valsalva maneuver. Reference:@ClevelandClinic

No history Of trauma Diagnosis.?

Syphilitic Chancre (Primary Syphilis) A syphilitic chancre is a solitary, painless, indurated ulcer with raised borders caused by Treponema pallidum at the inoculation site. This classic sign of primary syphilis often appears on the genitals or lips. Accompanying symptoms include regional lymphadenopathy. Spontaneous healing occurs, but the underlying infection remains systemic and transmissible. Source: @NEJM

Painless. What is the diagnosis?

From early cancer detection to optimizing drug discovery, AI-driven tools are reshaping the healthcare landscape. This review examines the shift toward personalized, data-driven medical interventions. academic.oup.com/pcm/article/8/…

C. Ivermectin Onchocerciasis is a parasitic disease caused by blackfly bites. It leads to severe itching, skin lesions, and "River Blindness."Ivermectin works by killing microfilariae, halting the inflammation that destroys eyes and skin. It prevents disease progression and transmission but does not eliminate adult worms. Early intervention prevents permanent blindness. Medical Insight: @WHO

Which one of the following is drug of choice for onchocerciasis (River blindness) infection❓ A. Metronidazole B. Albendazole C. Ivermectin D. Fluconazole

A) Jaundice Jaundice is a condition characterized by the yellowing of the skin and whites of the eyes caused by high levels of bilirubin (hyperbilirubinemia) in the blood. It is not a disease itself, but a symptom of an underlying issue involving the liver, gallbladder, or excessive red blood cell breakdown. Source: @medlineplus

What is the physical sign? A) Jaundice B) Raynaud's C)Cyanosis?

Precision oncology shifts from traditional treatments to tailored plans. Integrating diverse multi-omics data types through machine learning enables precise patient stratification and identifies molecular drivers of cancer progression. academic.oup.com/pcm/article/8/…

B. Bacterial vaginosis Bacterial vaginosis (BV) is a common vaginal infection in reproductive-aged women caused by an imbalance in normal vaginal flora, where beneficial bacteria are overtaken by, for example, Gardnerella vaginalis. It often causes thin, gray-white, fishy-smelling discharge, though many cases have no symptoms. It is treated with antibiotics like metronidazole or clindamycin. SOurce: @ClevelandClinic

A woman presents with thin, grey white discharge and fishy odor. Most likely diagnosis? A. Candidiasis B. Bacterial vaginosis C. Trichomoniasis D. Gonorrhea

B. Gottron Papules. Gottron papules are pathognomonic for dermatomyositis, an autoimmune disease. Pathophysiologically, interface dermatitis causes lymphocytic infiltration at the dermal-epidermal junction. These symmetric, violaceous, flat-topped papules typically appear over the finger joints (MCP and PIP) and may show scaling or telangiectasia. They represent characteristic skin involvement in this inflammatory myopathy. Source : @dermnetnz

What is the name of this clinical feature❓ A. Heliotrope Rash B. Gottron Papules C. Shawl Sign D. Mechanic's Hands

c. Point 3 (Erb’s point) Erb's point is located at the 3rd left intercostal space. It is the optimal site for hearing S2 heart sounds and murmurs from both aortic and pulmonic valves, especially aortic regurgitation.This specific anatomical location facilitates the identification of valvular dysfunction during a comprehensive cardiac physical exam, serving as a critical diagnostic crossroads for clinicians. Ref: @StatPearls1

Based on the image, which numbered point corresponds to Erb’s point during cardiac auscultation? a. Point 1 b. Point 2 c. Point 3 d. Point 4 e. Point 5

New meta-analysis comparing first-line treatments for advanced EGFR-mutant NSCLC. Evaluation of safety and efficacy across multiple therapies for improved patient outcomes. academic.oup.com/pcm/article/8/…

Monitoring ctDNA allows for real-time tracking of tumor burden and treatment efficacy. This technology identifies genomic alterations earlier than traditional imaging, facilitating more personalized cancer management strategies. academic.oup.com/pcm/article/8/…

Ankyloglossia (Tongue-tie) Ankyloglossia involves a short lingual frenulum tethering the tongue tip to the mouth's floor. This restricts movement, causing a heart-shaped tongue and difficulty protruding it. It often impacts breastfeeding and speech development. Treatment typically requires a simple surgical release (frenotomy) to improve range of motion. Attribution: @MayoClinic

Diagnosis?

A. Genu Varum Genu varum, or bow-leggedness, is a, common condition in infants and toddlers characterized by an outward bowing of the legs, creating a space between the knees when ankles are together. It is usually a normal, physiologic developmental stage that resolves on its own by age 3–4, although it may require treatment if it persists, causes pain, or is caused by underlying conditions like rickets or Blount’s disease. Source: @ClevelandClinic

What is the most likely diagnosis❓ A. Genu Varum B. Genu Valgum C. Coxa Vara D. Windswept Deformity

Hepatitis B or C Infection. Hepatitis is liver inflammation often transmitted via non-sterile tattoo equipment. Contaminated needles introduce HBV or HCV, damaging liver cells and impeding bilirubin metabolism. This results in jaundice, characterized by yellowing of the skin and eyes. Other symptoms include abdominal pain and dark urine. Source: @CDCgov

After getting a tattoo, she developed jaundice. What's the reason??

Targetable mutations in NSCLC, including EGFR, ALK, and KRAS G12C, are now standard in personalized care. This review explores current standards and the growing role of immunotherapy for better patient outcomes. academic.oup.com/pcm/article/2/…

C) Interstitial lung disease Interstitial lung disease (ILD) is a broad term for over 200 disorders causing inflammation and irreversible scarring (pulmonary fibrosis) in the lung tissue, making it hard to breathe and take in oxygen. Common symptoms include chronic shortness of breath and dry cough. While some types have unknown causes (idiopathic), others are linked to smoking, environmental exposure, and autoimmune diseases. Source: @LungAssociation

Honeycomb lung is seen in: A) Bronchial asthma B) COPD C) Interstitial lung disease D) Pulmonary TB

B) Carbamazepine Carbamazepine (Tegretol) is an anticonvulsant and mood-stabilizing medication used to treat epilepsy (partial and tonic-clonic seizures), trigeminal neuralgia, and bipolar disorder. It works by reducing abnormal electrical activity in the brain by blocking voltage-gated sodium channels. Common side effects include dizziness, drowsiness, ataxia, and nausea, with risks of serious, rare skin reactions (especially in certain Asian populations) or blood dyscrasias. Source: @medlineplus

DOC for trigeminal neuralgia: A) Gabapentin B) Carbamazepine C) Phenytoin D) Valproate

The 2019 CSCO lung cancer guidelines prioritize targeted therapies like Osimertinib and Alectinib for NSCLC. It also introduces immunotherapy combinations, such as Durvalumab and Atezolizumab, as first-line treatments for extensive-stage SCLC. academic.oup.com/pcm/article/3/…