Porphyria Made Easy By Prof Dr Bashir Ahmed Dar Sopore Kashmir

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Doctors need to be aware of a rare, hard to diagnose condition called Porphyria. To reach an accurate diagnosis of Porphyria a crystal clear understanding is needed

Health & Medicine

Porphyria Made Easy By Prof Dr Bashir Ahmed Dar Sopore Kashmir

Stroke is a common medical emergency and second leading cause of death worldwide. Strokes can be classified as transient ischemic attacks (TIAs), where symptoms resolve within 24 hours, or completed strokes, where deficits persist. The brain requires constant oxygenated blood flow to function; during a stroke, either a clot blocks blood flow (ischemic stroke), or bleeding occurs (hemorrhagic stroke). Treatment focuses on early diagnosis, preventing further injury through blood pressure control and anticoagulation/thrombolysis, and long-term prevention of recurrence through risk factor modification.

Neutropenic sepsis.pptx

RanaBilalLiaqat

Neutropenic sepsis is a life-threatening condition seen in patients with very low neutrophil counts. The document defines fever and the different levels of neutropenia. It outlines the diagnostic evaluation of patients with fever and neutropenia which includes blood cultures, microbiological testing, and imaging if a site of infection is suspected. Empiric antibiotic therapy should have broad gram-negative and gram-positive coverage and be given immediately. The initial antibiotic regimen is discussed as well as modifications based on clinical response. The duration of empiric therapy depends on resolution of fever and bone marrow recovery. Catheter removal is recommended for certain infections. Colony stimulating factors are not routinely recommended for established fever and neutropenia.

Trauma induced coagulopathy

Abdulgafoor MT

Trauma induced coagulopathy (TIC) starts early due to shock and hypoperfusion which activates the thrombomodulin-protein C pathway. TIC is associated with higher mortality, transfusion requirements, and organ dysfunction. Assessment of TIC requires thromboelastometry rather than standard coagulation tests due to confounding factors like hypothermia, acidosis, and dilution of clotting factors from fluid resuscitation. Treatment focuses on replacing depleted clotting factors, with fibrinogen and prothrombin concentrates highly recommended, as well as consideration of antifibrinolytics and recombinant factor VIIa in specific cases.

Haemostatic resuscitation

SCGH ED CME

This document provides an overview of haemostatic resuscitation for trauma patients. It discusses the goals of haemostatic resuscitation which include rapidly correcting hypothermia, hypocalcaemia, acidosis and other factors impairing haemostasis. It also aims to resuscitate patients with a balanced combination of blood products resembling whole blood to avoid dilutional coagulopathy. The document reviews the components of blood, various blood products used in resuscitation and their effects, and studies supporting haemostatic resuscitation approaches. It also discusses practical considerations for haemostatic resuscitation in the emergency department setting.

Approach to Bleeding disorder

Dr. A.S.M. Rizwan

This document discusses haemostasis and bleeding disorders. It covers the basics of haemostasis including primary and secondary phases. It describes taking a bleeding history including duration, site, precipitating factors and family history. Physical examination focuses on sites of bleeding. Investigations start with a platelet count and assessment of bleeding time followed by screening coagulation tests. Based on screening test results, further specific factor assays may be done. Treatment depends on the underlying cause and may include transfusions of specific clotting factors, platelets, cryoprecipitate or non-transfusional options like vitamins, desmopressin or antifibrinolytics.

Damage Control Resuscitation

Sun Yai-Cheng

02a Surgical hemostasis

Tantasurgery

This document discusses hemostasis in surgical patients. It begins by defining hemostasis as the state of fluid equilibrium within blood vessels. It then describes the two mechanisms of hemostasis - primary hemostasis involving vasoconstriction and platelet plug formation, and secondary hemostasis involving activation of the coagulation cascade and formation of a fibrin clot. The document outlines the coagulation cascade and its natural inhibitors. It discusses various defects of hemostasis, preoperative screening tests for bleeding risk, and strategies to achieve surgical hemostasis including direct pressure, cauterization, packing, topical hemostats, and fibrin glue.

Stroke can be either ischemic (caused by blockage of a blood vessel) or hemorrhagic (caused by bleeding). The goals of treatment are to reduce ongoing brain injury, prevent complications, and prevent future strokes. For ischemic strokes, intravenous tPA within 4.5 hours can reperfuse brain tissue. Aspirin is also given to reduce risk of future strokes. Hemorrhagic strokes require controlling blood pressure and intracranial pressure to prevent further brain damage.

357 Cerebral venous and sinus thrombosis

Neurosurgery Vajira

This document summarizes cerebral venous and sinus thrombosis. It discusses the pathogenesis, which can involve thrombosis in cerebral veins leading to venous hypertension and hypoxia. Risk factors include trauma, hypercoagulable states, infections, oral contraceptive use, and idiopathic causes. Clinical findings often include headache, seizures, neurological deficits, and features depending on the site of thrombosis. Diagnosis involves CT, MRI, MRA and MRV to detect thrombus. Treatment involves anticoagulants like heparin and warfarin, thrombolytics through interventional radiology, and occasionally surgery for complications. Outcomes depend on factors like coma, site of thrombosis, and degree of intracranial pressure.

Heparin induced thrombocytopenia(hit)

Figo Khan

This document provides an overview of heparin-induced thrombocytopenia (HIT). It discusses the history, pathogenesis, frequency, clinical features, diagnosis, and treatment of both type 1 and type 2 HIT. Type 2 HIT is an immune-mediated reaction, where antibodies form against the platelet factor 4-heparin complex, leading to platelet activation and thrombosis. The document outlines various laboratory tests used to diagnose HIT, including functional assays measuring platelet activation and immunoassays detecting antibodies.

Imaging in ischemic stroke

sks200166

This document provides information on imaging techniques used in the diagnosis and management of ischemic stroke. It discusses the advantages of different tests such as CT, CT angiography, CT perfusion, MRI, MR angiography, and diffusion weighted imaging at various time points after stroke onset. CT without contrast is useful in the hyperacute period to distinguish between ischemic and hemorrhagic stroke. Advanced imaging such as CT and MR perfusion can identify tissue at risk of infarction. Diffusion weighted imaging is highly sensitive and specific for acute ischemia. Together, imaging plays a key role in the evaluation and treatment of patients with ischemic stroke.

Heparin Induced Thrombocytopeia (HIT)

Dr.Sayeedur Rumi

This document provides information about heparin-induced thrombocytopenia (HIT). It begins by introducing HIT as an immune-mediated reduction in platelet count that occurs in 3-5% of patients receiving unfractionated heparin for 5 days or more, and less than 1% for low molecular weight heparin. It then describes HIT as characterized by a platelet decrease of over 50% from baseline 5-10 days after starting heparin, along with hypercoagulability and heparin-dependent antibodies. The document outlines the pathogenesis of HIT and differences between type I and type II, reviews potential clinical complications, diagnostic methods, and emphasizes the need to promptly discontinue heparin and

Febrile neutropenia final

hemang mendpara

This document discusses febrile neutropenia in a patient with acute myeloid leukemia (AML) who has recently undergone chemotherapy. The patient presents with a fever of 38°C. Key details include that the patient's absolute neutrophil count (ANC) is very low at 0.7 with 38% segments and 2% bands, indicating severe neutropenia. Management of febrile neutropenia depends on risk stratification based on factors like neutrophil count, expected duration of neutropenia, and presence of comorbidities. Initial evaluation includes blood cultures, screening for potential infection sites, and empiric intravenous antibiotics.

Blood and blood products in icu

Yasser Alwabli

1) The document discusses indications and complications of blood and blood product transfusions in intensive care units. It reviews evidence from clinical trials on appropriate transfusion thresholds for red blood cells, plasma, and platelets. 2) A landmark trial found a restrictive red blood cell transfusion strategy (maintaining hemoglobin between 7-9 g/dL) was as safe as a liberal strategy (10-12 g/dL) in critically ill patients, except in certain subgroups. 3) Evidence does not show consistent benefits of prophylactic or therapeutic plasma transfusion across many clinical settings and indications. Platelet transfusion is indicated at thresholds of 10-50 x 103 platelets/mL depending on bleeding risk.

Prova de física 1º ano 2º períodoDavi Gusmão

Haemostatic Resuscitation

SCGH ED CME

Haemostatic resuscitation is a vital part of damage control resuscitation for hemorrhagic shock. It involves restoring normal tissue perfusion while preserving effective clotting until definitive hemorrhage control is achieved, usually through surgery or angioembolization. Rotational thromboelastometry provides rapid assessment of coagulation to guide trauma resuscitation, including targeting fibrinogen and platelet levels and administering specific blood products to address deficiencies. Massive transfusion protocols aim to prevent trauma-induced coagulopathy by transfusing red blood cells, plasma, and platelets in a 1:1:1 ratio while also controlling hemorrhage through techniques like damage control surgery.

Acute ischemic limb

MohammedAlHinai18

Acute limb ischemia is a sudden decrease in limb perfusion that threatens limb viability. It is usually caused by thrombosis of atherosclerotic vessels or embolism from cardiac sources or aneurysms. Clinical manifestations include pain, pallor, coldness, and pulselessness. Imaging can help determine the severity and guide treatment, which may include thrombolysis, embolectomy, bypass surgery, or amputation depending on the classification and etiology. Complications include reperfusion injury and compartment syndrome.

Continuação da carta de Monique Medeiros

R7dados

Medicine in Mind Maps

Kerolus Shehata

This document provides an overview of abdominal trauma, including: 1) Initial assessment involves imaging like CXR, pelvis X-ray, and neck X-ray to identify injuries. Resuscitation focuses on airway, breathing, circulation, disability, and environment. 2) Further assessment includes inspection, palpation, FAST ultrasound, and CT scan. Blunt trauma most commonly injures the spleen and liver while penetrating trauma often injures the small intestine, liver, and colon. 3) Surgical intervention is usually required for gunshot wounds while most blunt solid organ injuries can now be managed non-operatively. Diagnostic peritoneal lavage can identify bleeding but does not locate the source.

An approach to_thyroid_swelling_seminar_final

Sayan Banerjee

Skin and Soft Tissue Infection.pptx

SitiHajar643369

This document provides an overview of skin and soft tissue infections (SSTIs). It discusses the anatomy of the skin and its layers that can become infected, including the epidermis, dermis, subcutaneous tissue, deep fascia and muscle. The main infectious pathogens are described such as bacteria, viruses, fungi and parasites. The most common types of SSTIs are then outlined, including impetigo, erysipelas, folliculitis, ecthyma, furuncle, carbuncle, cellulitis, necrotizing fasciitis, pyomyositis and clostridial myonecrosis. Histological images are provided to illustrate some of the conditions.

Uremic Bleed

edwinchowyw

This document discusses evidence-based treatment recommendations for uremic bleeding. It describes the complex pathophysiology of uremic bleeding, involving dysfunctional platelet function and coagulation factors due to uraemia and uremic toxins. Key recommended treatments include erythropoietin to increase red blood cell count and displace platelets closer to blood vessels, cryoprecipitate/desmopressin to increase functional clotting factors, and estrogens to decrease nitric oxide levels and increase platelet activators like thromboxane A2 and ADP. The treatment aims to address various aspects of the complex mechanisms underlying uremic bleeding.

Blood component therapy and blood substitutes

Himanshu Jangid

This document summarizes different types of blood products and transfusions. It discusses whole blood and its shelf life of 35 days when stored with CPDA-1. It also describes the production and storage of blood components like packed red blood cells, platelet concentrates, granulocytes and plasma derivatives. Key elements covered are donor screening, testing, storage conditions and guidelines for transfusion thresholds.

Massive transfusion

Arthi Rajasankar

Massive transfusion is defined as replacing over half the patient's blood volume within a day or 10 units of blood within hours. It can occur due to hemorrhagic shock, trauma, or surgery. Complications include acidosis, hypothermia, electrolyte abnormalities, coagulopathy from diluting coagulation factors, and microaggregates forming in the lungs. Treatment priorities are controlling bleeding, restoring volume, and considering component therapy with red blood cells, fresh frozen plasma, cryoprecipitate, and platelet transfusions based on test results. Close monitoring and treatment of underlying issues are important to prevent complications from massive transfusion.

Acute limb ischemia

Shahid Mohammed

1. Acute limb ischemia is a medical emergency that occurs when there is a sudden decrease in blood flow to a limb, threatening the viability of the limb. It requires urgent evaluation and management within 2 weeks of symptom onset. 2. The main treatment options are endovascular therapies like catheter-directed thrombolysis or mechanical thrombectomy, or surgical interventions like thrombectomy or bypass surgery. The goal is to rapidly restore arterial blood flow while minimizing risks to the patient. 3. Factors like the severity of ischemia, time since symptom onset, and patient characteristics help determine which treatment - thrombolysis, surgical thrombectomy, or in some cases immediate amputation - is most appropriate to salvage the limb.

Sickle cell ppt

Wahid altaf Sheeba hakak

This document discusses the history, genetics, pathophysiology, clinical manifestations, complications and management of sickle cell disease (SCD). Some key points: - SCD results from a mutation in the beta-globin gene that causes abnormal hemoglobin S production. It is inherited in an autosomal recessive pattern. - Clinical hallmarks include painful vaso-occlusive crises, acute chest syndrome, stroke and organ damage to lungs, kidneys and brain over time. - Perioperative management aims to prevent SCD complications using strategies like preoperative screening, transfusion if needed, adequate analgesia and oxygenation, and prompt treatment of crises. Regional anesthesia does not appear to increase

Massive transfusion protocol

DR SHADAB KAMAL

This document discusses massive transfusion protocols (MTP) for trauma victims who experience severe bleeding. It describes the presentation of a 64-year-old male trauma patient who suffered injuries from a motor vehicle crash including internal bleeding and fractures. He received over 18 units of blood products during treatment including surgery. The document then provides details on MTPs including their components, guidelines for blood product ratios, and studies investigating optimal resuscitation approaches to reduce mortality from hemorrhage.

Localization of brainstem lesion by Prof Dr Bashir Ahmed Dar Sopore Kashmir

Porphyria Made Easy By Prof Dr Bashir Ahmed Dar Sopore Kashmir

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