Aportación realizada por DE LA CALLE ANDRADE LUCILA JAZMIN

(P2025 - 1S) BIOQUIMICA II B - TEORIA -> Tutorías -> HORMONA COLESINA

de DE LA CALLE ANDRADE LUCILA JAZMIN -

Comparto el siguiente link que incluye la función de la hormona colesina para la regulación de la síntesis de colesterol. Con el fin de apoyar la comprensión integral del metabolismo de lípidos.


https://www.elespanol.com/ciencia/salud/20250524/norwitz-experto-harvard-comido-huevos-mes-bajado-colesterol-clave-carbohidratos/1003743770788_0.html

(P2025 - 1S) BIOQUIMICA II A - TEORIA -> Tutorías -> Metabolismo Intermediario -> Re: Metabolismo Intermediario

de DE LA CALLE ANDRADE LUCILA JAZMIN -
El metaboiismo es un proceso integrado y regulado. Una falla en una sola enzima puede causar la aleración no solo de una vía metabólolica específica, sino de aquellas relacionadas y puede afectar los niveles de los diferentes metabolitos.

CS-MR-IAAACIC-A10-PSP1-25 -> Investigación formativa: Medical cases analysis (infectious and other) -> MEDICAL CASE GROUP 3

de DE LA CALLE ANDRADE LUCILA JAZMIN -

Case Summary:

A 74-year-old female with a history of poorly controlled hypertension and atrial fibrillation presents with sudden-onset right-sided weakness and slurred speech. She has no history of trauma. CT brain shows an acute ischemic infarct in the right middle cerebral artery (MCA) distribution. Her BP is 185/110 mmHg on presentation.

Key Investigations:

  • CT Brain: Acute ischemic stroke in the right MCA territory
  • ECG: Atrial fibrillation with rapid ventricular response
  • Laboratory: Elevated D-dimer, normal INR

Questions:

  1. What is the most likely cause of this patient's stroke, and how does her history of hypertension and atrial fibrillation contribute to the stroke risk?
  2. What are the key diagnostic steps you would take in the acute management of this patient, including imaging and laboratory tests?
  3. Discuss the indications and contraindications for intravenous thrombolysis in the acute setting of ischemic stroke.
  4. What is the role of anticoagulation in secondary stroke prevention in this patient with atrial fibrillation?
  5. Discuss the long-term rehabilitation and secondary prevention strategies for this patient following an ischemic stroke.

References:

  • American Heart Association (AHA) Stroke Guidelines, 2023.
  • Powers, W.J., et al. (2015). "2015 Guidelines for the Early Management of Patients with Acute Ischemic Stroke." Stroke.

CS-MR-IAAACIC-A10-PSP1-25 -> Investigación formativa: Medical cases analysis (infectious and other) -> MEDICAL CASE GROUP 2

de DE LA CALLE ANDRADE LUCILA JAZMIN -

Case Summary:

A 65-year-old woman with a history of recurrent urinary tract infections (UTIs) and hypertension presents with fever, chills, and confusion. She has a 3-day history of dysuria and foul-smelling urine. On examination, she is hypotensive (BP 85/50 mmHg), tachycardic (HR 120 bpm), febrile (T 39°C), and her urine is cloudy with visible sediment.

Key Investigations:

  • Urine culture: E. coli, resistant to multiple antibiotics
  • Blood cultures: Positive for E. coli
  • Lactate: 5.5 mmol/L
  • Chest X-ray: Normal

Questions:

  1. What is the most likely source of this patient's septic shock, and what findings support this diagnosis?
  2. What are the primary mechanisms underlying septic shock, and how do they explain the patient's hypotension and elevated lactate levels?
  3. Why is this patient at risk for multi-drug resistant organisms, and how should her antibiotic therapy be managed?
  4. What initial interventions are critical in the management of septic shock, and how would you optimize fluid resuscitation?
  5. Discuss the role of vasopressors in this patient. When should they be initiated, and what are the targets for mean arterial pressure (MAP)?

References:

  • Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock, 2023.
  • Singer, M., et al. (2016). "Sepsis: The Pathophysiology of Shock." The Lancet

CS-MR-IAAACIC-A10-PSP1-25 -> Investigación formativa: Medical cases analysis (infectious and other) -> MEDICAL CASE GROUP 1

de DE LA CALLE ANDRADE LUCILA JAZMIN -

Case Summary:

A 45-year-old male immigrant from Bangladesh presents with a 3-month history of chronic cough, night sweats, weight loss, and hemoptysis. He has no significant past medical history and is not on any medications. On examination, he appears cachectic and febrile (38.4°C). Lung auscultation reveals crackles in the upper right lung. A chest X-ray shows a cavitary lesion in the right upper lobe.

Key Investigations:

  • Sputum smear: Acid-fast bacilli (AFB)
  • Sputum culture: Mycobacterium tuberculosis
  • Tuberculin skin test (TST): 15 mm induration
  • HIV test: Negative

Questions:

  1. What is the most likely diagnosis, and how does the chest X-ray and sputum smear support this?
  2. Discuss the pathophysiology of tuberculosis and how M. tuberculosis causes the formation of cavitary lesions.
  3. What is the recommended first-line treatment regimen for drug-sensitive tuberculosis, and what are the common side effects of the drugs?
  4. How would you manage the risk of multidrug-resistant tuberculosis (MDR-TB) in this patient?
  5. Discuss the public health measures necessary to control the spread of tuberculosis, especially in high-risk populations.

References:

  • World Health Organization (WHO) Global Tuberculosis Report, 2023.
  • Dheda, K., et al. (2017). "Diagnosis and Management of Tuberculosis." Lancet.