Decode Medicine from OPD to ICU rounds
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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CHRONIC PANCREATITIS At a glance Domain Practical point Definition Progressive fibro-inflammatory pancreatic condition with irreversible structural injury and leading to both exocrine/endocrine dysfunction. Etiology Use TIGAR-O: toxic-metabolic, idiopathic, genetic, autoimmune, recurrent/severe acute pancreatitis, obstructive. Clinical pattern Pain (major presentation) and/or maldigestion; later steatorrhea, weight loss, diabetes, nutritional and bone complications. Diagnosis CT or MRI/MRCP is
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ACUTE PANCREATITIS At a glance Domain Practical point Diagnosis (Revised Atlanta Classification 2012) 2 of 3: characteristic upper abdominal pain, Sr. Amylase/lipase ≥3× ULN, or compatible imaging. Etiology Gallstones and alcohol account for about two-thirds of cases; actively assess biliary, alcohol, metabolic, drug, structural and uncommon causes. Severity Persistent organ failure >48 h is the
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Pneumothorax Pneumothorax = Presence of air in the pleural space causing partial or complete collapse of the lung. Normal pleural pressure is negative relative to atmosphere. When air enters pleural space: Negative pressure is lost Lung recoils inward Chest wall expands outward Ventilation decreases Severe cases → hemodynamic compromise Classification Type Mechanism Primary Spontaneous Pneumothorax
Upper Gastrointestinal Bleeding (UGIB) Definition Upper GI bleeding refers to hemorrhage originating proximal to the ligament of Treitz (esophagus, stomach, duodenum). Anatomical Classification Site Examples Esophagus Varices, Mallory–Weiss tear, esophagitis Stomach Peptic ulcer, erosive gastritis, malignancy Duodenum Peptic ulcer, Dieulafoy lesion Etiology 1. Non-Variceal UGIB (≈ 80–85%) Peptic Ulcer Disease (most common) Duodenal ulcer >
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Refeeding Syndrome Refeeding syndrome is a potentially fatal metabolic complication that occurs after rapid reintroduction of nutrition (especially carbohydrates) in malnourished or starved patients, characterized by acute shifts of phosphate, potassium, magnesium, fluids, and vitamins (notably thiamine) due to insulin surge. Core hallmark: Hypophosphatemia after refeeding. diagnosis of exclusion Pathophysiology 1️⃣ Starvation State ↓ Insulin,
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Pleural Effusion Normal Pleural Space Contains 5–15 mL fluid Produced mainly by parietal pleura Absorbed via pleural lymphatics Functions as a lubricant allowing lung movement Pleural effusion develops when:Fluid formation > Fluid removal Etiology Transudative Pleural Effusion Cause Mechanism Heart failure(~80% of transudates) Increased hydrostatic pressure Cirrhosis (hepatic hydrothorax)(~13% of transudates) Ascitic fluid migration Nephrotic
Ascites Normal peritoneal cavity contains <50 mL fluid which is usually not visible on routine abdominal ultrasound. Clinically detectable ascites usually requires >1.5 L fluid. Most common cause worldwide: Liver cirrhosis (~80–85% cases). Epidemiology Among patients with cirrhosis: Ascites is the most common complication. Approximately 50% develop ascites within 10 years of diagnosis. Development of
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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