three types of Chiari malformation
pathogenesis, symptoms, complicationunderdevelopment of posterior fossa
type Ⅰ→herniation of celebellar tonsils
asymptomatic in childhood, manifest in
★adulthood with occipital headache,cerebellar dysfunction
syringomyelia(50-85%), hydrocephalus(10%)
type Ⅱ→herniation of celebellar vermis and tonsils
difficulty in breathing
meningomyelocele(100%)
hydrocephalus(90%)
(type Ⅳ)Dandy Walker syndrome→agenesis of cerebellar vermis leading to cystic enlargement of 4th ventricle(pic)
hydrocephalus
☆progressive skull enlargement neurologyUWorld国試直前 HirotoShishido
Picture
medication, other adverse effectslivedo reticularis(☆ lace-like purplish discoloration of the skin)
①septate hyphae (branches at 45°)
②nonsepate hyphae (branches at wide)
③encapsulated, budding yeast
④pseudohyphae and budding yeast(dimorphic)①aspergillus fumigatus
can cause ☆rhinosinusitis
(similar to mucormycosis)
*☆branching septate hyphae on KOH(pic)
→ Tinea★白癬(Trychophyton, Microsporum, and Epidermophyton.)
→topical antifungal therapy(eg ☆azoles, terbinafine(☆inhibit squalene epoxidase)
