Video by Jay!
Sunday, November 10, 2019
Multiple Myeloma notes and mnemonics
Hi!
Multiple myeloma - everything P
Multiple myeloma - everything P
- malignant Proliferation of Plasma cells derived from a single clone.
- Immunoglobulin produced is a "ParaProtein" (M- protein)
- POEMS syndrome
BONE MARROW INVOLVEMENT
- Pancytopenia
PERIPHERAL BLOOD
- plasma cell leukemia ( greater than 2,000 per mm3 )
BONE INVOLVEMENT
- punched-out lesions in radiographs of flat bones
- bone pain
- pathological fractures
RENAL INVOLVEMENT
- Bence -Jones proteinuria
- production of excess Amyloid protein
- hyPer- calci -emia and -uria
These three result in renal damage and renal failure.
IMMUNE SYSTEM INVOLVEMENT
- prone to infections, particularly in respiratory and urinary tract.
HYPERVISCOSITY SYNDROME
( mnemonic - HPRVSCST )
- Headache
- Postural hypotension
- Retinal venous congestion
- Vertigo
- Strain (blurred vision)
- Congestive cardiac failure
- subtype IgA
- nysTagmus
CLOTTING PROBLEMS
- purpura
- profuse bleeding ( epistaxis, gastrointestinal )
NEUROLOGICAL MANIFESTATIONS
- peripheral neuropathy
- compressive myopathy
- carpal tunnel syndrome ( nerve entrapment)
- Amyloidosis.
SERUM STUDIES
- total serum protein raised
- low albumin
- high globulin ( decreased A:G ratio )
- high beta-2 microglobulin ( greater than 5.5 mg/dL means poor prognosis; stage III)
Plasmacytomas in Paraskeletal soft tissues - poor prognosis; treated by palliative radiotherapy.
That's all
Anything more to add, you're most welcome :)
- Jaskunwar Singh
That's all
Anything more to add, you're most welcome :)
- Jaskunwar Singh
Saturday, November 9, 2019
How to calculate SVR and PVR using Ohm's law
Hi!
Ohms law: Current (I) equals the voltage difference (ΔV) divided by resistance (R)
Simplified, V=IR
In hemodynamics, what is voltage difference? The pressure difference or pressure gradient! (ΔP)
Ohms law: Current (I) equals the voltage difference (ΔV) divided by resistance (R)
Simplified, V=IR
In hemodynamics, what is voltage difference? The pressure difference or pressure gradient! (ΔP)
Friday, November 8, 2019
Drugs causing Thrombocytopenia mnemonic
Hi!
Drugs inhibiting platelet function/ causing Thrombocytopenia :-
ABCDE - HI
Monday, November 4, 2019
Sunday, November 3, 2019
Urinary neutrophil gelatinase-associated lipocalin (NGAL)
Neutrophil gelatinase-associated lipocalin (NGAL) is an iron-transporting protein.
Saturday, November 2, 2019
Pulmonary hypertension notes
Hi!
Pulmonary hypertension (PH) is defined as a resting mean pulmonary artery pressure of 25 mm Hg or greater measured during right heart catheterization.
(How I remember the number 25 - PH: 2 letters, Hyper: 5 letters).
Classification of Pulmonary Hypertension mnemonic
"A heart lung chronic thrombotic unclarity"
1: pulmonary Arterial hypertension
2: PH due to left-sided heart disease
3: PH due to lung diseases and/or hypoxia
4: Chronic thromboembolic pulmonary hypertension and other pulmonary artery obstructions
5: PH with unclear or multifactorial causes
The transpulmonary pressure gradient (TPG): The difference between mean pulmonary arterial pressure (mPAP) and left atrial pressure (LAP, commonly estimated by pulmonary capillary wedge pressure PCWP).
A TPG of >12 mmHg would result in a diagnosis of “out of proportion” pulmonary hypertension - suggesting intrinsic pulmonary vascular disease in patients with left-heart conditions associated with increased pulmonary venous pressure.
Will update post as I learn more...
Pulmonary hypertension (PH) is defined as a resting mean pulmonary artery pressure of 25 mm Hg or greater measured during right heart catheterization.
(How I remember the number 25 - PH: 2 letters, Hyper: 5 letters).
Classification of Pulmonary Hypertension mnemonic
"A heart lung chronic thrombotic unclarity"
1: pulmonary Arterial hypertension
2: PH due to left-sided heart disease
3: PH due to lung diseases and/or hypoxia
4: Chronic thromboembolic pulmonary hypertension and other pulmonary artery obstructions
5: PH with unclear or multifactorial causes
The transpulmonary pressure gradient (TPG): The difference between mean pulmonary arterial pressure (mPAP) and left atrial pressure (LAP, commonly estimated by pulmonary capillary wedge pressure PCWP).
A TPG of >12 mmHg would result in a diagnosis of “out of proportion” pulmonary hypertension - suggesting intrinsic pulmonary vascular disease in patients with left-heart conditions associated with increased pulmonary venous pressure.
Will update post as I learn more...
-IkaN
Platypnea-Orthodeoxia Syndrome in interatrial right-to-left shunt
Hi everyone! This is a short post :)
Platypnea (flat breathing): Dyspnea induced by upright posture and relieved by recumbency.
Orthodeoxia: Arterial oxygen desaturation accentuated by upright posture and improved by recumbency.
Platypnea (flat breathing): Dyspnea induced by upright posture and relieved by recumbency.
Orthodeoxia: Arterial oxygen desaturation accentuated by upright posture and improved by recumbency.
What's Wrong With My Gallbladder, Doc?
A quick mini-post to help you make a quick diagnosis.
[Please click on the image to enhance it]
Please remember to practise caution as the presentations may overlap.
Thank you for reading.
- Ashish Singh
Wednesday, October 30, 2019
Post-LP Headache
Hey guys!
Here's all you need to you know about that nasty headache some patients get, after a lumbar puncture (LP).
How common?
Up to one-thirds of all cases.
What are the risk factors?
None. Despite years of anecdotal advice to the contrary, none of the following has ever been scientifically shown to be a risk factor: position during or after the procedure; hydration status before, during or after; amount of CSF removed; immediate activity or rest post-LP.
When does it happen?
Within 24 hours of LP.
How does it present?
Let's SOCRATES the pain here.
Site: Frontal > Occipital
Onset: Acute
Character: Dull aching
Radiation: None
Association: Mild neck stiffness, nausea
Time Course: Lasts for 2 days to 2 weeks
Exacerbating factor: Sitting upright or standing, and so the relieving factor is lying down
Severity: Varies
What is the pathology?
Thought to be continued leakage of CSF from the puncture site and intracranial hypotension. Other neuro-vascular mechanisms may be involved.
How do I prevent it?
Using the smallest practical needle and keeping the bevel facing up. Before withdrawing the needle, reinserting the stilette.
How do I treat it?
It's self limiting. Can use analgesia, as per WHO Pain Ladder. In extreme cases, can also involve an anaesthetist for an epidural 'blood patch'.
Know something you'd like to add? Let me know.
Thank you for reading. Have a nice rest of the day, you.
- Ashish Singh
Here's all you need to you know about that nasty headache some patients get, after a lumbar puncture (LP).
How common?
Up to one-thirds of all cases.
What are the risk factors?
None. Despite years of anecdotal advice to the contrary, none of the following has ever been scientifically shown to be a risk factor: position during or after the procedure; hydration status before, during or after; amount of CSF removed; immediate activity or rest post-LP.
When does it happen?
Within 24 hours of LP.
How does it present?
Let's SOCRATES the pain here.
Site: Frontal > Occipital
Onset: Acute
Character: Dull aching
Radiation: None
Association: Mild neck stiffness, nausea
Time Course: Lasts for 2 days to 2 weeks
Exacerbating factor: Sitting upright or standing, and so the relieving factor is lying down
Severity: Varies
What is the pathology?
Thought to be continued leakage of CSF from the puncture site and intracranial hypotension. Other neuro-vascular mechanisms may be involved.
How do I prevent it?
Using the smallest practical needle and keeping the bevel facing up. Before withdrawing the needle, reinserting the stilette.
How do I treat it?
It's self limiting. Can use analgesia, as per WHO Pain Ladder. In extreme cases, can also involve an anaesthetist for an epidural 'blood patch'.
Know something you'd like to add? Let me know.
Thank you for reading. Have a nice rest of the day, you.
- Ashish Singh
Subscribe to:
Posts (Atom)