Decode Medicine from OPD to ICU rounds
APPROACH TO CHEST PAIN 1. What makes chest pain suspicious for ACS? Typical ischemic pain Typical ischemic pain • Central / retrosternal • Pressure, squeezing, gripping, heaviness, tightness • Exertional / stress-related • May radiate to left/right/both arms, jaw, neck, shoulders, epigastrium • Usually relieved by rest / nitroglycerin Angina equivalents Angina equivalents • Dyspnea, […]
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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
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Synovium lines the joint cavity ( Diarthroses – freely moveable joints located in the limbs and jaw ) -> covers the fibrous joint capsule and extends to the bone – cartilage interface. Not a true lining epithelium ( no basement membrane) Healthy synovium also covers intra-articular ligaments and tendons. Functions : Nutrient and metabolite trafficking.
BARRETT’S ESOPHAGUS AT A GLANCE Definition Metaplastic replacement of the normal stratified squamous epithelium of the distal esophagus by specialized intestinal-type columnar epithelium, usually as a consequence of chronic gastroesophageal reflux. Major association Chronic gastroesophageal reflux disease (GERD). Major cancer risk Esophageal adenocarcinoma (EAC). Site lower 1/3 of esophagus Major risk factors Male sex, age
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IRRITABLE BOWEL SYNDROME 2026 UPDATE Rome V is now available and updates IBS diagnostic criteria: recurrent abdominal pain or discomfort, on average ≥3 days/month during the previous 3 months, with symptom onset ≥6 months before diagnosis, plus ≥2 of: relationship to defecation, change in stool frequency, or change in stool form. The 2021 ACG/BSG guidance
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Acute Disseminated Encephalomyelitis (ADEM) Acute disseminated encephalomyelitis (ADEM) is a monophasic (in most cases), immune-mediated, demyelinating disorder of the CNS that classically follows a viral infection or vaccination — characterized by multifocal white and grey matter demyelination with encephalopathy, predominantly affecting children. At a Glance Domain Practical Point Definition CNS demyelinating syndrome, almost always monophasic,
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JVP(Jugular Venous Pressure) INTRODUCTION Topic Key Point Jugular Venous Pulse (JVP) • Oscillating top of vertical column of blood in right IJV that reflects pressure changes in Right Atrium in cardiac cycle. Jugular Venous Pressure (JVP) • Vertical height of oscillating column of blood. WHY RIGHT IJV OVER EJV ? • IJV has a