tag:blogger.com,1999:blog-10927202586906721942024-03-23T04:25:22.762-07:00Medical Lecture NoteCompilation lecture notes of medical subjectsUnknownnoreply@blogger.comBlogger1587125tag:blogger.com,1999:blog-1092720258690672194.post-63174790319058321132013-12-29T03:18:00.002-08:002013-12-29T03:18:24.091-08:00Rome III Criteria for Dyspepsia
An international committee of clinical investigators (Rome III Committee) defined dyspepsia as one or more of the following symptoms:
Postprandial fullness (termed postprandial distress syndrome).
Early satiation (meaning inability to finish a normal sized meal or postprandial fullness).
Epigastric pain or burning (termed epigastric pain syndrome).
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-59857100539242575672013-12-20T06:36:00.000-08:002013-12-20T06:36:03.750-08:00IDSA Update Guidelines for the treatment of acute bacterial rhinosinusitis (ABRS)
Guidelines for the treatment of acute bacterial rhinosinusitis (ABRS) have been released from the Infectious Disease Society of American (IDSA). Although it is difficult to distinguish viral from bacterial acute rhinosinusitis (ARS), three features suggest the diagnosis of ABRS:
1) persistent symptoms or signs of ARS lasting 10 or more days with no clinical improvement;
2) onset Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-8083224363373895902013-08-17T21:01:00.000-07:002013-08-17T21:01:01.505-07:00Lifestyle modifications to manage hypertension
1. Weight reduction
Maintain normal body weight (BMI : 18.5 – 24.9).
2. Adopt DASH eating plan
Consume a diet rich in fruits, vegetables, and low-fat dairy products with a reduced content of saturated fat and total fat.
3. Dietary sodium reduction
Reduce dietary sodium intake to no more than 100 mEq/d (2.4 g sodium or 6 g sodium chloride (NaCl) ).
4. Physical activity
Engage Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-709308937658881702013-08-16T20:14:00.000-07:002013-08-16T20:14:47.117-07:00How Is Blood Pressure Measured
Blood pressure should be measured with a well-calibrated sphygmomanometer.
The bladder width within the cuff should encircle at least 80% of the arm circumference.
Readings should be taken after the patient has been resting comfortably, back supported in the sitting or supine position, for at least 5 minutes and at least 30 minutes after smoking or coffee ingestion.
Source: CMDT Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-10663886140761420462013-08-13T21:07:00.000-07:002013-08-16T21:21:04.145-07:00Clinical trial and guideline basis for compelling indications for antihypertensive drugs
1. Hipertension with Heart failure
Recommended Drugs:
ACE Inhibitors
Aldosterone Antagonist
ARB
β-Blockers
CCB
Diuretic
Clinical Trial Basis:
ACC/AHA Heart Failure Guideline
MERIT-HF
COPERNICUS
CIBIS
SOLVD
AIRE
TRACE
ValHEFT
RALES
2. Hipertension with Post-myocardial infarction
Recommended Drugs:
ACE Inhibitors
Aldosterone Antagonist
β-Blockers
Clinical Trial Basis:
ACC/Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-50359758136213319072013-08-01T08:16:00.000-07:002013-08-16T20:45:19.979-07:00Common Causes of Secondary Hypertension
1. Genetic causes
Hypertension can be caused by mutations in single genes.
Liddle syndrome is an autosomal dominant condition characterized by early-onset hypertension, hypokalemic alkalosis, low renin and low aldosterone levels.
2. Renal disease
Renal parenchymal disease is the most common cause of secondary hypertension.
Mechanisms : related to increased intravascular volume or Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-79196670996413031802013-03-28T08:50:00.000-07:002013-03-28T08:50:00.097-07:00Lecture Notes: INH Chemoprophylaxis
Chemoprophylaxis appears to reduce significantly the risk for progression from latent infection to active disease. In patients who have not received chemotherapy, a positive skin test result implies the presence of a few dormant but viable tubercle bacilli, which have the potential for reactivation. It has been demonstrated that the administration of INH daily for 6 to 12 months reduces the riskUnknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-13056521733953289542013-03-27T08:47:00.000-07:002013-03-27T08:47:05.381-07:00Tuberculin Skin Test (Mantoux test / PPD)
The tuberculin skin test is the most useful test for the diagnosis of past or present tuberculous infection. The Mantoux test is more reliable than multiple-puncture tests, such as the tine test. PPD is available in three strengths:
the first strength contains 1 tuberculin unit (TU),
the intermediate strength contains 5 TU, and
the second strength contains 250 TU.
Only the Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-44330308146721705652013-02-23T09:00:00.000-08:002013-02-23T09:00:01.959-08:00Lecture Note: Antenatal Care: Tests & Procedures Week by Week
At each visit, weight, blood pressure, fundal height, fetal heart rate are measured, and a urine specimen is obtained and tested for protein and glucose. Review any concerns the patient may have about pregnancy, health, and nutrition.
6-12 Weeks
Confirm uterine size and growth by pelvic examination.
Document fetal heart tones (audible at 10–12 weeks of gestation by Doppler).
First Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-37899977331223211352013-02-20T09:13:00.000-08:002013-02-20T09:13:00.061-08:00Lecture Note: Significance of Specific Urinary Casts
Casts are composed of Tamm-Horsfall urinary mucoprotein in the shape of the nephron segment where they were formed.
Hyaline casts
Concentrated urine,
febrile disease,
after strenuous exercise,
in the course of diuretic therapy (not indicative of renal disease)
Red cell casts
Glomerulonephritis
White cell casts
Pyelonephritis,
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-20676345334350265692013-02-19T08:49:00.000-08:002013-02-19T08:49:00.102-08:00Lecture Note: Teratogenic or Fetotoxic Drugs
ACE inhibitors
Alcohol
A-II antagonists
Androgens
Anticonvulsants (phenytoin, valproic acid, carbamazepine)
Benzodiazepines
Carbarsone (amebicide)
Chloramphenicol (third trimester)
Cyclophosphamide
Diazoxide
Diethylstilbestrol
Disulfiram
Ergotamine
Estrogens
Griseofulvin
Isotretinoin
Lithium
Methotrexate
Misoprostol
NSAIDs (third trimester)
Opioids (prolonged use)
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-71448391899678054172013-02-18T07:59:00.001-08:002013-02-18T09:18:44.883-08:00Etiologic Classification of Diabetes Mellitus
DM is classified on the basis of the pathogenic process that leads to hyperglycemia, as opposed to earlier criteria such as age of onset or type of therapy. The two broad categories of DM are designated type 1 and type 2. Both types of diabetes are preceded by a phase of abnormal glucose homeostasis as the pathogenic processes progresses. Type 1 diabetes is the result of complete or near-total Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-21339393115399937992013-02-05T04:49:00.001-08:002013-02-05T04:49:49.039-08:00Dietary Intervention as Alternative Cancer Treatments
Proponents of alternative diets claim that life prolongation through adherence to a particular diet is an achievable goal for cancer patients. However, a systematic review based on evidence found indicates that there is no diet regimen that has been conclusively proven to cure cancer or significantly prolong the life of cancer patients.
Gerson regimen — Hildenbrand et al (1995) analysis Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-4210612849659098812013-02-04T04:55:00.000-08:002013-02-05T04:56:01.141-08:00Lactose Intolerance
Intolerance to lactose-containing foods (primarily dairy products) is a common problem. The term lactose intolerance is applied to the development of characteristic symptoms after the ingestion of lactose:
abdominal pain,
bloating,
flatulence,
diarrhea,
and, particularly in adolescents, vomiting.
The causes of lactose malabsorption can be divided into :
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-26644427273346387012012-09-13T08:20:00.000-07:002012-09-13T08:20:00.024-07:00Common Characteristics of Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder
Anorexia nervosa and bulimia nervosa are characterized by severe disturbances of eating behavior. The salient feature of anorexia nervosa is a voluntary restriction of food intake relative to caloric requirements leading to an inappropriately low body weight. Bulimia nervosa is characterized by recurrent episodes of binge eating followed by abnormal compensatory behaviors, such as self-induced Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-56482159120454289332012-09-12T08:18:00.001-07:002012-09-12T08:18:58.917-07:00Properties of Insulin Secretagogues
Insulin secretagogues stimulate insulin secretion by interacting with the ATP-sensitive potassium channel on the beta cell. These drugs are most effective in individuals with type 2 DM of relatively recent onset, who have residual endogenous insulin production.
Class/Generic Name Daily Dosage, mg Duration of Action, h
Sulfonylureas
Glimepiride 1–8 24
Glipizide 5–40 12–18
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-83893076858105415422012-08-25T07:16:00.002-07:002012-08-25T07:32:38.069-07:00Contraindications of Botulinum Toxin Injection for Cosmetic
Absolute contraindications to botulinum toxin injection include infection at the site of injection or known hypersensitivity to any component of the product.
AbobotulinumtoxinA should not be given to patients with allergies to cow’s milk protein; this limitation does not apply to onabotulinumtoxinA, incobotulinumtoxinA, or rimabotulinumtoxinB.
Relative contraindications to treatment Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-13877857026772048822012-08-24T07:30:00.000-07:002012-08-25T07:31:39.555-07:00Formulations of Botulinum Toxin for Cosmetic Use
Two serotypes of botulinum toxin have been formulated for clinical use, including botulinum toxin type A and botulinum toxin type B.
In order to prevent confusion between products, in 2009, the United States Food and Drug Administration (FDA) recommended the use of specific names, rather than serotypes, to refer to the available formulations of botulinum toxin.
OnabotulinumtoxinA
The Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-78485645822749373262012-06-10T00:02:00.000-07:002012-06-10T00:02:00.591-07:00Lecture Notes: Elderly Care Medicine 8th Edition
Elderly Care Medicine Lecture Notes provides all the necessary information, within one short volume, for a sound introduction to the particular characteristics and needs of elderly patients.
Presented in a user-friendly format, combining readability with high-quality illustrations, this eighth edition has been thoroughly revised to reflect advances in knowledge on how disease presents in Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-9911720300628477682012-06-09T08:55:00.000-07:002012-06-20T08:58:21.185-07:00Comparing decerebrate & decorticate postures
Decerebrate posture
Results from damage to the upper brain stem.
In this posture, the arms are adducted and extended, with the wrists pronated and the fingers flexed.
The legs are stiffly extended, with plantar flexion of the feet.
Decorticate posture
Results from damage to one or both corticospinal tracts.
In this posture, the arms are adducted and flexed, with the Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-83009434330551132492012-06-08T08:27:00.000-07:002012-06-20T08:37:11.587-07:00Abdominal Pain: Types & Locations
AFFECTED
ORGAN VISCERAL
PAIN PARIETAL
PAIN REFERRED
PAIN
Appendix Periumbilical area Right lower quadrant Right lower quadrant
Distal colon Hypogastrium and left flank for descending colon Over affected area Left lower quadrant and back (rare)
Gallbladder Middle epigastrium Right upper quadrant Right subscapular area
Ovaries, fallopian tubes, and uterus Hypogastrium and groin Over affected Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-48836987587356555192012-06-07T21:58:00.000-07:002012-06-20T08:38:08.300-07:00Major foodborne microbes by the principal presenting gastrointestinal symptom
Major presenting symptom Likely microbes Incubation period Likely food sources
Vomiting S. aureus 1 to 6 hours Prepared food, eg, salads, dairy, meat
B. cereus 1 to 6 hours Rice, meat
Norwalk-like viruses 24 to 48 hours Shellfish, prepared foods, salads, sandwiches, fruit
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-14987608654448657372012-06-06T08:27:00.000-07:002012-06-20T08:38:24.828-07:00Classification / Staging System for Acute Kidney Injury
Acute renal failure (ARF) has traditionally been defined as the abrupt loss of kidney function that results in the retention of urea and other nitrogenous waste products and in the dysregulation of extracellular volume and electrolytes. The loss of kidney function is most easily detected by measurement of the serum creatinine which is used to estimate the glomerular filtration rate (GFR).
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-47650240297701399342012-06-05T21:44:00.000-07:002012-06-06T21:45:48.362-07:00Clinical Manifestations of Listeria monocytogenes Infection
Listeria monocytogenes is an important bacterial pathogen in neonates, immunosuppressed patients, elderly adults, pregnant women, and occasionally, previously healthy individuals.
Febrile gastroenteritis
Listeria account for less than one percent of reported cases of bacterial foodborne infections, but outbreaks of febrile gastroenteritis from contaminated food have been described.
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-1092720258690672194.post-45338433006805808282012-06-04T16:09:00.000-07:002012-06-20T08:43:42.767-07:00Heart failure in Diabetes Mellitus
Diabetes mellitus (DM) increases the risk of heart failure (HF) independent of coronary heart disease and hypertension and may cause a cardiomyopathy.
DEFINITION
Diabetic cardiomyopathy has been defined as ventricular dysfunction that occurs in diabetic patients independent of a recognized cause (eg, coronary heart disease, hypertension)
EPIDEMIOLOGY
There is a well established Unknownnoreply@blogger.com