Showing posts with label Medicine. Show all posts
Showing posts with label Medicine. Show all posts

Thursday, April 27, 2023

Dysbarism - Emergency Medicine

 Hello all !

Dysbarism: 

refers to illness that is related to pressure changes in the body , that exceeds the body's capacity to adapt to these changes 

Pathophysiology of dysbariam depends on the Boyle's law : in which pressure is inversely related to volume

When you descend e.g deep water : Pressure increases and volume decreases

When you ascend : Volume increases and pressure decreases 

I will explain the main disorders of Descent and Ascent

Disorders of descent

1. Nitrogen Narcosis 

Gas we breath contains all gases : including nitrogen.

When you descend the nitrogen gas dissolves in blood and causes the symptoms of nitrogen intoxication.

Management : Ascent

2. Barotitis

Pressure damage to the ear due to squeezing secondary to the elevated pressures

Management: Ascent , supportive treatment

Disorders of Ascent

1. Arterial Gas Embolism 

Volume expansion in every air filled areas of the body e.g GIT, Alveoli 

When it occurs in the alveoli it cause the formation of an air embolus into the pulmonary vein : which can travel to the brain - causing stroke, in the heart - causing Myocardial Ischaemia

Usually acute onset : usually within minutes of ascent (e.g from diving)

Management: involves hyperbarric treatment

2. Decompression Sickness

This is caused by formation of nitrogen gas bubbles (opposite to when you descend where it dissolves)

There are two main types of decompression sickness

i. Type 1

- Usually involving the skin and joints : painful skin and joints

ii. Type 2

- Usually involving the CNS : paraesthesia, paralysis 

Management involves : Hyperbarric treatment , Oxygen, Aspirin 

NB : patient with type 1 DS : have to avoid air travel for upto one week ,those with type 2 DS : have to avoid air travel for upto 1 month 


I hope it was helpful ! For any queries feel free to contact me 

Happy reading !


Author : Mohammad Faruk Omar

Emergency Medicine Resident 

Muhimbili University of Health and Allied Sciences, Tanzania

Wednesday, July 27, 2022

AIDS - Defining conditions

 


CD < 100  Century

                  Cerebral Toxoplasmosis

                  Cryptococcal meningitis

                  Cryptosporidiosis (watery diarrhea)

                  Candida (oesophagitis)

                  Cowdry A oesophagitis (HSV 1)

 

CD < 50   MAC and Cheese

                 Mycobacterium Avium Complex

                 CMV (Retinitis ,Colitis)

                   

                   

 By- Shanmukh



Monday, January 3, 2022

Apex beat in Aortic stenosis vs regurgitation

 Hello

Clinical pearl: Retroperitoneal hematoma

 Hello

Vascular access during cardiac catheterization (in cases of myocardial infarction, for example) obtained through femoral artery above the level of inguinal ligament may lead to retroperitoneal hematoma due to arterial puncture.

Tuesday, December 28, 2021

Monday, December 27, 2021

Infective endocarditis vegetations - which side do they develop?

Infective endocarditis vegetations tend to develop on the upstream side of the valve (flow side) which is typically tend to be the lower pressure side. These are the ventricular side of the aortic valve and the atrial side of the mitral or tricuspid valve. 


Image shows parasternal long axis view on echocardiography showing vegetations on the mitral and aortic valve (green vegetations because vegetables are green lol!)

-IkaN 

Saturday, December 18, 2021

Mitral valve anatomy and types of mitral regurgitation mnemonic


Mnemonic:
Prolapse tip points towards LV
Flail tip flips away from LV
Secondary stay away from each other (dilation) 

Tuesday, December 14, 2021

Metoprolol tartrate vs succinate dosing mnemonic

Metoprolol tartrate is short acting. 

Metoprolol succinate is long acting. 

Mnemonic succinate single dose, tartrate two doses.

-IkaN (Nakeya Dewaswala Bhopalwala) 

Wednesday, November 17, 2021