-Antiplatelet medications are of greater efficacy in the prevention of arterial thrombosis and of less value in the prevention of venous thromboembolism.
-Thus, antiplatelet agents, such as aspirin, clopidogrel and, increasingly, ticagrelor, are the drugs of choice in acute coronary events and in ischaemic cerebrovascular disease.
-While Warfarin and other anticoagulants are favoured in VTE " venous " and management of atrial fibrillation.
#Medicine
-Thus, antiplatelet agents, such as aspirin, clopidogrel and, increasingly, ticagrelor, are the drugs of choice in acute coronary events and in ischaemic cerebrovascular disease.
-While Warfarin and other anticoagulants are favoured in VTE " venous " and management of atrial fibrillation.
#Medicine
-ESR: blood cells sediment in a period of one hour, Normally more in adult female.
-Increase in: - all collagen diseases (autoimmune), infection, malignancy.
-Decrease in: - polycythemia, congestive heart failure, sickle cell anemia, hereditary spherocytosis , Hyper viscosity.
#Medicine
-Increase in: - all collagen diseases (autoimmune), infection, malignancy.
-Decrease in: - polycythemia, congestive heart failure, sickle cell anemia, hereditary spherocytosis , Hyper viscosity.
#Medicine
Anemia according to WHO:
• Hb <13 g/dL in adult male.
• Hb <12 g/dL in adult females.
• Hb <11 g/dl in pregnancy.
#Medicine
• Hb <13 g/dL in adult male.
• Hb <12 g/dL in adult females.
• Hb <11 g/dl in pregnancy.
#Medicine
-Iron is absorbed from the duodenum & upper jejunum.
-Serum ferritin is the best single test to confirm iron deficiency.
#Medicine
-Serum ferritin is the best single test to confirm iron deficiency.
#Medicine
•Anisocytosis: the RBCs are not of the same size.
•Poikilocytosis: the RBCs are not of the same shape.
#Medicine
•Poikilocytosis: the RBCs are not of the same shape.
#Medicine
a)-Skin and mucous membranes pallor [hemoglobin level is 8-10 g/dL].
b)-Palmar creases pallor [hemoglobin level is <8 g/dL].
#Medicine
b)-Palmar creases pallor [hemoglobin level is <8 g/dL].
#Medicine
•Plummer-Vinson syndrome (PVS):
-Triad of iron deficiency anemia, postcricoid dysphagia, and upper esophageal webs.
-Associated with an increased risk of esophageal squamous cell carcinoma and glossitis.
#Medicine
-Triad of iron deficiency anemia, postcricoid dysphagia, and upper esophageal webs.
-Associated with an increased risk of esophageal squamous cell carcinoma and glossitis.
#Medicine
In case of Iron deficiency anemia
Monitoring response to iron therapy:
1)-Reticulocytosis starts on 3rd day & peaks at 7th after starting treatment.
2)-Hemoglobin rises by rate of 1g/dl per week.
3)-Normalization of the hemoglobin level (1 month).
4)-Repletion of iron stores (2-4 months).
Note: - If the patient is not responding look for another cause of anemia.
#Medicine
Monitoring response to iron therapy:
1)-Reticulocytosis starts on 3rd day & peaks at 7th after starting treatment.
2)-Hemoglobin rises by rate of 1g/dl per week.
3)-Normalization of the hemoglobin level (1 month).
4)-Repletion of iron stores (2-4 months).
Note: - If the patient is not responding look for another cause of anemia.
#Medicine
-Pernicious anemia is the most common cause of severe vitamin B12 deficiency worldwide and is due to autoimmune destruction of parietal cells and/or intrinsic factor.
-Pernicious anemia is more in persons of blood group A.
-Diphyllobothrium latum (fish tapeworm) competes with the body for cobalamin.
#Medicine
-Pernicious anemia is more in persons of blood group A.
-Diphyllobothrium latum (fish tapeworm) competes with the body for cobalamin.
#Medicine
-In the blood film in case of vir.B12 and folate deficiency, Oval Macrocytosis , but other causes of Macrocytosis give round shape.
-Hypersegmented neutrophils (first sign in blood film).
#Medicine
-Hypersegmented neutrophils (first sign in blood film).
#Medicine
Ivabradine
Mechanism of action: selectively inhibits "funny channels" If channel in the pacemaker cells of the SA node → prolongs slowdepolarization (phase 4) → slows heart rate.
Indications:
-Symptomatic stable coronary heart disease and congestive heart failure (NYHA II-IV) in patients who cannot tolerate beta blockers.
Adverse effects:
1-Vision changes: luminous phenomena (enhanced visual brightness)
2-Bradycardia
3-Hypertension.
#Medicine
Mechanism of action: selectively inhibits "funny channels" If channel in the pacemaker cells of the SA node → prolongs slowdepolarization (phase 4) → slows heart rate.
Indications:
-Symptomatic stable coronary heart disease and congestive heart failure (NYHA II-IV) in patients who cannot tolerate beta blockers.
Adverse effects:
1-Vision changes: luminous phenomena (enhanced visual brightness)
2-Bradycardia
3-Hypertension.
#Medicine
What is Caplan’s syndrome?
Rheumatoid lung nodules with pneumoconiosis is called Caplan’s syndrome. Common in coalworkers pneumoconiosis, may occur in any pneumoconiosis. Nodules are rounded, 0.5 to 2.5 cm, present at periphery of the lung. These may rupture causing pneumothorax or may cavitate and cause hemoptysis. It may be confused with tuberculosis or neoplasm.
#MCQ
#Writing
#Medicine
Rheumatoid lung nodules with pneumoconiosis is called Caplan’s syndrome. Common in coalworkers pneumoconiosis, may occur in any pneumoconiosis. Nodules are rounded, 0.5 to 2.5 cm, present at periphery of the lung. These may rupture causing pneumothorax or may cavitate and cause hemoptysis. It may be confused with tuberculosis or neoplasm.
#MCQ
#Writing
#Medicine
What are the mechanisms of anemia in rheumatoid arthritis?
Multiple factors are responsible:
1-Anemia of chronic disorder
2-Megaloblastic anemia (because of either folate deficiency or vitamin B12 deficiency, if associated with pernicious anemia)
3-Hypersplenism (in Felty’s syndrome)
4-Hemolytic anemia (Coombs’ test may be positive)
5-GIT bleeding (due to NSAID or vasculitis causing iron deficiency anemia)
6-Marrow suppression (gold and penicillamine—though less or no use now a days).
#MCQ
#Writing
#Medicine
Multiple factors are responsible:
1-Anemia of chronic disorder
2-Megaloblastic anemia (because of either folate deficiency or vitamin B12 deficiency, if associated with pernicious anemia)
3-Hypersplenism (in Felty’s syndrome)
4-Hemolytic anemia (Coombs’ test may be positive)
5-GIT bleeding (due to NSAID or vasculitis causing iron deficiency anemia)
6-Marrow suppression (gold and penicillamine—though less or no use now a days).
#MCQ
#Writing
#Medicine
In Osteoarthritis:
-Heberden nodes- distal
interphalangeal joints.
-Bouchard nodes- proximal interphalangeal joints.
#MCQ
-Heberden nodes- distal
interphalangeal joints.
-Bouchard nodes- proximal interphalangeal joints.
#MCQ
MS-typical regions = periventricular, juxtacortical, infratentorial, spinal cord.
"AO" is an initialism for the German "Arbeitsgemeinschaft für Osteosynthesefragen".
"OTA" is for "Orthopaedic Trauma Association" Committee.
"OTA" is for "Orthopaedic Trauma Association" Committee.
Contraindications for thrombolysis:
Recent stroke
Recent major surgery or major bleed like of varices
Recent eye surgery
History suggestive of or confirmed active duodenal/gastric ulcers
Pregnancy
Uncontrolled hypertension or coagulation disorders.
Recent stroke
Recent major surgery or major bleed like of varices
Recent eye surgery
History suggestive of or confirmed active duodenal/gastric ulcers
Pregnancy
Uncontrolled hypertension or coagulation disorders.
Complications of Chronic Osteomyelitis:
i. Acute excacerbation
ii. Growth abnormalities due to damage to adjacent growth plate
iii. Pathological fracture
iv. Joint stiffness
v. Sinus tract malignancy (very rare): Squamous cell carcinoma
vi. Amyloidosis
i. Acute excacerbation
ii. Growth abnormalities due to damage to adjacent growth plate
iii. Pathological fracture
iv. Joint stiffness
v. Sinus tract malignancy (very rare): Squamous cell carcinoma
vi. Amyloidosis
The Important Complications of Acute Osteomyelitis are:
i. Septicemia and pyaemia
ii. Septic arthritis
iii. Chronic osteomyelitis (most common complication)
iv. Metastatic infection to other body parts
v. Pathological fracture
vi. Altered growth from damage to epiphyseal growth plate.
vii. Recurrence
i. Septicemia and pyaemia
ii. Septic arthritis
iii. Chronic osteomyelitis (most common complication)
iv. Metastatic infection to other body parts
v. Pathological fracture
vi. Altered growth from damage to epiphyseal growth plate.
vii. Recurrence