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The circulatory system complete Info ppt
The circulatory system transports blood, nutrients, gases, hormones, and wastes throughout the body. It consists of the heart, blood vessels (arteries, veins, and capillaries), and blood. The heart pumps blood through two circuits - the pulmonary circulation and the systemic circulation. It has four chambers and uses valves to ensure one-way blood flow. The cardiovascular system is regulated by both intrinsic and neural factors. Diseases can occur if the circulatory system is not functioning properly.
Copd
1. The document discusses the evaluation and treatment of COPD exacerbations in the emergency department. Common causes of exacerbation include viral and bacterial infections.
2. Initial treatment involves bronchodilators, steroids, oxygen supplementation, and antibiotics if pneumonia is present. Ventilation may be considered for severe exacerbations.
3. Upon discharge, the focus shifts to optimizing inhaler therapy and assessing eligibility for pulmonary rehabilitation to reduce readmissions.
Nutrition
Enteral and parenteral nutrition are important for critically ill children to prevent further deterioration. Enteral nutrition is preferred when possible due to gut trophic effects. Nutritional requirements vary based on factors like age, illness severity, and metabolic stress. Careful monitoring is needed to avoid overfeeding and associated complications while meeting caloric and protein goals tailored for each patient.
Diagnosis and management of central line infections
The document discusses the diagnosis and management of catheter-related bloodstream infections, noting that differential time to positivity on blood cultures can diagnose CRBSI and certain organisms or clinical scenarios require catheter removal. It provides guidance on empiric antibiotic selection based on patient risk factors and outlines appropriate treatment duration.
Respiratory system
This document summarizes the respiratory system. It begins with an introduction and then discusses the developmental anatomy, functions including ventilation and gas exchange, and regulation of respiration through neural control centers in the brainstem. It also covers applied topics like effects of altitude and diving. The respiratory system works to oxygenate tissues and remove carbon dioxide through four main functions: ventilation, gas diffusion, transport, and regulation. Respiration is regulated by chemoreceptors sensitive to oxygen and carbon dioxide levels, as well as pH levels, to maintain homeostasis.
Alcohol withdrawal
Alcohol withdrawal symptoms and management are discussed. Symptoms include tachycardia, hypertension, fever, and agitation and occur 48 hours after last drink. The CIWA protocol monitors for withdrawal symptoms and manages with IV fluids, vitamins, and lorazepam prn. Electrolyte abnormalities should also be monitored and treated. Withdrawal risk is greatest 12-24 hours after last drink and complications like seizures or delirium tremens may require ICU care.
Management of inpatient hyperglycemia
- Correction insulin is preferable to sliding scale insulin for managing inpatient hyperglycemia as it treats current high blood sugars and prevents future highs through the use of basal, nutritional, and correctional insulin components.
- The case study patient should be started on correctional insulin therapy which includes initiation of basal insulin, nutritional insulin with meals, and additional correctional insulin for blood sugars over target.
- When initiating or adjusting insulin therapy in the hospital, consideration should be given to the patient's diabetes type and weight to determine the total daily insulin dose and regimen. Frequent monitoring and adjustments are important to achieve good glycemic control.
Acute coronary syndrome
Acute Coronary Syndrome (ACS) refers to a range of conditions caused by reduced blood flow in the coronary arteries. It includes Unstable Angina (UA), Non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). ACS is diagnosed based on electrocardiogram (ECG) findings and cardiac enzyme levels. STEMI shows ST elevations and enzyme elevations, while NSTEMI shows ST depressions/inversions and enzyme elevations without ST elevations. UA shows non-specific ECG changes and normal enzymes. Risk stratification systems like the TIMI score are used for NSTEMI/UA patients to guide management, which may
Recommended
The circulatory system complete Info ppt
The circulatory system transports blood, nutrients, gases, hormones, and wastes throughout the body. It consists of the heart, blood vessels (arteries, veins, and capillaries), and blood. The heart pumps blood through two circuits - the pulmonary circulation and the systemic circulation. It has four chambers and uses valves to ensure one-way blood flow. The cardiovascular system is regulated by both intrinsic and neural factors. Diseases can occur if the circulatory system is not functioning properly.
Copd
1. The document discusses the evaluation and treatment of COPD exacerbations in the emergency department. Common causes of exacerbation include viral and bacterial infections.
2. Initial treatment involves bronchodilators, steroids, oxygen supplementation, and antibiotics if pneumonia is present. Ventilation may be considered for severe exacerbations.
3. Upon discharge, the focus shifts to optimizing inhaler therapy and assessing eligibility for pulmonary rehabilitation to reduce readmissions.
Nutrition
Enteral and parenteral nutrition are important for critically ill children to prevent further deterioration. Enteral nutrition is preferred when possible due to gut trophic effects. Nutritional requirements vary based on factors like age, illness severity, and metabolic stress. Careful monitoring is needed to avoid overfeeding and associated complications while meeting caloric and protein goals tailored for each patient.
Diagnosis and management of central line infections
The document discusses the diagnosis and management of catheter-related bloodstream infections, noting that differential time to positivity on blood cultures can diagnose CRBSI and certain organisms or clinical scenarios require catheter removal. It provides guidance on empiric antibiotic selection based on patient risk factors and outlines appropriate treatment duration.
Respiratory system
This document summarizes the respiratory system. It begins with an introduction and then discusses the developmental anatomy, functions including ventilation and gas exchange, and regulation of respiration through neural control centers in the brainstem. It also covers applied topics like effects of altitude and diving. The respiratory system works to oxygenate tissues and remove carbon dioxide through four main functions: ventilation, gas diffusion, transport, and regulation. Respiration is regulated by chemoreceptors sensitive to oxygen and carbon dioxide levels, as well as pH levels, to maintain homeostasis.
Alcohol withdrawal
Alcohol withdrawal symptoms and management are discussed. Symptoms include tachycardia, hypertension, fever, and agitation and occur 48 hours after last drink. The CIWA protocol monitors for withdrawal symptoms and manages with IV fluids, vitamins, and lorazepam prn. Electrolyte abnormalities should also be monitored and treated. Withdrawal risk is greatest 12-24 hours after last drink and complications like seizures or delirium tremens may require ICU care.
Management of inpatient hyperglycemia
- Correction insulin is preferable to sliding scale insulin for managing inpatient hyperglycemia as it treats current high blood sugars and prevents future highs through the use of basal, nutritional, and correctional insulin components.
- The case study patient should be started on correctional insulin therapy which includes initiation of basal insulin, nutritional insulin with meals, and additional correctional insulin for blood sugars over target.
- When initiating or adjusting insulin therapy in the hospital, consideration should be given to the patient's diabetes type and weight to determine the total daily insulin dose and regimen. Frequent monitoring and adjustments are important to achieve good glycemic control.
Acute coronary syndrome
Acute Coronary Syndrome (ACS) refers to a range of conditions caused by reduced blood flow in the coronary arteries. It includes Unstable Angina (UA), Non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). ACS is diagnosed based on electrocardiogram (ECG) findings and cardiac enzyme levels. STEMI shows ST elevations and enzyme elevations, while NSTEMI shows ST depressions/inversions and enzyme elevations without ST elevations. UA shows non-specific ECG changes and normal enzymes. Risk stratification systems like the TIMI score are used for NSTEMI/UA patients to guide management, which may
Acute decompensated heart failure
The document discusses the inpatient management of acute decompensated heart failure. Key points include identifying signs and symptoms of ADHF, obtaining pertinent labs and imaging to evaluate the patient, and treating with intravenous diuretics followed by chronic medications like ACE inhibitors, beta blockers, and spironolactone prior to discharge with close follow up.
Management of constipation in adults 2.0
This document discusses the management of constipation in adults. Constipation is defined using Rome III criteria as having two of the following: straining, lumpy hard stools, incomplete evacuation, use of digital maneuvers, or less than three bowel movements per week. Therapy includes lifestyle modifications like increased fluid/fiber intake and exercise, as well as laxatives such as stimulants, osmotics, and bulk formers. For the case presented, an appropriate treatment would be the osmotic laxative lactulose.
Hospital pneumonia
This document defines different types of pneumonia including community acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), healthcare-associated pneumonia (HCAP), and ventilator-associated pneumonia (VAP). It describes common clinical features, diagnostic testing recommendations including chest radiographs, severity assessment scores, and treatment guidelines based on patient risk factors and pneumonia type. Initial treatment often includes broad-spectrum antibiotics while considering possible multidrug-resistant pathogens, with options to address a lack of improvement such as fungal infections or tuberculosis.
Antibiotics
This document provides an overview and guidelines for choosing antibiotics. It discusses collecting cultures before starting antibiotics and ensuring appropriate dosing. Common antibiotics are reviewed including beta-lactams like penicillins, cephalosporins, and carbapenems as well as quinolones, macrolides, and metronidazole. Factors to consider for antibiotic selection include location and type of infection, patient history, and risk of drug-resistant pathogens. Quick guides are provided for coverage of pseudomonas, anaerobes, MRSA, and VRE.
Renalstones
This document discusses renal stone disease. It identifies common risk factors like male sex, obesity, and dietary factors. Typical symptoms include flank pain, nausea, and hematuria. The most common types of stones are calcium oxalate, calcium phosphate, and struvite. Non-contrast CT is the gold standard for imaging. Stones less than 5mm often pass spontaneously, while larger stones may require urologic intervention.
Lipid management 2013 acc-aha guidelines
1. The new guidelines recommend initiating moderate or high-intensity statin therapy for patients in four categories based on their cardiovascular risk, rather than targeting a specific LDL-C level.
2. The four categories are: individuals with clinical atherosclerotic cardiovascular disease, LDL-C over 190 mg/dL, diabetes between ages 40-75 with LDL-C 70-189 mg/dL, and 10-year risk over 7.5% for ages 40-75 with LDL-C 70-189 mg/dL.
3. Lipids should be measured during follow-ups to assess adherence, not to achieve a specific target level.
Relative adrenal insufficiency
This document discusses relative adrenal insufficiency, a condition where the adrenal glands do not adequately increase cortisol production during physiological stress such as sepsis. It defines relative adrenal insufficiency and explains that testing for it can be unreliable. For patients in sepsis who require vasopressors, the document recommends having a low threshold to treat with hydrocortisone but not fludrocortisone, as it has not been shown to help. The case presented is of a man in sepsis, and the recommended next step is to administer hydrocortisone.
Sickle cell disease
The patient is a 20-year-old male with sickle cell disease who presents with several chronic and acute complications. He has a history of delayed puberty, joint pain, weakness and cough. Examination reveals decreased growth, severe anemia, leg ulcers, enlarged spleen and fever. Laboratory tests show hemoglobin of 8g/dL and reticulocyte count of 25%. The most probable cause of the patient's problems is sickle cell disease and its associated complications. The patient is at risk for further complications such as acute chest syndrome, stroke and infection due to his condition.
Anatomy of anterior_cruciate_ligament_by- dr. armaan singh
The anterior cruciate ligament (ACL) originates on the posterior medial femoral condyle and inserts on the anterior tibia. It consists of anteromedial and posterolateral bundles that twist during knee flexion. The ACL prevents anterior tibial translation and internal rotation. Injury is common in sports involving pivoting. Females have a higher risk due to narrower intercondylar notches. The posterior cruciate ligament (PCL) is the strongest ligament and prevents posterior tibial translation. Both cruciates receive blood supply from the middle genicular artery and have proprioceptive mechanoreceptors.
Peripheral vascular diseases
This document discusses peripheral vascular diseases, including arteries, veins, and specific conditions like arterial insufficiency and venous insufficiency. It covers the anatomy and layers of arteries and veins. Peripheral vascular diseases are characterized by reduced blood flow and oxygen delivery to tissues. Specific conditions discussed in detail include arteriosclerosis obliterans, thromboangitis obliterans (Buerger's disease), and Raynaud's phenomenon. Risk factors, clinical manifestations, diagnostic tests, and management approaches are described for each condition.
Cellulitis
This document discusses cellulitis, including its definition, diagnosis, microbiology, and treatment approaches. It provides guidelines for treating non-purulent versus purulent cellulitis, and recommendations for oral versus intravenous antibiotics. Hospitalization is warranted for extensive or systemic infections, including the case presented of a patient with a large, draining leg wound requiring IV vancomycin.
Cardiacphysiology&anaestheticconsiderationscardiacoutput,pulse,bp,cardiacinde...
The document discusses cardiac physiology and anesthetic considerations. It covers the structure of the heart, cardiac cycle, conduction system, blood flow, output and pressures. It describes measurements like ejection fraction, cardiac index and classifications of blood pressure. It discusses the effects of anesthetic agents on the heart and goals of anesthesia for cardiovascular diseases like avoiding tachycardia and hypocapnia.
Post mortem changes notes by dr. armaan singh
Immediate changes after death include permanent cessation of brain and circulatory function as well as respiratory function. Early postmortem changes involve cooling of the body, lividity/hypostasis as blood settles in the body, and rigor mortis as the muscles stiffen. Late changes include decomposition of tissues over time. These postmortem changes can help determine time of death and other forensic details.
Injury
This document provides information on different types of injuries from a medical-legal perspective. It defines injuries clinically and legally, and classifies mechanical injuries as blunt force injuries (abrasions, contusions, lacerations) or sharp force injuries (incised wounds, stab wounds, chop wounds). For each type of injury, it describes features, age determination, antemortem vs postmortem appearance, and medico-legal aspects. Weapon identification, manner and direction of force application, and wound age determination are important considerations in mechanical injury analysis.
Forensic toxicology (student version)
Forensic toxicology is the study of toxic substances and their physiological effects. Toxicologists investigate deaths through postmortem drug testing, workplace drug testing, and identifying contraband. They analyze tissue samples to understand how the body processes toxins and drugs. Common toxic substances include alkaloids like amphetamines, cocaine, opiates, and cannabinoids. Toxicologists use various detection methods like chromatography, spectroscopy, and mass spectroscopy to identify substances and determine cause of death.
Forensic pathology notes by dr. armaan singh
The document discusses forensic pathology and autopsy procedures. It describes the role of the forensic pathologist as determining the cause, manner, and time of death through postmortem examination. It outlines the typical steps of an autopsy, including external examination, a Y-shaped incision, examination of organs, and analysis of trauma wounds or other signs that could indicate the cause of death. Key autopsy goals are to examine the body for injuries or diseases that may have led to death.
Autopsy.ppt
The document discusses the process and objectives of a medico-legal autopsy. A medico-legal autopsy, also known as a post-mortem examination, is a scientific examination of a dead body that is carried out under state laws to determine the cause and manner of death and assist in legal investigations. It aims to establish the cause, manner, and estimated time of death, as well as identify the deceased individual and collect relevant tissues as evidence. The document outlines the typical process, examinations, and reporting of findings for a medico-legal autopsy.
Asphyxia notes by dr. armaan singh
Asphyxia is a condition caused by lack of oxygen to tissues. It can result from obstruction of air passages, inhalation of toxic gases, respiratory muscle spasms, or problems with the respiratory center of the brain. Common causes include hanging, strangulation, suffocation, and drowning. Features include cyanosis, capillary dilation and stasis, and increased capillary permeability. In hanging, ligature marks and petechial hemorrhages are seen externally, while internal findings include neck hemorrhages and carotid artery tears. Strangulation produces ligature marks and neck muscle injuries. Suffocation causes abrasions around the mouth and nose. Drowning results in fluid inhalation causing lung changes. Medico-
Heart by dr. armaan singh
The heart is a muscular organ about the size of a fist that pumps blood through the body. It has four chambers - two upper atria that receive blood and two lower ventricles that pump blood out. Deoxygenated blood enters the right atrium from the body and is pumped to the lungs by the right ventricle. Oxygenated blood returns from the lungs to the left atrium and is pumped by the left ventricle out to the body through the aorta. Valves between the chambers prevent backflow of blood. The conductive system coordinates heart muscle contraction.
Fever in icu by dr. armaan singh
Fever is a common complication in ICU patients and can arise from infectious as well as non-infectious causes. The most common infectious causes include ventilator-associated pneumonia (VAP), urinary tract infections (UTI), and bloodstream infections. VAP is diagnosed based on new infiltrates on CXR, fever, and purulent secretions; investigations include quantitative cultures of lower respiratory tract secretions. Clostridium difficile infection is a common cause of diarrhea and is associated with antibiotic use. Sinusitis can occur in intubated patients and requires imaging and drainage for diagnosis. Non-infectious causes of fever include drug reactions, deep vein thrombosis, and inflammatory conditions. Fever
Anxiety in teenagers for educators
This document discusses anxiety disorders in teenagers. It notes that anxiety disorders are common among children and adolescents, affecting about 13% of youth, and are more prevalent in girls. Anxiety manifests in feelings of dread, fears of catastrophe, and somatic complaints. It outlines several types of anxiety disorders including generalized anxiety disorder, post-traumatic stress disorder, panic disorder, phobias, and obsessive-compulsive disorder. Comorbidity with depression and substance use is also common. The document provides strategies for treating anxiety and supporting anxious students.
Skull & brain
The document discusses the skull, brain, cranial nerves and related structures. It provides details on:
1) The bones that make up the skull, their openings and functions in protecting the brain.
2) The meninges and cerebrospinal fluid which surround and nourish the brain and spinal cord.
3) The 12 pairs of cranial nerves, their attachments, functions and pathways through openings in the skull.
4) Key structures of the brain like the cerebrum, brainstem, ventricles and blood supply.
5) Membranes, bones and pathways involved in protecting and supplying the brain.
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Acute decompensated heart failure
The document discusses the inpatient management of acute decompensated heart failure. Key points include identifying signs and symptoms of ADHF, obtaining pertinent labs and imaging to evaluate the patient, and treating with intravenous diuretics followed by chronic medications like ACE inhibitors, beta blockers, and spironolactone prior to discharge with close follow up.
Management of constipation in adults 2.0
This document discusses the management of constipation in adults. Constipation is defined using Rome III criteria as having two of the following: straining, lumpy hard stools, incomplete evacuation, use of digital maneuvers, or less than three bowel movements per week. Therapy includes lifestyle modifications like increased fluid/fiber intake and exercise, as well as laxatives such as stimulants, osmotics, and bulk formers. For the case presented, an appropriate treatment would be the osmotic laxative lactulose.
Hospital pneumonia
This document defines different types of pneumonia including community acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), healthcare-associated pneumonia (HCAP), and ventilator-associated pneumonia (VAP). It describes common clinical features, diagnostic testing recommendations including chest radiographs, severity assessment scores, and treatment guidelines based on patient risk factors and pneumonia type. Initial treatment often includes broad-spectrum antibiotics while considering possible multidrug-resistant pathogens, with options to address a lack of improvement such as fungal infections or tuberculosis.
Antibiotics
This document provides an overview and guidelines for choosing antibiotics. It discusses collecting cultures before starting antibiotics and ensuring appropriate dosing. Common antibiotics are reviewed including beta-lactams like penicillins, cephalosporins, and carbapenems as well as quinolones, macrolides, and metronidazole. Factors to consider for antibiotic selection include location and type of infection, patient history, and risk of drug-resistant pathogens. Quick guides are provided for coverage of pseudomonas, anaerobes, MRSA, and VRE.
Renalstones
This document discusses renal stone disease. It identifies common risk factors like male sex, obesity, and dietary factors. Typical symptoms include flank pain, nausea, and hematuria. The most common types of stones are calcium oxalate, calcium phosphate, and struvite. Non-contrast CT is the gold standard for imaging. Stones less than 5mm often pass spontaneously, while larger stones may require urologic intervention.
Lipid management 2013 acc-aha guidelines
1. The new guidelines recommend initiating moderate or high-intensity statin therapy for patients in four categories based on their cardiovascular risk, rather than targeting a specific LDL-C level.
2. The four categories are: individuals with clinical atherosclerotic cardiovascular disease, LDL-C over 190 mg/dL, diabetes between ages 40-75 with LDL-C 70-189 mg/dL, and 10-year risk over 7.5% for ages 40-75 with LDL-C 70-189 mg/dL.
3. Lipids should be measured during follow-ups to assess adherence, not to achieve a specific target level.
Relative adrenal insufficiency
This document discusses relative adrenal insufficiency, a condition where the adrenal glands do not adequately increase cortisol production during physiological stress such as sepsis. It defines relative adrenal insufficiency and explains that testing for it can be unreliable. For patients in sepsis who require vasopressors, the document recommends having a low threshold to treat with hydrocortisone but not fludrocortisone, as it has not been shown to help. The case presented is of a man in sepsis, and the recommended next step is to administer hydrocortisone.
Sickle cell disease
The patient is a 20-year-old male with sickle cell disease who presents with several chronic and acute complications. He has a history of delayed puberty, joint pain, weakness and cough. Examination reveals decreased growth, severe anemia, leg ulcers, enlarged spleen and fever. Laboratory tests show hemoglobin of 8g/dL and reticulocyte count of 25%. The most probable cause of the patient's problems is sickle cell disease and its associated complications. The patient is at risk for further complications such as acute chest syndrome, stroke and infection due to his condition.
Anatomy of anterior_cruciate_ligament_by- dr. armaan singh
The anterior cruciate ligament (ACL) originates on the posterior medial femoral condyle and inserts on the anterior tibia. It consists of anteromedial and posterolateral bundles that twist during knee flexion. The ACL prevents anterior tibial translation and internal rotation. Injury is common in sports involving pivoting. Females have a higher risk due to narrower intercondylar notches. The posterior cruciate ligament (PCL) is the strongest ligament and prevents posterior tibial translation. Both cruciates receive blood supply from the middle genicular artery and have proprioceptive mechanoreceptors.
Peripheral vascular diseases
This document discusses peripheral vascular diseases, including arteries, veins, and specific conditions like arterial insufficiency and venous insufficiency. It covers the anatomy and layers of arteries and veins. Peripheral vascular diseases are characterized by reduced blood flow and oxygen delivery to tissues. Specific conditions discussed in detail include arteriosclerosis obliterans, thromboangitis obliterans (Buerger's disease), and Raynaud's phenomenon. Risk factors, clinical manifestations, diagnostic tests, and management approaches are described for each condition.
Cellulitis
This document discusses cellulitis, including its definition, diagnosis, microbiology, and treatment approaches. It provides guidelines for treating non-purulent versus purulent cellulitis, and recommendations for oral versus intravenous antibiotics. Hospitalization is warranted for extensive or systemic infections, including the case presented of a patient with a large, draining leg wound requiring IV vancomycin.
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Anatomy of anterior_cruciate_ligament_by- dr. armaan singh
Anatomy of anterior_cruciate_ligament_by- dr. armaan singh
More from Dr. Armaan Singh
Cardiacphysiology&anaestheticconsiderationscardiacoutput,pulse,bp,cardiacinde...
The document discusses cardiac physiology and anesthetic considerations. It covers the structure of the heart, cardiac cycle, conduction system, blood flow, output and pressures. It describes measurements like ejection fraction, cardiac index and classifications of blood pressure. It discusses the effects of anesthetic agents on the heart and goals of anesthesia for cardiovascular diseases like avoiding tachycardia and hypocapnia.
Post mortem changes notes by dr. armaan singh
Immediate changes after death include permanent cessation of brain and circulatory function as well as respiratory function. Early postmortem changes involve cooling of the body, lividity/hypostasis as blood settles in the body, and rigor mortis as the muscles stiffen. Late changes include decomposition of tissues over time. These postmortem changes can help determine time of death and other forensic details.
Injury
This document provides information on different types of injuries from a medical-legal perspective. It defines injuries clinically and legally, and classifies mechanical injuries as blunt force injuries (abrasions, contusions, lacerations) or sharp force injuries (incised wounds, stab wounds, chop wounds). For each type of injury, it describes features, age determination, antemortem vs postmortem appearance, and medico-legal aspects. Weapon identification, manner and direction of force application, and wound age determination are important considerations in mechanical injury analysis.
Forensic toxicology (student version)
Forensic toxicology is the study of toxic substances and their physiological effects. Toxicologists investigate deaths through postmortem drug testing, workplace drug testing, and identifying contraband. They analyze tissue samples to understand how the body processes toxins and drugs. Common toxic substances include alkaloids like amphetamines, cocaine, opiates, and cannabinoids. Toxicologists use various detection methods like chromatography, spectroscopy, and mass spectroscopy to identify substances and determine cause of death.
Forensic pathology notes by dr. armaan singh
The document discusses forensic pathology and autopsy procedures. It describes the role of the forensic pathologist as determining the cause, manner, and time of death through postmortem examination. It outlines the typical steps of an autopsy, including external examination, a Y-shaped incision, examination of organs, and analysis of trauma wounds or other signs that could indicate the cause of death. Key autopsy goals are to examine the body for injuries or diseases that may have led to death.
Autopsy.ppt
The document discusses the process and objectives of a medico-legal autopsy. A medico-legal autopsy, also known as a post-mortem examination, is a scientific examination of a dead body that is carried out under state laws to determine the cause and manner of death and assist in legal investigations. It aims to establish the cause, manner, and estimated time of death, as well as identify the deceased individual and collect relevant tissues as evidence. The document outlines the typical process, examinations, and reporting of findings for a medico-legal autopsy.
Asphyxia notes by dr. armaan singh
Asphyxia is a condition caused by lack of oxygen to tissues. It can result from obstruction of air passages, inhalation of toxic gases, respiratory muscle spasms, or problems with the respiratory center of the brain. Common causes include hanging, strangulation, suffocation, and drowning. Features include cyanosis, capillary dilation and stasis, and increased capillary permeability. In hanging, ligature marks and petechial hemorrhages are seen externally, while internal findings include neck hemorrhages and carotid artery tears. Strangulation produces ligature marks and neck muscle injuries. Suffocation causes abrasions around the mouth and nose. Drowning results in fluid inhalation causing lung changes. Medico-
Heart by dr. armaan singh
The heart is a muscular organ about the size of a fist that pumps blood through the body. It has four chambers - two upper atria that receive blood and two lower ventricles that pump blood out. Deoxygenated blood enters the right atrium from the body and is pumped to the lungs by the right ventricle. Oxygenated blood returns from the lungs to the left atrium and is pumped by the left ventricle out to the body through the aorta. Valves between the chambers prevent backflow of blood. The conductive system coordinates heart muscle contraction.
Fever in icu by dr. armaan singh
Fever is a common complication in ICU patients and can arise from infectious as well as non-infectious causes. The most common infectious causes include ventilator-associated pneumonia (VAP), urinary tract infections (UTI), and bloodstream infections. VAP is diagnosed based on new infiltrates on CXR, fever, and purulent secretions; investigations include quantitative cultures of lower respiratory tract secretions. Clostridium difficile infection is a common cause of diarrhea and is associated with antibiotic use. Sinusitis can occur in intubated patients and requires imaging and drainage for diagnosis. Non-infectious causes of fever include drug reactions, deep vein thrombosis, and inflammatory conditions. Fever
Anxiety in teenagers for educators
This document discusses anxiety disorders in teenagers. It notes that anxiety disorders are common among children and adolescents, affecting about 13% of youth, and are more prevalent in girls. Anxiety manifests in feelings of dread, fears of catastrophe, and somatic complaints. It outlines several types of anxiety disorders including generalized anxiety disorder, post-traumatic stress disorder, panic disorder, phobias, and obsessive-compulsive disorder. Comorbidity with depression and substance use is also common. The document provides strategies for treating anxiety and supporting anxious students.
Skull & brain
The document discusses the skull, brain, cranial nerves and related structures. It provides details on:
1) The bones that make up the skull, their openings and functions in protecting the brain.
2) The meninges and cerebrospinal fluid which surround and nourish the brain and spinal cord.
3) The 12 pairs of cranial nerves, their attachments, functions and pathways through openings in the skull.
4) Key structures of the brain like the cerebrum, brainstem, ventricles and blood supply.
5) Membranes, bones and pathways involved in protecting and supplying the brain.
Postoperative pulmonary hypertension
This document provides guidelines for managing pulmonary hypertension in cardiac surgery patients. It discusses that pulmonary hypertension can increase in the postoperative period due to various factors like SIRS, protamine, hypoxia, hypercarbia, and mechanical ventilation. It recommends avoiding these triggers and using selective pulmonary vasodilators like inhaled nitric oxide, inhaled prostacyclin, inhaled iloprost, and sildenafil to treat pre-capillary pulmonary hypertension. For post-capillary pulmonary hypertension, it suggests improving left ventricular function and using nesiritide to decrease pulmonary artery pressures and improve outcomes.
Postoperative bleeding & guidelines for transfusion
This document discusses guidelines for transfusion therapy and management of postoperative bleeding in cardiac surgery patients. It provides an overview of factors that can influence bleeding, complications of blood transfusions, and tests to assess coagulation status. The document outlines guidelines for transfusion of blood products like platelets, plasma, cryoprecipitate based on results of coagulation tests or thromboelastography. It also provides guidelines for surgical re-exploration based on chest tube output. Management of massive bleeding and tamponade is discussed.
Blood conservation in cardiac surgery
This document provides clinical practice guidelines for blood conservation strategies in cardiac surgery from the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists. It recommends various preoperative, intraoperative, and postoperative interventions to reduce bleeding and blood transfusions during cardiac procedures. These include discontinuing antiplatelet agents preoperatively, using antifibrinolytics intraoperatively, and employing blood salvage techniques. The guidelines provide evidence and recommendations for different blood derivative products and perfusion strategies to optimize blood conservation.
Volume therapy in cardiac surgery patients
The document outlines goals for cardio-circulatory therapy in post-operative cardiac surgery patients. It recommends targeting specific hemodynamic parameters like mean arterial pressure, cardiac index, central venous pressure, and lactate levels. It also discusses guidelines for fluid management in these patients, noting medium molecular weight hydroxyethyl starch derivatives like Voluven are preferred for volume substitution over crystalloids or albumin. Voluven is not associated with increased bleeding or renal failure risks like other colloids at higher doses.
Postoperative pulmonary hypertension
The document provides guidelines for the management of pulmonary hypertension in cardiac surgery patients. It discusses causes of increased pulmonary vascular resistance postoperatively including hypoxia, hypercarbia, acidosis, and pulmonary vasoconstriction. It recommends treating the underlying cause by avoiding factors that cause pulmonary vasoconstriction. For passive pulmonary hypertension, it suggests improving left ventricular contractility and decreasing mitral regurgitation. It also discusses selective pulmonary vasodilators like inhaled nitric oxide, prostacyclin, and iloprost as well as oral sildenafil.
Management of right heart failure
This document provides guidelines for managing right heart failure in cardiac surgery patients. Pulmonary vasoconstriction due to factors like hypoxia, hypercarbia, and pulmonary hypertension can increase right ventricular afterload and precipitate right heart failure. Right ventricular dysfunction can be caused by systolic dysfunction, volume overload, or pressure overload. Right heart failure is manifested by elevated central venous pressure, decreased blood pressure, and decreased cardiac output. Echocardiography can evaluate right ventricular function and pressures. The goals of treatment are to ensure adequate preload, reduce pulmonary vascular resistance, and improve contractility. This involves optimizing ventilation to avoid hypoxemia and hypercarbia, using pulmonary vasodilators, and administer
Management of postoperative hypertension.pptx
The document discusses guidelines for managing cardio-circulatory therapy and hemodynamics for cardiac surgery patients, including recommended goals for parameters such as blood pressure, cardiac index, oxygen saturation, and diuresis. It also outlines causes and risks of postoperative hypertension and provides guidance on pharmacological management using intravenous vasodilators, beta blockers, and diuretics to control blood pressure in the postoperative period.
Management of left heart failure
The document provides guidelines for the management of left heart failure in cardiac surgery patients, outlining indicators of cardiocirculatory failure, recommendations for increasing preload and use of vasodilating and inotropic agents, and noting that drugs like nesiritide and levosimendan can help optimize hemodynamics by reducing preload, afterload, and pulmonary vascular resistance.
Guidelines for intraaortic balloon counterpulsation
The document discusses guidelines for intraaortic balloon counterpulsation (IABP). IABP involves inflating and deflating a balloon in the aorta to assist the heart. Precise timing of balloon inflation and deflation is important. Inflation should occur at the beginning of diastole to increase coronary blood flow and reduce left ventricular workload. Deflation should happen at the beginning of systole to reduce afterload on the heart. Complications can include lower extremity ischemia or damage to the aorta. Guidelines are provided on indications, complications, troubleshooting, and weaning a patient from IABP support.
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一比一原版(McGill毕业证书)麦吉尔大学毕业证如何办理
学校原件一模一样【微信：6496090 】【(McGill毕业证书)麦吉尔大学毕业证成绩单】【微信：6496090 】学位证，留信认证（真实可查，永久存档）原件一模一样纸张工艺/offer、雅思、外壳等材料/诚信可靠,可直接看成品样本，帮您解决无法毕业带来的各种难题！外壳，原版制作，诚信可靠，可直接看成品样本。行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备。十五年致力于帮助留学生解决难题，包您满意。
本公司拥有海外各大学样板无数，能完美还原。
1:1完美还原海外各大学毕业材料上的工艺：水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠。文字图案浮雕、激光镭射、紫外荧光、温感、复印防伪等防伪工艺。材料咨询办理、认证咨询办理请加学历顾问Q/微6496090
【主营项目】
一.毕业证【q微6496090】成绩单、使馆认证、教育部认证、雅思托福成绩单、学生卡等！
二.真实使馆公证(即留学回国人员证明,不成功不收费)
三.真实教育部学历学位认证（教育部存档！教育部留服网站永久可查）
四.办理各国各大学文凭(一对一专业服务,可全程监控跟踪进度)
如果您处于以下几种情况：
◇在校期间，因各种原因未能顺利毕业……拿不到官方毕业证【q/微6496090】
◇面对父母的压力，希望尽快拿到；
◇不清楚认证流程以及材料该如何准备；
◇回国时间很长，忘记办理；
◇回国马上就要找工作，办给用人单位看；
◇企事业单位必须要求办理的
◇需要报考公务员、购买免税车、落转户口
◇申请留学生创业基金
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
办理(McGill毕业证书)麦吉尔大学毕业证【微信：6496090 】外观非常简单，由纸质材料制成，上面印有校徽、校名、毕业生姓名、专业等信息。
办理(McGill毕业证书)麦吉尔大学毕业证【微信：6496090 】格式相对统一，各专业都有相应的模板。通常包括以下部分：
校徽：象征着学校的荣誉和传承。
校名:学校英文全称
授予学位：本部分将注明获得的具体学位名称。
毕业生姓名：这是最重要的信息之一，标志着该证书是由特定人员获得的。
颁发日期：这是毕业正式生效的时间，也代表着毕业生学业的结束。
其他信息：根据不同的专业和学位，可能会有一些特定的信息或章节。
办理(McGill毕业证书)麦吉尔大学毕业证【微信：6496090 】价值很高，需要妥善保管。一般来说，应放置在安全、干燥、防潮的地方，避免长时间暴露在阳光下。如需使用，最好使用复印件而不是原件，以免丢失。
综上所述，办理(McGill毕业证书)麦吉尔大学毕业证【微信：6496090 】是证明身份和学历的高价值文件。外观简单庄重，格式统一，包括重要的个人信息和发布日期。对持有人来说，妥善保管是非常重要的。
Confidence is Key: Fashion for Women Over 50
Unlock your personal style and confidence at 50 and beyond! Our fashion blog provides actionable tips and inspiration on how to improve your dressing sense according to your body type, skin tone, and personal style, ensuring you look and feel amazing.
快速办理(加拿大CBU毕业证书)卡普顿大学毕业证毕业完成信一模一样
学校原件一模一样【微信：741003700 】《(加拿大CBU毕业证书)卡普顿大学毕业证》【微信：741003700 】学位证，留信认证（真实可查，永久存档）原件一模一样纸张工艺/offer、雅思、外壳等材料/诚信可靠,可直接看成品样本，帮您解决无法毕业带来的各种难题！外壳，原版制作，诚信可靠，可直接看成品样本。行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备。十五年致力于帮助留学生解决难题，包您满意。
本公司拥有海外各大学样板无数，能完美还原。
1:1完美还原海外各大学毕业材料上的工艺：水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠。文字图案浮雕、激光镭射、紫外荧光、温感、复印防伪等防伪工艺。材料咨询办理、认证咨询办理请加学历顾问Q/微741003700
【主营项目】
一.毕业证【q微741003700】成绩单、使馆认证、教育部认证、雅思托福成绩单、学生卡等！
二.真实使馆公证(即留学回国人员证明,不成功不收费)
三.真实教育部学历学位认证（教育部存档！教育部留服网站永久可查）
四.办理各国各大学文凭(一对一专业服务,可全程监控跟踪进度)
如果您处于以下几种情况：
◇在校期间，因各种原因未能顺利毕业……拿不到官方毕业证【q/微741003700】
◇面对父母的压力，希望尽快拿到；
◇不清楚认证流程以及材料该如何准备；
◇回国时间很长，忘记办理；
◇回国马上就要找工作，办给用人单位看；
◇企事业单位必须要求办理的
◇需要报考公务员、购买免税车、落转户口
◇申请留学生创业基金
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
MISS RAIPUR 2024 - WINNER POONAM BHARTI.
Poonam Bharti, a guide of ability and diligence, has been chosen as the champ from Raipur for Mrs. India 2024, Pride of India, from the DK Show. Her journey to this prestigious title is a confirmation of her commitment, difficult work, and multifaceted gifts. At fair 23 a long time ago, Poonam has as of now made noteworthy strides in both her proficient and individual lives, encapsulating the soul of present-day Indian ladies who adjust different parts with beauty and competence. This article dives into Poonam Bharti’s foundation, achievements, and qualities that separated her as a meriting champion of this award.
一比一原版(UoL毕业证)伦敦大学毕业证如何办理
UoL毕业证成绩单【微信95270640】国外文凭购买伦敦大学留信认证毕业证书印刷品《Q微信95270640》学历认证怎么做：原版仿制伦敦大学电子版成绩单毕业证认证《伦敦大学毕业证成绩单》、伦敦大学文凭证书成绩单复刻offer录取通知书、购买UoL圣力嘉学院本科毕业证、《伦敦大学毕业证办理UoL毕业证书哪里买》、伦敦大学 Offer在线办理UoL Offer伦敦大学Bachloer Degree。
【实体公司】办伦敦大学伦敦大学毕业证学历书学历认证学位证文凭认证办留信网认证办留服认证办教育部认证（网上可查实体公司专业可靠）
— — — 留学归国服务中心 — — -
【主营项目】
一.伦敦大学毕业证成绩单使馆认证教育部认证成绩单等！
二.真实使馆公证(即留学回国人员证明,不成功不收费)
三.真实教育部学历学位认证（教育部存档！教育部留服网站永久可查）
四.办理各国各大学文凭(一对一专业服务,可全程监控跟踪进度)
国外毕业证学位证成绩单办理流程：
1客户提供伦敦大学伦敦大学毕业证学历书办理信息：姓名生日专业学位毕业时间等（如信息不确定可以咨询顾问：我们有专业老师帮你查询）；
2开始安排制作毕业证成绩单电子图；
3毕业证成绩单电子版做好以后发送给您确认；
4毕业证成绩单电子版您确认信息无误之后安排制作成品；
5成品做好拍照或者视频给您确认；
6快递给客户（国内顺丰国外DHLUPS等快读邮寄）。
专业服务请勿犹豫联系我！本公司是留学创业和海归创业者们的桥梁。一次办理终生受用一步到位高效服务。详情请在线咨询办理,欢迎有诚意办理的客户咨询!洽谈。
招聘代理：本公司诚聘英国加拿大澳洲新西兰美国法国德国新加坡各地代理人员如果你有业余时间有兴趣就请联系我们咨询顾问：+微信:95270640山娃很高兴夏令营就设在附近一所小学山娃发现那所小学比自己的学校更大更美操场上还铺有塑胶跑道呢里面很多小朋友一班一班的快快乐乐原来城里娃都藏这儿来了怪不得平时见不到他们山娃恍然大悟起来吹拉弹唱琴棋书画山娃都不懂却什么都想学山娃怨自己太笨什么都不会斟酌再三山娃终于选定了学美术当听说每月要交元时父亲犹豫了山娃也说爸算了吧咱学校一学期才交元呢买图画书回家咱自己练父亲摸着山娃的小平头擤了擤鼻子很感动很无奈窄
一比一原版塔夫斯大学毕业证Tufts成绩单一模一样
原件一模一样【微信：6496090】【塔夫斯大学毕业证Tufts学位证成绩单】【微信：6496090】（留信学历认证永久存档查询）采用学校原版纸张、特殊工艺完全按照原版一比一制作（包括：隐形水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠，文字图案浮雕，激光镭射，紫外荧光，温感，复印防伪）行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备，十五年致力于帮助留学生解决难题，业务范围有加拿大、英国、澳洲、韩国、美国、新加坡，新西兰等学历材料，包您满意。
【业务选择办理准则】
一、工作未确定，回国需先给父母、亲戚朋友看下文凭的情况，办理一份就读学校的毕业证【微信：6496090】文凭即可
二、回国进私企、外企、自己做生意的情况，这些单位是不查询毕业证真伪的，而且国内没有渠道去查询国外文凭的真假，也不需要提供真实教育部认证。鉴于此，办理一份毕业证【微信：6496090】即可
三、进国企，银行，事业单位，考公务员等等，这些单位是必需要提供真实教育部认证的，办理教育部认证所需资料众多且烦琐，所有材料您都必须提供原件，我们凭借丰富的经验，快捷的绿色通道帮您快速整合材料，让您少走弯路。
留信网认证的作用:
1:该专业认证可证明留学生真实身份【微信：6496090】
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
→ 【关于价格问题（保证一手价格）
我们所定的价格是非常合理的，而且我们现在做得单子大多数都是代理和回头客户介绍的所以一般现在有新的单子 我给客户的都是第一手的代理价格，因为我想坦诚对待大家 不想跟大家在价格方面浪费时间
对于老客户或者被老客户介绍过来的朋友，我们都会适当给一些优惠。
选择实体注册公司办理，更放心，更安全！我们的承诺：可来公司面谈，可签订合同，会陪同客户一起到教育部认证窗口递交认证材料，客户在教育部官方认证查询网站查询到认证通过结果后付款，不成功不收费！
办理塔夫斯大学毕业证Tufts学位证【微信：6496090 】外观非常精致，由特殊纸质材料制成，上面印有校徽、校名、毕业生姓名、专业等信息。
办理塔夫斯大学毕业证Tufts学位证【微信：6496090 】格式相对统一，各专业都有相应的模板。通常包括以下部分：
校徽：象征着学校的荣誉和传承。
校名:学校英文全称
授予学位：本部分将注明获得的具体学位名称。
毕业生姓名：这是最重要的信息之一，标志着该证书是由特定人员获得的。
颁发日期：这是毕业正式生效的时间，也代表着毕业生学业的结束。
其他信息：根据不同的专业和学位，可能会有一些特定的信息或章节。
办理塔夫斯大学毕业证Tufts学位证【微信：6496090 】价值很高，需要妥善保管。一般来说，应放置在安全、干燥、防潮的地方，避免长时间暴露在阳光下。如需使用，最好使用复印件而不是原件，以免丢失。
综上所述，办理塔夫斯大学毕业证Tufts学位证【微信：6496090 】是证明身份和学历的高价值文件。外观简单庄重，格式统一，包括重要的个人信息和发布日期。对持有人来说，妥善保管是非常重要的。
MISS TEEN LUCKNOW 2024 - WINNER ASIYA 2024
In the dynamic city of Lucknow, known for its wealthy social legacy and authentic importance, a youthful star has developed, capturing the hearts of numerous with her elegance, insights, and eagerness. Asiya, as of late delegated as the champ from Lucknow for Miss Youngster India 2024 by the DK Pageant, stands as a confirmation of the monstrous ability and potential dwelling inside the youth of India. This exceptional young lady is a signal of excellence and a paragon of devotion and aspiration.
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Bruno Amezcua's entry into the film and visual arts world seemed predestined. His grandfather, a distinguished film editor from the 1950s through the 1970s, profoundly influenced him. This familial mentorship early on exposed him to the nuances of film production and a broad array of fine arts, igniting a lifelong passion for narrative creation. Over 15 years, Bruno has engaged in diverse projects showcasing his dedication to the arts.
Self-Discipline: The Secret Weapon for Certain Victory
Amid the constant barrage of distractions and dwindling motivation, self-discipline emerges as the unwavering beacon that guides individuals toward triumph. This vital quality serves as the key to unlocking one’s true potential, whether the aspiration is to attain personal goals, ascend the career ladder, or refine everyday habits.
Understanding Self-Discipline
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