Medicine With Sid

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This is a page where we would be discussing various clinical skills,clinical scenarios,integrated medicine and a lot more!Let's make learning medicine more fun!

This is an image showing External Ventricular Drainage.Ideally placed at the frontal horn of Lateral VentricleCan you co...
10/02/2026

This is an image showing External Ventricular Drainage.
Ideally placed at the frontal horn of Lateral Ventricle

Can you comment the indication of such a drainage device?

Can you say the finding in the given CT Aortogram?And also the murmur that can be expected in such patient?
30/01/2026

Can you say the finding in the given CT Aortogram?
And also the murmur that can be expected in such patient?

*Left Thalamic Bleed**Clinical Features*1.Loss of all modalities of sensation in right side of body including face(VPL &...
30/01/2026

*Left Thalamic Bleed*

*Clinical Features*

1.Loss of all modalities of sensation in right side of body including face(VPL & VPM nucleus involvement respectively)

2.Thalamic sensory syndrome (Dejerine–Roussy) – later
Initially numbness
Weeks later → severe burning, unpleasant pain on the right side
Pain is disproportionate, stimulus-induced, emotionally disturbing

3.Right Sided Homonymous Hemianopia
if the posterior thalamus is involved

4.Mild Right sided Hemiparesis due to surrounding edema compressing on internal capsule

13/01/2026

Renal Transplant.

11/01/2026

*Ionised Calcium in ABG*

1.12 – 1.32 mmol/L

< 1.10 mmol/L → ionized hypocalcemia
> 1.32 mmol/L → ionized hypercalcemia

Ionized calcium is the physiologically active fraction

Preferred over total calcium in:
ICU patients
Acid–base disturbances
Hypoalbuminemia

Low iCa²⁺ → ↓ myocardial contractility, hypotension, arrhythmias

*Normal Pressure Hydrocephalus*Can you name the classic Triad associated with the disease and its components?⚡Imaging (M...
27/12/2025

*Normal Pressure Hydrocephalus*

Can you name the classic Triad associated with the disease and its components?

⚡Imaging (MRI Brain)

Image 1: Ventriculomegaly out of proportion to atrophy

Image 2: Evans index > 0.30

Image 3: Tight high-convexity sulci

Image 4: DESH(Disproportionately Enlarged SubArachnoid Space Hydrocephalus) pattern

Dilated Sylvian fissures

07/11/2025

Petechial Spots is a sign of platelet type of bleeding disorder

Based on size,various types of bleeding spots classified as:

Petechiae: < 2 mm

Purpura: 2 mm – 1 cm

Ecchymosis: > 1 cm

30/10/2025

FALSE LOCALISING SIGN IN NEUROLOGY

This patient has been diagnosed as a case of viral meningoencephalitis

Note the Left sided LR palsy

It is due to the involvement of the 6th Cranial Nerve,which has the longest intracranial course.

Hence it is susceptible to compression or stretching in conditions with raised ICP

As the ICP gradually decreases, the palsy usually recovers spontaneously.

Therefore, 6th nerve palsy due to raised ICP is considered a false localising sign in neurology — it reflects raised ICP rather than a true focal lesion at the nerve nucleus.

28/10/2025

*DVT Treatment Summarised*

•Normal renal function → NOAC preferred

•Mild–moderate renal impairment (eGFR 30–50) Apixaban preferred (least renal clearance)

•Renal dysfunction or ESRD → Warfarin

•Provoked → 3 months
Unprovoked → extended duration

27/10/2025

Management of *Gout in CKD* for GPs

🧠 Ventriculomegaly on NCCT Brain1️⃣ Ventricular DilatationFrontal horn width > 30 mm (normal ≤ 25 mm)Evans index > 0.3→ ...
27/10/2025

🧠 Ventriculomegaly on NCCT Brain

1️⃣ Ventricular Dilatation

Frontal horn width > 30 mm (normal ≤ 25 mm)

Evans index > 0.3
→ (Maximum width of frontal horns ÷ maximal internal skull diameter)

2️⃣ Temporal Horn Dilatation

Early and sensitive sign of hydrocephalus

Even mild ballooning suggests increased intraventricular pressure

3️⃣ Rounding of Frontal Horns

Normally slit-like; become rounded or ballooned in ventriculomegaly

NCCT Brain of TB Meningitis patient

Image 1: Shows the Evan's Index and Rounding of Frontal Horns

Image 2: Temporal Horn Dilatation

Management of *GOUT IN CKD* for GPs•Acute Attack- Prednisolone(preferred)>ColchicineAvoid NSAID•ProphylaxisUrice Acid Lo...
26/10/2025

Management of *GOUT IN CKD* for GPs

•Acute Attack-

Prednisolone(preferred)>Colchicine

Avoid NSAID

•Prophylaxis

Urice Acid Lowering Therapy(ULT)

Allopurinol(preferred)>Febuxostat

Remember risk of SJS with Allopurinol

Use Colchicine for initial 3-6months after starting ULT

To know in details click on this link of my youtube channel

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