Dr Harshit Aggarwal

Hepatorenal Syndrome

Gastro and HepatoBilliary Critical Care​ / /

Hepatorenal Syndrome (HRS) Definition Hepatorenal syndrome (HRS) is a functional, potentially reversible acute kidney injury (AKI) occurring in patients with advanced cirrhosis and portal hypertension(Ascites), in the absence of intrinsic renal disease or structural kidney damage. Epidemiology  Occurs in advanced decompensated cirrhosis (often Child-Pugh C) Triggers: Refractory ascites Spontaneous bacterial peritonitis (SBP) Large-volume paracentesis without […]

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Alcoholic Hepatitis

Gastroenterology / /

Alcoholic Hepatitis  Definition Alcohol-associated hepatitis (AAH), formerly called alcoholic hepatitis, is an acute inflammatory liver injury occurring in patients with prolonged heavy alcohol consumption .It represents the most severe manifestation of alcohol-associated liver disease (ALD) and carries a high short-term mortality. Spectrum of Alcohol-Associated Liver Disease Stage Reversibility Clinical Significance Hepatic steatosis Completely reversible Earliest

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Hepatitis B

Uncategorized / /

Hepatitis B (HBV)  Introduction Hepatitis B is a DNA virus infection affecting the liver and remains one of the leading causes of: Chronic hepatitis Liver cirrhosis Hepatocellular carcinoma (HCC) Liver failure Need for liver transplantation HBV infection may present as: Acute hepatitis Chronic hepatitis Fulminant hepatic failure Inactive carrier state Occult infection Virus Characteristics Component

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Autoimmune Hepatitis

Gastroenterology / /

Autoimmune Hepatitis (AIH) Autoimmune hepatitis (AIH) is a chronic, progressive, immune-mediated inflammatory liver disease.It results from loss of tolerance to hepatic autoantigens, leading to T-cell–mediated hepatocyte injury. Needs Exclusion of other causes of hepatitis (viral, drug-induced, metabolic).  Pathophysiology 1. Immunogenetic Susceptibility HLA associations: AIH type 1: HLA-DR3, DR4 AIH type 2: HLA-DR7, DQ2 AIH type

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HYPONATREMIA

Fluid and Electrolytes / /

HYPONATREMIA   DEFINITION Hyponatremia = Serum Na⁺ < 135 mEq/L Most common electrolyte abnormality in ICU Severity classification Severity Serum Na⁺ Mild 130–134 Moderate 125–129 Severe <125  PATHOPHYSIOLOGY   Hyponatremia is fundamentally a disorder of water balance, NOT sodium deficit Excess ADH (vasopressin) → water retention → dilution of Na⁺ ADH PHYSIOLOGY Released from posterior pituitary Stimuli:

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Acute Exacerbation of COPD

Pulmonology Critical care / /

 Acute Exacerbation of COPD (AECOPD)  AECOPD by GOLD = An event characterized by worsening dyspnea, cough, and/or sputum production over less than 14 days, which may be accompanied by tachypnea and/or tachycardia and is often associated with increased local and systemic inflammation caused by airway infection, pollution, or other insults. Respiratory failure is usually due

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Community Acquired Pneumonia

Pulmonology Critical care / /

Community Acquired Pneumonia Community-acquired pneumonia (CAP) is an acute infection of the lung parenchyma occurring in a non-hospitalized individual or developing ≤48 hours of hospital admission, not residing in long-term care and without recent healthcare exposure. Category Definition Clinical relevance CAP Outside hospital or ≤48 hr admission Standard community pathogens HAP ≥48 hr after admission

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Septic Cardiomyopathy

Cardiac Critical care / /

Septic Cardiomyopathy (Sepsis-Induced Myocardial Dysfunction, SIMD)  Septic cardiomyopathy (SCM) is an acute, reversible myocardial dysfunction occurring during sepsis or septic shock(20–60% of septic shock patients), characterized by: Reduced myocardial contractility Ventricular dilatation Impaired response to fluid and catecholamines Usually recovers within 7–10 days in survivors SCM occurs without acute coronary artery occlusion and is caused

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Warfarin Induced Coagulopathy

Hemat Critical Care / /

Warfarin Induced Coagulopathy (Warfarin Over-Anticoagulation) Normal Vitamin K Cycle Vitamin K is required for γ-carboxylation of: Factors II, VII, IX, X Protein C Protein S Vitamin K is recycled by:Vitamin K epoxide reductase (VKORC1) Warfarin inhibits VKORC1.Factor VII falls first—>PT/INR rises within 24–36 hours.Maximum anticoagulant effect:≈ 5 days Causes of Warfarin-Induced Coagulopathy 1. Excess Dose

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Intracerebral Hemorrhage

Uncategorized / /

Intracerebral Hemorrhage (ICH)  1️⃣ Introduction It accounts for: 10–15% of all strokes But causes disproportionately high mortality (35–50%) 2️⃣ Classification A. By Etiology Type Cause Primary ICH Hypertension, cerebral amyloid angiopathy Secondary ICH AVM, aneurysm, tumor, anticoagulation, trauma B. By Location  Deep ICH (Hypertensive)- Pathophysiology- presence of small penetrating arteries in deeper lobe with no

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