Decode Medicine from OPD to ICU rounds
URINALYSIS 1. Sample Collection & Pre-Analytical Factors Avoid strenuous physical exercise for 24 h before collection (can cause transient proteinuria/hematuria). Midstream, 1st morning urine — most concentrated, most acidic, best for preserving formed particles (cells/casts). Preferred for pregnancy test, TB culture, and detecting orthostatic proteinuria. Permanent indwelling catheter → associated with bacteriuria, hematuria, WBCs, and […]
Essential Tremor 1. At a Glance Parameter Key Point Definition Isolated tremor syndrome of bilateral upper-limb action tremor, ≥3 years, without other neurological signs Prevalence Most common movement disorder — ~1% overall; ~5% of those >60 years (pooled prevalence 0.9%) Age at onset Bimodal — peaks in 2nd and 6th decades; prevalence rises sharply >70
ESOPHAGEAL CANCER AT A GLANCE Major histologies Squamous cell carcinoma (SCC) and adenocarcinoma (AC). Classic presentation Progressive dysphagia, usually solids → liquids, with weight loss. Diagnosis Upper GI endoscopy with multiple biopsies. Staging Contrast CT chest/abdomen ± pelvis; FDG PET-CT when potentially curable; EUS for locoregional T/N assessment when feasible. Early disease Selected superficial T1a
PEPTIC ESOPHAGEAL STRICTURE AT A GLANCE Domain Key point Definition Benign fibrotic narrowing caused by chronic reflux-related mucosal injury, usually in the distal esophagus. Typical symptom Progressive dysphagia to solids. Typical location Distal esophagus, often near the gastroesophageal junction. Diagnosis EGD with careful inspection and biopsy; barium esophagram for selected tight or complex strictures. Definitive
PEPTIC ESOPHAGEAL STRICTURE Read More »
Hepatic Encephalopathy Hepatic encephalopathy (HE) is a brain dysfunction caused by liver insufficiency and/or portosystemic shunting, producing a spectrum ranging from subtle cognitive impairment to coma. HE is a clinical syndrome, not a diagnosis made by ammonia alone.HE is a diagnosis of exclusion. DEFINITION HE is a syndrome of neurological and psychiatric abnormalities occurring in
Hepatic Encephalopathy Read More »
HYPOPHOSPHATEMIA 1. Definition Hypophosphatemia = serum phosphate < 2.5 mg/dL (0.81 mmol/L) Severity Serum Phosphate Mild 2.0–2.5 mg/dL (<0.65-0.81 mmol/L) Moderate 1.0–1.9 mg/dL (<0.32-0.65 mmol/L) Severe (life-threatening) < 1.0 mg/dL (<0.32 mmol/L) Symptoms usually appear when <1 mg/dL 2. Functions of phosphate ATP synthesis → cellular energy 2,3-DPG in RBCs → oxygen delivery Cell membrane
TUMOR LYSIS SYNDROME (TLS) What is Tumor Lysis Syndrome? Tumor lysis syndrome (TLS) is a potentially life-threatening oncologic emergency caused by rapid destruction of malignant cells, either: Spontaneously, or After anticancer therapy(TLS generally occurs 12-72 hours after chemotherapy initiation) The massive release of intracellular contents produces the characteristic biochemical abnormalities: ↑ K⁺ + ↑ phosphate
TUMOR LYSIS SYNDROME Read More »
Hypercalcemia Normal total serum calcium: Approximately 8.5–10.5 mg/dL (2.1–2.6 mmol/L) Ionized calcium >1.32 mmol/L This severity Classification values are different in Different sources(ionized calcium does not have a universally accepted equivalent 3-tier classification.) Severity Total serum calcium Ionized calcium Normal 8.5–10.5 mg/dL 1.12–1.32 mmol/L Mild 10.5–11.9 mg/dL ~1.33–1.50 mmol/L Moderate 12.0–13.9 mg/dL ~1.51–1.75 mmol/L Severe
Heart Failure with Preserved Ejection Fraction (HFpEF) 1. Definition Symptoms ± signs of heart failure LVEF ≥50% Evidence of cardiac structural and/or functional abnormality Elevated natriuretic peptides Feature HFpEF HFrEF EF ≥50% ≤50% Dysfunction Diastolic Systolic LV Geometry Concentric Eccentric Main cause HTN CAD 2. Pathophysiology A. Central Concept It is systemic disease with multi-organ
Heart Failure with Preserved Ejection Fraction Read More »
Pulmonary Embolism Pulmonary embolism is obstruction of the pulmonary arterial circulation, usually by thrombus originating from the deep veins of the lower extremities or pelvis. Risk Factors—Virchow’s Triad Mechanism Examples Venous stasis Immobilization, ICU stay Hypercoagulability Cancer, pregnancy Endothelial injury Surgery, trauma,Central venous Catheter Major Major surgery Trauma Malignancy Prior VTE Pregnancy/postpartum Moderate OCP use
Pulmonary Embolism Read More »