This document provides an overview of respiratory medicine, covering topics such as anatomy and physiology of the lungs, respiratory failure, pleural diseases, asthma, COPD, and more. It defines conditions, lists their typical causes and presentations, and outlines recommended diagnostic tests and treatment approaches. Key areas covered include the mechanics of breathing, definitions of respiratory failure types, common pleural effusions and their management, asthma diagnosis and treatment guidelines, risk factors and management of COPD, and criteria for exacerbation treatment.
Clubbing, also known as Hippocrates fingers, is the bulbous enlargement of the fingertips and nails. It is caused by proliferation of subcutaneous tissues due to chronic hypoxemia from conditions like lung diseases, heart diseases, and liver or gastrointestinal diseases. Examination involves comparing the fingernails to look for reduced or absent diamond-shaped spaces, indicating clubbing. While clubbing itself has no treatment, addressing the underlying condition can potentially reverse it over time.
This document discusses a case of lung consolidation seen in a patient. It provides definitions and causes of lung consolidation, including pneumonia, malignancy, and infarction. Differential diagnoses for consolidation are discussed. The document also contains sections on carcinoma of the lung, bronchial carcinoma, clinical features, investigations, management, and classifications of pneumonia by pathogen, anatomy, presentation, duration, and environment.
Pallor is a pale skin color caused by reduced oxyhemoglobin levels. It can be caused by anemia, leukemia, heart disease, shock, endocrine disorders, and more. Anemia itself is a reduction in red blood cells, hemoglobin, or red blood cell volume. The most common type is iron deficiency anemia from inadequate iron intake or absorption. Other types include megaloblastic anemia from B12 or folate deficiency, hemolytic anemia from red blood cell membrane issues or immune/non-immune causes, aplastic anemia from bone marrow failure, and anemia of chronic disease seen in infections, inflammation, or cancers.
This document provides an overview of cyanosis, including its definition, mechanisms, types (central, peripheral, differential), etiology, factors affecting detection, and treatment principles. Cyanosis is a bluish discoloration of the skin and mucous membranes that results from low oxygen saturation in the blood. It can be caused by issues in oxygen intake, diffusion, or circulation. The underlying etiology could be pulmonary (hypoventilation, diffusion impairment), cardiac (decreased or increased pulmonary blood flow), or a hemoglobinopathy. Detection is affected by hemoglobin level, fetal hemoglobin, and skin pigmentation. Treatment focuses on addressing the underlying condition rather than cyanosis itself, and may include oxygen therapy, warming, and intravenous
A comparison between Nephritic and Nephrotic syndrome from Professor Hossam Mowafy Internal Medicine textbook nephrology section, Please inform me if there is any error or wrong information include.
The document describes several types of arterial pulses:
1) Anacrotic pulses have a low amplitude with a slow rise and fall and are seen in aortic stenosis. Dicrotic pulses have two peaks, one in systole and one in diastole, and are caused by low stroke volume and decreased peripheral resistance.
2) Collapsing or water hammer pulses have a rapid upstroke and downstroke due to increased stroke volume and decreased peripheral resistance, seen in aortic regurgitation and other conditions.
3) Pulsus bisferiens has two peaks in systole, best felt in the brachial and femoral arteries and caused by conditions like aortic stenosis and regurgitation.
Brief Presentation on clinical examination of Respiratory System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
R Alagappan - Manual of Practical Medicine, 4th Edition
Clubbing, also known as Hippocrates fingers, is the bulbous enlargement of the fingertips and nails. It is caused by proliferation of subcutaneous tissues due to chronic hypoxemia from conditions like lung diseases, heart diseases, and liver or gastrointestinal diseases. Examination involves comparing the fingernails to look for reduced or absent diamond-shaped spaces, indicating clubbing. While clubbing itself has no treatment, addressing the underlying condition can potentially reverse it over time.
This document discusses a case of lung consolidation seen in a patient. It provides definitions and causes of lung consolidation, including pneumonia, malignancy, and infarction. Differential diagnoses for consolidation are discussed. The document also contains sections on carcinoma of the lung, bronchial carcinoma, clinical features, investigations, management, and classifications of pneumonia by pathogen, anatomy, presentation, duration, and environment.
Pallor is a pale skin color caused by reduced oxyhemoglobin levels. It can be caused by anemia, leukemia, heart disease, shock, endocrine disorders, and more. Anemia itself is a reduction in red blood cells, hemoglobin, or red blood cell volume. The most common type is iron deficiency anemia from inadequate iron intake or absorption. Other types include megaloblastic anemia from B12 or folate deficiency, hemolytic anemia from red blood cell membrane issues or immune/non-immune causes, aplastic anemia from bone marrow failure, and anemia of chronic disease seen in infections, inflammation, or cancers.
This document provides an overview of cyanosis, including its definition, mechanisms, types (central, peripheral, differential), etiology, factors affecting detection, and treatment principles. Cyanosis is a bluish discoloration of the skin and mucous membranes that results from low oxygen saturation in the blood. It can be caused by issues in oxygen intake, diffusion, or circulation. The underlying etiology could be pulmonary (hypoventilation, diffusion impairment), cardiac (decreased or increased pulmonary blood flow), or a hemoglobinopathy. Detection is affected by hemoglobin level, fetal hemoglobin, and skin pigmentation. Treatment focuses on addressing the underlying condition rather than cyanosis itself, and may include oxygen therapy, warming, and intravenous
A comparison between Nephritic and Nephrotic syndrome from Professor Hossam Mowafy Internal Medicine textbook nephrology section, Please inform me if there is any error or wrong information include.
The document describes several types of arterial pulses:
1) Anacrotic pulses have a low amplitude with a slow rise and fall and are seen in aortic stenosis. Dicrotic pulses have two peaks, one in systole and one in diastole, and are caused by low stroke volume and decreased peripheral resistance.
2) Collapsing or water hammer pulses have a rapid upstroke and downstroke due to increased stroke volume and decreased peripheral resistance, seen in aortic regurgitation and other conditions.
3) Pulsus bisferiens has two peaks in systole, best felt in the brachial and femoral arteries and caused by conditions like aortic stenosis and regurgitation.
Brief Presentation on clinical examination of Respiratory System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
R Alagappan - Manual of Practical Medicine, 4th Edition
Wheeze is a high-pitched whistling sound caused by airflow moving through partially obstructed airways. It is produced when air passes through narrowed portions of the airways at high velocity, causing the airway walls to vibrate and alternately flatten and reopen. This vibration creates a continuous musical sound. Wheeze can be caused by conditions that narrow the airways such as asthma, bronchitis, pneumonia, and foreign body obstruction.
Hemoptysis is defined as coughing up blood originating below the vocal cords. It can range from blood-streaked sputum to coughing up pure blood. The document discusses the definition, causes, differential diagnosis, diagnosis and treatment of hemoptysis. The main causes discussed are tracheobronchial diseases like bronchitis and tumors, as well as cardiovascular issues. Diagnosis involves history, examination, labs, chest imaging like CXR, CT, and procedures like bronchoscopy.
The thyroid gland develops from an endodermal thickening in the third week of gestation. It descends as the thyroglossal duct and bifurcates into two lobes connected by an isthmus. The gland is the first to become functionally active, synthesizing thyroid hormones through iodination of thyroglobulin. It is uniquely dependent on iodine from the external environment and has the ability to store hormones for later release.
Aspiration pneumonia is caused by bacteria from the mouth or stomach entering the lungs. It can develop hours to days after aspiration occurs. The most common pathogens have changed from anaerobic bacteria to aerobic bacteria. Diagnosis is based on clinical history, risk factors, and chest x-ray. Treatment depends on whether it is community-acquired or hospital-acquired pneumonia. Antibiotics are used but duration depends on severity and response. Preventive measures focus on oral hygiene and early mobilization of high-risk patients like stroke patients.
Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi. It can be caused by airway obstruction, pulmonary infections, genetic disorders like cystic fibrosis, or idiopathic factors. Symptoms include persistent cough with large amounts of sputum, hemoptysis, and clubbing of the fingers. Diagnosis is made through chest imaging like HRCT. Treatment focuses on clearing secretions through postural drainage, chest physiotherapy, antibiotics, bronchodilators, and smoking cessation. Nursing management centers on helping patients perform breathing exercises and techniques to clear pulmonary secretions.
This document discusses pleural effusions, which are collections of fluid in the pleural space. Pleural effusions are usually secondary to other diseases rather than primary. There are two main types - transudative effusions which occur without inflammation from conditions like heart failure, and exudative effusions which occur with inflammation from things like infections or cancer. Diagnosis involves chest imaging and analyzing fluid obtained via thoracentesis. Treatment focuses on resolving the underlying cause as well as draining fluid to relieve symptoms. Nursing care centers around maintaining normal breathing patterns and monitoring for complications.
This document discusses anaphylactic shock, including:
- Definitions of anaphylaxis and anaphylactoid reactions.
- The pathophysiology of anaphylaxis, which involves mast cell and basophil activation leading to mediator release and various symptoms.
- Etiologies of anaphylaxis including allergens, foods, drugs, and other causes.
- Clinical manifestations across multiple organ systems like skin, respiratory, cardiovascular and more.
- Diagnosis, prevention, and management, which focuses on epinephrine administration, airway management, fluids, and adjunctive treatments.
Jaundice, or icterus, is caused by an excess of bilirubin in the plasma, which leads to a yellowish discoloration of the skin and mucous membranes. There are three main types of jaundice: hemolytic, obstructive, and hepatocellular. Hemolytic jaundice occurs when there is an increased bilirubin load due to excessive breakdown of red blood cells. Obstructive jaundice is caused by an obstruction to the passage of conjugated bilirubin from the liver cells to the intestines. Hepatocellular jaundice results from a failure of the conjugating mechanism in the liver cells or an obstruction of conjugated bilirub
The document discusses pulmonary eosinophilias, which are a heterogeneous group of disorders characterized by varying degrees of pulmonary or blood eosinophilia. It classifies the main types as Loeffler's syndrome, drug and toxin induced eosinophilic pneumonia, tropical pulmonary eosinophilia, and allergic bronchopulmonary aspergillosis. Loeffler's syndrome is characterized by transient pulmonary infiltrates associated with eosinophilia caused by parasites. Tropical pulmonary eosinophilia is caused by a hypersensitivity reaction to filarial parasites. Allergic bronchopulmonary aspergillosis involves a hypersensitivity response to inhaled fungal antigens like Aspergillus.
Dr. Arun Karmakar presented on hyponatremia. Hyponatremia is defined as a serum sodium below 135 mmol/L and is the most common electrolyte disorder. It is clinically important because acute severe hyponatremia can cause morbidity and mortality, and outcomes are worse in hyponatremic patients with underlying diseases. Hyponatremia can be hypovolemic, euvolemic, or hypervolemic depending on water and sodium levels. Treatment depends on the severity and cause of hyponatremia, with aggressive correction for symptomatic cases and slower correction for chronic cases to avoid osmotic demyelination syndrome.
This document discusses thyrotoxicosis and hyperthyroidism. It begins by covering thyroid physiology including iodine metabolism and thyroid hormone synthesis. It then discusses the causes and clinical manifestations of Graves' disease (diffuse toxic goiter), toxic multinodular goiter, and toxic adenoma. Diagnostic tests and treatment options including antithyroid drugs, radioactive iodine therapy, and surgery are described for hyperthyroidism. Thyroid storm, a medical emergency, is also summarized.
1) Cold abscesses are collections of pus that develop slowly without signs of inflammation and are usually caused by tuberculosis infection elsewhere in the body, commonly the lymph nodes or bones.
2) They form via a pathological process where the tuberculosis bacteria are phagocytosed by immune cells, forming granulomas with caseous necrosis that can break down and track along tissue planes, appearing as painless swellings distant from the original infection site.
3) Diagnosis involves tuberculin skin testing, biopsy or aspiration of the abscess, and radiological imaging like ultrasound or CT scan may help locate the abscess. Treatment consists of anti-tuberculosis drugs alongside drainage of palpable abscesses.
Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
- The document discusses pneumothorax, describing its classification, pathogenesis, clinical presentation, diagnosis, and treatment options.
- Key points include that tension pneumothorax can cause rapid deterioration and requires immediate treatment, while spontaneous pneumothorax is classified as primary or secondary depending on underlying lung health.
- Treatment involves observation for small primary pneumothoraces or procedures like aspiration, chest tube placement, or surgery depending on the size and symptoms.
This document discusses the anatomy, causes, symptoms, diagnosis and treatment of tonsillitis. It describes the anatomy of the palatine tonsils and their location in the oropharynx. It explains that tonsillitis is commonly caused by bacterial or viral infections, and presents as sore throat, difficulty swallowing and fever. The types of acute tonsillitis - catarrhal, follicular and membranous - are outlined. Treatment involves rest, fluids, analgesics and antibiotics. Complications and differential diagnoses are also summarized.
Multinodular goitre (MNG) is characterized by the growth of multiple nodules within the thyroid gland that are structurally and functionally altered. It develops through stages of thyroid hyperplasia and hypertrophy followed by fluctuations in TSH levels which promote the formation of inactive nodules within areas of active and inactive thyroid tissue. MNG most commonly affects middle-aged females and presents as a slowly progressive disease with multiple, firm nodules of varying sizes within the thyroid gland. While often benign, MNG can potentially lead to complications such as hyperthyroidism, thyroid cancer, or tracheal obstruction.
Pyothorax or empyema is the accumulation of pus and infected material within the pleural sac, causing symptoms like fever, breathing difficulties, and weight loss. It is typically caused by direct introduction of bacteria via trauma, surgery or extension from other infected sites. Diagnosis involves examining pleural fluid for bacteria, chest x-rays showing effusion, and ruling out other causes. Treatment requires tube drainage of the pleural space along with intravenous antibiotics and fluid therapy. Chylothorax is a similar condition involving accumulation of lymph fluid in the pleural space, often due to trauma or cancer causing a rupture of the thoracic duct.
Bronchiectasis is a chronic lung condition defined by abnormal dilation of the bronchi caused by inflammation and damage to the bronchial walls. It has several causes including post-infection, airway obstruction, immune deficiencies, and genetic disorders. Patients experience excessive sputum production, chronic cough, recurrent pneumonia, and sometimes hemoptysis. Diagnosis involves imaging like CT scans showing characteristic findings and ruling out other conditions. Treatment focuses on airway clearance and long-term antibiotics tailored to sputum cultures. Surgery may be considered for severe, localized cases or massive hemoptysis.
This document discusses acute rheumatic fever, an inflammatory disorder caused by an untreated Group A streptococcal infection. It is characterized by an inflammatory lesion of the connective tissues, especially the heart, joints, blood vessels, and skin. The main manifestations include carditis, arthritis, chorea, erythema marginatum, and subcutaneous nodules. The pathogenesis involves an autoimmune response triggered by the streptococcal infection that results in damage to connective tissues. Diagnosis is based on the Jones criteria of major and minor manifestations along with evidence of a prior streptococcal infection. Complications can include permanent cardiac damage if carditis is not properly treated.
SHOCK - PATHOPHYSIOLOGY, TYPES, APPROACH, TREATMENT.DR K TARUN RAO
1. Shock is defined as a state of poor tissue perfusion and cellular metabolism due to circulatory failure and hypoperfusion.
2. The main causes of shock include hypovolemic, cardiogenic, septic, anaphylactic, neurogenic, and respiratory etiologies.
3. The pathophysiology of shock involves a low cardiac output state leading to vasoconstriction and redistribution of blood flow away from non-vital organs to preserve perfusion of vital organs. Persistent shock can progress to cellular damage, organ dysfunction, and death.
Body Systems: Homeostasis, blood, cardio and respiratorymeducationdotnet
- The cell membrane is a phospholipid bilayer that separates the intracellular and extracellular fluids and controls the movement of substances into and out of cells. Transport proteins allow selective uptake of nutrients and removal of waste.
- Water movement across the membrane is determined by osmosis, moving from low to high solute concentration areas. Osmotic pressure and tonicity regulate water distribution and fluid balance in the body.
- The glycocalyx layer contains carbohydrates that protect the cell membrane and aid processes like cell adhesion and immune response.
This document lists signs and symptoms of various respiratory system diseases. Some of the most commonly described symptoms include cough, shortness of breath, fever, weight loss, and chest pain. Specific diseases mentioned and their typical symptoms include tuberculosis (cough, fever, night sweats), bronchitis (cough), pneumonia (fever, breathlessness), asthma (wheeze, cough), chronic obstructive pulmonary disease (breathlessness, cough), and lung cancer (cough, weight loss, chest pain). The document provides a comprehensive overview of clinical manifestations of numerous respiratory conditions.
Wheeze is a high-pitched whistling sound caused by airflow moving through partially obstructed airways. It is produced when air passes through narrowed portions of the airways at high velocity, causing the airway walls to vibrate and alternately flatten and reopen. This vibration creates a continuous musical sound. Wheeze can be caused by conditions that narrow the airways such as asthma, bronchitis, pneumonia, and foreign body obstruction.
Hemoptysis is defined as coughing up blood originating below the vocal cords. It can range from blood-streaked sputum to coughing up pure blood. The document discusses the definition, causes, differential diagnosis, diagnosis and treatment of hemoptysis. The main causes discussed are tracheobronchial diseases like bronchitis and tumors, as well as cardiovascular issues. Diagnosis involves history, examination, labs, chest imaging like CXR, CT, and procedures like bronchoscopy.
The thyroid gland develops from an endodermal thickening in the third week of gestation. It descends as the thyroglossal duct and bifurcates into two lobes connected by an isthmus. The gland is the first to become functionally active, synthesizing thyroid hormones through iodination of thyroglobulin. It is uniquely dependent on iodine from the external environment and has the ability to store hormones for later release.
Aspiration pneumonia is caused by bacteria from the mouth or stomach entering the lungs. It can develop hours to days after aspiration occurs. The most common pathogens have changed from anaerobic bacteria to aerobic bacteria. Diagnosis is based on clinical history, risk factors, and chest x-ray. Treatment depends on whether it is community-acquired or hospital-acquired pneumonia. Antibiotics are used but duration depends on severity and response. Preventive measures focus on oral hygiene and early mobilization of high-risk patients like stroke patients.
Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi. It can be caused by airway obstruction, pulmonary infections, genetic disorders like cystic fibrosis, or idiopathic factors. Symptoms include persistent cough with large amounts of sputum, hemoptysis, and clubbing of the fingers. Diagnosis is made through chest imaging like HRCT. Treatment focuses on clearing secretions through postural drainage, chest physiotherapy, antibiotics, bronchodilators, and smoking cessation. Nursing management centers on helping patients perform breathing exercises and techniques to clear pulmonary secretions.
This document discusses pleural effusions, which are collections of fluid in the pleural space. Pleural effusions are usually secondary to other diseases rather than primary. There are two main types - transudative effusions which occur without inflammation from conditions like heart failure, and exudative effusions which occur with inflammation from things like infections or cancer. Diagnosis involves chest imaging and analyzing fluid obtained via thoracentesis. Treatment focuses on resolving the underlying cause as well as draining fluid to relieve symptoms. Nursing care centers around maintaining normal breathing patterns and monitoring for complications.
This document discusses anaphylactic shock, including:
- Definitions of anaphylaxis and anaphylactoid reactions.
- The pathophysiology of anaphylaxis, which involves mast cell and basophil activation leading to mediator release and various symptoms.
- Etiologies of anaphylaxis including allergens, foods, drugs, and other causes.
- Clinical manifestations across multiple organ systems like skin, respiratory, cardiovascular and more.
- Diagnosis, prevention, and management, which focuses on epinephrine administration, airway management, fluids, and adjunctive treatments.
Jaundice, or icterus, is caused by an excess of bilirubin in the plasma, which leads to a yellowish discoloration of the skin and mucous membranes. There are three main types of jaundice: hemolytic, obstructive, and hepatocellular. Hemolytic jaundice occurs when there is an increased bilirubin load due to excessive breakdown of red blood cells. Obstructive jaundice is caused by an obstruction to the passage of conjugated bilirubin from the liver cells to the intestines. Hepatocellular jaundice results from a failure of the conjugating mechanism in the liver cells or an obstruction of conjugated bilirub
The document discusses pulmonary eosinophilias, which are a heterogeneous group of disorders characterized by varying degrees of pulmonary or blood eosinophilia. It classifies the main types as Loeffler's syndrome, drug and toxin induced eosinophilic pneumonia, tropical pulmonary eosinophilia, and allergic bronchopulmonary aspergillosis. Loeffler's syndrome is characterized by transient pulmonary infiltrates associated with eosinophilia caused by parasites. Tropical pulmonary eosinophilia is caused by a hypersensitivity reaction to filarial parasites. Allergic bronchopulmonary aspergillosis involves a hypersensitivity response to inhaled fungal antigens like Aspergillus.
Dr. Arun Karmakar presented on hyponatremia. Hyponatremia is defined as a serum sodium below 135 mmol/L and is the most common electrolyte disorder. It is clinically important because acute severe hyponatremia can cause morbidity and mortality, and outcomes are worse in hyponatremic patients with underlying diseases. Hyponatremia can be hypovolemic, euvolemic, or hypervolemic depending on water and sodium levels. Treatment depends on the severity and cause of hyponatremia, with aggressive correction for symptomatic cases and slower correction for chronic cases to avoid osmotic demyelination syndrome.
This document discusses thyrotoxicosis and hyperthyroidism. It begins by covering thyroid physiology including iodine metabolism and thyroid hormone synthesis. It then discusses the causes and clinical manifestations of Graves' disease (diffuse toxic goiter), toxic multinodular goiter, and toxic adenoma. Diagnostic tests and treatment options including antithyroid drugs, radioactive iodine therapy, and surgery are described for hyperthyroidism. Thyroid storm, a medical emergency, is also summarized.
1) Cold abscesses are collections of pus that develop slowly without signs of inflammation and are usually caused by tuberculosis infection elsewhere in the body, commonly the lymph nodes or bones.
2) They form via a pathological process where the tuberculosis bacteria are phagocytosed by immune cells, forming granulomas with caseous necrosis that can break down and track along tissue planes, appearing as painless swellings distant from the original infection site.
3) Diagnosis involves tuberculin skin testing, biopsy or aspiration of the abscess, and radiological imaging like ultrasound or CT scan may help locate the abscess. Treatment consists of anti-tuberculosis drugs alongside drainage of palpable abscesses.
Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
- The document discusses pneumothorax, describing its classification, pathogenesis, clinical presentation, diagnosis, and treatment options.
- Key points include that tension pneumothorax can cause rapid deterioration and requires immediate treatment, while spontaneous pneumothorax is classified as primary or secondary depending on underlying lung health.
- Treatment involves observation for small primary pneumothoraces or procedures like aspiration, chest tube placement, or surgery depending on the size and symptoms.
This document discusses the anatomy, causes, symptoms, diagnosis and treatment of tonsillitis. It describes the anatomy of the palatine tonsils and their location in the oropharynx. It explains that tonsillitis is commonly caused by bacterial or viral infections, and presents as sore throat, difficulty swallowing and fever. The types of acute tonsillitis - catarrhal, follicular and membranous - are outlined. Treatment involves rest, fluids, analgesics and antibiotics. Complications and differential diagnoses are also summarized.
Multinodular goitre (MNG) is characterized by the growth of multiple nodules within the thyroid gland that are structurally and functionally altered. It develops through stages of thyroid hyperplasia and hypertrophy followed by fluctuations in TSH levels which promote the formation of inactive nodules within areas of active and inactive thyroid tissue. MNG most commonly affects middle-aged females and presents as a slowly progressive disease with multiple, firm nodules of varying sizes within the thyroid gland. While often benign, MNG can potentially lead to complications such as hyperthyroidism, thyroid cancer, or tracheal obstruction.
Pyothorax or empyema is the accumulation of pus and infected material within the pleural sac, causing symptoms like fever, breathing difficulties, and weight loss. It is typically caused by direct introduction of bacteria via trauma, surgery or extension from other infected sites. Diagnosis involves examining pleural fluid for bacteria, chest x-rays showing effusion, and ruling out other causes. Treatment requires tube drainage of the pleural space along with intravenous antibiotics and fluid therapy. Chylothorax is a similar condition involving accumulation of lymph fluid in the pleural space, often due to trauma or cancer causing a rupture of the thoracic duct.
Bronchiectasis is a chronic lung condition defined by abnormal dilation of the bronchi caused by inflammation and damage to the bronchial walls. It has several causes including post-infection, airway obstruction, immune deficiencies, and genetic disorders. Patients experience excessive sputum production, chronic cough, recurrent pneumonia, and sometimes hemoptysis. Diagnosis involves imaging like CT scans showing characteristic findings and ruling out other conditions. Treatment focuses on airway clearance and long-term antibiotics tailored to sputum cultures. Surgery may be considered for severe, localized cases or massive hemoptysis.
This document discusses acute rheumatic fever, an inflammatory disorder caused by an untreated Group A streptococcal infection. It is characterized by an inflammatory lesion of the connective tissues, especially the heart, joints, blood vessels, and skin. The main manifestations include carditis, arthritis, chorea, erythema marginatum, and subcutaneous nodules. The pathogenesis involves an autoimmune response triggered by the streptococcal infection that results in damage to connective tissues. Diagnosis is based on the Jones criteria of major and minor manifestations along with evidence of a prior streptococcal infection. Complications can include permanent cardiac damage if carditis is not properly treated.
SHOCK - PATHOPHYSIOLOGY, TYPES, APPROACH, TREATMENT.DR K TARUN RAO
1. Shock is defined as a state of poor tissue perfusion and cellular metabolism due to circulatory failure and hypoperfusion.
2. The main causes of shock include hypovolemic, cardiogenic, septic, anaphylactic, neurogenic, and respiratory etiologies.
3. The pathophysiology of shock involves a low cardiac output state leading to vasoconstriction and redistribution of blood flow away from non-vital organs to preserve perfusion of vital organs. Persistent shock can progress to cellular damage, organ dysfunction, and death.
Body Systems: Homeostasis, blood, cardio and respiratorymeducationdotnet
- The cell membrane is a phospholipid bilayer that separates the intracellular and extracellular fluids and controls the movement of substances into and out of cells. Transport proteins allow selective uptake of nutrients and removal of waste.
- Water movement across the membrane is determined by osmosis, moving from low to high solute concentration areas. Osmotic pressure and tonicity regulate water distribution and fluid balance in the body.
- The glycocalyx layer contains carbohydrates that protect the cell membrane and aid processes like cell adhesion and immune response.
This document lists signs and symptoms of various respiratory system diseases. Some of the most commonly described symptoms include cough, shortness of breath, fever, weight loss, and chest pain. Specific diseases mentioned and their typical symptoms include tuberculosis (cough, fever, night sweats), bronchitis (cough), pneumonia (fever, breathlessness), asthma (wheeze, cough), chronic obstructive pulmonary disease (breathlessness, cough), and lung cancer (cough, weight loss, chest pain). The document provides a comprehensive overview of clinical manifestations of numerous respiratory conditions.
This document provides information on various respiratory conditions including definitions, signs and symptoms, investigations, and management. It covers topics such as asthma, COPD, tuberculosis, pulmonary embolism, pleural effusion, pneumonia, and others. For asthma, it defines it as a chronic inflammatory airway disease, lists common symptoms and signs, and outlines acute and chronic management according to BTS guidelines. For COPD, it defines the condition and describes the differences between emphysema and bronchitis. It also provides details on assessing severity and treatment approaches.
The vagus nerve connects organs in the neck and below to the brainstem. It has both sensory and motor functions and helps control the heart rate, digestion, and other involuntary processes. Stimulation of the vagus nerve has been shown to reduce seizures, experimental pain, and inflammation, and may help treat conditions like epilepsy, obesity, and heart disease. Damage to the vagus nerve or its connections in the brainstem can impact swallowing, heart rate variability, and level of consciousness.
1. Brown-Séquard syndrome was first described in 1850 based on observations of machete injuries in sugar cane farmers, with key features being ipsilateral motor paralysis and mixed sensory loss below the level of the spinal cord lesion.
2. Understanding the anatomy of ascending and descending spinal tracts is important for explaining the clinical features of Brown-Séquard syndrome and other spinal cord injuries.
3. Injuries can disrupt motor or sensory tracts differently, causing varying neurological deficits depending on whether the lesion involves upper or lower motor neurons.
Cancer is a leading cause of death that is increasing in incidence but decreasing in mortality. Risk factors include lifestyle choices like smoking and diet, as well as genetic predispositions. Cancer is typically detected through screening, clinical presentation of symptoms, or incidental findings. Treatment depends on the cancer type, stage, and patient characteristics, and may involve surgery, radiation, chemotherapy, targeted therapies, or palliative care. Improving prevention, early detection, and more effective treatments continue to help reduce the impact of cancer.
1. A patient with chronic kidney disease is least likely to have hyperphosphataemia.
2. For a patient with a potassium of 6.7 mmol/L and peaked T waves on ECG, initial management should include calcium chloride, insulin, and dextrose.
3. Complement is not routinely considered as part of a renal screen in investigating new-onset renal failure.
This document provides an introduction to the anatomy and examination of the breast. It describes the key anatomical structures including the lobules, alveoli, lactiferous ducts, nipple, areola, and blood and lymphatic drainage patterns.
It then outlines the process for examining the breasts including inspection with the arms raised, palpation of each quadrant and the nipple, and examination of the axillae, arms, supraclavicular fossae, abdomen, chest, and lumbar spine. The goal is to check for lumps, discharge, lymph node enlargement, and signs of spread to other organs.
Glomerular Filtration is High and is Regulated Preciselymeducationdotnet
The three main functions of the kidneys are ultrafiltration through glomerular capillaries, glomerular filtration, and renal handling of substances. Ultrafiltration occurs as blood passes through the glomerular capillaries, which filter fluid at a rate of about 180 liters per day. Glomerular filtration involves blood passing through the glomerulus, which contains capillaries that filter ultrafiltrate into Bowman's capsule. Substances in the blood are filtered through capillary walls and the basement membrane into the filtrate. The filtrate then travels to the proximal convoluted tubule. Renal handling of substances involves reabsorption and secretion as the filtrate passes through the tubules and neph
Mod 1-8. Cough - Clinical perspectives and therapymeducationdotnet
This document discusses perspectives and therapies for cough. It covers common causes like GERD, asthma, sinusitis, and infections. For GERD, PPIs are often used but their effectiveness is unclear. Non-acid reflux may be involved. Asthma treatments may not reduce cough and reasons for treatment failure need exploration. Idiopathic cough has enhanced airway sensitivity and inflammation. Theobromine shows potential as a novel anti-tussive without side effects. Evaluation of chronic cough involves detailed history, examination, spirometry, imaging, and treating any underlying conditions found.
Type I hypersensitivity reactions involve IgE binding to mast cells, causing rapid degranulation and release of inflammatory mediators. This results in conditions like allergic rhinitis and asthma. Type II reactions involve antibody binding directly to cells, causing haemolytic anaemia or thrombocytopenia. Type III reactions occur when immune complexes are deposited in tissues, activating complement and causing conditions like SLE. Type IV reactions are T cell-mediated, with CD4 T cells secreting inflammatory cytokines and CD8 T cells directly killing target cells, as seen in rheumatoid arthritis. Each hypersensitivity reaction has a distinct mechanism and time course.
Personality disorders, Eating disorders and Addictionsmeducationdotnet
This document summarizes key aspects of psychiatry, including normal personality traits, personality disorders, eating disorders, substance misuse, and other relevant topics. It describes the five factor model of normal personality as well as features and clusters of personality disorders. It also discusses etiology, assessment, and management of conditions like anorexia nervosa, bulimia nervosa, cannabis use, LSD use, and ecstasy use. Common co-morbidities, consequences, and risk factors are summarized.
- Surface tension in alveoli is reduced by pulmonary surfactant, which decreases the forces that cause alveoli to collapse. This increases lung compliance by reducing the pressure required to inflate the lungs.
- Surfactant especially reduces surface tension in smaller alveoli due to its area-dependent effects. This helps prevent smaller alveoli from emptying into larger ones.
- Increased lung compliance from surfactant reduces fluid movement into alveoli from pulmonary capillaries.
This document lists various autoantibodies and the diseases they are associated with, including the prevalence of the autoantibody in each disease. Some of the major autoantibodies listed are anti-dsDNA which is present in 70% of SLE patients, anti-nuclear antibodies which are present in SLE, systemic sclerosis, and Sjogren's syndrome, and anti-CCP which is present in rheumatoid arthritis patients. The list provides autoantibodies and their linked diseases as well as the percentage prevalence of each autoantibody in its associated disease.
Type 1 diabetes results from a failure of insulin production due to destruction of pancreatic beta cells, often due to an autoimmune reaction. It typically develops in younger people and requires lifelong insulin treatment. Type 2 diabetes involves insulin resistance where cells do not respond properly to insulin despite adequate insulin secretion. It usually develops in older, overweight individuals and can often be managed with oral medications and lifestyle changes initially. Diabetes management involves monitoring blood glucose levels, taking medications as prescribed, maintaining a healthy lifestyle, and screening for complications involving the eyes, feet, kidneys, and other organs.
The document summarizes the anatomy and features of the upper respiratory tract, specifically focusing on the pharynx. It is divided into 3 parts: the nasopharynx, oropharynx, and laryngopharynx. Key structures discussed include the eustachian tubes, tonsils (pharyngeal, tubal, palatine, lingual), muscles that control swallowing, and blood supply. The pharynx acts as a shared passageway for both respiration and digestion and contains lymphatic tissue to aid in immune function.
This document discusses blood products and transfusions. It provides information on when to consider red blood cell transfusions, how to treat iron overload, observation frequency during transfusions, typical hemoglobin increase from a unit of red blood cells, universal donor and receiver types for red blood cells and platelets, uses of fresh frozen plasma, albumin as a plasma volume expander alternative, early and delayed complications of transfusions, direct and indirect Coombs tests, type of red blood cells used for neonates, autologous donation, platelet transfusion requirements, and patients requiring irradiated blood products.
This document provides an overview of content to be covered in a 1.5 hour session on respiratory medicine. It includes objectives to familiarize learners with potential OSCE scenarios and key respiratory conditions, signs, symptoms, investigations, and management. It also provides sample OSCE scenarios and outlines content on topics like asthma, COPD, pneumonia, and tuberculosis that will be discussed, followed by some sample SBA questions for practice.
This patient presents with classic symptoms of Sjogren's syndrome including dry eyes, dry mouth, and joint pain. A Schirmer's test, which measures tear production, showed a result of 3mm in 5 minutes, confirming the diagnosis of dry eyes. Sjogren's syndrome is an autoimmune disease characterized by decreased tear and saliva production due to inflammation of the lacrimal and salivary glands. It most commonly affects middle-aged women and can cause a variety of systemic symptoms in addition to dry eyes and dry mouth. The patient's symptoms and positive Schirmer's test suggest she has primary Sjogren's syndrome.
This document discusses neonatal respiratory distress, including signs, symptoms, and common etiologies. The main pulmonary causes discussed are transient tachypnea of newborn, respiratory distress syndrome, meconium aspiration syndrome, pneumonia, and air leak syndromes. For each cause, risk factors, pathophysiology, clinical manifestations, diagnostic findings, and management approaches are summarized. The document provides an overview of evaluation and treatment of neonatal respiratory distress.
This document summarizes several pulmonary emergencies: pneumothorax, hemoptysis, and status asthmaticus.
It defines pneumothorax and discusses its classification, etiology, signs and symptoms, management including tube thoracostomy. For hemoptysis, it defines massive versus non-massive hemoptysis, discusses etiology, diagnostic clues on physical exam, and management approaches including bronchoscopy, arterial embolization, and surgery.
Status asthmaticus is defined as a severe asthma attack unresponsive to treatment. Classification of asthma severity and acute asthma is presented. Diagnosis, risk factors for life-threatening attacks, and emergency management including medications, monitoring
anaesthetic implications of Congenital diaphragmatic-herniaPramod Sarwa
This document discusses congenital diaphragmatic hernia (CDH), including its embryology, pathophysiology, diagnosis, management, and complications. CDH is a birth defect where abdominal organs protrude into the chest cavity through a hole in the diaphragm. It causes respiratory distress and often requires emergency care. Treatment involves stabilizing the infant and then surgically repairing the diaphragmatic defect. Outcomes depend on the severity of lung hypoplasia and associated anomalies. Extracorporeal membrane oxygenation (ECMO) may be used to support infants with severe respiratory failure.
The document summarizes chronic obstructive pulmonary disease (COPD). It covers the general considerations, epidemiology, risk factors, pathogenesis, clinical findings, differential diagnosis, diagnostic testing including spirometry and imaging, and treatment including smoking cessation, oxygen therapy, bronchodilators, corticosteroids, and antibiotics. COPD is characterized by airflow obstruction due to chronic bronchitis or emphysema and is generally progressive. Cigarette smoking is the most important risk factor.
The patient is a 38-year-old male presenting with left-sided chest pain and breathlessness for 6 months. CT scan revealed pleural mesothelioma stage IV. Biopsy confirmed malignant mesothelioma. The patient's condition deteriorated and he eventually suffered cardiac arrest and passed away. Mesothelioma is caused by asbestos exposure and has a very poor prognosis. Treatment options include surgery, chemotherapy and palliative care but the median survival is only 4-12 months.
This document discusses chronic obstructive pulmonary disease (COPD). It defines COPD as a progressive lung disease characterized by airflow limitation that is not fully reversible. The main phenotypes of COPD are chronic bronchitis and emphysema. The document discusses the pathogenesis and risk factors of COPD, as well as the clinical presentation and complications. It provides details on diagnosing COPD through pulmonary function tests, blood tests, imaging and other evaluations. Treatment options are outlined for acute exacerbations and management of stable COPD based on disease severity. Management includes bronchodilators, corticosteroids, pulmonary rehabilitation, oxygen therapy and occasionally surgery.
EM Board Review Pulmonary & Critical Care...Carrie ClarkTroy Pennington
Sweat chloride >60mmol/L on quantitative sweat test confirms
diagnosis
Genetic testing
Identifies mutations in CFTR gene
This document provides a summary of respiratory physiology, hypoxemia, critical care topics including ARDS, and disorders of the pleura, mediastinum, and chest wall. It also reviews obstructive lung diseases such as asthma, COPD, and cystic fibrosis including their etiology, symptoms, diagnosis, and management. Key points covered include the alveolar gas equation, causes of hypoxemia, management of ARDS with low tidal volume ventilation and PEEP, diagnosis and treatment of pneumothorax and ple
1) Respiratory distress in neonates can have many pulmonary and non-pulmonary causes and requires early intervention. Signs of respiratory distress include tachypnea, grunting, and work of breathing.
2) Assessment of respiratory distress involves evaluating the rate and pattern of breathing, skin color, and neurological status. Scores like Downes and Silverman-Andersen are used to grade the severity.
3) Differential diagnosis of respiratory distress includes conditions like RDS, TTN, meconium aspiration, pulmonary hypoplasia, and various cardiac and non-cardiac issues. A thorough history and examination helps identify the underlying cause.
The document discusses peri-operative pneumothorax, including its definition, epidemiology, classification, causes related to anesthesia, and features of tension pneumothorax. It then presents a case scenario of a 55-year-old male patient who developed respiratory distress after craniotomy and was found to have a pneumothorax. The diagnosis, investigations, management, and different treatment modalities for pneumothorax are reviewed.
Neuromuscular weakness in critically ill patients- critical care aspects of t...Surendra Patel
The document outlines 10 basic rules for respiratory care of neuromuscular patients. It discusses assessing lung function in all neuromuscular patients, distinguishing between rapidly and slowly progressive diseases, and evaluating possible cardiovascular and aspiration issues. It notes that difficulty draining secretions may require respiratory physiotherapy or mechanical assistance. Ventilatory support is indicated when FVC is below 50% or there are symptoms of diaphragmatic dysfunction or hypoventilation. The correct choice of portable equipment and ventilation mode is important.
The document provides an overview of respiratory anatomy and physiology, focusing on the respiratory system, gas exchange, blood flow through the lungs, oxygenation, and sleep apnea. It defines obstructive sleep apnea as repeated cessation of breathing during sleep due to upper airway collapse. Risk factors include obesity, age, male gender, and anatomical abnormalities. Symptoms include loud snoring, witnessed breathing pauses, and daytime sleepiness. Consequences include cardiovascular disease, accidents, and decreased quality of life. Diagnosis involves assessing symptoms, risk factors, and polysomnography. Treatment aims to reduce risks and includes weight loss, positive airway pressure, and surgery.
This document provides information on anaesthesia for laparoscopic surgery. It discusses the history of laparoscopy, advantages and disadvantages, physiological changes during pneumoperitoneum, gas choices, positioning, fluid management, complications, and special considerations for laparoscopy in infants/children and pregnancy. Key points include CO2 being the gas of choice due to its solubility, general anaesthesia typically being used, and importance of fluid management and monitoring physiological changes during the procedure.
This document provides information on acute pulmonary embolism (PE), including its definition, risk factors, pathophysiology, clinical features, diagnostic tests, treatment with anticoagulation therapy, and classifications. It describes PE as obstruction of the pulmonary artery or its branches by material originating elsewhere. Risk factors include older age, surgery, trauma, cancers, and prolonged immobilization. Diagnostic tests include D-dimer, CT pulmonary angiogram, ventilation-perfusion scan, echocardiogram, and angiogram. Treatment involves anticoagulation therapy such as low molecular weight heparin, fondaparinux, warfarin, or direct oral anticoagulants. Duration of therapy depends on whether the PE was
This document discusses several pulmonary conditions including pleural effusion, acute respiratory distress syndrome (ARDS), bronchial asthma, chronic obstructive pulmonary disease (COPD), and lung abscess. For pleural effusion, it describes the causes, signs and symptoms, investigations including pleural fluid analysis, and treatments including thoracentesis. For ARDS, it provides the definition, precipitating factors, symptoms, investigations, and management including supportive care and treating the underlying cause. It also summarizes the definitions, common triggers, signs and symptoms, diagnosis, investigations, and treatment including bronchodilators and corticosteroids for bronchial asthma and COPD.
This document provides guidance on clinically examining the respiratory system. It describes how to inspect, palpate, percuss, and auscultate the chest. Inspection involves examining chest shape, symmetry, movement, and veins. Palpation checks the trachea position, apex beat, chest expansion, vocal fremitus, and tenderness. Percussion distinguishes lung from liver dullness. Auscultation assesses breath sounds and vocal resonance. The examination evaluates the lungs, pleura, chest wall, and underlying bony structures in a systematic manner to detect abnormalities.
Dr. Rohit and Dr. Sagar presented on shock, defining it as inadequate tissue perfusion resulting from an imbalance in oxygen delivery and consumption. They discussed the main types of shock - hypovolemic, cardiogenic, obstructive, and distributive - and the pathogenesis of each. Key signs of shock include tachycardia, tachypnea, poor pulses, and altered mental status. Early goal-directed resuscitation within the "golden hour" is important for outcomes. Management involves addressing the underlying cause, optimizing preload and cardiac output, and monitoring for resolution of shock.
1. The document discusses acute respiratory distress syndrome (ARDS), describing its pathophysiology, causes, diagnosis, treatment and prognosis.
2. ARDS is characterized by hypoxemia, reduced lung compliance and diffuse pulmonary infiltrates leading to respiratory failure. Common causes include sepsis, pneumonia and trauma.
3. Treatment involves treating the underlying cause, supportive care including mechanical ventilation with low tidal volumes, and managing fluid levels and oxygenation. Prognosis depends on severity of illness, with reported mortality ranging from 41-65%.
Central Neuroxial blockage ( Spinal and Epidural block ) By Dr Sachin GaikwadSachin Gaikwad
This document provides information on central neuroaxial blockade including spinal and epidural anesthesia. It discusses:
1) Applied anatomy of the vertebral column and spinal cord levels.
2) Contents and landmarks of the epidural space.
3) Advantages of neuroaxial blockade over general anesthesia.
4) Physiological effects including cardiovascular, respiratory, and thermoregulatory changes.
5) Procedures, drugs, and complications of spinal and epidural anesthesia.
1. Mechanical ventilation can be used to treat respiratory failure in COPD patients by providing respiratory support and avoiding intubation complications. Non-invasive ventilation is preferred over invasive ventilation when possible.
2. Key goals of mechanical ventilation in COPD patients include using low tidal volumes to minimize excessive work of breathing, ensuring synchrony between breaths, and preventing complications like barotrauma and respiratory muscle atrophy.
3. Indications for intubation include when a COPD patient fails conservative management, has severe persistent acidosis or hypoxemia, or has additional illnesses. Close monitoring is needed to optimize ventilator settings and prevent issues in mechanically ventilated COPD patients.
The document discusses several inflammatory arthropathies known as spondylarthropathies. They are commonly associated with the HLA B27 gene and involve entheses, synovium, and the spine. Major types include ankylosing spondylitis, psoriatic arthropathy, reactive arthritis, and enteropathic arthritis. They often present with enthesitis, uveitis, and spondylitis and are treated with NSAIDs, DMARDs, anti-TNF drugs, or surgery depending on the specific condition and symptoms.
Lung cancer is classified into two main types - non-small cell lung carcinoma (NSCLC) and small cell lung carcinoma (SCLC). NSCLC makes up about 80% of cases and can be further divided into squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. SCLC accounts for 10-15% of lung cancers and grows more quickly. The main symptoms are cough, chest pain, and coughing up blood. Risk factors include smoking, asbestos exposure, and radiation exposure. Diagnosis involves tests such as sputum analysis, biopsies, CT scans, and PET scans to determine the cancer type and stage. Treatment options depend on the cancer type and stage but may include surgery, chemotherapy
Eczema herpeticum is a potentially life-threatening herpes infection that occurs when herpes simplex virus infects disrupted skin in patients with pre-existing skin conditions like eczema or atopic dermatitis. It presents with clusters of vesicles and punched-out erosions that spread and become hemorrhagic and crusted. Diagnosis involves identifying characteristic lesions along with fever and pain, and can be confirmed with tests like Tzanck smear, viral culture, or antibody testing. Aggressive treatment with IV acyclovir is required to prevent complications like herpes keratitis, which can lead to blindness. Early recognition and effective antiviral therapy are important given the potential severity of eczema her
Poor water and sanitation are responsible for a huge global burden of disease, with contaminated water alone contributing to about 2.4 million preventable deaths per year, mainly in children. While progress has been made in increasing access to safe water and improved sanitation, current rates of progress will not meet the Millennium Development Goal targets. Water and sanitation remain a low priority on international development agendas despite their importance for health and achieving the MDGs. Coordinated efforts are still needed to address this critical issue.
This document discusses medical student electives in developing countries. It notes potential benefits like exposure to rare diseases and personal growth, but also flags ethical issues. Electives could exploit local health systems and raise false expectations. They may perpetuate neo-colonial practices by benefiting students and health systems in wealthy countries more than local populations. The document also examines how non-governmental organizations can undermine public health systems and calls for electives to minimize harm, respect local needs, and establish long-term exchange programs to provide mutual benefit.
This document provides an overview of global health by defining key terms, outlining major players and organizations, and summarizing the history and evolution of the field from 1945 to the present day. It describes how global health has shifted from a focus on infectious disease control to addressing social determinants of health and health issues that transcend national borders. Major milestones discussed include the founding of the UN and WHO, the Alma-Ata Declaration, structural adjustment policies, the Millennium Declaration and MDGs, debt relief campaigns, and the establishment of the Global Fund. The summary highlights the ongoing tension between disease-specific and comprehensive primary healthcare approaches.
The document discusses how international organizations like the WTO and treaties it has established like TRIPS and GATS impact healthcare. The WTO aims to liberalize trade and its dispute process enforces agreements. TRIPS established intellectual property standards that require drug patenting, raising prices. Some countries like Brazil and South Africa have issued compulsory licenses to produce cheaper generics, facing opposition from pharmaceutical companies but helping improve access to treatment.
Global health examines influences on health across borders, including issues like globalization, poverty, and human rights. It draws from multiple disciplines. Globalization refers to reducing barriers between countries, leading to increased trade, investment, and communication. This has effects like economic growth but also rising inequalities. Agreements like TRIPS have increased pharmaceutical patent protection globally, raising concerns about access to medicines, especially in developing countries. Networks of both commercial and civil society actors have been important in debates over balancing intellectual property with public health.
Migration of health care workers has both positive and negative effects on health. It reduces the availability of health services in source countries while increasing access in destination countries. This unequal distribution of health workers is driven by push factors like low pay and poor working conditions in source countries and pull factors like higher wages in destination countries. As a result, source countries experience worse health outcomes due to lack of health workers, while destination countries receive an indirect subsidy through the receipt and employment of trained medical professionals from poorer nations. Proposed policy responses aim to strengthen health systems in source countries, implement ethical recruitment practices, and foster partnerships between nations to promote more equitable health worker distribution.
Global institutions play major roles in health financing and policy. The key players discussed are the World Health Organization (WHO), World Bank, International Monetary Fund (IMF), and World Trade Organization (WTO). The WHO is the UN agency for health, working with 192 member states. The World Bank aims to reduce poverty through loans and policy advice to developing countries. The IMF promotes international monetary cooperation and provides temporary financial assistance. The WTO, formed in 1995, ensures trade flows freely through treaties and enforcement mechanisms, which some criticize can undermine public health systems.
Haemochromatosis is an autosomal recessive condition characterized by excessive iron accumulation in the body. It affects around 0.5% of Caucasians and usually presents in the 40s-50s with a triad of pigmentation, diabetes mellitus, and hepatomegaly. Diagnosis involves blood tests showing elevated serum iron, transferrin saturation over 50%, and elevated serum ferritin. Liver biopsy can confirm iron deposition and damage. Treatment aims to reduce iron stores through weekly venesection of 1 unit of blood for 6-12 months followed by maintenance venesection.
Ascites is an abnormal collection of fluid in the peritoneal cavity, commonly caused by portal hypertension due to cirrhosis. It results from sodium and water retention triggered by vasodilation and activation of the renin-angiotensin system, as well as increased hydrostatic pressure and transudation of fluid from the liver and spleen into the peritoneal cavity. Hypoalbuminemia due to decreased liver function also contributes by reducing plasma oncotic pressure. Spironolactone is used as treatment as it is an aldosterone antagonist. Management involves dietary sodium restriction, diuretics, stopping alcohol, monitoring for complications, and procedures such as paracentesis or shunts.
The liver has two lobes, separated by veins, and is divided into sections supplied by individual blood vessels. Blood flows through hepatic arteries and portal veins into sinusoids, where waste is filtered by Kupffer cells in the space of Disse before draining into hepatic veins. The liver performs many functions including synthesizing proteins, metabolizing carbohydrates and lipids, and detoxifying hormones and drugs. Liver function can be assessed through blood tests of enzymes and proteins.
Antidepressants such as SSRIs, TCAs, and MAOIs work by increasing levels of serotonin, norepinephrine, or both in the brain. SSRIs are generally first-line treatment and safer in overdose than TCAs, but TCAs may be better for severe depression. Both classes of drugs can cause side effects like dry mouth, nausea, and sexual dysfunction. Antidepressants may take 10-20 days to work and should be continued for at least 6 months after symptoms improve to prevent relapse. Combining certain antidepressants can be dangerous due to increased serotonin levels.
Gout is caused by deposition of uric acid crystals in the joints, which leads to acute inflammation. It typically presents as sudden severe pain, swelling and redness in one joint, most commonly the big toe. Diagnosis is made based on symptoms and identification of crystals in joint fluid under polarized microscopy. Treatment involves medications to reduce symptoms during acute attacks as well as long-term drugs like allopurinol or probenecid to lower uric acid levels and prevent future episodes. Without treatment, gout can progress to a chronic stage with multiple joint involvement and growth of tophi deposits in the tissues.
Review of orthopaedic services: Prepared for the Auditor General for Scotland...meducationdotnet
1. Orthopaedics is a large specialty that treats musculoskeletal conditions through surgery, medication, and rehabilitation. It accounts for a significant portion of NHS spending and activity in Scotland.
2. Waiting times for orthopaedic services have reduced in recent years through changes to service delivery and additional funded activity. However, further improvements to meet 18-week referral targets will be challenging to sustain.
3. There is variation in orthopaedic efficiency across Scotland that is not fully explained by resources or procedures. The report finds opportunities to use existing resources more efficiently through measures like increasing day surgery and reducing hospital length of stay.
This document discusses the use of muscle relaxants in anesthesia and the potential role of sugammadex as a reversal agent. It provides background on why muscle relaxants are used, types of muscle relaxants, and current problems with reversal agents. It then summarizes research on sugammadex, which appears to be a more effective reversal agent than anticholinesterases, allowing faster recovery from neuromuscular blockade. Sugammadex may allow safer use of muscle relaxants and replace agents like suxamethonium, but economic factors will also influence its adoption.
This document contains a series of slides related to ophthalmology. It tests the reader's knowledge on topics like visual acuity measurements, refractive errors, eye abnormalities, causes of vision loss, and eye examination techniques. The slides include images showing conditions like cataracts, glaucoma, retinal detachments, and more. Key details are provided about diagnoses, symptoms, investigations, and treatments.
1) Keloid and hypertrophic scars differ in that keloids grow beyond the boundaries of the original wound while hypertrophic scars remain within the boundaries and eventually regress.
2) Second degree burns extend into the deeper dermal layers and can cause blistering and moderate pain due to damage of some nerve endings, while third degree burns reach the subcutaneous fat and cause minimal pain as most nerve endings have been destroyed.
3) Venous ulcers on the legs indicate severe venous insufficiency and are the most common type of leg ulcer, affecting around 80% of cases. They are associated with signs of venous stasis such as hemosiderin deposition, telangiectasia,
This document discusses restrictive interstitial lung diseases. Restrictive lung diseases are caused by loss of lung volume from conditions affecting the lungs, chest wall, or pleura. Interstitial lung diseases involve thickening of alveolar walls due to inflammation, granulomas, hemorrhage or fibrosis. Specific restrictive interstitial diseases covered include sarcoidosis, cryptogenic fibrosing alveolitis, pneumoconioses caused by organic or inorganic dust exposure, and lung diseases associated with connective tissue disorders or systemic inflammation.