后巩膜炎诊断困境ppt课件.pptVIP

* * * * * * * 生活家饮食保健孕期选择食用油的学问邢台市第四病院罕见护理应急预案猪气喘病综合防制技术动物营养系列理想蛋白与氨基酸模式的研究进展皮肤病的诊断包括病史体格检查和必要的实验室检查我国有关食物添加剂营养强化剂食物新资本的治理律例与标准 MULTI-NODULAR POSTERIOR SCLERITIS Dr Nilutpal Borah, M.S. Guwahati Eye Institute and Research Center Assam , India 15 year old girl was admitted in a neurology hospital suspecting of intracranial lesion. Referred for eye examination. Ocular history OS – 1 week- sudden , complete, painful loss of vision with swelling. Pain around the left periorbital region, radiating towards left hemicranium, left ear and left side of the neck. Nausea and vomiting . Past history 5 months ago- OS – pain, redness, dimness of vision. Treatment was incomplete. 1 year ago- OD - similar episode of pain redness. No treatment . Clinical findings Tender globe VA -OD 6/6, OS PL negative (max illumination with IDO) OS - RAPD + Lids swollen, mild superior conjunctival and episcleral congestion. flare +, cell+ , fibrinous deposition on crystalline lens Fundus- OD- vitreous cells + OS- vitreous cells ++, Several small and medium, yellowish, sub-retinal mass lesions. Retinal blot hemorrhage, exudative detachment. Disc – hyperaemic edematous Investigations Blood R/E - ESR 40 mm(1st hr) Hb 9.0% Urine R/E - Albumin trace Pus cell 2-4/HPF Epithelial cells 1-2/HPF Investigations Systemic examinations - unremarkable. Paranasal sinuses - normal CT Scan brain - normal X - ray -chest - normal Stool R/E - ova cysts- absent Montoux test - negative VDRL - non-reactive ANA -negative HIV - negative Retrovirus/HBsAg - negative FFA Early phase- multiple, irregular blocked fluorecscent spots with focal hyperfluorescence at the margins. Late phase - pooling of dye with minimal