Management of ARDS
-ARDS is a life-threatening condition that usually requires early lung-protective ventilation (i.e., with low tidal volumes and low plateau pressures) to prevent further lung damage.
لأن الـ Alveoli السليمة تشل Oxygen أكثر من قدرتها بسبب اللي جنبها تكون ملان fluid، و حين تجي تسوي Ventilation ضروري تنقص TV لأنه لو عطيت مثل الطبيعي عينفجرين السليمات وبالتالي ينتهي المريض.
All patients with ARDS
Oxygenation: Hypoxemia is a hallmark feature of ARDS and should be addressed immediately
Lung-protective ventilation: All patients with ARDS should be treated with lung-protective ventilation to decrease the risk of VILI.
General initial settings include:
Low tidal volume
Low plateau pressure
PEEP > 5 cm H2O
A low tidal volume and low plateau pressure are the principles of lung-protective ventilation!!!
#Respiratory
-ARDS is a life-threatening condition that usually requires early lung-protective ventilation (i.e., with low tidal volumes and low plateau pressures) to prevent further lung damage.
لأن الـ Alveoli السليمة تشل Oxygen أكثر من قدرتها بسبب اللي جنبها تكون ملان fluid، و حين تجي تسوي Ventilation ضروري تنقص TV لأنه لو عطيت مثل الطبيعي عينفجرين السليمات وبالتالي ينتهي المريض.
All patients with ARDS
Oxygenation: Hypoxemia is a hallmark feature of ARDS and should be addressed immediately
Lung-protective ventilation: All patients with ARDS should be treated with lung-protective ventilation to decrease the risk of VILI.
General initial settings include:
Low tidal volume
Low plateau pressure
PEEP > 5 cm H2O
A low tidal volume and low plateau pressure are the principles of lung-protective ventilation!!!
#Respiratory
Remember:
-Polymyositis is the commonest cause of inflammatory muscle disease in people under 50-years-old.
-Inclusion body myositis is the commonest in those over 50- years-old.
#Rheumatology
-Polymyositis is the commonest cause of inflammatory muscle disease in people under 50-years-old.
-Inclusion body myositis is the commonest in those over 50- years-old.
#Rheumatology
Remember:
-AMOIDRONE is contraindicated in individuals with polymorphic ventricular tachycardia as it is associated with a prolonged QT interval which will be made worse with anti-arrhythmic drugs.
#Cardiology
-AMOIDRONE is contraindicated in individuals with polymorphic ventricular tachycardia as it is associated with a prolonged QT interval which will be made worse with anti-arrhythmic drugs.
#Cardiology
Common pathogens in pneumonia and lower respiratory tract infections:
-COPD exacerbations 👉🏼 H.influenza.
-Cystic fibrosis 👉🏼Pseudomonas ( foul smelling sputum ).
-Alcoholic and diabetic 👉🏼 klebsiella ( cavitation).
-HIV 👉🏼 PCP , Histoplasmosis ( insidous cavitation) , staph aureus( acute, cavitation) , and cryptococcus ( positive India ink).
-Hypogamaglobulinemia 👉🏼 streptococcus and hemoohilus influenza .
-Exposure to bats 👉🏼 Histoplasmosis .
#mrcp1
#Respiratory
-COPD exacerbations 👉🏼 H.influenza.
-Cystic fibrosis 👉🏼Pseudomonas ( foul smelling sputum ).
-Alcoholic and diabetic 👉🏼 klebsiella ( cavitation).
-HIV 👉🏼 PCP , Histoplasmosis ( insidous cavitation) , staph aureus( acute, cavitation) , and cryptococcus ( positive India ink).
-Hypogamaglobulinemia 👉🏼 streptococcus and hemoohilus influenza .
-Exposure to bats 👉🏼 Histoplasmosis .
#mrcp1
#Respiratory
Remember:
-Hyponatremia + abdominal pain + vomiting:
With hypotension 👉🏼 think in Addison
With hypertension ( and neuro psychatric symptoms )👉🏼Porphyria .
-Do not give metoclopramide in patients with suspected porphyria.
Best treatment for acute intermittent porphyria IV glucose infusion with mild cases and haem arginate IV with severe cases .
#mrcp1
#Endocrine
-Hyponatremia + abdominal pain + vomiting:
With hypotension 👉🏼 think in Addison
With hypertension ( and neuro psychatric symptoms )👉🏼Porphyria .
-Do not give metoclopramide in patients with suspected porphyria.
Best treatment for acute intermittent porphyria IV glucose infusion with mild cases and haem arginate IV with severe cases .
#mrcp1
#Endocrine
Exercise ECG is not useful in patients with:
1) Conduction abnormalities: e.g. LBBB.
2) Resting ECG abnormalities like ST segment depression of ˃ 1 mm.
3) WPWS
4) Those with ventricular pacing rhythm.
5) Those on digoxin.
#Cardiology
1) Conduction abnormalities: e.g. LBBB.
2) Resting ECG abnormalities like ST segment depression of ˃ 1 mm.
3) WPWS
4) Those with ventricular pacing rhythm.
5) Those on digoxin.
#Cardiology
Sudden cardiac death (SCD):
-It is an unexpected death due to cardiac causes that occurs in a short time period (generally within 1 hour of symptom onset) in a person with known or unknown cardiac disease.
#Cardiology
-It is an unexpected death due to cardiac causes that occurs in a short time period (generally within 1 hour of symptom onset) in a person with known or unknown cardiac disease.
#Cardiology
8 Hand Findings of Cirrhosis: 🤚
1. Palmar Erythema
2. Dupuytren's Contracture
3. Asterixis
4. Terry's Nails
5. Clubbing
6. Spider Angiomas
7. Muscle Wasting
8. Leukonychia
#Liver
1. Palmar Erythema
2. Dupuytren's Contracture
3. Asterixis
4. Terry's Nails
5. Clubbing
6. Spider Angiomas
7. Muscle Wasting
8. Leukonychia
#Liver
💊6 Clinical Uses of ACE Inhibitors:
1⃣ Hypertension
2⃣ Heart failure
3⃣ Diabetic nephropathy
4⃣ In patients at risk of ischemic heart disease
5⃣ Following myocardial infarction; especially with ventricular dysfunction
6⃣ Chronic renal insufficiency, to prevent progression.
#Cardiology
1⃣ Hypertension
2⃣ Heart failure
3⃣ Diabetic nephropathy
4⃣ In patients at risk of ischemic heart disease
5⃣ Following myocardial infarction; especially with ventricular dysfunction
6⃣ Chronic renal insufficiency, to prevent progression.
#Cardiology