Little Doctor

02/11/2020

15/09/2020

06/06/2020

Emergency steps💯

27/04/2020

This creepy, fictional figure is a version of the homunculus—it represents the weighted significance of our sensory receptors.

Learn how this concept plays a role in psychology: http://bit.ly/Homunclus

26/04/2020

Serum K+ < 3.5 mmol/L

:-
1) ↓ intake:-
☞ Dietary deficiency
☞ K+ free IV fluids

2) Redistribution into cells :-
☞ Alkalosis
☞ Insulin
☞ Catecholamine
☞ B2 agonist

3) ↑Urinary excretion(Urine K > 20-30 mmol/L)
* Activation of Mineralocorticoid receptors :-
☞ Conn's syndrome
☞ Cushing syndrome
☞ Glucocorticoid excess
☞ Carbenoxelone

* Genetic disorder :-
☞ Liddle's syndrome
☞ Bartter syndrome
☞ Gitelman's syndrome
☞ RTA (type I & II)
☞ Acetazolamide
☞ Diuretics :- loop , thiazides

* Increase GI loss :- ( Urine K < 20-30mmol/L)
☞Upper GI:- Vomiting , NG aspiration
☞ Lower GI :- Diarrhoea , laxative abuse , villous adenoma , Bowel obstruction

:-
(3.0-3.3)
☞ Asymptomatic
reduction < 3.0
☞ Muscular weakness
☞ Tiredness
☞ Ventricular ectopic beats
☞ Arrhythmias
☞ Functional bowel obstruction
☞ Renal tubular damage
☞ polyuria , polydypsia
☞ :- Flattened T-wave , U wave , ST dep

:-
☞ Plasma Electrolytes
☞ Bicarbonate
☞ Urine K
☞ Plasma Ca
☞ Mg level
☞ Plasma renin

If kidney is route then urine K > 30
If GI is route then urine K < 20

:-
☞ Treat the underlying cause
☞ Slow release K-Cl tablets
☞ In acute case → Iv KCl
☞ K bicarbonate
☞ Mg supplements
☞ K sparring diuretics → Amiloride

25/04/2020

> 5 mmol/L

:-
☞ Hemolysis during venepuncture
☞ Hemolysis in vitro
☞ Thrombocytosis / Leukocytosis
☞ ↑ K+ intake
☞ Acidosis
☞ Insulin def
☞ severe hyperglycemia
☞ Beta adrenergic blockers
☞ Rhabdomylosis
☞ severe hemolysis
☞ Tumour lysis syndrome
☞ ↓Urine excretion :-
* Acute kidney inj , chronic kid inj
* Reduce mineralocorticoid
* Addison's disease
* Congenial adrenal hyperplasia
* Isolated aldosterone def
* ACEI / ARBs
* Spirolonolactone , Eplerenone
* Heparin , NSAIDs
* Interstitial nephritis
* Diabetic nephropathy
* obstructive uropathy

:-
☞ Nausea , Vomiting
☞ Interstitial colic
☞ Progressive muscle weakness
☞ Flaccid paralysis
☞ Cardiac Arrhythmias
☞ :- Tall peaked T-wave , wide QRS
Prolonged PR interval

:-
☞ Electrolytes level
☞ Creatinine
☞ bicarbonate
☞ Plasma sodium ( in aldosterone def)
☞ ECG

:-
level < 6.5 mmol/L :-
☞ reduce intake of K
> 6.5-7.0
1) Stabilize cell membrane potential:-
☞ IV calcium gluconate (10 ml of 10% sol)

2) Shift K into cells:-
☞ Inhaled B2 adrenoceptor agonist
☞ IV glucose (50 ml of 50% sol )
☞ Insulin (5 IU )
☞ Iv sodium bicarbonate

3) Remove K from body:-
☞ IV furosemide and Normal saline
☞ Ion-exchange resin (Resonium)
☞ dialysis

25/04/2020

It is to announce with heavy heart that Prof. Muhammad Javed of ENT department Hayatabad Medical Complex Peshawar, lost his battle against , he is no more with us. He met his Creater today early morning.
May GOD give him highest Rankin in jannat.

24/04/2020

The most authentic dhikr (remembrance) at the time of breaking fast.

But it is preferable to diversify one’s supplications, between the aforementioned and those that are of interest to a person concerning his religion and worldly life — without restriction.

-Shaykh Abdul Aziz At-tarefe.

24/04/2020

Covid19' sty home sty safe😇

23/04/2020

:-
When HCO3- < 24 mmol/L , PCO2 < 5.33 kPa2
Blood H+ > 40 nmol/L , PH < 7.35

:-
1) :-
☞ Ingestion or infusion of inorganic acid (HCl , NH4Cl)
☞ GI Hco3 loss ( diarrhea , small bowel fistula)
☞ Renal tubular acidosis

2) :-

☞ DKA
☞ Starvation Ketoacidosis
☞ Alcoholic Ketoacidosis
☞ Lactic acidosis
☞ kidney disease

☞ Aspirin poisoning
☞ Methanol poisoning
☞ Ethylene glycol poisoning

:-
☞ Nausea , Vomiting
☞ diarrhea
☞ Confusion
☞ loss of consciousness
☞ Arrhythmias
☞ Increase heart rate
☞ Increase Resp rate

:-
☞ Blood gas measurement
☞ Creatinine
☞ Bicarbonate level
☞ Electrolytes :- Potassium level
☞ acid challenge test
☞ Urine PH
☞ ketone (blood & urine)
☞ blood glucose
☞ Plasma lactate


:-
☞ diarrhea :- fluid
☞ lactic acidosis :- restore oxygenation & tissue perfusion
☞ Salicylate pois :- Vigorous gastric lavage with isotonic saline , activated charcoal
☞ Ethanol intox :- Osmotic diuresis , thiamine , fomepizole
☞ Diabetic KA :- Iv fluid , insulin
☞ Alcoholism & starvation KA :- Iv glucose
☞ Type I & II RTA :- Sodium & potassium bicarbonate
☞ type IV RTA :- loop diuretics , thiazides or Fludrocortisone

When PH < 7.00 or H+ > 100 nmol/L

For Renal failure