Amir's Medical Notes

21/01/2022

Acute Coronary Syndrome(ACS) Mnemonic😍

Feel free to click this link to read on ACS on my blog 🙈

https://amirruddi96.blogspot.com/2022/01/acute-coronary-syndrome-acs-mnemonic.html?m=1

https://amirruddi96.blogspot.com/2022/01/acute-coronary-syndrome-acs-mnemonic.html?m=1

https://amirruddi96.blogspot.com/2022/01/acute-coronary-syndrome-acs-mnemonic.html?m=1

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07/09/2021

7 cardinal movement in labour

08/08/2021

🎄COMMON causes of finger clubbing: ICE ABCDEF CiLL 👉👈

(CLubbing- CVS & Lungs,most commonly).

❤️ICE from CVS:
-IE
-Cyanotic heart dss
-Eisenmenger syndrome

🌬️ABCDEF from Respi:
-Abcess (or asbestosis)
-Bronchiectasis
-Cancer of lungs(broncho ca,mesothelioma) (or C for cystic fibrosis)
-Diffuse alveolar fibrosis
-Empyema
-Fibrosis

🥑CILL (chill) from GIT
Celiac dss
IBD (UC,Crohn's)
Lymphoma of GI
Liver Cirrhosis

29/07/2021

🍾Chronic venous insufficiency(CVI)

Causes
➡️Obstruction of venous flow
➡️Dysfunction of venous valve
➡️Failure of venous pump

Manifestation of CVI:
1️⃣Venous dilatation: telangiectasia,reticular vein, varicosities,corono phlebectactica
2️⃣Skin changes: hyperpigmentation,atrophie blanche,venous stasis eczema,lipodermatosclerosis,cellulitis
3️⃣Pitting edema(hallmark of CVI)
4️⃣Venous ulcer formation

❤️Associated symptoms:
➡️Leg fullness
➡️Aching discomfort
➡️Heaviness
➡️Nocturnal leg cramps
➡️Bursting pain upon standing

🎄CEAP Classification for CVI:
C0: no changes
C1: telangiectasia, reticular vein
C2: varicose vein
C3: edema
C4A: pigmentation and/or eczema
C4B: lipodermatosclerosis and/or atrophie blanche(white sclerosis)
C5: healed ulcer
C6: active ulceration

27/07/2021

🎄Acute diverticulitis

Symptoms:
Fever
Left lower quadrant pain
Abdominal mass
Hematochezia

Classification: Hinchey classification

22/07/2021

😫 Peptic ulcer disease(PUD)

✅Risk factors:
H.pylori
NSAIDs
Smoking
Alcohol

✅Symptoms:
Hematemesis
Epigastric pain
Hunger pain(duodenal ulcer)
Eating pain(gastric ulcer)

✅Investigation:
Oesophagogasteoduodenoscopy(OGDS)
CLO test(yellow to red)
CXR: air under diaphragm(perforation)

🎄 Forest classification for Peptic Ulcer Disease : risk of rebleeding

✅Management:
Stop aetiological factors

H.pylori eradication: Omeprazole,amoxicilin,clarithromycin

OGDS: if bleeding
Epinephrine injection
Heater probe
Hemo clip

Surgery:
If perforation small: omental patch
If perforation very big: gastrectomy with Bilroth II

✅Complications:
Bleeding
Perforation
Gastric outlet obstruction

17/07/2021

❤️Malaria
*Notifiable disease

✅Mosquito: female anopheles

✅Organisms:
P.knowlesi
P.falciparum
P.malariae
P.vivax
P.ovale

✅Investigation :
Blood fillm for malaria parasit(BFMP)
1️⃣Thin smear: identify malarial species
2️⃣Thick smear: detect malarial parasite

✅Complications:
Cerebral malaria
Anemia
ARDS
Renal failure
Hypoglycemia
Shick
Coagulopathy
Acute pulmonary edema
Convulsion

*Referred from Management Guidelines Of Malaria In Malaysia

17/07/2021

❤️ Leptospirosis(kencing tikus)
*Notifiable disease

✅History: rodents sighting, river

✅Organism: Leptospira interrogans

✅Clinical manifestation:
1️⃣mild influenza like ilness
2️⃣ Weil's syndrome: jaundice,renal failure,hemorrhage,myocarditis,arrhythmia
3️⃣meningitis/meningoencephalitis
4️⃣pulmonary hemorrhage with respiratory failure

✅Investigation:
Microscopic agglutinin test(gold standard)
➡️Single serum specimen => 1:400
➡️Paired sera: more than 4 folds increase in titre

✅Antibiotics:
Adults: Severe(C penicillin), less severe(Doxycycline)
Paediatrics: Penicillin G

*Referred from GUIDELINES FOR THE DIAGNOSIS,
MANAGEMENT, PREVENTION AND CONTROL OF LEPTOSPIROSIS IN MALAYSIA

17/07/2021

Notifiable disease in Malaysia

16/07/2021

❤️Melioidosis

✅Organism: Burkholderia pseudomallei
*Older name is Pseudomonas pseudomallei
*Common infection in Pahang and also other Pantai Timur states
*Can be found in contaminated soil

✅Risk factors:
DM
Farmer(agricultural related)
Chronic lung disease, chronic renal failure, liver disease

✅Presentations:
Pneumonia
Septicemia
Pyrexia of unknown origin
Septic arthritis
Liver abscess(need to do US)- if abscess more than 5cm X 5cm, refer to surgeon for drainage

✅Investigation:
Blood culture

✅Management:
Ceftazidime
Notify disease to PKD

*From Guidelines for Clinical and Public Health Management of Melioidosis in Pahang

14/07/2021

🌩️Rheumatoid Arthritis

➡️5 syndromes associated with RA:
✅KFC N Sos by SANTA✅

1.K(c)arpal tunnel syndrome

2.Felty syndrome : SANTA

-Splenomegaly
-Anemia
-Neutropenia
-Thrombocytopenia
-Arthritis

3.CaPlan syndrome

P-rheumatoid Pneumoconiosis(lung fibrosis)
Sx:cough, SOB

4.NePHROTic syndrome

Features:PHRO
PROTEINURIA
HYPOALBUMINEMIA
RAISED LIPID
OEDEMA

Cx: TIC
Thrombosis
Infection
Cholesterol and TG high

5.Sjogren syndrome
Lymphocytic infiltration of exocrine gland
-dy eye, dry tongue
-parotid enlargement