Medical science, drawn into focus.

Hyper-IgE Syndrome (Job’s Syndrome)

Overview Hyper-IgE syndrome (HIES) is a rare primary immunodeficiency characterised by markedly elevated serum IgE, recurrent staphylococcal skin and lung infections, eczema, and connective tissue/ skeletal abnormalities. Most commonly caused by autosomal dominant mutations in STAT3 , it results in impaired Th17 cell differentiation and defective neutrophil chemotaxis. Autosomal recessive forms (DOCK8, TYK2 mutations) present…

Chronic Lower Limb Ischaemia: Intermittent Claudication

Overview Chronic lower limb ischemia can be classified using the Fontaine classification: I – asymptomatic II – intermittent claudication III – rest pain IV – ulcers/gangrene Grades III and IV are classified as Critical Limb Ischemia. Intermittent claudication is a type of chronic lower limb ischemia that presents with muscle pain on exercise and is…

Substance Dependence (Addiction), Withdrawal and Overdose

Overview of addition medicine. This section is a brief introduction to substance abuse, followed by section that look at specific drugs of addiction. Substance Misuse: Consumption above designated low risk levels Substance Abuse: repetitive substance use resulting in social complications (financial, occupational and legal) Substance Tolerance: Defined by either of the following: a need for…

Acute Respiratory Distress Syndrome

Overview ARDS is an acute, diffuse, inflammatory lung injury that leads to increased pulmonary vascular permeability, increased lung weight, and a loss of aerated tissue. Clinical hallmarks of ARDS are hypoxemia and bilateral radiographic opacities, while the pathological hallmark is diffuse alveolar damage. Pathophysiology Aetiology Indirect lung injury: sepsis, shock, trauma, pancreatitis, drug OD, intracranial haemorrhage,…

Aortic Stenosis

Overview Aortic valve stenosis is characterised by obstruction of left ventricular outflow, resulting in inadequate cardiac output, decreased exercise capacity, heart failure, and death from cardiovascular causes. Mild to moderate aortic stenosis is usually a symptomatic, but occasionally can be found on routine examination Locations of stenosis – Valvular (common), supravalvular and subvalvular Aortic Stenosis…

Biceps Tendon Rupture

Overview A biceps tendon rupture is a partial or complete tear of the tendon attaching the biceps muscle to the shoulder or elbow.  Proximal ruptures, usually involving the long head of the biceps at the shoulder, are more common and often result from age-related degeneration or associated rotator-cuff disease. They typically cause upper-arm pain, bruising…

ACL Tear

Overview Anterior cruciate ligament (ACL) tear is one of the most common knee injuries, particularly in young athletes involved in pivoting sports (soccer, basketball, skiing). ACL injuries account for ~50% of all knee ligament injuries, with an incidence of ~68 per 100,000 annually, more common in females due to anatomical and biomechanical risk factors. ACL…

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