MTD 🩺
153 posts
MTD 🩺
@MTDMED
Medicine explained through cases & visuals. Posts ≠ medical advice.
Katılım Mayıs 2026
189 Takip Edilen729 Takipçiler
🩺 "Wet, Wobbly, Wacky" is the classic mnemonic for Normal pressure hydrocephalus:
• Wet → Urinary incontinence
• Wobbly → Gait disturbance (magnetic gait)
• Wacky → Cognitive impairment/dementia
The classic triad is:
Gait disturbance (usually the earliest symptom)
Urinary incontinence
Dementia
Brain imaging typically shows ventriculomegaly with normal CSF pressure. Symptoms may improve after CSF drainage or ventriculoperitoneal shunting.
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✅ Answer: C. Exogenous glucocorticoid useCushing syndrome is most commonly caused overall by prolonged use of glucocorticoid medications.Key distinction:
• Most common overall cause of Cushing syndrome: Exogenous glucocorticoid use
• Most common endogenous cause: Pituitary ACTH-secreting adenoma (Cushing disease)❌ Pituitary adenoma — most common endogenous cause, not overall.
❌ Adrenal adenoma — less common.
❌ Ectopic ACTH production — classically from Small-cell lung cancer, but less common.✅ Exogenous glucocorticoid use.
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✅ Answer: B. Clostridioides difficile infection
Clostridioides difficile infection is the most common cause of pseudomembranous colitis, typically occurring after antibiotic use due to overgrowth of C. difficile and production of toxins A and B.
❌ Salmonella — causes inflammatory diarrhea but not pseudomembranous colitis.
❌ Escherichia coli — may cause watery or bloody diarrhea depending on the strain.
❌ Shigella — causes dysentery with bloody diarrhea.
✅ Clostridioides difficile infection.
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✅ Answer: B. Phenylketonuria
Phenylketonuria is caused by deficiency of phenylalanine hydroxylase (or tetrahydrobiopterin deficiency), leading to accumulation of phenylalanine.
Classic features:
• Fair skin and light-colored eyes
• Musty/mousy body odor
• Intellectual disability if untreated
• Eczema
❌ Alkaptonuria — dark urine and ochronosis.
❌ Maple syrup urine disease — sweet "maple syrup" urine odor.
❌ Homocystinuria — marfanoid habitus, lens subluxation (downward), thrombosis.
✅ Phenylketonuria (PKU).
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✅ Answer: D. Diffuse esophageal spasm
A corkscrew esophagus on barium swallow is the classic radiographic finding of Diffuse esophageal spasm, caused by uncoordinated, simultaneous esophageal contractions.
❌ Esophageal carcinoma — typically causes an irregular narrowing or obstructing mass.
❌ Achalasia — shows a bird-beak appearance at the lower esophageal sphincter.
❌ Esophageal web — appears as a thin membranous narrowing, usually in the upper esophagus.
✅ Diffuse esophageal spasm — classic corkscrew appearance.
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✅ Answer: A. Aortic dissection
The patient most likely has Marfan syndrome. The most feared cardiovascular complication is aortic root dilation with subsequent aortic dissection, which is the major cause of death.
❌ Coarctation of the aorta — more commonly associated with Turner syndrome.
❌ Mitral stenosis — classically linked to Rheumatic fever.
❌ Restrictive cardiomyopathy — not a typical complication of Marfan syndrome.
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Answer: Troponin T 🧪⭐
★ It rises within hours after myocardial infarction ⏰
★ It remains elevated for about 10-14 days 📅
★ It persists longer than CK-MB 📈
★ Helpful when the patient presents late 🚑
★ Troponin I also rises but clears sooner ↘️
★ Always interpret with ECG and symptoms 📋
#USMLE #Cardiology #MedEd
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@MTDMED C. Troponins, they are the most sensitive and the longest-lasting markers after MI.
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