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Being able to identify the key symptoms of stroke allows one to be treated as soon as possible. Identifying it in someone, can help save their life. So Remember BE FAST and save a person having a stroke! Be a Hero!
Continue readingEPIDEMIOLOGY Increasing diabetes mellitus by 38% since 2004. Financial burden of foot ulcer is approximately $20,000 dollars within 2 years of diagnosis and lifetime cost of an amputation is approximately $50,000. PATHOPHYSIOLOGY - Direct bacterial invasion from skin ulcer break in the skin barrier - Oxidative stress, poor nutrition, impaired neutrophil function, ischemia from vascular insufficiency - Peripheral neuropathy leads to risk of developing foot ulcers. Sensory neuropathy leads to loss of protective sensation. Motor neuropathy leads to deformities that leading developing pressure points. Autonomic ...
Continue readingHerpes Zoster is the reactivation of varicella zoster virus infection. It usually presents as a painful vesicular eruption with a dermatomal distribution. PATHOPHYSIOLOGY The varicella virus lives inactive in the dorsal root / cranial nerve ganglia after primary infection. Reactivation of this virus causes replication of the virus in the neuronal bodies and are then carried along the axons to the skin dermatomes, causing the inflammatory eruptions. RISK FACTORS 1. Age (mostly seen in geriatric population) 2. Immunosuppressed state (pregnancy, HIV, malignancy) 3. Spinal surgery 4. Stress 5. ...
Continue readingCluster headaches are more common in middle aged men, with a ratio of 2:1 In women, it is usually seen earlier in life (in their 20s) ASSOCIATED WITH 1. Depression 2. Asthma 3. History of migraines 4. Sleep apnea CLINICAL PRESENTATION The diagnosis is clinical 1. Unilateral, recurrent periorbital pain that lasts from 15 min upto 3 hours 2. Usually at night time 3. Ipsilateral injection, lacrimation and nasal congestion 4. Neurological exam is normal PATHOPHYSIOLOGY Posterior hypothalamus activation > increased parasympathetic outflow The lacrimation, redness and congestion is due to parasympathetic hyperactivity The ptosis and ...
Continue readingPneumonia is the infection of the lower respiratory tract. There are 2 main types; Community acquired pneumonia (CAP) and Health care associated pneumonia (HCAP) EPIDEMIOLOGY - approx 4 million adults in the US are diagnosed with CAP every year ETIOLOGY - Viral (most common, 85% cases) - Common bacterial; S.pneumoniae, Hemophilus influenzae, Staph aureus, MRSA, Pseudomonas - Other; TB, fungi, legionella RISK FACTORS - Age (>65yrs) - Smoking, Alcohol use - Asthma, COPD - Previous h/o of pneumonia - Immunosuppression - Malnutrition PATHOLOGY BASED ON RISK FACTORS 1. Alcohol - S.pneumoniae, Klebsiella, S aureus, Anaerobes 2. ...
Continue readingConsists of 2 types; primary and secondary Primary adrenal insufficiency is also called Addison's disease ETIOLOGY Primary - Autoimmune (most common) - Hemorrhage; trauma, illness, pregnancy - Infections; HIV, CMV, TB - Amyloidosis and Hemochromatosis - Congenital - Drugs; ketoconazole, etomidate, mitotane Secondary - Iatrogenic CLINICAL FEATURES - Weakness, Fatigue - Weight loss - Nausea, Vomiting, Diarrhea, Abdominal pain - Orthostatic hypotension - Coma, Death - Hyper pigmentation of oral mucosa and palmar creases DIAGNOSIS - Blood work; BMP (hyponatremia, hyperkalemia) - Cortisol test - Cosyntropin stimulation test TREATMENT - Fludrocortisone, Hydrocortisone, Prednisone
Continue readingTreating & Preventing Cold Injuries: Exposure Risks: Risk factors are elevated for people who spend extended time working or recreating in cold environments. Many winter time injuries occur at the end of the work or recreational day when the temperature drops, surfaces get icy and slick, and people are fatigued and/or dehydrated. Complacency or lack of awareness, especially in warmer climates, can also heighten injury risk. Other contributing factors include: 1. Wearing inadequate or wet clothing. 2. Consuming substances that inhibit the body's response to cold and/or ...
Continue readingHydrocarbons are a heterogeneous group of organic substances that are primarily composed of carbon and hydrogen molecules. They are quite abundant in modern society. Some of the most commonly ingested hydrocarbons include gasoline, lubricating oil, motor oil, mineral spirits, lighter fluid/naphtha, lamp oil, and kerosene. [1] Other common sources of hydrocarbons include dry cleaning solutions, paint, spot remover, rubber cement, and solvents. In addition, many volatile substances that contain hydrocarbons (eg, glue, propellants) are commonly abused for their euphoric effects.[1] EPIDEMIOLOGY Hydrocarbon ingestion accounts ...
Continue readingAbdominal adhesions are pathological bands of scar tissue that forms between two previously separated structures within an abdomen. They may be between omentum, abdominal wall or intestinal loops. ETIOLOGY - Congenital or Acquired - Iotragenic; trauma, surgery or postinflammatory RISK FACTORS - Emergent surgeries - Lower GI procedures - H/o abdominal abscess, surgery or trauma CLINICAL FINDINGS - Crampy abdominal pain - Nausea and/or vomiting - Minimal to no flatus - Borborygmi (loud bowel sounds) - Abdominal distention and tenderness - Vitals: fever, tachycardia - Peritoneal signs; guarding, rebound and rigidity INVESTIGATIONS - WBC, Lactate, Electrolytes, BUN/Cr - ...
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The pretest probability of a patient presenting to a PCP with a complain of headache to be migraine is 6-15%. A meta analysis identified nausea, photophobia, phonophobia and exacerbation with physical activity to be best individual symptoms for ruling in or out migraine. The best predictor was nausea. Headache with nausea = increases likelihood of headache being migraine to 90% 5 Item ...
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