Flutter waves.
Tuesday, September 18, 2012
Tuesday, September 11, 2012
Wednesday, May 2, 2012
Glasgow coma scale
1. Eye Opening (E)
a. Spontaneous 4
b. To Speech 3
c. To Pain 2
d. Nil 1
2. Best Motor Response (M)
a. Spontaneous 6
b. Localises 5
c. Withdraws 4
d. Abnormal flexion 3
e. Extensor Response 2
f. Nil 1
3. Best Verbal Response (V)
a. Oriented 5
b. Confused 4
c. Inappropriate words 3
d. Incomprehensible sounds 2
e. Nil 1
a. Spontaneous 4
b. To Speech 3
c. To Pain 2
d. Nil 1
2. Best Motor Response (M)
a. Spontaneous 6
b. Localises 5
c. Withdraws 4
d. Abnormal flexion 3
e. Extensor Response 2
f. Nil 1
3. Best Verbal Response (V)
a. Oriented 5
b. Confused 4
c. Inappropriate words 3
d. Incomprehensible sounds 2
e. Nil 1
Brain injury is classified as:
- Severe, with GCS ≤ 8
- Moderate, GCS 9 - 12
- Minor, GCS ≥ 13.
Tuesday, January 17, 2012
Bradycardia
When the resting heart rate of an adult is less than 60 beats/ minute, the condition is termed as bradycardia. Clinical symptoms generally appear when the heart rate goes below 50 beats/ minute.
In case of atheletes the heart rate may be even below 50 beats/ minute.
In case of atheletes the heart rate may be even below 50 beats/ minute.
Causes-
- Normal esp in athletes, young healthy individuals
- Medications - Calcium channel blockers, beta blockers, digitalis, clonidine, amiodarone, anti-arrhythmic drugs.
- Sick sinus syndrome
- Vaso vagal response
- Hypothermia
- Hypothyroidism
- Arterioventricular blocks.
- Myocardial ischaemia involving right coronary artery.
- increased intracranial pressure (Cushing's reflex)
- Cardiac infiltrative diseases - amyloidosis, sarcoidosis, hemochromatosis.
Sunday, January 15, 2012
Cough - Chronic
Common causes- Post nasal drip, Asthma, Gastroesophageal reflux disease.
Pulmonary infections-
Pulmonary infections-
- Post viral
- Bronchitis esp in smokers
- Bronchiectasis
- Tuberculosis
- Cystic fibrosis
- Mycobacterium avium complex
- pertusis
- mycoplasma
- Respiratory synctial virus
- Parasites- ascaris
- Asthma
- beta blockers causing asthma
- chronic obstructive pulmonary disease - COPD
- Ace inhibitors
- irritant inhalation- smoking
- endotracheal lesions- tumors
- Interstitial lung disease
- Sarcoidosis
- Chronic microaspiration
- Gastroesophageal reflux disease
- Post nasal drip
- Sinusitis
- Congestive Cardiac Failure
- laryngitis
- Eustachian tube or tympanic membrane infections
- Psychogenic or habit cough
Saturday, January 14, 2012
Cough- Acute in onset
Cough may be acute in onset or chronic.
Causes-
Causes-
- Viral Upper respiratory infection or post viral cough ( most common)
- Bacterial upper respiratory infections
- Allergic rhinitis ( post nasal drip)
- Pneumonia
- Pulmonary oedema e.g. congestive cardiac failures
- Pulmonary embolism
- Aspiration Pneumonia
- Foreign body aspiration
Wednesday, January 11, 2012
Diagnostic flowchart for Chronic Dyspnea
Chronic dyspnea is defined as dyspnea lasting more than one month.
Indications for CT/HRCT include :
- restrictive lung disease.
- preoperative assessment of patients who are being referred for lung reduction surgery.
- patients who have dyspnoea and reduced single-breath diffusing capacity for carbon monoxide without evidence of airflow obstruction.
- patients with chronic dyspnoea in whom the initial evaluation (clinical assessment, CXR and pulmonary testing) is non diagnostic or non revealing.
Difficulty in breathing or Dyspnea
Dyspnea is uncomfortable awareness of breathing.
Or
Shortness of breath
Or
Difficulty in breathing
Causes:
Or
Shortness of breath
Or
Difficulty in breathing
Causes:
Acute-
- Asthma
- Pneumonia
- Pulmonary edema
- Pneumothorax
- Pulmonary embolism
- metabolic acidosis
- Panic attacks
Pulmonary-
- Airflow obstruction diseases- Asthma, COPD, upper airway obstruction
- restrictive lung diseases- interstitial lung disease, pleural thickening or effusion, respiratory muscles weakness, obesity
- Pneumonia
- Pulmonary edema
- Pneumothorax
- Pulmonary embolism
Cardiac-
- myocardial ischaemia
- congestive heart failure
- valvular obstruction
- arrythmias
- cardiac tamponade
Metabolic-
- acidosis
- hypercapnia
- sepsis
Hematologic-
- anaemia
- methemoglobinemia
Psychiatric-
- anxiety
Episodic dyspnea can occur in following cases-
- congestive cardiac failure
- asthma
- acute or chronic bronchitis
- recurrent pulmonary emboli
Tuesday, January 10, 2012
Cyanosis
Bluish discoloration of skin and mucous membranes, resulting from increased amount of reduced hemoglobin or hemoglobin derivatives in the capillary blood.
Most marked in lips, nails beds, ears and malar eminence.
Causes-
A. central cyanosis
Most marked in lips, nails beds, ears and malar eminence.
Causes-
A. central cyanosis
- Due to decreased arterial saturation
- Cardiac causes-
- fallot's tetralogy
- Eisenmenger's syndrome
- congestive cardiac failure
2. Pulmonary causes-
- chronic bronchitis
- interstitial lung disease
- pulmonary arteriovenous fistula
3. High altitude
4. Cirrhosis of liver
- Due to abnormal hemobglobin derivatives
- Methemoglobinemia
- sulphahemoglobinemia
B. Peripheral cyanosis
- due to diminished blood flow resulting from decreased cardiac output
- Mitral stenosis
- caongestive cardiac failure
- shock
2. due to local vasoconstriction
- cold exposure
- raynaud's disease
- peripheral vascular disease
Monday, January 9, 2012
Chest Pain
Common Causes
1. Cardiac Causes:
- Angina Pectoris
- Myocardial Infarction
- Mitral Valve Prolapse
- Pericarditis
- Hypertrophic Cardiomyopathy
2. Lung and Pleura
- Pleurisy
- Pneumothorax
- Pulmonary embolism
3. Dissecting Aneurysm of Aorta
4. Oesophageal
- Reflux Oesophagitis
- Diffuse Oesophageal spasm
5. Musculoskeletal
6. Intraabdominal conditions
7. Anxiety state
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