Unclear Medicine

16/12/2024

Understanding nerve injuries through visual mnemonics! 🧠

🔵 Wrist Drop: Radial nerve injury
🔵 Claw Hand: Ulnar nerve injury
🔵 Hand of Benediction: Median nerve injury

🔍 Mnemonic: DR. CUMA

• DROP = RADIAL
• CLAW = ULNAR
• MEDIAN = APE

🩺 Contexts & Locations:

• Radial Nerve Injury: Loss of elbow, wrist & digits extension, decrease in grip strength. Location: Superficial branch of Radial nerve.
• Ulnar Nerve Injury: Hyperextension of digits & flexion of 4th & 5th digits or at rest. Location: Distal ulnar nerve.
• Median Nerve Injury: Extension of 1st, 2nd, 3rd digits when trying to make a fist. Location: Proximal median nerve.

16/12/2024

Respiratory Acidosis

Pathophysiology:

• Lung problem: The lungs are retaining too much CO2.
• Kidneys compensate: The kidneys excrete hydrogen & retain bicarbonate (HCO3).

PH: < 7.35
CO2: > 45

Causes:

• Retaining CO2 - “DEPRESS” breathing
• Drugs (Opioids & Sedatives)
• Edema (Fluid in the lungs)
• Pneumonia (Excess mucus in the lungs)
• Respiratory center of the brain is damaged
• Emboli (Pulmonary emboli)
• Spasms of the bronchial (Asthma)
• Sac elasticity damage (COPD & Emphysema)
• All these things cause impaired gas exchange

Signs & Symptoms:

• Hypoxic
• Decreased blood pressure
• Increased respiration rate
• Increased heart rate
• Restlessness
• Confusion
• Headache
• Sleepy/coma

Interventions:

• Administer O2
• Semi-Fowler’s position
• Turn, cough, & deep-breathe (TCDB)
• Pneumonia: Increase fluids to thin secretions & administer antibiotics
• Monitor potassium levels (normal 3.5 - 5.0 mmol/L)
• If CO2 > 50, they may need an endotracheal tube

Respiratory Alkalosis

Pathophysiology:

• Lung problem: The lungs are losing too much CO2.
• Kidneys compensate: The kidneys excrete bicarbonate (HCO3) & retain hydrogen.

PH: > 7.35
CO2: < 35

Causes:

• Losing CO2 - “TACHYPNEA”
• Increased temperature
• Aspirin toxicity
• Hyperventilation

Signs & Symptoms:

• Respiratory rate > 20
• Increased heart rate
• Confused & tired
• Tetany
• EKG changes
• Positive Chvostek sign (Twitching of the facial muscles when tapping the facial nerve in response to hypocalcemia)

Interventions:

• Provide emotional support
• Fix the breathing problem!
• Encourage good breathing patterns
• Rebreathing into a paper bag
• Give anti-anxiety medications or sedatives to decrease breathing rate
• Monitor potassium (K+) & calcium (Ca-) levels

16/12/2024

Grave’s disease is an autoimmune disorder and the most common cause of hyperthyroidism. It is characterized by the presence of autoantibodies to the TSH receptor, leading to excessive thyroid hormone production. The condition predominantly affects women (8:1) aged 20-40 years and often runs in families.

Key Features:
1. Pathophysiology:
• Autoantibodies stimulate the thyroid gland, causing enlargement (goiter) and hyperfunction.
• Immune responses may also target orbital and dermal fibroblasts, leading to ophthalmopathy and pre-tibial myxedema.
2. Triad of Symptoms:
• Diffuse Goiter: Smooth, enlarged thyroid with or without a bruit.
• Ophthalmopathy: Eye changes such as bulging (proptosis), lid retraction, and vision disturbances.
• Dermopathy: Non-pitting edema on the shins (pre-tibial myxedema).
3. Clinical Presentation:
Symptoms of hyperthyroidism include heat intolerance, weight loss, fine tremor, tachycardia, and anxiety. Musculoskeletal, cardiovascular, and neuropsychiatric effects are also common.
4. Diagnosis:
• Low/undetectable TSH and elevated T3/T4.
• Positive thyroid antibodies (TRAb).
• Thyroid scintigraphy showing diffuse uptake.
5. Treatment:
• Beta-blockers to control symptoms.
• Anti-thyroid drugs like methimazole or propylthiouracil.
• Definitive options: Radioactive iodine therapy or thyroidectomy.

07/05/2024

7 ways to correct hyperkalemia

07/05/2024

May is National Stroke Awareness Month — A Good Time to Review the Warning Signs of a Stroke and Learn to B.E.F.A.S.T.!
Did you know? Most strokes are preventable. And a large percentage of the ones that happen are treatable with the right care, right away. It's a matter of knowing what to do, taking action and spreading the word.

07/05/2024

Poor R-wave progression (PRWP) is a common ECG finding that is often inconclusively interpreted as suggestive, but not diagnostic, of anterior myocardial infarction (AMI). PRWP is defined by R wave height ≤ 3 mm in V3

Causes of PRWP
The major causes associated with PRWP include:

Prior anteroseptal MI
Left Ventricular Hypertrophy (LVH)
Right Ventricular Hypertrophy (RVH)
Inaccurate lead placement (e.g. transposition of V1 and V3)
Dilated cardiomyopathy
May be a normal variant

06/05/2024

03/12/2023

management algorithm

04/11/2023

Management algorithm of Acute in adults

Encephalopathy characterized by seizures (often status epilepticus) with acellular CSF and rapid recovery

The administration of empiric corticosteroids has not been shown to improve outcomes in infectious encephalitis

antibiotic therapy can often be discontinued after a single dose if bacterial testing returns negative, although clinical judgment should be exercised if there is a significant neutrophilic pleocytosis or the patient has been pretreated with antibiotics.

21/05/2023

❤️Protocolized Tracheal and Thoracic Ultrasound for Confirmation of Endotracheal Intubation and Positioning.
📢a protocolized, systematic approach using tracheal and thoracic ultrasonography can be used to confirm endotracheal intubation, detect main stem intubations, and adjust tube positioning in the critically ill.
🌐DOI: 10.1097/CCE.0000000000000225

08/02/2023

08/02/2023

It is the most commonly used tool for estimating the short-term risk for death and nonfatal myocardial infarction in patients with a NSTE-ACS (Table). The TIMI risk score is most useful to assist in deciding whether patients will benefit from an early invasive treatment strategy.

The estimated rates of death and nonfatal myocardial infarction also are useful to counsel patients regarding their risk.

ln patients at low risk (TlMI score of 0-2), practice guidelines recommend an ischemia-guided strategy that utilizes invasive treatment only if medical therapy is ineffective.

Patients at higher risk (TIMI score 3 or greater) are more likely to benefit from an early invasive approach.