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  #1  
Old 07-27-2011
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Default neumology

A 25 year old man who last month suffered a head injury and required mechanical ventilation for five days. He left the hospital without any neurological sequelae, but two weeks later he started to have progressive shortness of breath with episodes of inspiratory stridor. He has not improved with inhaled salbutamol.
The most likely diagnosis is:
1. Thromboembolism
2. Extrinsic allergic asthma
3. Left heart failure
4. Inflammatory tracheal stenosis
5. Subdural hematoma
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  #2  
Old 07-27-2011
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Subdural Haematoma
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  #3  
Old 07-27-2011
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it should be 4. inflammatory tracheal stenosis
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  #4  
Old 07-28-2011
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Quote:
Originally Posted by medkary View Post
A 25 year old man who last month suffered a head injury and required mechanical ventilation for five days. He left the hospital without any neurological sequelae, but two weeks later he started to have progressive shortness of breath with episodes of inspiratory stridor. He has not improved with inhaled salbutamol.
The most likely diagnosis is:
1. Thromboembolism
2. Extrinsic allergic asthma
3. Left heart failure
4. Inflammatory tracheal stenosis
5. Subdural hematoma
inspiratory stridor a sign of upper airway obstruction so must b No.4
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Old 07-28-2011
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Quote:
Originally Posted by medkary View Post
a 25 year old man who last month suffered a head injury and required mechanical ventilation for five days. He left the hospital without any neurological sequelae, but two weeks later he started to have progressive shortness of breath with episodes of inspiratory stridor. He has not improved with inhaled salbutamol.
The most likely diagnosis is:
1. Thromboembolism
2. Extrinsic allergic asthma
3. Left heart failure
4. Inflammatory tracheal stenosis
5. Subdural hematoma

444444444444
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  #6  
Old 07-28-2011
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Star 4

4. Inflammatory tracheal stenosis
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  #7  
Old 07-28-2011
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Its starting after 2 weeks so can the inflammatory stenosis occur even after 2 weeks of mechanical ventilation.

I was thinking of laryngeal nerve paralysis after Subdural hematoma as it frequently changes its size

May be I am thinking too much
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Old 07-28-2011
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i think 4 is the answer
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Old 07-28-2011
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I remember hearing / seeing somewhere this:

Can anyone explain why it happens?

Was it due to traction caused by the endotrachel tube?
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  #10  
Old 07-28-2011
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Quote:
Originally Posted by patelMD View Post
I remember hearing / seeing somewhere this:

Can anyone explain why it happens?

Was it due to traction caused by the endotrachel tube?

its D..inflammatory tracheal stenosis..
Intubation can lead to stenosis of trachea..
This is what i found..


"Recent technics to provide prolonged respiratory assistance by positive pressure ventilation through endotracheal or tra- cheostomy tubes have saved lives which otherwise may have been lost.The tubes have required a mechanism to occlude the trachea sothat gas under pressure inflates the lungs and doesnot escape through the larynx into the pharynx.This has usualy been accomplished by inflation of an elastic cuff about the tube to a pressure suficient to prevent escape of gas from the assist-system.
Increased use of assisted ventilation has been associated with reports of tracheal stenosis."
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