Right Ventricular MI
Right ventricular MI is a not uncommonly seen clinical event. Characteristics of this lesion are:
ECG findings
abnormalities in V1-V6
Coronary artery involved
proximal right coronary
Cardiac areas affected
1. right ventricle and atrium
2. SA node
3. AV node (up to 90% affected)
4. Bundle of His
5. posterior septum
6. posterior inferior part of left bundle branch
Clinical Complications
1. Elevated central venous pressure
2. Decreased cardiac output
3. AV block
The post Right Ventricular MI appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - April 10, 2013 Category: Surgeons Authors: Editor Tags: Cardiology bundle branch block ECG MI Source Type: blogs
Inferior MI
(myocardial infarction) is a common clinical diagnosis made in both the inpatient and emergency room settings. Some clinical and ECG findings associated with inferior MI are:
ECG
1. II, III, and AVF affected
2. AV block (more common in women)
Coronary Artery Involved
right coronary involved
Cardiac Areas Affected
1. SA node (55%)
2. AV node (90%)
3. Bundle of His
4. left bundle branch – posterior inferior division
5. Right atrium and ventricle
6. left ventricle inferior surface
7. posterior 1/3 of septum
Clinical Complications
1. Sinus node disturbances including sinus arrest, bradycardia, and block
2. AV block R...
Source: Inside Surgery - April 3, 2013 Category: Surgeons Authors: Editor Tags: Cardiology AvF MI myocaridal infarction Source Type: blogs
“Death is easy on the nursing staff and cheap for the hospital”
Anonymous
The post “Death is easy on the nursing staff and cheap for the hospital” appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - April 3, 2013 Category: Surgeons Authors: Editor Tags: Surgery and Medicine Quotations Source Type: blogs
Anaphylaxis Diagnostic Criteria
Anaphylaxis should be considered in the differential diagnosis when any one of the three main criteria list below occurs in a patient:
1. Acute onset of an illness (minutes to hours) with involvement of the skin, mucoasal tissue, or both (e.g., generalized hives, pruritus and or flushing, swollen lips/tongue/uvula and at least one of the following:
a.) respiratory compromise – dyspnea, wheeze-bronchospasm, stridor, reduced peakflow, hypoxemia
b.) reduced blood pressure or associated symptoms of end-organ dysfunction – hypotonia, collapse, syncope, incontinence
2. Two or more of the following that occur rapidly...
Source: Inside Surgery - March 24, 2013 Category: Surgeons Authors: Editor Tags: Surgpedia Source Type: blogs
Breast Cancer
Pathophysiology of Breast Cancer
Breast cancer is a:
1) neoplastic transformation of glandular epithelium of the terminal duct unit, lactiferous proximal ducts, or lobules of the breast
2) almost always adenocarcinoma
3) classification is controversial, but most experts recognize in situ (malignant cells do not invade through the basement membrane) and invasive forms
4) in situ types – intraductal (comedo and noncomedo sutypes) in situ, lobular in situ, and papillary in situ
5) invasive types – ductal, lobular, tubular, colloid, and medullary
Signs and Symptoms
1) palpable mass – hard, irregular, no discr...
Source: Inside Surgery - March 21, 2013 Category: Surgeons Authors: Editor Tags: Breast Surgery Oncology adenocarcinoma BRCA1 BRCA2 comedo in situ invasive ductal Li Fraumeni lobular peau d'orange Source Type: blogs
Congestive Heart Failure
Pathophysiology of Congestive Heart Failure
Congestive heart failure is:
1) inability of heart to deliver sufficient cardiac output to meet physiologic needs
2) both diastolic and systolic phases are abnormal
3) initially, compensatory mechanisms occur(increased catecholamines, increased atrial natriuretic factor, myocardial hypertrophy), but eventual failure of these ensues causing congestive heart failure
4) result is increase in venous pressure with congestion of liver, spleen, and kidney (“backward failure”) and sodium retention, peripheral edema, and pulmonary sequelae (“forward” failure”...
Source: Inside Surgery - March 20, 2013 Category: Surgeons Authors: Editor Tags: Cardiology backward failure enlarged heart foward failure myocardial hypertrophy nutmeg liver peripheral edema Source Type: blogs
Lyme Disease
Pathophysiology of Lyme Disease
Lyme disease is an
1) infection with Borrelia burgdorferi via tick bite
2) previous thinking held tick vector was Ixodes but transmission is now thought by some experts to be possible with additional tick species
3) occurs in stage I and stage II days to weeks after infection and in stage III months to years after infection (usually with preceding latency period
Signs and Symptoms
Stage I
1) characteristic expanding annular rash with central clearing (“bull’s eye or “target” rash) that occurs in only 40% of infections
Stage II
2) multiple secondary annular skin lesio...
Source: Inside Surgery - March 19, 2013 Category: Surgeons Authors: Editor Tags: Infectious Disease babesia bulls eye rash coinfections deer tick erythema migrans hyperbaric ixodes target rash Source Type: blogs
Marfan’s Disease
Pathophysiology of Marfan’s disease
Marfan’s disease is
1) disease of connective tissue
2) marked by dilation of aorta and aortic dissection in a young person
Signs and Symptoms
1) tall stature with long lower torso
2) long limbs and digits
3) pectus carinatum (pigeon breast)
4) inguninal hernias
5) hypermobile joints
6) severe chest pain
7) lightheadedness
8) retinal detachment
9) myopia
10) bilateral subluxation of lines in outward and upward direction (ectopia lentis)
11) aortic regurgitation
12) mitral prolapse and “floppy” mitral valve
13) abnormal head (enlarged supraorbital ridges)
14) kypho...
Source: Inside Surgery - March 17, 2013 Category: Surgeons Authors: Editor Tags: Pediatrics Surgpedia ectopia lentis FBN1 lens subluxation rfibrillin 1 Source Type: blogs
Parkinson’s Disease
Pathophysiology of Parkinson’s Disease
Parkinson’s disease is a neurodegenerative disease marked by:
1) progressive slowing of all voluntary movements
2) muscular “cogwheel” rigidity
3) tremors at rest
4) mask-like facies
5) emotional lability
Signs and Symptoms
1) tremors disappear with voluntary movement
2) drooling
3) dementia (15%)
4) depression
5) micrographia
6) “pill rolling”
7) hesitancy when rising from chair
8) short shuffling gait
9) decreased blink rate
10) diminished arm swing
11) stooped posture
12) loss of postural righting reflexes
13) autonomic problems (constipation, i...
Source: Inside Surgery - March 16, 2013 Category: Surgeons Authors: Editor Tags: Neurology cogwheel rigidity dopaminergic neurons Lewy bodies mask like face pill rolling shuffling gate substantia nigra tremor tremors at rest Source Type: blogs
Graves Disease
Pathophysiology of Graves Disease
1) Graves disease is marked by hyperfunctioning of thyroid gland owing to stimulation by autoantibodies
2) has exacerbations and remissions
3) if untreated, leads to eventual thyroid failure
Signs and Symptoms
1) fine hair
2) muscle wasting
3) exophthalmos
4) pretibial myxedema
5) fatigue/weakness
6) palpitations/nervousness/tremor/sweating
7) diffuse goiter
8) emotional lability
9) weight loss
10) tachycardia
11) bruit and thrill over thyroid
12) some Graves disease patients can have loss of eyebrows particularly laterally in the later stages of the disease
Characteristic Test Findings
...
Source: Inside Surgery - March 2, 2013 Category: Surgeons Authors: Editor Tags: Endocrinology Source Type: blogs
C. Everett Koop Dies at Age 96
C. Everett Koop, the former surgeon general of the United States, has died at age 96.
The post C. Everett Koop Dies at Age 96 appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - February 26, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire C. Evertett Koop dies Surgeon General Source Type: blogs
Peptic Ulcer Disease
Pathophysiology of Peptic Ulcer Disease
1) peptic ulcer disease is marked by a break in mucosal lining of stomach and duodenum
2) main causes are infection with Helicobacter pylori and use of NSAIDs
Signs and Symptoms
1) burning epigastric pain relieved by antacids and eating
2) epigastric pain causing patient to wake up in the middle of the night
3) chest pain mimicking angina
4) epigastric tenderness
5) gastrointestinal bleeding (15%) with coffee-ground emesis or vomiting bright red blood or lower gastrointestinal bleeding
6) perforation (8%) with peritonitis and rigid abdomen
7) duodenal obstruction (3%) with nausea and...
Source: Inside Surgery - February 24, 2013 Category: Surgeons Authors: Editor Tags: Gastroenterology Source Type: blogs
Flu Vaccine Shows Only Modest Protection
Flu vaccine statistics reported by the CDC for this year’s flu season has shown only modest protection in preventing people from contracting the disease overall and very poor coverage of those aged 65 and older.
Flu virus
The post Flu Vaccine Shows Only Modest Protection appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - February 21, 2013 Category: Surgeons Authors: Editor Tags: Bird Flu Infectious Disease CDC coverage vaccine Source Type: blogs
Johns Hopkins Obgyn Suspected of Filming Patients
Johns Hopkins Obgyn Dr. Nikita Levy was suspended by Johns Hopkins Medical Center after he was suspected of filming patients during medical examinations without their permission or knowledge. Several days later he was reportedly found dead in his home of an apparent suicide.
The post Johns Hopkins Obgyn Suspected of Filming Patients appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - February 21, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire filming Johns Hopkins Nikita levy obgyn patients Source Type: blogs
Penn Health To Go Tobacco Free for New Hires
Penn Health will implementing a new policy starting this summmer that all new hires with a few exceptions must be tobacco free for six months as a condition of employment. Officials at the health system give several reasons, including reduced healthcare costs for insuring employees. Employees hired under the new rule will be subject to possible dismissal if they are found to have used alcohol.
The condition applies to physicians, including new residents and fellows starting in July, 2014.
The first major health system to adopt such measures was the Cleveland Clinic in 2007.
The post Penn Health To Go Tobacco Free for New ...
Source: Inside Surgery - February 20, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire Penn Health tobacco free university of pennsylvania Source Type: blogs
