Decode Medicine from OPD to ICU rounds
ASTHMA EXACERBATION Recommendations below are aligned primarily with the 2026 GINA Strategy Report, the current GINA reference available in 2026. ADULT ASTHMA EXACERBATION — QUICK DOSE TABLE 1. WHAT IS AN ASTHMA EXACERBATION? An asthma exacerbation is an acute or subacute worsening of asthma symptoms and lung function compared with the patient’s usual state.Typical manifestations: […]
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LVOT-VTI — Left Ventricular Outflow Tract Velocity–Time Integral LVOT-VTI is the distance that blood travels through the LV outflow tract during one systolic ejection. It is one of the most useful echocardiographic measurements for estimating stroke volume (SV) and cardiac output (CO). How to measure LVOT-VTI Step 1 —Apical 5-chamber view or Apical 3-chamber
LA AND RA SIZE ON POCUS The formal echo guidelines favor volumetric assessment over a single linear dimension, although POCUS usually uses qualitative/semiquantitative assessment. LEFT ATRIUM — LA For formal echocardiography, LA volume indexed to body surface area (LAVI) is preferred over a single linear dimension. The ASE/EACVI upper normal limit is approximately 34 mL/m².
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Immune Thrombocytopenic Purpura (ITP) Definition Immune Thrombocytopenic Purpura (ITP) — also known as Immune Thrombocytopenia — is an acquired autoimmune disorder characterized by isolated thrombocytopenia (platelet count <100,000/µL) It is a diagnosis of exclusion — no other cause of thrombocytopenia should be present. Hematologist Referral is must Classification Type Description Primary ITP Isolated thrombocytopenia without
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Neurogenic Pulmonary Edema(NPE) Introduction Neurogenic pulmonary edema (NPE) is an acute pulmonary edema syndrome occurring after a severe acute CNS insult, particularly when the neurological event causes an abrupt rise in intracranial pressure and/or massive sympathetic activation. It can be confused with: aspiration pneumonitis cardiogenic pulmonary edema ARDS pneumonia fluid overload pulmonary embolism NPE may
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Acute Decompensated Heart Failure (ADHF) What is ADHF? Acute Decompensated Heart Failure (ADHF) is the rapid onset or worsening of signs and symptoms of heart failure requiring urgent therapy and often hospitalization. It may occur as: De novo HF (newly diagnosed) Acute decompensation of chronic HF Progression to cardiogenic shock Major guidelines: American Heart Association
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CONSTIPATION IN ICU 1. DEFINITION (No universal consensus) Most ICU studies define constipation as: No bowel movement for ≥3 days OR need for rescue laxatives/enema OR hard stools / difficult evacuation 2. EPIDEMIOLOGY Incidence: 15–83% (very common in ICU) Higher in: Mechanically ventilated patients Sedated/paralyzed patients Opioid use Enteral feeding patients 3. WHY IT MATTERS
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HYPERPHOSPHATEMIA Hyperphosphatemia = Serum phosphate > 4.5 mg/dL (1.45 mmol/L) in adults Severity Serum Phosphate Mild 4.6–6 mg/dL Moderate 6–9 mg/dL Severe >9–10 mg/dL Life-threatening when associated with: Hypocalcemia Arrhythmias Acute kidney injury Tumor lysis syndrome Normal Phosphate Physiology Distribution 85% – bone (hydroxyapatite) 14% – intracellular <1% – extracellular (measured serum phosphate) Normal Serum
EFAST (Extended Focused Assessment with Sonography for Trauma) EFAST is an extension of FAST (Focused Assessment with Sonography for Trauma) that adds thoracic views . PROBE & SETTINGS Probe: Curvilinear (3–5 MHz) or phased array Depth: 15–20 cm (abdomen), shallow for lung Mode: B-mode (main), M-mode (for lung) 1. Pericardial View (Cardiac) A. Subxiphoid
Gastric Ultrasound Gastric point-of-care ultrasound (Gastric POCUS or Gastric USG) is a bedside ultrasound technique used to determine: Whether the stomach is empty or contains contents Nature of gastric contents (empty, clear fluid, thick fluid, solid) Estimated gastric volume Aspiration risk Suitability for anesthesia, procedural sedation, extubation, or enteral feeding The technique was pioneered by
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