L1 introduction to respiratory medicine
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This medical document discusses a patient who experienced a unilateral pulmonary embolism in 2018-2019 and has a history of Wegener's granulomatosis and polyarteritis nodosa. The document lists these three conditions but does not provide any other context or details about the patient.
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L 6.approach to chest pain
This document discusses the approach to evaluating chest pain. It begins by defining chest pain and noting that it is a common reason patients present for medical care. The causes of chest pain are then reviewed, with 14% being cardiac in origin. Key aspects of evaluating chest pain are discussed, including asking the patient 10 questions about the characteristics of the pain and differentiating ischemic from non-ischemic chest pain. Features that help determine if chest pain is cardiac-related are outlined. The differential diagnosis of chest pain is also reviewed, noting potential cardiac, pulmonary, gastrointestinal and other causes. Diagnostic testing is then discussed to help identify the underlying reason for a patient's chest pain.
L 5. approach to diarhea
1. Diarrhea is defined as an increase in stool frequency and decrease in stool consistency resulting in a stool weight exceeding 200g in 24 hours.
2. Acute diarrhea lasts less than 2 weeks and is usually infectious in origin such as viral gastroenteritis, while chronic diarrhea lasts over 4 weeks and is often non-infectious such as irritable bowel syndrome.
3. A thorough history relating the diarrhea to the patient's medical history, medications, travel, diet and symptoms is important to determine the cause and guide evaluation and treatment.
L 3 4.approach to fever
Fever is a common symptom of infection but not all fevers are caused by infections and some infections do not present with fever. Certain febrile illnesses present with a rash at a predictable time relative to the onset of fever, which can help identify the specific condition.
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- Internal medicine deals with preventing, diagnosing, and treating non-surgical diseases affecting adults. Doctors in this field are called internists or physicians.
- Internal medicine has many subspecialties including cardiology, endocrinology, gastroenterology, and others focused on specific organ systems.
- The diagnostic process in internal medicine involves taking a history, performing an examination, and ordering relevant investigations to arrive at a diagnosis and guide treatment. Accurately diagnosing patients' conditions is crucial for determining the correct management approach.
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Pneumothorax is the presence of air in the pleural space and can occur spontaneously or due to injury. It is classified as primary, occurring without lung disease usually in young, tall smokers, or secondary, affecting those with lung diseases like COPD. Symptoms include chest pain and breathlessness. Examination may find reduced or absent breath sounds on the affected side. Chest x-ray shows the lung edge and any mediastinal shift. Small, asymptomatic primary pneumothoraces may resolve without treatment while larger ones often require chest tube drainage. Surgery is recommended after recurrent episodes to prevent future occurrences.
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Lung consolidation is caused by pneumonia, malignancy, or infarction and results in the accumulation of solid and liquid material in the air spaces of the lung. Pneumonia is the most common cause and presents with symptoms like fever and productive cough. Malignancy like lung cancer often presents with cachexia, clubbing, and productive cough. The document discusses the diagnosis, causes, and types of pneumonia and lung cancer. Smoking is responsible for 90% of lung cancers. Pneumonia can be classified by pathogen, anatomy, or presentation as lobar, bronchial, or atypical.
L9 pulmonary embolism
Pulmonary embolism is a blockage in the pulmonary arteries usually caused by blood clots. It can be diagnosed based on risk factors, symptoms, and tests like a D-dimer blood test, CT scan, or lung scan. Treatment depends on severity but generally involves blood thinners like heparin or warfarin to prevent further clots. For severe cases, thrombolysis can dissolve clots while a vena cava filter may be placed for recurrent clots or if blood thinners are contraindicated.
L8 pleural effusion
This document discusses a medical case involving a patient presenting with yellow, brittle nails and a triad of pleural effusion, bronchiectasis, and lymphedema.
L6 7.interstitial lung disease
This very short document does not contain enough substantive information to summarize in 3 sentences or less. It is a single date with no other context provided.
L4 5 .copd
This document provides information about COPD (chronic obstructive pulmonary disease). It defines COPD as a preventable and treatable lung disease characterized by persistent airflow limitation. The primary cause is cigarette smoking. COPD is the 4th leading cause of death and is expected to rise to 3rd by 2020. The document discusses the clinical presentation, diagnosis through spirometry testing, and management through smoking cessation and bronchodilator medications.
L2 3-bronchial asthma
This document discusses the pathophysiology and clinical presentation of asthma. It notes that airway hyper-reactivity and inflammation are integral to asthma. Common allergens that can trigger asthma attacks include house dust mites, pets, cockroaches, and fungi. Aspirin can also trigger asthma attacks through its effects on leukotriene production. Clinically, asthma presents with wheezing, coughing, chest tightness, and shortness of breath. Allergic bronchopulmonary aspergillosis is a condition that can complicate asthma and cystic fibrosis through an allergic reaction to fungal spores, and is generally treated with oral corticosteroids and antifungal medications.
ECG
This document discusses an approach to interpreting an electrocardiogram (ECG). It examines the heart rate, identifies any premature atrial contractions, analyzes the axis of the heart, and checks for signs of ST elevation myocardial infarction.
L 13-15 .Approach to nutrition
This document discusses approaches to nutrition and appetite. It covers causes of loss of appetite like gastrointestinal issues, chronic diseases, and psychiatric illnesses. Increased appetite can occur with exercise, recovery from illness, mania, and hyperthyroidism. Perverted appetites like pica may be seen with iron deficiency or pregnancy. Obesity is categorized as generalized or central, and central obesity can be measured by waist circumference or waist-to-height ratio. Weight loss is also addressed.
L 11 12 .Approach to edema & clubbing
1. Clubbing involves swelling of the fingers and toes, while edema refers more broadly to swelling caused by excess fluid in the tissues.
2. Edema is graded on a scale from 1-4 based on the pitting of the skin when pressed (pit recovery time), with higher numbers indicating more severe edema likely due to increased hydrostatic pressure like in heart failure.
3. Angioedema is episodic swelling of subcutaneous tissues, often affecting the face, and potentially causing respiratory or intestinal issues if the larynx, tongue, or intestinal mucosa is involved.
L 10.approach to orthostatic hypotension and shock
Orthostatic hypotension occurs more frequently in the elderly and frail, and is associated with lightheadedness after standing, increased falls risk, history of heart attack or stroke, and risk of future stroke. Shock is characterized by inadequate blood flow and tissue perfusion, usually with low blood pressure, though blood pressure may be maintained in early stages, especially in young fit individuals. During resuscitation, assessing causes of shock based on wide or narrow pulse pressure can provide a quick starting point. Stages of hypovolemia and septic shock are also outlined.
L 8 9 .Approach to cough and hemoptysis
This document discusses cough and hemoptysis (coughing up blood). It defines cough and outlines its main causes such as infections, lung diseases, and gastroesophageal reflux disease. It classifies cough as either acute (less than 3 weeks) or chronic (more than 8 weeks) and discusses potential causes and diagnostic tests for each. The document also discusses hemoptysis, noting that any amount of blood in the cough requires medical attention, as it could indicate a serious condition like lung cancer, tuberculosis, or blood clots in the lungs. A history of the cough or hemoptysis can provide clues to identify potential causes.
L 7.approach to dyspnea
This document discusses the approach to dyspnea, or shortness of breath. It defines dyspnea as a subjective feeling of breathing discomfort that can vary in intensity. Dyspnea is classified into four stages from exertional to resting. Common causes are then outlined for cardiac, pulmonary, and miscellaneous origins. The differential diagnosis process for acute versus chronic dyspnea is explained. Physical exam signs and investigations are also reviewed to help identify the underlying cause.
L 6.approach to chest pain
This document discusses the approach to evaluating chest pain. It begins by defining chest pain and noting that it is a common reason patients present for medical care. The causes of chest pain are then reviewed, with 14% being cardiac in origin. Key aspects of evaluating chest pain are discussed, including asking the patient 10 questions about the characteristics of the pain and differentiating ischemic from non-ischemic chest pain. Features that help determine if chest pain is cardiac-related are outlined. The differential diagnosis of chest pain is also reviewed, noting potential cardiac, pulmonary, gastrointestinal and other causes. Diagnostic testing is then discussed to help identify the underlying reason for a patient's chest pain.
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1. Diarrhea is defined as an increase in stool frequency and decrease in stool consistency resulting in a stool weight exceeding 200g in 24 hours.
2. Acute diarrhea lasts less than 2 weeks and is usually infectious in origin such as viral gastroenteritis, while chronic diarrhea lasts over 4 weeks and is often non-infectious such as irritable bowel syndrome.
3. A thorough history relating the diarrhea to the patient's medical history, medications, travel, diet and symptoms is important to determine the cause and guide evaluation and treatment.
L 3 4.approach to fever
Fever is a common symptom of infection but not all fevers are caused by infections and some infections do not present with fever. Certain febrile illnesses present with a rash at a predictable time relative to the onset of fever, which can help identify the specific condition.
L 2. approach to jaundice
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L1 introduction to respiratory medicine
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- 21. • Unilateral – Pulmonary embolism Wegner granulomatosus, polyarteritis nodosa