Friday, April 28, 2017

ABC Survey On Emergency Patient

ABC Survey Consist of :

  • Primary survey
  • Secondary survey
  • History
  • Others


During the initial assessment, as one moves sequentially through the mnemonic ABCDE, life-threatening conditions are diagnosed and corrected at each stage.

A - Upper airway is established and maintained with cervical spine control
B - Breathing (or the adequecy of air exchange) is evaluated and established
C - Circulation - BP is evaluated and corrected, and bleeding is arrested
D - Deficits of neurologic function are identified, and treatment is initiated (AVPU)
E - Exposure is obtained by completely undressing the patient

A - Upper airway is established and maintained with cervical spine control

Cervical spine control

All patients presenting with abnormalities of mental status after trauma, however subtle, must be assumed to have injuries to the cervical spine --> hard cervical collar & manual maintenance of the head in the neutral position. Immobilization must be maintained until radiologic visualization of C1-C7 (and T1?) is complete and determined to be normal. Commonly, an initial view of the cervical spine demonstrates only the more proximal vertebrae; this must never be interpreted as a normal study, and an additional view must be taken while downward traction is applied to the forearms. If the distal vertebrae remain nonvisualized with this maneuver, a swimmer’s view should be obtained.

Friday, March 31, 2017


Trichomonas vaginalis - Ilustration
Trichomoniasis is the most common nonviral sexually transmitted infection (STI). Approximately 5 million women in the United States are infected annually. This may actually be an underestimate of the incidence of trichomoniasis. Screening methods are relatively insensitive and this infection is often not reported. It is caused by a protozoan, Trichomonas vaginalis. Infection with T vaginalis is easily transmitted sexually and is associated with an increased risk of acquiring HIV. The mechanism of action is thought to be an increase in the vaginal secretions of CD4+ cells, which serve as target cells for the HIV virus. Furthermore, trichomoniasis infection is also associated with coinfection with other STIs.


Thursday, March 30, 2017

Management of Nephrotic Syndrome in Adult

Nephrotic Syndrome
By Laurie Barclay, MD

Recommendations for primary care clinicians regarding the diagnosis and treatment of nephrotic syndrome in adults are reviewed in the November 15 issue of the American Family Physician.

"In nephrotic syndrome, a variety of disorders cause proteinuria, often resulting in marked edema and hypoalbuminemia," write Charles Kodner, MD, from the University of Louisville School of Medicine in Louisville, Kentucky. "Hyperlipidemia is a common associated finding. Family physicians may encounter persons with nephrotic syndrome from primary (idiopathic) renal disease or a number of secondary causes, and should initiate appropriate diagnostic workup and medical management pending specialist consultation."

Nephrotic syndrome may be classified as primary (or idiopathic) renal disease, or it may be secondary to various causes. The most common primary causes in adults are focal segmental glomerulosclerosis and membranous nephropathy.

Wednesday, March 29, 2017



Amoebiasis is an infection of the large intestine produced by Entamoeba histolytica.

There are 7 species of amoeba that naturally parasitize the human mouth and intestine, but of these only E. histolytica causes disease. The organism may behave as a parasite (by harming the host) or as a commensal (when it does no harm to the host).


Worldwide distribution

It is estimated that 10% of the world’s population is infected with amoebae. More prevalent in tropical areas where invasive amoebic infection is common. The presence of pathological zymodemes in tropics and poor sanitation is responsible for this state of affairs.

Vulvovaginal Candidiasis

Vulvovaginal Candidiasis
Vulvovaginal Candidiasis (VC) is the most common cause of infectious vaginitis, accounting for between 40% and 50% of all cases. It may cause genital discomfort, loss of productivity, reduced sexual pleasure, psychological problems, and medical expenses.[36] Seventy-five percent of reproductive-age women will have at least one episode of VC in their lifetime, and 40% to 45% will have two or more episodes.[1,38]

Candidal infection is most often caused by Candida albicans, a fungal organism that is a part of the normal flora of the vagina of reproductive-age woman, but causes >90% of cases of symptomatic vaginitis. However, infection can also be caused by other species, such as C glabrata and C tropicalis. The latter two types often are more resistant to treatment.[25] The relationship between colonization of the vagina (growth of C albicans on vaginal culture) and vaginitis symptoms is not understood. Certain factors are predictive of yeast colonization: positive HIV status, having diabetes, recent IV drug use, and recent antibiotic use.[1,37] It is thought that other host factors play a role in whether or not women are symptomatic because a large number of women who are colonized have no symptoms.[37] VC is classified as uncomplicated or complicated based on frequency, symptoms, microbiology, and response to treatment ( Table 3 ).

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