Decode Medicine from OPD to ICU rounds
Peritonitis Definition Peritonitis is inflammation of the peritoneum caused by infection, chemical irritation, ischemia, foreign material, or sterile inflammatory processes. Anatomy Relevant to Peritonitis The peritoneum is a serous membrane consisting of: Layer Description Parietal peritoneum Lines abdominal wall Visceral peritoneum Covers abdominal organs The peritoneal cavity normally contains:<50–100 mL sterile fluid Classification of Peritonitis […]
NON ST ELEVATION ACUTE CORONARY SYNDROME (NSTE-ACS) Definition NSTE-ACS includes: NSTEMI (Non-ST Elevation Myocardial Infarction) → myocardial necrosis + ↑ troponin Unstable Angina (UA) → ischemia(ECG CHANGES) without necrosis (normal troponin) PATHOPHYSIOLOGY Plaque rupture/erosion → platelet activation → thrombus formation Partial or intermittent occlusion (NOT complete like STEMI) Leads to subendocardial ischemia Feature NSTE-ACS STEMI
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Approach to Oliguria in the ICU Oliguria = Urine output <0.5 mL/kg/hr. KDIGO AKI Criteria (Urine Output) Stage Urine Output Criteria Stage 1 <0.5 mL/kg/hr for 6–12 hours Stage 2 <0.5 mL/kg/hr for ≥12 hours Stage 3 <0.3 mL/kg/hr for ≥24 hours OR anuria ≥12 hours Definitions Term Definition Oliguria <400–500 mL/day Severe Oliguria <100
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Amiodarone 1. CLASSIFICATION Amiodarone = Class III antiarrhythmic (Vaughan-Williams classification) 2. MECHANISM OF ACTION K⁺ channel blockade (Phase 3) ↑ repolarization time ↑ QT interval ↑ refractory period → prevents re-entry circuits Na⁺ channel blockade ↓ conduction velocity (especially in ischemic tissue) Ca²⁺ channel blockade ↓ AV node conduction Non-competitive β-blockade ↓ sympathetic drive
Acute Kidney Injury (AKI) AKI is a rapid decline in kidney function (hours to days), resulting in the accumulation of nitrogenous waste, electrolyte imbalance, and dysregulation of volume and acid-base status. Category Definition / Time Course Acute Kidney Injury (AKI) Abrupt decline in kidney function occurring within ≤7 days. KDIGO AKI is identified by an
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Hypersensitivity Pneumonitis (HP) / Extrinsic Allergic Alveolitis (EAA) Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) caused by repeated inhalation of a sensitizing antigen in susceptible individuals, leading to inflammation of: Alveoli Terminal bronchioles Interstitium Unlike asthma, HP primarily affects the alveolar-interstitial compartment rather than the conducting airways. HP may progress from reversible
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Ventilator Associated Pneumonia (VAP) Pneumonia occurring ≥48 hours after endotracheal intubation and initiation of invasive mechanical ventilation Infection not present or incubating at the time of intubation Related Terms (CDC Surveillance) Term Definition VAP Clinical diagnosis Ventilator-Associated Event (VAE) Surveillance definition VAC Ventilator-associated condition IVAC Infection-related VAC Possible VAP IVAC + microbiology Exams focus: Clinical
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Fournier’s Gangrene Fournier’s gangrene (FG) is a rapidly progressive, life-threatening form of necrotizing fasciitis involving the perineum, genitalia, and perianal region. It is characterized by: Necrosis of superficial and deep fascial planes Microvascular thrombosis Extensive tissue destruction Polymicrobial infection Severe sepsis and septic shock Why Is It Dangerous? Mortality remains:20–40% ,Can exceed:70–80% when: Septic shock
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The Consultant Forgot a Fact. The Residents Laughed. They Missed the Entire Lesson. “Knowledge is knowing that a tomato is a fruit. Wisdom is knowing not to put it in a fruit salad.” I witnessed something recently that stayed with me longer than I expected. During morning rounds, a senior consultant was discussing a complex
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How to Prepare for NEET SS: Why Some People Crack NEET SS and Others Don’t Before I start, let me establish some credibility.I secured AIR 72 in NEET SS while doing residency. No dedicated one-year study leave. No Himalayan retreat. No disappearing from clinical work. Just residency. So either I got extraordinarily lucky, or I
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