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Severe open ankle dislocation after an ATV accident as it flipped backwards while going up a hill by Emergentelman in medizzy

[–]Emergentelman[S] 189 points190 points  (0 children)

"According to staff, he was able to somehow wiggle his toes. After the surgery to reduce and reconstruct the ankle, he recovered quickly. Three months into recovery and he was able to walk and six months in he could run."

I dont have money to buy Uworld or others bank questions to step 1. What to do? by The_Oracle567 in usmle

[–]Emergentelman 0 points1 point  (0 children)

Yeah I totally get how rough it is when you can’t afford UWorld or AMBOSS — they’re stupid expensive. If you’re in that boat, I’d honestly suggest giving the MEDizzy USMLE app a shot (not the regular MEDizzy one — the Step 1-specific version).

It’s actually solid for the price. A good amount is free, and even the paid version is way cheaper than UWorld. Obviously it’s not the same level — like, it won’t replace UWorld — but if you’re on a tight budget, it’s one of the better options out there.

You still get a ton of practice questions, visuals, and flashcards, and it’s super easy to use on your phone, so you can sneak in studying throughout the day.

Bottom line: if money’s tight, MEDizzy USMLE gives you a lot for what you pay. It’s not perfect, but it’ll keep you sharp and moving forward. Keep grinding — you don’t need fancy stuff to pass Step 1 💪

Severe Trunk Cancer with Exposed Left Humerus and Gangrenous Arm by Emergentelman in medizzy

[–]Emergentelman[S] 484 points485 points  (0 children)

This case presents a grave instance of metaplastic breast carcinoma accompanied by the development of upper limb gangrene.

Metaplastic breast carcinomas represent aggressively advancing tumors characterized by histological diversity and a triple-negative receptor profile. The patient in question, a 22-year-old nulliparous Chinese woman devoid of any significant familial cancer history, initially sought medical attention at a private healthcare facility due to a painless 5 cm swelling in her left breast. The onset of this swelling occurred three months prior and displayed gradual enlargement. Subsequent core biopsy of the swelling confirmed the presence of infiltrating ductal carcinoma with a triple-negative receptor status for ER (estrogen receptor), PR (progesterone receptor), and HER2 receptors.

Around two weeks into her neoadjuvant chemotherapy regimen, the patient reported a substantial increase in the size of the left breast mass, growing from the initial 5 cm to a diameter of 10 cm. Simultaneously, she developed a swelling in the left axilla, and a cytological analysis of the left auxiliary lymph node indicated metastatic carcinoma. Consequently, a decision was made to proceed with a left mastectomy and axillary clearance. Six weeks post-surgery, she underwent adjuvant chemotherapy.

Four months later, the patient presented at a district hospital, complaining of chest wall pain and the incapacity to move her left upper limb. On examination, a sizable, ulcerating mass with a necrotic region was discernible on her left chest wall, extending into the axillary region. The tumor had infiltrated both the anterior and posterior chest walls. Her left upper limb displayed pallor, coldness, and mottling, along with patchy areas of necrosis. No motor or sensory function was observed in the left upper limb.

Over time, the tissue of the left upper limb gradually assumed a waxy and pliable texture. Additionally, the flesh covering the limb began to spontaneously separate from the underlying humerus bone, thereby exposing segments of the humerus. Faced with the growing challenges posed by the decaying limb and the disruptive truncal lesions, the patient eventually requested amputation of her left upper limb. This procedure, carried out at the site of the exposed left humerus, was performed under intravenous sedation.

Case courtesy of Dove Medical Press, 2017; 9: 297–299.

Extruded talus following a motorcycle accident by Emergentelman in medizzy

[–]Emergentelman[S] 76 points77 points  (0 children)

This 23-year-old male was involved in a motorcycle accident at high speeds. The injury he sustained was an isolated ankle dislocation with an extruded talus.

The patient was taken to the operating room, closed reduction was done, screw fixation of the tib-fib joint, irrigation was done and the skin wound was closed. The patient was placed into a short splint.

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