Supracondylar fracture of the humerus
- Transverse fracture of the distal part of the humerus.
- Bruises of anterior elbow (Proximal fragments buttons through the brachialis muscle)
- Posterior fat pad sign is seen in non displaced fracture of the humerus.
IMPORTANT: Assess radial and ulnar pulses because brachial artery can be compromised.
That's all!
-IkaN
"Selena Gomez and Ke$ha both are young and have big hearts."
Selenium deficiency causes Keshan disease which is cardiomyopathy in young children. Also, singers like to dye their hair (Loss of hair pigment is seen in Selenium deficiency aka Keshan disease).
Submitted by Krutika.
Interesting fact: Keshans disease is thought to be caused by Selenium deficiency and coxsackie virus. It's common in places where selenium content in soil is low (China).
That's all!
Thanks Krutika for the mnemonic =)
-IkaN
Brain abscess notes
Here's what I studied =)
Causes
- Direct spread (Paranasal sinusitis, otitis media, mastoiditis, dental infection)
- Head trauma or surgical procedure
- Hematogenous spread (Pneumonia, endocarditis)
Organisms:
- Streptococci
- Bacteroides
- Pseudomonas
- Hemophilus
- Enterobacteriaceae
- MRSA (Head trauma, neurosurgical procedure)
Symptoms:
- Headache > 75% patients
- Fever only in 50% patients (Important: Absence of fever should not exclude the diagnosis)
- Focal neurologic deficits > 60% patients
- Other symptoms - Papilledema, nausea, vomiting, drowsiness, confusion
Hemiparesis - Frontal lobe abscess
Dysphasia - Temporal lobe abscess
Nystagmus, ataxia - Cerebellar abscess
Neuroimaging:
- MRI is better than CT.
- Ring enhancing lesion with surrounding edema on neuro imaging studies is seen.
- Most accurate: Brain biopsy
High yield: Biopsy is essential to distinguish brain abscess from cancer and also to determine the precise organism.
Don'ts: Do NOT do a LP. CSF analysis doesn't contribute to diagnosis or therapy. Increases the risk of herniation.
Extra: Abscesses due to Listeria have blood culture positive > 85% of the time.
Differentials:
- Meningitis
- Meningoencephalitis
- Brain tumors (Cancer can give fever)
Treatment:
- Empirical antibiotics should be modified after results of gram stain and culture.
- Surgical drainage.
- Prophylactic anticonvulsant therapy (High risk [>35%] of seizures)
- Glucocorticoids are reserved for substantial periabscess edema and mass effect due to increased ICP.
- Serial MRI or CT scan monthly to document resolution of abscess.
That's all!
-IkaN
Recently, while studying pharmacology, I came to know about the third system of ANS - Enteric nervous system, apart from sympathetic and parasympathetic systems .
Here is some information of ENS:
It consists of highly organized neurons situated in the wall of GI tract.
It mainly includes Auerbach's plexus and Meissner's plexus.
The most interesting point about ENS is this network receives preganglionic fibers from the parasympathetic system and from postganglionic sympathetic neurons.
ENS controls GI motility, secretions, mucosal blood flow.
ENS causes relaxation or stimulation of smooth muscles.
Non-cholinergic excitatory transmitters such as substance - P plays a modulatory role in controlling ENS!
~Ojas
Hello. How are you awesomites?
Let's talk about scarlet fever today!
Scarlet fever, also known as scarlatina, is characterize by exudative pharyngitis, fever and scarlatiniform rash.
It's caused by erythrogenic toxin producing GABHS (Group A Beta Hemolytic Streptococci)
Characterized by:
- Fever, headache
- Sore throat, circumoral pallor
- Sandpaper rash (Pinpoint, erythematous blanchable papules), erythema trunk, pastia lines
- Lymphadenopathy
Diagnosis:
- Rapid antigen detection test is specific, but not sensitive.
- If it is negative, do throat culture.
- Elevated ASO, DNAse maybe seen.
Treatment:
- Treatment as long as 9 days after the onset of symptoms prevents rheumatic fever.
- Oral penicillin, amoxicillin for 10 days.
- Cephalosporins, macrolides are alternatives. (Penicillin resistant group A staphylococcus doesn't exist.)
- If adherence problem, intramuscular benzathine penicillin G.
That's all!
The only fever I have is for Scarlett Johansson =P
-IkaN
It is a condition that develops when Rh-negative women is pregnant with Rh-positive baby .
It causes phagocytosis of the fetus's RBC's (Baby inherits Rh positive antigen from father ).
As mother is Rh-negative , exposure to fetus's antigen causes development of anti-Rh agglutinins .
These agglutinins(mostly IgG antibody ) diffuse through the placenta and enters fetus blood cells and leads to phagocytosis of the RBCs ,which leads to release of hemoglobin into blood !Then fetus's macrophages converts the hemoglobin into bilirubin ,which causes baby skin to become yellow(jaundiced).Although the severe form of anemia is responsible for many deaths of infants ,many children who barely survive the anemia exhibit permanent mental impairment , because of precipitation of bilirubin in the neuronal cells ,causing destruction of many cells , condition known as Kernicterus
It usually doesn't affect the first child ,since sensitization occurs during parturition.However ,if Rh-negative mother was sensitized earlier with Rh antigen then first child can get affected .
Treatment:
1)One treatment of HDNF is to replace the neonate's blood with Rh-negative blood .About 400ml of Rh negative blood is infused over a period of 1.5 or more hours ,while neonate's own blood is removed,the process may be repeated several times during the first week of life ,to prevent Kernicterus .
Prevention:
Anti-D antibody is administered to the expectant mother ,starting at 28-30 weeks of gestation.The anti -D antibody is also administered to Rh-negative women who deliver Rh -positive babies to prevent sensitization of the mothers to the D antigen .This greatly reduces the risk of developing large amounts of D antibodies during second pregnancy !
~ojas
Features of contrast induced nephropathy
- Due to iodinated contrast agents (Other agents that cause AKI: Gadolinium for MRI, sodium phosphate solutions as purgatives)
- Prevented by use of non ionic contrast agents, IV hydration, acetyl cysteine.
- Serum Creatinine rises 24-48 hours after exposure. Resolves in a week.
- FeNa low, benign urinary sediment.
- Risk increases in CKD, Diabetic nephropathy, multiple myeloma.
