Getting to know your A's, B's and C's

[drabc-blog-blog]

Back Pain principles. Adapted from Apleys Concise guide to Orthopaedics

[drabc-blog-blog]

Basic classifications of Neck Of Femor (NOF) fractures

[drabc-blog-blog]

Dosage of Fluoxetine for Depression

Starting dose 20mg of Fluoxetine Can titrate up to a maximal dose of 60mg Note that the major side effects include: - no improvement for first few 2 weeks - first few days of feeling a bit odd - nausea and vomiting - insomnia - may experience worsening of depression or suicidality

[drabc-blog-blog]

Side effects of Anti-tuberculous drugs Source - Get Ahead! 300 SBAs for Medicine

[drabc-blog-blog]

Source - Get Ahead! 300 SBAs for Medicine

[drabc-blog-blog]

Management of Vesicourereric Reflux

1. Medical - Abx for acute episodes, long term abx for prophylaxis 2. General management - double micturition, hygiene 3. Surgical - avoid if possible!

[drabc-blog-blog]

Reflux nephropathy (paediatrics)

Investigate any child for Vesicourereric Reflux (VUR) and subsequent Reflux Nephropathy if: First UTI in a boy Second UTI in a girl Along with biochemistry, we can image with - IVP ("gold standard") - Renal US - CT - DMSA (excellent for visualizing hard to see renal scarring) - other imagine modalities We are looking for signs such as small kidneys, scarring, calyceal changes, etc Note that hypertension in children is a LATE SIGN of Reflux nephropathy Source - Prof Agar's "Nephrology Made Easy" (comprehensive yet easy to read and understand guide to nephrology)

[drabc-blog-blog]

Greenstick Fracture In brief - an incomplete fracture through the radius of a child, owing to their more flexible bones. Source - Radiopedia (amazing resource)

[drabc-blog-blog]

Oesophageal Atresia and VATER association

Oesophageal atresia may accompany the VATER association: Vertebral anomalies Anal imperforation Tracheo-Esophageal fistula Radial anomaly (limb deformity) Renal anomaly

Note that tracheo-esophageal fistulae can present later with recurrent pneumonias/pneumonitis (particularly H-type fistulae)

[drabc-blog-blog]

MMSE and Dementia

Expect a 2 point drop in MMSE score each year in the patient with dementia.

[drabc-blog-blog]

GALS framework

GALS= gait, arms, legs and spine 3 quick screening questions to rule out musculoskeletal complaints: - any stiffness or pain in your muscles, joints or back? - can you dress yourself completely without difficulty? (Upper limb screen) - can you walk up and down stairs without difficulty?

[cluelessmedic]

Paediatric Hip Disease - Tips!!

0-2 years - think Developmental Dysplasia of Hip (DDH)

2-4 years - think transient synovitis

4-10 years - think Perthes’ Disease

10-14 years - think Slipped Upper Femoral Epiphysis (SUFE)

0-100 years - ALWAYS THINK INFECTION!!

[drabc-blog-blog]

Top tips. To Add - "if you've got grey hair, you've probably got a rotator cuff tear"

[cluelessmedic]

Mallampati Assessment

used in the anaesthetists patient assessment to help predict difficulties during intubation

patient sat upright, open mouth and maximally protrude tongue

view of pharynx is noted and given a score from I to IV

grades III and IV suggest difficult intubation - combined with a thyromental distance of <7cm predicts 80% of difficult intubations

[drabc-blog-blog]

Good Ano's practice

[blue-lights-and-tea]

Those pesky 4 H's and 4 T's as the reversible causes in an arrest situation:

Reversible Causes

Hypoxia

Hypovolaemia

Hypo- / hyperkalaemia / metabolic

Hypothermia

Thrombosis - coronary or pulmonary

Tamponade - cardiac

Toxins

Tension pneumothorax

[drabc-blog-blog]

Hot tips for Clexane dosages

Therapeutic dose: 1.5mg/kg once daily DVT prophylaxis: 20-40mg s/c once daily

[drabc-blog-blog]

ECG Changes of Acute MI (Myocardial Infarct)

Progression Giant tall T waves --> ST elevation --> Q waves --> ST back to normal and T wave inversion Source - Case Files Series - Internal Medicine

[drabc-blog-blog]

Revision of First Generation (Typical) Antipsychotics

Examples - Haloperidol, Chlorpromazine Mechanism - Dopamine antagonism Indication - great for positive symptoms of Schizophrenia (mediated by Dopamine). Largely superceded by the atypical antipsychotics. Major Side Effects: Motor - acute dystonia, tardiness dyskinesia Anti-cholinergic - dry mouth Cardiovascular - Orthostatic hypotension, prolonged QT Endocrine - DAergic effects can cause galactorrhoea, gynaecomastia and sexual dysfunction Weight gain Also beware of Neuroleptic Malignant Syndrome - motor symptoms (rigidity) + autonomic disturbances (agitation, sweats, fever)