Renal physiology and diuretics : [REVISITED]
Posted by: drhaisook on: March 11, 2009
I’m presenting here content already posted before, but it has gotten much attention and acclaim from my visitors, so I thought I’d re-publish it. It has also been used in Wikipedia in three articles.
It’s an illustration I’ve made a long time ago on the renal physiology and corresponding diuretics. My visitors liked it so much. One of them, va, used it for his MRCS exam, and another one, khairul Majumder, showed the illustration to the nurses, explaining to them the basics of the renal physiology.
Head over to the original post to view a full-sized version of the illustration, read the detailed description, and be able to comment.
Notes on Myocardial Infarction
Posted by: drhaisook on: January 30, 2009
SITE
• Largely localized to left ventricle
TYPES (ACC. TO DEPTH)
• Transmural (“Prolonged-” Q wave MI)
• Subendocardial (Non-Q wave MI or Non-ST Elevation MI; NSTEMI)
TYPES (ACC. TO SITE)
Type: Corresponding EKG changes in
• Inferior: Leads II, III, aVF
• Anterior: Leads V1-V4
• Lateral: Leads I, aVL, V4-V6
• Posterior: Leads V1, V2 (Tall T, ST depression)
DEFINITE DIAGNOSIS
By EKG
• ST segment changes, or
• New LBBB (left bundle branch block)
EKG PATTERNS
• Transmural MI (Q wave MI):
Hyperacute T & ST elevation » T-wave inversion » prolonged Q
• Non-Q-Wave MI (Also termed non-ST elevation MI, or NSTEMI):
ST depression » persistent ST-T-wave changes without Q-wave development
Hypersensitivity Reactions
Posted by: drhaisook on: January 25, 2009
Quick intro:
Hypersensitivity reactions occur due to the introduction of a certain antigen (Ag) which the body finds foreign and thus tries to eliminate it with the help of certain cells and antibodies (Ab). This conflict produces an immune process, a war-like phenomenon known as hypersensitivity reaction.
Remember the mnemonic: [ ACID ]:
Type I; Anaphylactic/Atopic
- Mast cell or basophil + Ag + IgE
- e.g. Anaphylaxis (e.g. to penicillin), Asthma
Type II; Cytotoxic (kills cells)
- Affected cell + Ag + IgM/IgG
- e.g. Autoimmune hemolytic anemia, Rh factor dse, Rheumatic fever
Type III; Immune complex
- Ag + Ab + complement (e.g. C3, C5)
- e.g. Post-streptococcal glomerulonephritis, SLE, Rheumatoid arthritis
Type IV; Delayed (T-cell mediated)
- T lymphocytes + Ag » formation of lymphokines
- e.g. TB skin test, Transplant rejection, Contact dermatitis
Some information, including the mnemonic, was taken from First Aid for USMLE Step 1 book.
Causes of Hemoptysis
Posted by: drhaisook on: January 22, 2009
Most common
• Bronchogenic Carcinoma (++)
• Pulmonary Infarction (++)
• T.B. (+)
Common
• Bronchiectasis
• Lung abscess (+ pus)
• Bronchitis (acute; chronic; COPD)
Uncommon
• Tumors of Trachea, Larync
• Bronchial Adenoma
• Lung secondaries
Others
• Chest trauma
• F.B.
• Iatrogenic
Abnormalities of Heart Beats
Posted by: drhaisook on: January 17, 2009
¶ S1
• pronounced in MS
• weak in MR/MP
¶ S2
weak in both AS and AR
¶ S3 (blood splash!)
• comes just after S2 (early diastole)
• lub-dub-‘dub’
• normal in children, young adults, athletes, pregnancy, fever
• abnormal in others
• cause:
large poorly contractile left ventricle usually due to volume overload
“blood from pulmonary veins forcefully hits the inside of the LARGE ventricle making this sound”. This is common in MR and AR.
¶ S4 (atrium contracts!)
• comes just before S1 (late diastole)
• ‘da’-lub-dub
• almost always abnormal
• cause:
left ventricle hypertrophy (not enlargement) due to an obstructive cause
“atrium forcefully contracts to get blood into the highly tense muscular ventricle”. It is common in HTN, AS, MS “late”, restrictive cardiomyopathy.
Copyright 2009
Dr Haisook's
Medicopedia
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