-First thing to do it in case of acute lower limb ischemia is giving the patient heparin to avoid clot propagation.
-First thing to do it in case of diabetic patient come with on toe gangrene is chicking the pedal pulse.
-First drug described for Raynaud's disease is Calcium channel blocker.
#Surgery
-First thing to do it in case of diabetic patient come with on toe gangrene is chicking the pedal pulse.
-First drug described for Raynaud's disease is Calcium channel blocker.
#Surgery
-The primary therapy of Buerger disease is cessation of smoking.
-Acute ischemic leg +signs of emboli (acute history ) , should do Embolectomy.
-Acute ischemic leg + signs of thrombus (chronic history ) , Thrombolize.
-Chronic ischemic leg +short occlusion, we do angioplasty.
-Chronic ischemic leg + long occlusion , we do Bypass graft.
#Surgery
-Acute ischemic leg +signs of emboli (acute history ) , should do Embolectomy.
-Acute ischemic leg + signs of thrombus (chronic history ) , Thrombolize.
-Chronic ischemic leg +short occlusion, we do angioplasty.
-Chronic ischemic leg + long occlusion , we do Bypass graft.
#Surgery
•Difference between submandibular lymph node and submandibular gland swelling:
1. Nodes usually are multiple while gland single swelling
2. Node could be over rided the body of mandible while the gland is not
3. Gland could be palpated bimanually
(From the skin and from the floor of tongue )
4.gland swelling and pain may increase during induce sour food while node show no changes
5. As the most common cause of submandibular gland swelling is duct stone we may feel it by palpation.
#Surgery
1. Nodes usually are multiple while gland single swelling
2. Node could be over rided the body of mandible while the gland is not
3. Gland could be palpated bimanually
(From the skin and from the floor of tongue )
4.gland swelling and pain may increase during induce sour food while node show no changes
5. As the most common cause of submandibular gland swelling is duct stone we may feel it by palpation.
#Surgery
•Indirect inguinal hernia:
-Inside the spermatic cord
-Usually extend to the scrotum
-Narrow neck of the hernia sac
-Lateral to the inferior epigastric artery
-More common
-Occurs in babies and adult
-Enters from the deep ring
-Goes out from the superficial ring.
#Surgery
-Inside the spermatic cord
-Usually extend to the scrotum
-Narrow neck of the hernia sac
-Lateral to the inferior epigastric artery
-More common
-Occurs in babies and adult
-Enters from the deep ring
-Goes out from the superficial ring.
#Surgery
•Direct inguinal hernia:
-Outside the spermatic
-Not or rarely extend to the scrotum
-Wide neck of the hernia sac
-Medial to the inferior epigastric artery -Less common
-Occurs in old age
-Not enter from the deep ring
-Goes out from the superficial ring.
#Surgery
-Outside the spermatic
-Not or rarely extend to the scrotum
-Wide neck of the hernia sac
-Medial to the inferior epigastric artery -Less common
-Occurs in old age
-Not enter from the deep ring
-Goes out from the superficial ring.
#Surgery
Bilirubin (serum):
Conjugated: 01-0.3 mg/dL
Total: 0.2-1.3 mg/dL
Serum glutamic-pyruvic transaminase (SGPT) 👉🏼Alanine transaminase "ALT"
Serum glutamic-oxalic transaminsae (SGOT)👉🏼 Aspartate transaminase"AST".
Normal is up to 45 IU/L.
Alkaline phosphatase 👉🏼 45-115 IU.
#Medicine
Conjugated: 01-0.3 mg/dL
Total: 0.2-1.3 mg/dL
Serum glutamic-pyruvic transaminase (SGPT) 👉🏼Alanine transaminase "ALT"
Serum glutamic-oxalic transaminsae (SGOT)👉🏼 Aspartate transaminase"AST".
Normal is up to 45 IU/L.
Alkaline phosphatase 👉🏼 45-115 IU.
#Medicine
Systemic inflammatory response syndrome (SIRS):
Core body temperature <36°C or >38°C; heart rate >90/minute; respira tory rate >20/minute or PaCO2 <32 mmHg; WBC count <4,000 cells/ mm3 or >12000/mm3. If SIRS is present >48 hours the patient is likely to have severe pancreatitis.
#Surgery
Core body temperature <36°C or >38°C; heart rate >90/minute; respira tory rate >20/minute or PaCO2 <32 mmHg; WBC count <4,000 cells/ mm3 or >12000/mm3. If SIRS is present >48 hours the patient is likely to have severe pancreatitis.
#Surgery
•Sepsis: ≥ 2 SIRS criteria PLUS a suspected or confirmed underlying infection .
•Severe sepsis: sepsis PLUS dysfunction of at least one organ or system .
•Multiple organ dysfunction syndrome (MODS) :
-Progressive, but potentially reversible, dysfunction of several organs and/or systems .
-The more organs that are affected, the greater the mortality risk.
•Bacteremia: the presence of viable bacteria in the bloodstream, with or without clinical signs of infection .
#Medicine
#Surgery
•Severe sepsis: sepsis PLUS dysfunction of at least one organ or system .
•Multiple organ dysfunction syndrome (MODS) :
-Progressive, but potentially reversible, dysfunction of several organs and/or systems .
-The more organs that are affected, the greater the mortality risk.
•Bacteremia: the presence of viable bacteria in the bloodstream, with or without clinical signs of infection .
#Medicine
#Surgery
•Sepsis:
-It is a severe, life-threatening condition that results from a dysregulation of the patient's response to an infection, causing tissue and organ damage and subsequent organ dysfunction.
•Septic shock:
-It is a sepsis syndrome accompanied by circulatory and metabolic abnormalities that can significantly increase mortality .
Diagnostic criteria:
-Persistent hypotension: Vasopressors are required to maintain mean arterial pressure(MAP) ≥ 65 mm Hg.
-Persistent lactic acidosis: lactate > 2 mmol/L(18 mg/dL) despite adequate fluid resuscitation.
#Surgery
#Medicine
-It is a severe, life-threatening condition that results from a dysregulation of the patient's response to an infection, causing tissue and organ damage and subsequent organ dysfunction.
•Septic shock:
-It is a sepsis syndrome accompanied by circulatory and metabolic abnormalities that can significantly increase mortality .
Diagnostic criteria:
-Persistent hypotension: Vasopressors are required to maintain mean arterial pressure(MAP) ≥ 65 mm Hg.
-Persistent lactic acidosis: lactate > 2 mmol/L(18 mg/dL) despite adequate fluid resuscitation.
#Surgery
#Medicine
Systemic inflammatory response syndrome (SIRS) :
-a group of physiological and immune-mediated reactions that are triggered in response to an infectious or noninfectious insult (e.g., an acute inflammatory process or trauma) .
•SIRS is diagnosed if ≥ 2 of the following 4 criteriaare fulfilled:
-Temperature: > 38°C or < 36°C
-Heart rate: > 90/min
-Respiratory rate: > 20/min or PaCO2 < 32 mm Hg
-White blood cell count: > 12,000 mm3, < 4000/mm3, and/or > 10% band cells.
#Infections
-a group of physiological and immune-mediated reactions that are triggered in response to an infectious or noninfectious insult (e.g., an acute inflammatory process or trauma) .
•SIRS is diagnosed if ≥ 2 of the following 4 criteriaare fulfilled:
-Temperature: > 38°C or < 36°C
-Heart rate: > 90/min
-Respiratory rate: > 20/min or PaCO2 < 32 mm Hg
-White blood cell count: > 12,000 mm3, < 4000/mm3, and/or > 10% band cells.
#Infections
INDICATIONS OF CBD EXPLORATION:
1. History of charcot’s triad
2. USG proven stones in CBD
3. Dilated CBD (>1cm)
4. OTCshows filling deffect
5. Palpable stones in CB.
#Surgery
1. History of charcot’s triad
2. USG proven stones in CBD
3. Dilated CBD (>1cm)
4. OTCshows filling deffect
5. Palpable stones in CB.
#Surgery
Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery.
#Surgery
#Surgery