Decode Medicine from Ward Rounds to ICU rounds
Acute Pancreatitis Acute Pancreatitis is an acute inflammatory process of the pancreas caused by premature activation of pancreatic digestive enzymes leading to autodigestion, inflammation, edema, necrosis, and systemic inflammatory response. It ranges from: Mild self-limiting interstitial edema to Severe necrotizing pancreatitis with multiorgan failure. Diagnostic Criteria (Revised Atlanta Classification) Diagnosis requires 2 of 3 criteria: […]
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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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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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Hepatitis B (HBV) Introduction Hepatitis B is a DNA virus infection affecting the liver and remains one of the leading causes of: Chronic hepatitis Liver cirrhosis Hepatocellular carcinoma (HCC) Liver failure Need for liver transplantation HBV infection may present as: Acute hepatitis Chronic hepatitis Fulminant hepatic failure Inactive carrier state Occult infection Virus Characteristics Component
Autoimmune Hepatitis (AIH) Autoimmune hepatitis (AIH) is a chronic, progressive, immune-mediated inflammatory liver disease.It results from loss of tolerance to hepatic autoantigens, leading to T-cell–mediated hepatocyte injury. Needs Exclusion of other causes of hepatitis (viral, drug-induced, metabolic). Pathophysiology 1. Immunogenetic Susceptibility HLA associations: AIH type 1: HLA-DR3, DR4 AIH type 2: HLA-DR7, DQ2 AIH type
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Acute Diarrhoea 1. Definition Acute diarrhoea = Passage of ≥3 loose/watery stools per day lasting <14 days. Persistent: 14–28 days Chronic: >4 weeks Always clarify duration, volume, blood, travel, antibiotics, immunocompromise, and systemic toxicity. Acute Diarrhoea vs Dysentery Feature Acute Watery Dysentery Stool Watery Blood + mucus Fever Mild High Pain Mild Severe cramps Cause