Lithium toxicity HY
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Lithium toxicity can occur from acute overdose or chronic use. Acute toxicity presents with gastrointestinal issues like nausea and vomiting, while chronic toxicity presents with neurological symptoms like lethargy, confusion, and ataxia. Treatment involves intravenous hydration and hemodialysis in severe cases to remove lithium from the body and decrease toxicity.
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Gout
GoutNarayan Medical College, Gopal Narayan Singh University
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Crystal deposition diseases like gout result from the buildup of crystals in the joints and surrounding tissues. Gout is caused by elevated uric acid levels leading to monosodium urate monohydrate crystal deposition. It most commonly affects middle-aged men and post-menopausal women. Acute gout causes sudden, severe joint pain and swelling, while chronic gout results in recurrent attacks, joint stiffness, deformity, and tophi formation. Treatment involves lifestyle changes to reduce uric acid along with medications like NSAIDs for acute flares and allopurinol or colchicine for long-term management.Gout and other crystal deposit diseases
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This document discusses gout and other crystal deposition diseases. It describes gout as a disorder of purine metabolism that results in monosodium urate monohydrate crystal deposition in joints, tendons and other tissues, causing inflammation. There are two main types of gout: primary gout due to overproduction or underexcretion of uric acid, and secondary gout associated with conditions like myeloproliferative disorders or renal failure. Acute gout causes sudden, severe joint pain while chronic gout leads to increased stiffness, deformity and tophi formation. Diagnosis involves synovial fluid analysis identifying urate crystals. Treatment involves NSAIDs for acute flares and allopurinol to reduceVaccines during pregnancy HY
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Vaccines during pregnancy are recommended for Tdap, inactive influenza, and Rho(D) immunoglobulin. Hepatitis B, hepatitis A, pneumococcus, haemophilus influenzae, meningococcus, and varicella-zoster immunoglobulin are indicated for high-risk patients. HPV, MMR, live attenuated influenza, and varicella are contraindicated during pregnancy.Urinary tract infection in children HY
Urinary tract infection in children HYRickettsia Rickettsii
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Urinary tract infections in children can be caused by female sex, uncircumcised males, anatomical defects, dysfunctional voiding, or constipation. Symptoms include dysuria, fever, and pain in the bladder area or back/flank. Diagnosis involves finding white blood cells and bacteria in the urine. Treatment is with antibiotic therapy and sometimes additional imaging tests.Uric acid kidney stones HY
Uric acid kidney stones HYRickettsia Rickettsii
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Uric acid kidney stones can form when urine is too acidic, causing uric acid to precipitate into crystals and stones. Risk factors include gout, dehydration, and conditions causing low urine pH like diarrhea or diabetes. Treatment involves raising urine pH through potassium citrate to keep uric acid dissolved in the urine and prevent stone formation.Tourette syndrome HY
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Tourette syndrome is a disorder characterized by both multiple motor and at least one vocal tic occurring for over one year. Common motor tics include facial grimacing and head jerking, while vocal tics include grunting and yelling. Treatment options include behavioral therapy, medications that impact dopamine such as antipsychotics and tetrabenazine, and alpha-2 adrenergic receptor agonists.Systemic lupus erythematosus HY
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The patient presented with multiple stomach ulcers and thickened gastric folds. To check for a possible gastrinoma, doctors measured the patient's serum gastrin level after stopping proton pump inhibitor therapy for a week, and performed a secretin stimulation test. Based on the results, further testing was recommended to localize a gastrinoma.Spikes protocol for delivering serious news HY
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The SPIKES protocol outlines six steps for delivering serious medical news to patients and their families: set the stage by arranging a private setting and introducing everyone; assess their perception of the situation; invite them to share how much information they want; provide knowledge of the situation in a clear and empathetic manner while checking for understanding; express empathy in response to emotions; and summarize by creating a follow-up plan.Side effects & risks of combination oral contraceptives HY
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Combination oral contraceptives can cause side effects like breakthrough bleeding, breast tenderness, nausea, bloating, and amenorrhea. They also carry risks such as hypertension, blood clots, and increased triglycerides. However, combination oral contraceptives decrease the risk of ovarian and endometrial cancers while increasing the risk of cervical cancer.Scurvy (vitamin c deficiency) HY
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Scurvy is caused by vitamin C deficiency due to insufficient dietary intake of citrus fruits and vegetables. It commonly affects those with alcohol or substance use disorders and severe malnutrition. Symptoms include skin hemorrhages, bleeding gums, joint pain, fatigue, and impaired wound healing. Treatment involves oral or injected vitamin C supplementation, which resolves most symptoms within days, though excessive doses can cause side effects like abdominal pain.Retroperitoneal abdominal organs HY
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This document lists retroperitoneal abdominal organs such as the adrenal glands, aorta, inferior vena cava, parts of the duodenum, pancreas, ureters, parts of the colon, kidneys, esophagus, and parts of the rectum. It provides a mnemonic - SAD PUCKER - to help remember these retroperitoneal organs and notes that some organs like the duodenum, pancreas and colon are secondarily retroperitoneal having developed intraperitoneally and migrated retroperitoneally.Red blood cell transfusion thresholds HY
Red blood cell transfusion thresholds HYRickettsia Rickettsii
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This document provides recommendations for red blood cell transfusion thresholds based on hemoglobin levels. Transfusions are generally indicated for hemoglobin levels below 7 g/dL, may be considered for levels between 7-8 g/dL depending on factors like cardiac surgery or cancer treatment, and are not generally recommended above 10 g/dL.Panic disorder HY
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Panic disorder is characterized by recurrent, unexpected panic attacks involving physical symptoms like chest pain, palpitations, shortness of breath, trembling, and feelings of choking, as well as cognitive symptoms such as fear of losing control or dying. Treatment involves first-line therapies of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) and/or cognitive-behavioral therapy for maintenance, and benzodiazepines can be used for acute distress from panic attacks.Normal postpartum lochia HY
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Lochia rubra lasts from birth to 3-4 days postpartum and consists of dark or bright red blood and clots. Lochia serosa lasts from days 4-10 or 14 and is pink or brown blood that gradually decreases. Lochia alba lasts from days 11-6 weeks and is white or yellow and light in quantity. Lochia may increase with breastfeeding or sloughing of the placental site scab around days 7-14.Noninvasive positive pressure ventilation HY
Noninvasive positive pressure ventilation HYRickettsia Rickettsii
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Noninvasive positive pressure ventilation (NPPV) is recommended for patients with severe COPD exacerbation, cardiogenic pulmonary edema, acute respiratory failure, postoperative hypoxemic respiratory failure, and immunosuppressed patients to facilitate early extubation. Contraindications for NPPV include medical instability such as cardiac or respiratory arrest, severe acidosis, acute respiratory distress syndrome, nonrespiratory organ failure, unstable cardiac arrhythmias or hemodynamic instability, encephalopathy, or gastrointestinal bleeding. Inability to protect the airway due to being uncooperative, agitated, or unable to clear secretions with a high aspiration risk are also contraindications. Mechanical issues like a recent esophageal anastomosis orManagement of endometriosis HY
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This document provides guidance on managing endometriosis. It lists symptoms that could indicate suspected endometriosis such as chronic pelvic pain, painful periods, painful sex, and painful bowel movements. For patients with suspected endometriosis, the document recommends considering over-the-counter pain relievers and birth control pills initially, and performing a laparoscopy if symptoms do not improve or if there are concerns about infertility, medical contraindications, need for diagnosis, or potential malignancy.Lung cancer HY
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This document discusses the four main types of lung cancer: adenocarcinoma, squamous cell carcinoma, small cell carcinoma, and large cell carcinoma. It provides information on the incidence, typical location in the lungs, and common clinical associations for each type of lung cancer. Adenocarcinoma makes up 40-50% of lung cancers and is usually located in the periphery of the lungs. Squamous cell carcinoma accounts for 20-25% of cases and is typically central. Small cell carcinoma comprises 10-15% of lung cancers and is also usually central. Large cell carcinoma represents 5-10% of lung cancers and tends to be peripheral.Leukocyte adhesion deficiency HY
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Leukocyte adhesion deficiency is caused by a defect in CD18-containing integrins, which impairs leukocyte adhesion and endothelial transmigration. This results in recurrent skin and mucosal infections without pus formation, impaired wound healing, and delayed umbilical cord separation beyond 3 weeks of age. Laboratory findings include leukocytosis and neutrophilia.Intrauterine fetal demise HY
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Intrauterine fetal demise is defined as fetal death at 20 weeks or later. It is diagnosed by the absence of fetal cardiac activity on ultrasound. Management depends on gestational age - between 20-23 weeks dilation and evacuation or vaginal delivery is recommended, while at 24 weeks or later vaginal delivery is recommended, though cesarean delivery is an option based on maternal history. A complication can be coagulopathy if the fetus is retained for several weeks.Infectious mononucleosis HY
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Factors associated with a poor outcome after witnessed out-of-hospital sudden cardiac arrest include an initial rhythm of pulseless electrical activity or asystole, time elapsed prior to effective resuscitation through delayed bystander CPR or defibrillation, prolonged CPR lasting over 5 minutes, absence of vital signs after CPR, advanced age, prior history of cardiac disease, having two or more chronic illnesses, remaining in a coma after CPR, and developing pneumonia, renal failure, sepsis, stroke, or severe heart failure after receiving CPR.Evaluation of subacute or chronic cough HY
Evaluation of subacute or chronic cough HYRickettsia Rickettsii
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Endometriosis is caused by ectopic implantation of endometrial glands. It causes chronic pelvic pain, dysmenorrhea, dyspareunia, and can lead to infertility. Diagnosis involves direct visualization and biopsy during laparoscopy, while treatment options include oral contraceptives, NSAIDs, or surgical resection to remove lesions.Contact dermatitis HY
Contact dermatitis HYRickettsia Rickettsii
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This document discusses contact dermatitis, which can be allergic or irritant in nature. Allergic contact dermatitis is a type IV hypersensitivity reaction, while irritant contact dermatitis results from physical or chemical irritation. Common triggers include plants like poison ivy, nickel, rubber, leather dyes, soaps, chemicals and medications. Symptoms typically appear on exposed skin as well-demarcated erythema, papules, vesicles or chronic lichenification, often on the hands presenting as erythema and fissures.Common etiologies of chronic cough HY
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This document outlines the common causes of chronic cough, which include upper airway disorders such as upper airway cough syndrome and chronic sinusitis, lower airway and parenchymal disorders such as asthma, chronic bronchitis and bronchiectasis, as well as other causes such as gastroesophageal reflux and ACE inhibitors.
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Combination oral contraceptives can cause side effects like breakthrough bleeding, breast tenderness, nausea, bloating, and amenorrhea. They also carry risks such as hypertension, blood clots, and increased triglycerides. However, combination oral contraceptives decrease the risk of ovarian and endometrial cancers while increasing the risk of cervical cancer.Scurvy (vitamin c deficiency) HY
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Scurvy is caused by vitamin C deficiency due to insufficient dietary intake of citrus fruits and vegetables. It commonly affects those with alcohol or substance use disorders and severe malnutrition. Symptoms include skin hemorrhages, bleeding gums, joint pain, fatigue, and impaired wound healing. Treatment involves oral or injected vitamin C supplementation, which resolves most symptoms within days, though excessive doses can cause side effects like abdominal pain.Retroperitoneal abdominal organs HY
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This document lists retroperitoneal abdominal organs such as the adrenal glands, aorta, inferior vena cava, parts of the duodenum, pancreas, ureters, parts of the colon, kidneys, esophagus, and parts of the rectum. It provides a mnemonic - SAD PUCKER - to help remember these retroperitoneal organs and notes that some organs like the duodenum, pancreas and colon are secondarily retroperitoneal having developed intraperitoneally and migrated retroperitoneally.Red blood cell transfusion thresholds HY
Red blood cell transfusion thresholds HYRickettsia Rickettsii
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This document provides recommendations for red blood cell transfusion thresholds based on hemoglobin levels. Transfusions are generally indicated for hemoglobin levels below 7 g/dL, may be considered for levels between 7-8 g/dL depending on factors like cardiac surgery or cancer treatment, and are not generally recommended above 10 g/dL.Panic disorder HY
Panic disorder HYRickettsia Rickettsii
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Panic disorder is characterized by recurrent, unexpected panic attacks involving physical symptoms like chest pain, palpitations, shortness of breath, trembling, and feelings of choking, as well as cognitive symptoms such as fear of losing control or dying. Treatment involves first-line therapies of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) and/or cognitive-behavioral therapy for maintenance, and benzodiazepines can be used for acute distress from panic attacks.Normal postpartum lochia HY
Normal postpartum lochia HYRickettsia Rickettsii
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Lochia rubra lasts from birth to 3-4 days postpartum and consists of dark or bright red blood and clots. Lochia serosa lasts from days 4-10 or 14 and is pink or brown blood that gradually decreases. Lochia alba lasts from days 11-6 weeks and is white or yellow and light in quantity. Lochia may increase with breastfeeding or sloughing of the placental site scab around days 7-14.Noninvasive positive pressure ventilation HY
Noninvasive positive pressure ventilation HYRickettsia Rickettsii
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Noninvasive positive pressure ventilation (NPPV) is recommended for patients with severe COPD exacerbation, cardiogenic pulmonary edema, acute respiratory failure, postoperative hypoxemic respiratory failure, and immunosuppressed patients to facilitate early extubation. Contraindications for NPPV include medical instability such as cardiac or respiratory arrest, severe acidosis, acute respiratory distress syndrome, nonrespiratory organ failure, unstable cardiac arrhythmias or hemodynamic instability, encephalopathy, or gastrointestinal bleeding. Inability to protect the airway due to being uncooperative, agitated, or unable to clear secretions with a high aspiration risk are also contraindications. Mechanical issues like a recent esophageal anastomosis orManagement of endometriosis HY
Management of endometriosis HYRickettsia Rickettsii
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This document provides guidance on managing endometriosis. It lists symptoms that could indicate suspected endometriosis such as chronic pelvic pain, painful periods, painful sex, and painful bowel movements. For patients with suspected endometriosis, the document recommends considering over-the-counter pain relievers and birth control pills initially, and performing a laparoscopy if symptoms do not improve or if there are concerns about infertility, medical contraindications, need for diagnosis, or potential malignancy.Lung cancer HY
Lung cancer HYRickettsia Rickettsii
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This document discusses the four main types of lung cancer: adenocarcinoma, squamous cell carcinoma, small cell carcinoma, and large cell carcinoma. It provides information on the incidence, typical location in the lungs, and common clinical associations for each type of lung cancer. Adenocarcinoma makes up 40-50% of lung cancers and is usually located in the periphery of the lungs. Squamous cell carcinoma accounts for 20-25% of cases and is typically central. Small cell carcinoma comprises 10-15% of lung cancers and is also usually central. Large cell carcinoma represents 5-10% of lung cancers and tends to be peripheral.Leukocyte adhesion deficiency HY
Leukocyte adhesion deficiency HYRickettsia Rickettsii
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Leukocyte adhesion deficiency is caused by a defect in CD18-containing integrins, which impairs leukocyte adhesion and endothelial transmigration. This results in recurrent skin and mucosal infections without pus formation, impaired wound healing, and delayed umbilical cord separation beyond 3 weeks of age. Laboratory findings include leukocytosis and neutrophilia.Intrauterine fetal demise HY
Intrauterine fetal demise HYRickettsia Rickettsii
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Intrauterine fetal demise is defined as fetal death at 20 weeks or later. It is diagnosed by the absence of fetal cardiac activity on ultrasound. Management depends on gestational age - between 20-23 weeks dilation and evacuation or vaginal delivery is recommended, while at 24 weeks or later vaginal delivery is recommended, though cesarean delivery is an option based on maternal history. A complication can be coagulopathy if the fetus is retained for several weeks.Infectious mononucleosis HY
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Infectious mononucleosis is characterized by fever, tonsillitis or pharyngitis that may have exudates, enlarged lymph nodes in the neck, fatigue, and possibly enlargement of the liver and spleen. Complications can include airway obstruction, autoimmune conditions affecting red blood cells or platelets, and rupture of the spleen.Indications for urgent dialysis (aeiou) HY
Indications for urgent dialysis (aeiou) HYRickettsia Rickettsii
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Acidosis, electrolyte abnormalities, ingestion of toxic substances, overload states, and uremia are indications for urgent dialysis according to the AEIOU mnemonic. Specifically, metabolic acidosis with a pH below 7.1, hyperkalemia causing ECG changes or arrhythmias, ingestion of toxic alcohols, volume overload refractory to diuretics, and uremia causing encephalopathy, pericarditis or bleeding require immediate dialysis treatment.Hemophilia A & B HY
Hemophilia A & B HYRickettsia Rickettsii
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Hemophilia A and B are X-linked recessive bleeding disorders caused by deficiencies in clotting factor VIII or IX. Patients experience prolonged or delayed bleeding after minor injuries, joint bleeding, internal bleeding, and risk of intracranial hemorrhage. Diagnosis is made through laboratory tests showing increased activated partial thromboplastin time and absent or decreased factor VIII or IX activity levels. Treatment involves replacing the deficient clotting factor through intravenous administration.Factors associated with poor outcome after witnessed out of-hospital sudden c...
Factors associated with poor outcome after witnessed out of-hospital sudden c...Rickettsia Rickettsii
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Factors associated with a poor outcome after witnessed out-of-hospital sudden cardiac arrest include an initial rhythm of pulseless electrical activity or asystole, time elapsed prior to effective resuscitation through delayed bystander CPR or defibrillation, prolonged CPR lasting over 5 minutes, absence of vital signs after CPR, advanced age, prior history of cardiac disease, having two or more chronic illnesses, remaining in a coma after CPR, and developing pneumonia, renal failure, sepsis, stroke, or severe heart failure after receiving CPR.Evaluation of subacute or chronic cough HY
Evaluation of subacute or chronic cough HYRickettsia Rickettsii
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This document provides guidance on evaluating patients presenting with subacute or chronic cough lasting 3-8 weeks or longer. It recommends first considering the suspected etiology based on history and exam, then evaluating and treating accordingly, such as stopping ACE inhibitors, using antihistamines for upper airway cough, or testing for asthma. If the cough does not improve after intervention, further testing with chest X-ray is suggested to check for underlying lung disease.Endometriosis HY
Endometriosis HYRickettsia Rickettsii
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Endometriosis is caused by ectopic implantation of endometrial glands. It causes chronic pelvic pain, dysmenorrhea, dyspareunia, and can lead to infertility. Diagnosis involves direct visualization and biopsy during laparoscopy, while treatment options include oral contraceptives, NSAIDs, or surgical resection to remove lesions.Contact dermatitis HY
Contact dermatitis HYRickettsia Rickettsii
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This document discusses contact dermatitis, which can be allergic or irritant in nature. Allergic contact dermatitis is a type IV hypersensitivity reaction, while irritant contact dermatitis results from physical or chemical irritation. Common triggers include plants like poison ivy, nickel, rubber, leather dyes, soaps, chemicals and medications. Symptoms typically appear on exposed skin as well-demarcated erythema, papules, vesicles or chronic lichenification, often on the hands presenting as erythema and fissures.Common etiologies of chronic cough HY
Common etiologies of chronic cough HYRickettsia Rickettsii
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This document outlines the common causes of chronic cough, which include upper airway disorders such as upper airway cough syndrome and chronic sinusitis, lower airway and parenchymal disorders such as asthma, chronic bronchitis and bronchiectasis, as well as other causes such as gastroesophageal reflux and ACE inhibitors.Factors associated with poor outcome after witnessed out of-hospital sudden c...
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- 1. Lithium toxicity Etiology Acute toxicity Intentional overdose Chronic toxicity Decreased renal perfusion ( lithium clearance) Dehydration Thiazide diuretics, NSAIDs, ACE inhibitors Clinical features Acute toxicity Gastrointestinal: nausea, vomiting, diarrhea Late neurologic sequelae Chronic toxicity (neurologic) Lethargy, confusion, agitation Ataxia, tremor/fasciculations, seizure Treatment Intravenous hydration Hemodialysis (severe cases)