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Verified User Primary Care Comments Off on Diabetic Foot Infections 1309 views

EPIDEMIOLOGY 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 ...

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Verified User Primary Care , USMLE Step 2 Comments Off on Abdominal Adhesions 2072 views

Abdominal 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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