Dr Imtyaz

19/10/2025

Common Nephrotoxic Agents Leading to Acute Tubular Necrosis

19/10/2025

Acute Respiratory Distress Syndrome (ARDS)🫁👇

Acute Respiratory Distress Syndrome (ARDS)
is a life-threatening condition in which the lungs suddenly become severely inflamed and filled with fluid, leading to severe breathing difficulty and low oxygen levels in the blood.

🫁 Definition

ARDS is a rapid-onset respiratory failure caused by widespread inflammation and increased permeability of the alveolar–capillary membrane, leading to fluid leakage into the alveoli (air sacs).
👉 This prevents normal gas exchange (oxygen in, carbon dioxide out).

🛑Causes (Common Triggers)

ARDS is not a disease itself, but a complication of other serious conditions such as:

Direct Lung Injury
• Pneumonia
• Aspiration (inhalation of vomit, food, or stomach acid)
• Smoke or toxic gas inhalation
• Chest trauma

Indirect Lung Injury
• Sepsis (severe infection in the body)
• Severe trauma or burns
• Pancreatitis
• Massive blood transfusions
• Drug overdose

🛑Pathophysiology
1. Injury to alveolar-capillary membrane → inflammation
2. Fluid and proteins leak into alveoli → pulmonary edema
3. Alveoli collapse (loss of surfactant)
4. Impaired gas exchange → hypoxemia (low oxygen)
5. Stiff lungs → decreased lung compliance (hard to breathe)

🛑Symptoms
• Severe shortness of breath (even at rest)
• Rapid, shallow breathing
• Low oxygen levels (hypoxemia) not improving with oxygen therapy
• Bluish skin, lips, or nails (cyanosis)
• Crackles or rales heard on lung exam
• Fatigue and confusion

🛑Diagnosis
• Chest X-ray or CT scan: shows bilateral lung infiltrates (white “cloudy” areas from fluid)
• Arterial blood gases (ABG): shows low PaO₂ despite oxygen therapy
• Echocardiogram: rules out heart failure as the cause

🛑Treatment

There is no single cure — management focuses on supporting breathing and treating the cause.

1. Oxygen therapy / Ventilatory support
• Mechanical ventilation (intubation) with low tidal volume strategy
• PEEP (Positive End-Expiratory Pressure) to keep alveoli open

2. Treat the underlying cause
• Antibiotics for infection
• Fluids and vasopressors for shock
• Drainage of aspiration or trauma management

3. Other supportive care
• Prone positioning (lying face-down) improves oxygenation
• Fluid management (avoid overhydration)
• Nutrition (enteral feeding)
• Sedation to ease breathing effort

⚠️Complications
• Respiratory failure
• Multiple organ failure
• Pulmonary fibrosis (scarring)
• Prolonged ventilator dependence

🛑Prognosis
• Mortality: about 30–40% (higher in severe cases)
• Survivors may have long-term breathing problems, fatigue, or psychological effects

18/10/2025

Intestinal obstruction

18/10/2025

Deep Vein Thrombosis (DVT) - Pathogenesis

18/10/2025

MRI machines create strong magnetic fields. Metal on the body or in belongings can move suddenly and cause injury. Metal can heat up and burn the skin during the scan. Small items like hairpins, coins, or jewelry are dangerous. Metal inside the body, including pacemakers or implants, can stop working. All metal must be removed before entering the MRI room to ensure safety and clear scan results.

09/10/2025

Intubation equipment

08/10/2025

08/10/2025

Big thanks to

Do Rean, Yurmie Zunzhine, Dew Drop, Nokuthula MakaBongeka Miya, Siraj Raajo, Hussaini Ibrahim, Krishna Murari, Nurotonaereo Okala Mmadu Azeaumedix, Comrades Webster, Choudhary Rashid, Silvano Domino Monzales Palacio, Nrs Hcl, Md Irfan Mansuri, صابر محمد السقلدي السقلديetKalunga MatthewsirThet Tun AungShJawahir HussainenMD Shabbir AhmedNgNgen Sreypich, Thai Nguyen Thi Minh GJijie Mendoza Bicera Gabuyo aKhawaja Drwaishort! Congrats for being top fans on a streak 🔥!

07/10/2025

Understanding Pneumothorax🫁👇🩺⚠️

Pneumothorax is the presence of air in the pleural space (the space between the lung and chest wall), which causes partial or complete collapse of the affected lung.

📌Risk Factors
• Smoking
• Chronic lung diseases (COPD, asthma)
• Mechanical ventilation
• Chest trauma
• Tall, thin young males (for spontaneous type)

📌Pathophysiology
• Air enters pleural cavity → loss of negative pressure → lung recoils and collapses → decreased gas exchange → hypoxemia.
• In tension pneumothorax, pressure shifts the mediastinum → compresses the heart and opposite lung → decreased venous return → hypotension and shock.

📌Signs & Symptoms

General Pneumothorax:
• Sudden sharp chest pain
• Shortness of breath (dyspnea)
• Tachypnea (rapid breathing)
• Decreased or absent breath sounds on affected side
• Hyperresonance on percussion
• Decreased chest expansion on affected side

Tension Pneumothorax (Emergency):
• Severe respiratory distress
• Hypotension & tachycardia
• Tracheal deviation to the opposite side
• Distended neck veins (JVD)
• Cyanosis, anxiety, restlessness

📌Diagnosis
• Chest X-ray: shows collapsed lung and air in pleural space
• CT scan: for detailed imaging
• Ultrasound: quick bedside detection
• ABG: shows hypoxemia, possible hypercapnia

📌Management

Emergency Care (Tension Pneumothorax):
• Immediate needle decompression:
• Large-bore needle in 2nd intercostal space, midclavicular line to release trapped air.
• Followed by chest tube insertion.

Other Pneumothorax:
• Small & stable: May resolve on its own; give O₂ therapy and monitor.
• Large or symptomatic: Chest tube thoracostomy to evacuate air.
• Recurrent cases: May need pleurodesis (chemical or surgical adhesion of pleura).

📌Nursing Care
• Monitor respiratory status (rate, depth, SpO₂)
• Assess for tracheal deviation or worsening distress
• Keep oxygen available
• Prepare for and assist during chest tube insertion
• Monitor chest tube drainage system:
• Ensure it’s below chest level
• No kinks or clots in tubing
• Watch for continuous bubbling (air leak)
• Provide pain control and emotional support

📌 Key Points
• Pneumothorax = air in pleural space → lung collapse
• Tension pneumothorax is life-threatening and needs immediate needle decompression
• Always monitor for signs of respiratory distress and shock

07/10/2025

Management of scorpion sting

06/10/2025

Status Epilepticus

06/10/2025

Understanding Nervous system👁️🧠🩺🧐👇

Nervous system is the body’s control and communication network.
It regulates body activities, receives and interprets sensory information, and sends signals to muscles and glands.

🧠2. Main Functions
• Sensory Input: Receives information from internal & external environment.
• Integration: Processes and interprets sensory input to decide response.
• Motor Output: Sends instructions to muscles and glands.
• Homeostasis & Reflexes: Maintains balance in body functions.
• Mental Activity: Thinking, learning, memory, emotions.

🧩 3. Divisions of the Nervous System

A. Central Nervous System (CNS)

➡️ Brain + Spinal Cord
• Brain: Control center for thoughts, emotions, memory, voluntary & involuntary actions.
• Cerebrum: Thinking, memory, voluntary movement
• Cerebellum: Balance & coordination
• Brainstem (midbrain, pons, medulla): Breathing, heartbeat, reflexes
• Diencephalon (thalamus & hypothalamus): Sensory relay, temperature, hormones
• Spinal Cord: Pathway for messages between brain & body; controls reflexes.

B. Peripheral Nervous System (PNS)

➡️ All nerves outside CNS
1. Somatic Nervous System – controls voluntary muscles (e.g., moving your arm).
2. Autonomic Nervous System (ANS) – controls involuntary activities (e.g., heartbeat, digestion).
• Sympathetic: “Fight or Flight” – ↑ heart rate, dilates pupils.
• Parasympathetic: “Rest & Digest” – slows heart rate, increases digestion.

C. Sensory (Afferent) & Motor (Efferent) Pathways
• Afferent neurons: Carry sensory info → CNS
• Efferent neurons: Carry commands → muscles & glands

🛑4. Basic Unit – Neuron
• Neuron: Nerve cell that transmits impulses.
• Dendrites: Receive signals
• Cell body (Soma): Processes signals
• Axon: Sends impulses away
• Myelin sheath: Speeds up signal conduction

➡️ Synapse: Junction where a neuron communicates with another neuron or cell using neurotransmitters (e.g., dopamine, serotonin, acetylcholine).