Medical Advice

24/07/2022

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USMLE, MRCP, PLAB, AMC, MCCQE questions for practice. We post MCQs everyday with explanations.

02/02/2021

HOW TO MANAGE HYPOGLYCAEMIC PATIENTS?

Throughout the day, depending on multiple factors, blood sugar (also called blood glucose) levels will vary—up or down. This is normal. If it varies within a certain range, you probably won’t be able to tell. But if it goes below the healthy range and is not treated, it can get dangerous.

Low blood sugar is when your blood sugar levels have fallen low enough that you need to take action to bring them back to your target range. This is usually when your blood sugar is less than 70 mg/dL (3.9 mmol/L).

A low blood sugar level triggers the release of epinephrine (adrenaline), the “fight-or-flight” hormone. Epinephrine is what can cause the symptoms of hypoglycemia such as thumping heart, sweating, tingling and anxiety.

If the blood sugar level continues to drop, the brain does not get enough glucose and stops functioning as it should. This can lead to blurred vision, difficulty concentrating, confused thinking, slurred speech, numbness, and drowsiness. If blood sugar stays low for too long, starving the brain of glucose, it may lead to seizures, coma and very rarely death.

Low blood sugar can occur for a number of reasons. It’s usually a side effect of diabetes treatment.
Other causes include alcohol and liver failure, excess paracetamol, aspirin, sulfonylureas(e.g. glibenclamide).

Management:
•If patient is conscious and can swallow—>give 200ml fruit juice.
•If patient is conscious but can’t swallow—>administer 200ml of 10% IV glucose or 1mg glucagon IM or SC.
•If patient is unconscious—>IV 75ml of 20% glucose.

02/02/2021

NAIL CLUBBING

Clubbing of the fingers, in which the fingertips spread out and become rounder than normal, is often linked to heart or lung conditions.
The exact cause of finger clubbing is not known. but it is a common symptom of respiratory disease, congenital heart disease, and gastrointestinal disorders.
Causes:
1. Respiratory diseases associated with finger clubbing include lung cancer, lung abscess, cystic fibrosis (thick mucus in the throat and digestive tract), and bronchiectasis (destruction of the large airways).
2. Congenital heart diseases (heart diseases present since birth) that lead to finger clubbing are typically cyanotic, meaning that they cause a person to appear blue due to reduced oxygen in the blood.
3. Clubbing has been seen in pregnancy and acromegal (gigantism due to pituitary tumor).
4. Gastrointestinal disorders that can lead to clubbing of the fingers include celiac disease, inflammatory bowel disease, and liver disease, especially in severe cases, such as cirrhosis of the liver.
5. Other diseases associated with finger clubbing include Hodgkin’s lymphoma and Graves’ disease (thyroid condition). Clubbing may be accompanied by cyanosis (blue coloration of the skin) and shortness of breath.

24/10/2020

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Top 15 Important health TIPS!!!
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30/04/2020

“Locked in” syndrome also known as pseudocoma because it mimics coma.
•Patients are completely paralyzed (with sparing of muscles required for respiration, blinking and vertical eye movement).
•Patients are fully aware of their surroundings and capable of feeling pain.
•This is usually caused by infarction or hemorrhage of the ventral pons.

28/04/2020

What is Cushing syndrome?
•Cushing syndrome results from excessive levels of glucocorticoids (cortisol is the principle glucocorticoid) due to any cause.
•Cushing disease results from pituitary Cushing syndrome(pituitary adenoma)

What are the causes?
•Iatrogenic Cushing syndrome is the most common cause, and is due to prescribed prednisone or other steroids.
•ACTH-secreting adenoma of the pituitary is the second most common cause.
•Adrenal adenomas and carcinomas
•Ectopic ACTH-production

What are the clinical features?
•Muscle weakness with thin extremities-Cortisol breaks down muscle to produce amino acids for gluconeogenesis.
•Moon facies, buffalo hump and truncal obesity-high insulin increases storage of fat centrally.
•Abdominal striae-due to impaired collagen synthesis resulting in thinning of skin.
•HTN often with hypokalemia and metabolic alkalosis
•Osteoporosis
•Immune suppression may cause infection
•Musculinization in females (androgen excess)-only seen in ACTH-dependent forms
•Hypogonadism-menstrual irregularity and infertility

How to diagnose Cushing syndrome?
•An overnight low dose dexamethasone suppression test is the initial screening test(cause cortisol to decrease in normal individuals but fail to suppress in patients with Cushing syndrome)
•24 hour urine cortisol level (increased)
•Late night salivary cortisol level(increased)

How to treat?
•Iatrogenic Cushing syndrome: tapering of glucocorticoid
•Pituitary Cushing syndrome: surgery
•Adrenal adenoma or carcinoma: surgery (adrenalectomy)

25/04/2020

What is Molluscum contagiosum ?
•It is a common, self-limited viral infection caused by poxvirus.
•It manifests as small papules with central umbilication. Lesions are asymptomatic. In HIV patients, lesions can extensive.

How does it transmit?
•It is transmitted via skin-to-skin contact and is highly contagious.

How long does it persist?
•It persists up to 6 months but spontaneously regress with time. In immunosuppresed individual, the lesions can progress to grow quite large and often are refractory to treatment.

How to treat?
•Multiple treatment modalities are effective (e.g.,curettage, drops containing podophyllin and cantharidin, cryosurgery), but scarring is always a risk.

25/04/2020

What is scabies?
•Scabies caused by the human skin mite Sarcoptes scabiei var hominis.

Is it contagious?
•It is highly contagious-transmitted via skin-to-skin contact or through towels, bed linens or clothes.

What are the common locations?
•Fingers, interdigital areas and wrists(most common)
•Elbows, feet, ankles, p***s, sc***um, buttocks and axillae
•Head, neck, palms and soles are typically spared.

What are the symptoms?
•Severe itching (often most severe at night)
•Burrows—Linear marks represent the tunneled path of the mite. There is typically a dark dot at one end, representing the female mite.
•Scratching may lead to excoriations.

What is the treatment?
•Permethrin 5 % cream (Elimite)

25/04/2020

What is cataract?
•Cataract is opacification of the natural lens of the eye: half of the people over 75 have cataracts
•There is a loss of visual acuity that progresses slowly over many years. Patients may complain of glare and difficulty driving at night.

What are the risk factors?
•Old age, smoking, glucocorticoid use, prolonged UV radiation exposure, trauma, diabetes, Wilson disease, Down syndrome and certain metabolic diseases.

What is the treatment?
•Surgery is the definite treatment and is very effective in restoring vision. It is indicated if visual loss is significant to the patient and interferes with daily or occupational activities. It involves extraction of the cataract with implantation of an artificial intraocular lens.

11/04/2020

09/04/2020

Exposing yourself to the sun or to temperature higher than 25 degree Celsius does not prevent COVID-19.