Specialty
Causes of sensorimotor polyneuropathy Causes of motor neuropathy Causes of sensory neuropathy
History – patient relative Agent Dose Time of ingestion Examination Vital signs Neurological – tone, clonus, reactive pupils Abdomen – bowel sounds Skin changes Urinary retention Clinical syndromes Anticholinergic syndrome Delirium with mumbling speech, tachycardia, dry, flushed skin, Cholinergic syndrome Muscurinic effect – diarrhoea, urination, miosis, bronchospasm, emesis Nicotinic effect – mydriasis, tachycardia, weankess, hypertension, […]
75yo John presents to the hospital with a lower respiratory tract infection. His blood test show eGFR is 40 and creatinine >100. His previous blood test earlier in the year eGFR 79 and creatinine 65. You diagnose him with acute kidney injury.
Overview Hypertension is defined as BP ≥140/90 mmHg. Hypertension can be divided into Primary or Secondary. The main goal of treatment is to decrease the risk of mortality and of cardiovascular and renal morbidity. For more information on hypertension as a chronic disease click here Life Threatening Differential Diagnosis Management of Chronic Hypertension Approach Management of Hypertensive Urgency […]
Overview Orthostatic hypotension is an important, treatable cause of dizziness, syncope and falls. Less frequently it leads to visual disruption, dyspnea on exertion, angina and even stroke. Orthostatic hypotension also known as postural hypotension results from a failed sympathetic response when standing upright resulting in decrease venous return and cardiac output causing dizziness, syncope and/or fall. […]
Remember Wounds require tetanus prophylaxis and broad spectrum antibiotic if significant risk of contamination, or debridement of necrotic tissue. History Side note Small projectiles at high velocities increase the likelihood of penetrating trauma. Symptoms include loss of vision, pain on movement and diplopia. Features requiring urgent referral Contact lens wearer Previous eye surgery or […]
Overview Parkinson’s disease is a progressive neurodegenerative disorder characterised by tremor, rigidity, bradykinesia, and a wide spectrum of non-motor symptoms including sleep disorders, hyposmia, bladder and bowel dysfunction, fatigue, dementia, and other neuropsychiatric symptom. Although the disease has no cure, available treatments effectively control motor symptoms and improve quality of life. Parkinson disease affects approximately 1 percent […]
Approach Differential Diagnosis Pruritic Non-pruritic Pityriasis rosea Roseola infantum Atopic dermatitis Scarlet fever Erythema infectiosum Molluscum contagiosum Tinea infection Distribution Roseola Infantum (Exanthema Subitum) Pityriasis Rosea Herpesvirus 6 and 7 Molluscum Contagiousm Poxvirus Erythema infectiosum Parovirus B19 Scarlet fever Impetigo
Overview DefinitionDelirium: Cognitive impairment typically caused by acute illness or drug toxicity (sometimes life threatening) and is often reversible. Delirium mainly affects attention.Confusion: disturbed orientation in regard to time, place, or person, sometimes accompanied by disorderedDementia: Cognitive impairment typically caused by anatomic changes in the brain, has slower onset, and is generally irreversible. Dementia mainly affects memory. Differential […]
Overview Differential diagnosis causing bradycardia Remember Life threatening causes of bradycardia include: hypotension, raised intracranial pressure and MI. History Examination Acute Management Pharmacology Atropine Investigations
Overview Abdominal trauma can result in injuries that are intraperitoneal and retroperitoneal Abdominal trauma is divided into blunt and penetrating mechanisms. Blunt abdominal trauma involves a crushing force that causes disruption of solid viscera (spleen or liver) or hollow viscera (intestine). These injuries are most common after falls or MVCs. Penetrating abdominal trauma occurs most […]
Overview Thoracic trauma causes injuries to the chest wall, lungs, great vessels, and heart. It is clinically divided into blunt and penetrating injuries. PAMD Preparation Assessment – Primary Survey – ABCDE Remember If the patient is able to communicate verbally, the airway is usually patent. Side note Ventilation may be reduced for a number of […]
Overview Devastatingly disabling injury. Can be missed as ambulant patients may have an unstable vertebral injury. Up to 10% of unconscious patients have a significant vertebral injury. Most common cause of spinal injuries include MVA, Falls and pedestrian on roads. Ask yourself: Neurogenic Shock Triad Hypotension, bradycardia, peripheral dilation. Autonomic Dysreflexia PAMD Preparation Assessment – Primary Survey – ABCDE Remember If the patient is able to communicate verbally, the airway is usually patent Side note Ventilation may […]
Overview PAMD Preparation Assessment – Primary Survey – ABCDE Remember If the patient is able to communicate verbally, the airway is usually patent. Side note Ventilation may be reduced for a number of reasons, (1) diaphragm fatigue, (2) Progressively ascending spinal cord damage from primary damage or secondary ascending spinal cord oedema encroaching on C3-C5, […]
Overview Potassium (K+) is an important ion in the body. K+ is found mainly intracellularly (inside the cells) whereas sodium (Na+) is found extracellularly (outside the cells). Therefore: As the pH rises , K+ is shifted intracellularly and the serum levels falls; conversely when serum pH decreases, intracellular K+ shits extracellularly into the vascular space […]
Overview Jaundice or icterus is the yellowish discoloration of the skin and sclerae from increased levels of bilirubin, a bile pigment derived chiefly from the breakdown of hemoglobin. Mechanism of Jaundice
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Overview At least 90% of children with fever and petechiae will NOT have meningococcal disease. However, recognition and early treatment of the child with meningococcal disease is paramount. All children with fever and petechiae should be reviewed by a registrar or consultant. If invasive meningococcal disease is suspected, administer parenteral antibiotics immediately, but do not delay […]
POISONING “All things are poison and nothing is without poison, only the dose permits something not to be poisonous.”–Paracelsus Overview Children are curious and explore their world with all their senses, including taste. As a result, the home and its surroundings can be a dangerous place when poisonous substances are inadvertently ingested – every year […]
Young children develop 6-12 respiratory tract infections per year, usually accompanied by cough. In most children, the cough is self-limiting (1-3 weeks), but it is sometimes prolonged. Cough that lasts for more then 3 weeks should be investigated.
The presence of a wheeze implies narrowing of airways of any size throughout the proximal conducting airways. Wheezing occurs during the prolonged expiratory phase. Children wheeze more often than adults because of physical differences.
