Two doctors: Hysterias and Posteriors

""Two doctors, a psychiatrist and a proctologist, opened an office in a
small town and put up a sign reading: "Dr. Smith and Dr. Jones: Hysterias
and Posteriors"

The town council was not happy with the sign, so the doctors changed it to
read, "Schizoids and Hemorrhoids."

This was not acceptable either, so in an effort to satisfy the council,
they changed the sign to "Catatonics and High Colonic'."

No go. Next, they tried "Manic Depressives and Anal Retentive's." Thumbs
down again.

Then came "Minds and Behinds." Still no good.

Another attempt resulted in "Lost Souls and Butt Holes." Unacceptable
again!

So they tried "Analysis and Anal Cysts." Not a chance.

"Nuts and Butts?" No way.

"Freaks and Cheeks?" Still no go.

"Loons and Moons?" Forget it.

Almost at their wit's end, the doctors finally came up with:
"Dr. Smith and Dr. Jones, Odds and Ends."

Everyone loved it !!!""

with thanks to Dr. Sita Bhatt from her posting in forum at pathoindia.com

Kayser-Fleischer ring

Kayser-Fleischer rings (KF rings) are rings that appear to encircle the iris of the eye. They are due to copper deposition as a result of particular liver diseases.

Appearance-The rings, which consist of copper deposits where the cornea meets the sclera, in Descemet's membrane, first appear as a crescent at the top of the cornea. Eventually, a second crescent forms below, at 6 o'clock, and ultimately completely encircles the cornea.

C/F- abnormalities of the basal ganglia of the brain, liver cirrhosis, splenomegaly, involuntary movements, muscle rigidity, psychiatric disturbances, dystonia and dysphagia. The combination of neurological symptoms, a low blood ceruloplasmin level and KF rings is diagnostic of Wilson's disease
Other causes- cholestasis (obstruction of the bile ducts), primary biliary cirrhosis and "cryptogenic" cirrhosis.

lesson to learn- KF rings r not seen only in wilsons disease, it can also be seen in chronic liver diseases.
Serum ceruloplasmin- 27-37mg/dl.
Serum copper- 70-140ug/dl

What is protocols before thyroid function test in known thyroid pt on medicine?

Is there any need of stop medicine in patient taking external thyroxin [eg. eltroxin] before blood is drawn for a thyroxine function test.?

What should precautions be taken before sample collection for TFT?

please gives yours comments....

Toxic granules and Polymorph count (updated)

What is more important in predicting acute bacterial infection?

presence of toxic granules or

neutrophilia

many patients have neutrophilia without any changes in granules while some patients presents with toxic granules in neutrophils with normal counts

In my personal observation most patients with toxic granules in neutrophils also have increased numbers of large granular lymphocytes, does it suggest some specific group of infections?

kindly give your comments...