What are the signs of activity in rheumatic fever?
-Persistent fever
-Tachycardia
-High ESR
-Leukocytosis
-Evidence of carditis.
#Cardiology
-Persistent fever
-Tachycardia
-High ESR
-Leukocytosis
-Evidence of carditis.
#Cardiology
Remember:
-Skin infection with streptococci is not associated with RF. It may be associated with acute post streptococcal glomerulonephritis.
#Cardiology
-Skin infection with streptococci is not associated with RF. It may be associated with acute post streptococcal glomerulonephritis.
#Cardiology
•What are the causes of migrating polyarthritis?
-Rheumatic fever
-Septicemia
-Gonococcal arthritis
-Syphilitic arthritis
-Lyme arthritis
-Hyperlipidemia (type 2)
-SLE.
#Cardiology
-Rheumatic fever
-Septicemia
-Gonococcal arthritis
-Syphilitic arthritis
-Lyme arthritis
-Hyperlipidemia (type 2)
-SLE.
#Cardiology
-Differential cyanosis (cyanosis in toes, not in the hand) occurs in PDA.
-Clubbing (differential clubbing clubbing in toes, not in the hand, occurs in PDA).What are the causes of mid diastolic murmur (MDM)?
-MS
-ASD (due to increased flow through tricuspid valve)
-Tricuspid stenosis
-Left atrial myxoma
-Austin-Flint murmur in aortic regurgitation
-Carey Coomb’s murmur (a soft MDM due to mitral valvulitis in acute rheumatic fever.
#Cardiology
-MS
-ASD (due to increased flow through tricuspid valve)
-Tricuspid stenosis
-Left atrial myxoma
-Austin-Flint murmur in aortic regurgitation
-Carey Coomb’s murmur (a soft MDM due to mitral valvulitis in acute rheumatic fever.
#Cardiology
-When Eisenmenger’s syndrome develops, there is cyanosis, clubbing and evidence of pulmonary hypertension.
-Pansystolic murmur may disappear, because of equalization of pressure in right and left ventricle.
#Cardiology
-Pansystolic murmur may disappear, because of equalization of pressure in right and left ventricle.
#Cardiology
•What is Eisenmenger’s syndrome?
-Pulmonary hypertension with reversal of shunt is called Eisenmenger’s syndrome.
-Causes are:
VSD
ASD
PDA
-In VSD, this occurs in early life, in PDA a little later than VSD, in ASD this occurs in adult life.
#Cardiology
-Pulmonary hypertension with reversal of shunt is called Eisenmenger’s syndrome.
-Causes are:
VSD
ASD
PDA
-In VSD, this occurs in early life, in PDA a little later than VSD, in ASD this occurs in adult life.
#Cardiology
-Asthma with IHD:
-Antianginal nitrates, calcium channel blocker (diltiazem and verapamil) are drug of choice.
-Clopidogrel is preferred than aspirin (as it may trigger or aggravate asthma).
-Sometimes, cardioselective b-blocker (like metoprolol) may be given.
-Asthma should be well controlled.
#Respiratory
-Antianginal nitrates, calcium channel blocker (diltiazem and verapamil) are drug of choice.
-Clopidogrel is preferred than aspirin (as it may trigger or aggravate asthma).
-Sometimes, cardioselective b-blocker (like metoprolol) may be given.
-Asthma should be well controlled.
#Respiratory
Asthma with heart Failure:
-Diuretic is the drug of choice.
-ACE inhibitors should be continued, if tolerated.
-Digoxin may be given.
-Carvedilol may be used in low doses.
#Respiratory
-Diuretic is the drug of choice.
-ACE inhibitors should be continued, if tolerated.
-Digoxin may be given.
-Carvedilol may be used in low doses.
#Respiratory
Asthma with Pain:
-Paracetamol and tramadol are preferred for pain management.
COX 2 inhibitor can be used.
-NSAIDs like aspirin, diclofenac, etc. should be avoided.
-Steroid may be given, if needed.
-DMARDs are safe.
#Respiratory
-Paracetamol and tramadol are preferred for pain management.
COX 2 inhibitor can be used.
-NSAIDs like aspirin, diclofenac, etc. should be avoided.
-Steroid may be given, if needed.
-DMARDs are safe.
#Respiratory
-Asthma with Arrhythmia:
-Digoxin and amiodarone may be used.
-Aminophylline or theophylline should be avoided.
#Respiratory
-Digoxin and amiodarone may be used.
-Aminophylline or theophylline should be avoided.
#Respiratory
Drug of choice—calcium channel blocker or ARB (losartan, valsartan). ACE inhibitor is avoided as it may induce cough in Asthma.
#Respiratory
#Respiratory
Remember:
-Metformin should be avoided in uncontrolled asthma and contraindicated in acute severe asthma.
#Respiratory
-Metformin should be avoided in uncontrolled asthma and contraindicated in acute severe asthma.
#Respiratory
Cardiac asthma:
-It means left ventricular failure in which the patient usually presents with sudden severe dyspnea and cough with profuse mucoid expectoration.
-On examination, there are bilateral basal crepitations and no rhonchi or wheeze.
#Respiratory
-It means left ventricular failure in which the patient usually presents with sudden severe dyspnea and cough with profuse mucoid expectoration.
-On examination, there are bilateral basal crepitations and no rhonchi or wheeze.
#Respiratory
Gordon’s sign:
-Elicited by pinching the calcaneus tendon.
-If present, there is extensor plantar response.
#Neurology
-Elicited by pinching the calcaneus tendon.
-If present, there is extensor plantar response.
#Neurology
Oppenheim’s sign:
-Elicited by squeezing the calf or pressing heavily along the inner border of the tibia.
-If present, there is extensor plantar response.
#Neurology
-Elicited by squeezing the calf or pressing heavily along the inner border of the tibia.
-If present, there is extensor plantar response.
#Neurology
Hoffman’s sign:
-Elicited by briskly flicking down the patient’s tip of the middle finger with the examiner’s thumb and index. If there is flexion of thumb or all fingers, it is positive.
-It indicates extensive upper motor neuron lesion.
#Neurology
-Elicited by briskly flicking down the patient’s tip of the middle finger with the examiner’s thumb and index. If there is flexion of thumb or all fingers, it is positive.
-It indicates extensive upper motor neuron lesion.
#Neurology
•What are the causes of dyspnea on exertion?
-COPD
-Bronchial asthma
-DPLD (Interstitial lung disease)
-LVF
-Valvular diseases of the heart
-Anemia.
#Respiratory
-COPD
-Bronchial asthma
-DPLD (Interstitial lung disease)
-LVF
-Valvular diseases of the heart
-Anemia.
#Respiratory
•What is Macleod’s syndrome?
-It is a type of unilateral emphysema due to childhood bronchitis or bronchiolitis, resulting in subsequent impairment of alveolar growth.
-t is a rare disease (also called Swyer-James syndrome).
#Respiratory
-It is a type of unilateral emphysema due to childhood bronchitis or bronchiolitis, resulting in subsequent impairment of alveolar growth.
-t is a rare disease (also called Swyer-James syndrome).
#Respiratory
•Why lip pursing is present in emphysema?
-By this in expiration through partly closed lips, there is increased end-expiratory pressure that keeps airway open, helping to minimize air trapping.
#Respiratory
-By this in expiration through partly closed lips, there is increased end-expiratory pressure that keeps airway open, helping to minimize air trapping.
#Respiratory
•What are the types of emphysema?
-Four types:
1-Centriacinar:
-Involves the proximal part of acini, limited to respiratory bronchiole with relatively less change in acinus.As in COPD.
2-Panacinar:
-All the alveoli and alveolar ducts in acinus are involved, both central and peripheral portion. It occurs mostly in a1-antitrypsin deficiency.
3-Paraseptal:
-Along the septa, blood vessels and pleura.
4-Scar or irregular emphysema:
-Scarring and damage affecting the lung parenchyma without involving acinus structure.
#Respiratory
-Four types:
1-Centriacinar:
-Involves the proximal part of acini, limited to respiratory bronchiole with relatively less change in acinus.As in COPD.
2-Panacinar:
-All the alveoli and alveolar ducts in acinus are involved, both central and peripheral portion. It occurs mostly in a1-antitrypsin deficiency.
3-Paraseptal:
-Along the septa, blood vessels and pleura.
4-Scar or irregular emphysema:
-Scarring and damage affecting the lung parenchyma without involving acinus structure.
#Respiratory