Medical chocos. .Cmc

07/06/2024

Chest X Ray misses nearly half of the cardiomegaly.

06/06/2024

06/06/2024

Nucleus
Mitochondria
Plastids
Have double membrane.

06/06/2024

RER basophilic
Takes blue staining with H & E

05/06/2024

Metabolic alkalosis is common in hyperaldosteronism.

11/08/2021

A click from G*T
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11/04/2021

General interventions in the management of Massive obstetric haemorrhage:

Empty uterus
Deliver fetus
Remove placenta and retained tissue.

Massage uterus i.e to rub up the contractions.

Give drugs that increase the uterine contractions
Oxytocin
Ergometrine
Misoprostol
Carboprost.

Apply bimanual compression.
Repair ge***al tract injuries including cervical tears
Uterine temponade using rusch balloon.

Laporatomy.

If there is bleeding from placental bed may need oversewing & insertion of rusch balloon

If uterus is atonic and not responding to drug treatment and bleeding is decrease with compression apply B lynch and vertical compression sutures.
Internal iliac and uterine artery ligation.
Uterine artery embolization may be helpful but is not always an option in emergency situation.
Total or subtotal hysterectomy

Compression of aorta may be used to gain temporary control while a definitive treatment gets underway.

10/04/2021

Massive obstetric haemorrhage.

Blood loss & cardiovascular parameters.

10% to 15% blood loss
Heart rate increase
Systolic B.p normal
Tissue perfusion, postural hypotension.

15% to 30% blood loss
Heart rate increase
Systolic B.p normal
Tissue perfusion, peripheral vasoconstriction.

30% to 40% blood loss
Heart rate increase
Systolic B.P 70 to 80 mmhg
Tissue perfusion,
Pallor oliguria confusion restlessness.

40% blood loss
H.R increase
Systolic B.p less than 60mmhg
Tissue perfusion
Dyspnea anuria collapse.

10/04/2021

Massive obstetric haemorrhage.

Blood loss more than 1000 ml may result in:

_Acute hypovolemia
_shock due to sudden reduction in perfusion to the vital organs.
-loss of clotting factors (wash out phenomenon)
-DIC
-hypoxia leading to the anaerobic metabolism, accumulation of lactic acid and metabolic acidosis.
-multi organ dysfunction /failure.