shark trank medie knowledge

21/09/2025

Anatomy hand drawing

21/09/2025

Furosemide – A Powerful Loop Diuretic

🔬 Mechanism of Action
- Inhibits the Na⁺-K⁺-2Cl⁻ cotransporter in the thick ascending limb of Henle’s loop
- Promotes excretion of Na⁺, Cl⁻, K⁺, Ca²⁺, Mg²⁺, and water
- Reduces preload and afterload, improving symptoms in CHF

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📋 Indications
- Congestive Heart Failure (CHF)
- Pulmonary Edema
- Hypertension
- Edema due to renal or liver disease

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⚠️ Contraindications
- Anuria
- Hypersensitivity to furosemide
- Electrolyte imbalance
- Severe renal failure

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😣 Side Effects
- Hypokalemia, Hyponatremia, Hypomagnesemia
- Hyperuricemia
- Ototoxicity (especially with IV use)

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🧠 Clinical Pearls
- Rapid onset: IV in 5 min, oral in 30–60 min
- Monitor electrolytes and renal function regularly
- Avoid in sulfa allergy
- IV furosemide relieves symptoms but does not reduce mortality
- Avoid NSAIDs—they may blunt its diuretic effect

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🩺 Takeaway
Furosemide is essential for managing fluid overload and heart failure, but requires close monitoring to prevent electrolyte disturbances and renal complications.

21/09/2025

Antihypertensive Medications – Masterclass Breakdown

1. ACE Inhibitors
🧬 Mechanism: Block conversion of Angiotensin I → II → ↓ vasoconstriction & aldosterone
💊 Examples: Lisinopril, Enalapril, Ramipril
⚠️ Side Effects: Dry cough, hyperkalemia, angioedema
🚫 Avoid in pregnancy

Mnemonic: “ACE coughs in pregnancy”
- Think: ACE → Cough → 🚫👶

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2. ARBs (Angiotensin II Receptor Blockers)
🧬 Mechanism: Block Angiotensin II receptors → ↓ vasoconstriction & aldosterone
💊 Examples: Losartan, Valsartan, Candesartan
✅ No cough (unlike ACE inhibitors)

Mnemonic: “ARBs are ACEs without the cough”

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3. Beta-Blockers
🧬 Mechanism: ↓ HR, ↓ cardiac output, ↓ renin release
💊 Examples: Metoprolol, Bisoprolol, Atenolol, Propranolol
⚠️ Side Effects: Bradycardia, fatigue, depression, masks hypoglycemia

Mnemonic: “Beta slows the beat”

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4. Calcium Channel Blockers (CCBs)
🧬 Mechanism: Block calcium influx → ↓ vascular tone & cardiac workload
💊 Examples: Amlodipine, Nifedipine, Diltiazem, Verapamil
⚠️ Side Effects: Edema, constipation, gingival hyperplasia

Mnemonic: “Calcium Can’t Contract”

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5. Diuretics
🧬 Mechanism: Promote Na⁺ & H₂O excretion → ↓ blood volume
💊 Examples:
- Thiazide: Hydrochlorothiazide
- Loop: Furosemide
- K⁺-sparing: Spironolactone
⚠️ Monitor electrolytes (esp. K⁺ & Na⁺)

Mnemonic: “Diuretics Drain the Volume”

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6. Alpha-2 Agonists
🧬 Mechanism: Stimulate central α2 → ↓ sympathetic outflow
💊 Examples: Clonidine, Methyldopa
⚠️ Side Effects: Sedation, rebound hypertension

Mnemonic: “Alpha-2 chills the brain”

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7. Vasodilators
🧬 Mechanism: Directly relax vascular smooth muscle
💊 Examples: Hydralazine, Minoxidil
⚠️ Side Effects: Reflex tachycardia, fluid retention

Mnemonic: “Vasodilators = Vessel Relaxers”

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8. Other Specialties
💊 Examples:
- Alpha-blockers: Prazosin, Doxazosin
- Centrally acting: Clonidine, Methyldopa

Used in resistant hypertension or specific cases (e.g., pregnancy, pheochromocytoma)

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🧠 Clinical Integration Tips

- ACE vs ARB: Use ARBs if ACE cough is intolerable
- Beta-blockers: Avoid abrupt withdrawal → rebound HTN
- Diuretics: Loop for acute, thiazide for chronic HTN
- Methyldopa: Safe in pregnancy
- Hydralazine: Often used with nitrates in heart failure

21/09/2025

Essential Cardiac Drugs Overview

1. Calcium Channel Blockers (CCBs)
Examples: Amlodipine, Diltiazem, Verapamil
Uses: Hypertension, Angina
Side Effects:
- Constipation
- Edema (especially peripheral)
- Gingival hyperplasia

Key Considerations:
- 🚫 Avoid grapefruit juice (CYP450 interaction)
- 🦷 Oral hygiene matters (gingival changes)

Mnemonic: “A Very Dull heart slows with CCBs”
- Amlodipine
- Verapamil
- Diltiazem

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2. Beta Blockers (BBs)
Examples: Metoprolol, Atenolol, Carvedilol
Uses: Hypertension, Heart Failure, Arrhythmias
Side Effects:
- Bradycardia
- Fatigue
- Depression

Key Considerations:
- 🫀 Monitor HR & BP
- ⚠️ Discontinue slowly (rebound tachycardia)
- 🍬 Mask hypoglycemia symptoms—caution in diabetics

Mnemonic: “MAC slows the heart”
- Metoprolol
- Atenolol
- Carvedilol

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3. ACE Inhibitors
Examples: Lisinopril, Enalapril, Ramipril
Uses: Hypertension, Heart Failure, Diabetic Nephropathy
Side Effects:
- Dry cough
- Hyperkalemia
- Angioedema

Key Considerations:
- 🧪 Monitor renal function & potassium
- 🚫 Contraindicated in pregnancy

Mnemonic: “LER protects the kidney but may cause a cough”
- Lisinopril
- Enalapril
- Ramipril

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🧠 Clinical Integration Tips

- Compare & Contrast:
- CCBs vs BBs in angina—CCBs for vasodilation, BBs for rate control
- ACE inhibitors for renal protection in diabetics

- Patient Counseling Pearls:
- Explain why grapefruit juice is risky with CCBs
- Warn about fatigue and mood changes with BBs
- Discuss dry cough and pregnancy risks with ACE inhibitors

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21/09/2025

Asm Saikat
Head & Neck

- Temporal Pulse
📍 Location: Side of the forehead, above the zygomatic arch
🔍 Use: Assessed in cases of temporal arteritis or head trauma

- Carotid Pulse
📍 Location: Neck, between the trachea and sternocleidomastoid muscle
🔍 Use: Vital in emergency settings (e.g., CPR); reflects central circulation

- Apical Pulse
📍 Location: Left 5th intercostal space, midclavicular line (over the heart)
🔍 Use: Auscultated for heart rate and rhythm, especially in cardiac patients

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💪 Upper Limb

- Brachial Pulse
📍 Location: Inner aspect of the upper arm, near the elbow crease
🔍 Use: Common in infants and for blood pressure measurement

- Radial Pulse
📍 Location: Lateral wrist, just below the thumb
🔍 Use: Most accessible; used routinely for pulse checks

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🦵 Lower Limb

- Femoral Pulse
📍 Location: Groin, midway between p***c symphysis and anterior superior iliac spine
🔍 Use: Assesses central circulation and vascular integrity

- Popliteal Pulse
📍 Location: Behind the knee, deep in the popliteal fossa
🔍 Use: Evaluates blood flow to the lower leg; harder to palpate

- Posterior Tibial Pulse
📍 Location: Behind the medial malleolus (ankle bone)
🔍 Use: Key in diabetic foot exams and peripheral vascular assessments

- Dorsalis Pedis Pulse
📍 Location: Top of the foot, between the first and second metatarsals
🔍 Use: Monitors distal perfusion; absence may indicate arterial disease

10/09/2025

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