Psoriatic arthritis is a chronic arthritis. In some people, it is mild, with just occasional flare ups. In other people, it is continuous and can cause joint damage if it is not treated. Early diagnosis is important to avoid damage to joints. Psoriatic arthritis typically occurs in people with skin psoriasis, but it can occur in people without skin psoriasis, particularly in those who have relatives with psoriasis. Psoriatic arthritis typically affects the large joints, especially those of the lower extremities, distal joints of the fingers and toes, and also can affect the back and sacroiliac joints of the pelvis. For most people, appropriate treatments will relieve pain, protect the joints, and maintain mobility. Physical activity helps maintain joint movement. Psoriatic arthritis is sometimes misdiagnosed as gout, rheumatoid arthritis or osteoarthritis. - See more at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis#sthash.VsBTUw76.dpuf

Vital Signs and Chest Examination

Watch that video to see How Snake Poison Coagulates Human Blood

Learn a simple way to tell if you might be suffering from an undiagnosed autoimmune condition. Examples of autoimmune conditions include: • alopecia areata

Recurrent Giant Cell Tumor of Tendon Sheath

Laparoscopic ventral hernia repair is a technique to fix tears or openings in the abdominal wall using small incisions, laparoscopes (small telescopes inserted into the abdomen) and a patch (screen or mesh) to reinforce the abdominal wall.

After the cell membranes are dissolved, the typical branching and budding yeast cells can be seen. Sometimes, it has the appearance of a tangled web of threads. At other times, only small branches will be seen.Yeast are normal inhabitants of the vagina, but only in very small numbers. If you visualize any yeast in your sample, it is considered significant.

Pediatric Lumbar puncture

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Starting dialysis often means creating a new normal for yourself and your family. There’s a lot to think about, from choosing a treatment option, to finding new ways to enjoy your favorite activities, to managing a new diet. The FIRST30 program is all about helping you through this period of adjustment.

Find out more at KidneyFund.org/FIRST30.

Ganglion Cyst Removal

Earlobe surgery or repair is a reconstructive plastic surgery procedure performed to restore the appearance of earlobes that have been torn or stretched due to ear tearing, trauma, or piercing, including the insertion of ear gauges. This can also be called earlobe reconstructive surgery or split earlobe repair .

Totally Laparoscopic Collis-Nissen Fundoplication

The cyst was technically 46.5 pounds and her doctors call it the largest in world history. I am not sure if that is true, but it is a massive cyst

The da Vinci® Surgical System provides surgeons with an alternative to both traditional open surgery and conventional laparoscopy, putting a surgeon's hands at the controls of a state-of-the-art robotic platform. Our surgeons can perform even the most complex and delicate procedures through very small incisions with unmatched precision.

Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness. Untreated, aneurysms tend to become progressively larger, although the rate of enlargement is unpredictable for any individual. Rarely, clotted blood which lines most aortic aneurysms can break off and result in an embolus. They may be found on physical examination. Medical imaging is necessary to confirm the diagnosis. Symptoms may include: anxiety or feeling of stress; nausea and vomiting; clammy skin; rapid heart rate. In patients presenting with aneurysm of the arch of the aorta, a common symptom is a hoarse voice as the left recurrent laryngeal nerve (a branch of the vagus nerve) is stretched. This is due to the recurrent laryngeal nerve winding around the arch of the aorta. If an aneurysm occurs in this location, the arch of the aorta will swell, hence stretching the left recurrent laryngeal nerve. The patient therefore has a hoarse voice as the recurrent laryngeal nerve allows function and sensation in the voicebox. Abdominal aortic aneurysms, hereafter referred to as AAAs, are the most common type of aortic aneurysm. One reason for this is that elastin, the principal load-bearing protein present in the wall of the aorta, is reduced in the abdominal aorta as compared to the thoracic aorta (nearer the heart). Another is that the abdominal aorta does not possess vasa vasorum, hindering repair. Most are true aneurysms that involve all three layers (tunica intima, tunica media and tunica adventitia), and are generally asymptomatic before rupture. The most common sign for the aortic aneuysm is the Erythema nodosum also known as leg lesions typically found near the ankle area. The prevalence of AAAs increases with age, with an average age of 65–70 at the time of diagnosis. AAAs have been attributed to atherosclerosis, though other factors are involved in their formation. An AAA may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some AAAs may swell to over 15 cm in diameter before rupturing. Before rupture, an AAA may present as a large, pulsatile mass above the umbilicus. A bruit may be heard from the turbulent flow in a severe atherosclerotic aneurysm or if thrombosis occurs. Unfortunately, however, rupture is usually the first hint of AAA. Once an aneurysm has ruptured, it presents with a classic pain-hypotension-mass triad. The pain is classically reported in the abdomen, back or flank. It is usually acute, severe and constant, and may radiate through the abdomen to the back. The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture could be indicated by the presence of free fluid in potential abdominal spaces, such as Morison's pouch, the splenorenal space (between the spleen and left kidney), subdiaphragmatic spaces (underneath the diaphragm) and peri-vesical spaces. A contrast-enhanced abdominal CT scan is needed for confirmation. Only 10–25% of patients survive rupture due to large pre- and post-operative mortality. Annual mortality from ruptured abdominal aneurysms in the United States alone is about 15,000. Another important complication of AAA is formation of a thrombus in the aneurysm.

Dr. Matthew Slater talks about why cardiac surgery may be necessary if medications aren't an effective treatment option.

Spirotome macrobiopsy of a lung as a minimal invasive way to complete the diagnosis of lung lesions.

Watch that video of Removing Gauze From a Spider's Bite

Borderline Personality Disorder Information

Head Eye and ENT Physical Examination