Introduction When gallbladder neck is impacted by gallstones or when gallstones passing through the common bile duct, the gallstones may cause pain Features No fever No jaundice, no pape stool, no tea-colored urine White cell count not raised Differential Diagnosis Acute coronary syndrome (ACS) Acute cholecystitis / Ascending cholangitis Peptic ulcer disease Acute pancreatitis Urinary […]
“Aortic dissection is uncommon. However, if it occurs, the mortality rate is very high” Presentation • Always presents as a hypertensive emergency Clinical Features Signs • Different in BP at both arms [1], i.e. discrepancy of SBP >20 mmHg between both arms [2]• Radio-radial delay [1] References Atypical presentation of acute aortic dissection in a […]
Introduction Causes Clinical Features Presentation • Altered mental status e.g. due to acute massive haemorrhagic stroke / intracranial bleed due to trauma etc. Symptoms • • Vomiting Signs • Cushing’s response: bradycardia + elevated BP• Altered GCS / Drowsiness • Irritability • Investigations Imaging CT brain • Effacement of the ventricles, basal cisterns and other […]
“Any bleed within the cranium is a medical emergency!” Introduction Classification • VS • VS Subtopics Blood • FBC• Coagulation profile • Imaging — (i) Possible findings:• Haematoma• Hydrocephalus• Midline shift (ii) Estimation of haematoma volume: Tips in Referring Neurosurgery for ICB Intracranial haemorrhage requires Neurosurgical referral, but not all intracranial haemorrhage require neurosurgical intervention. […]
“The biggest MISTAKE in managing acute appendicitis is to discharge patient from primary care with referral to SOPD as outpatient!” Related Posts Abdominal pain Important Points during Clerking / Presentation
Introduction • Pneumothorax = presence of air in pleural space Classification • Closed pneumothorax• Open pneumothorax• Tension pneumothorax Presentation • • May have SOB Clinical Features Physical examination (i) Lungs• Reduced chest movement on the affected side• Hyper-resonance of affected side • Decreased breath sounds of affected side (ii) • • Subcutaneous emphysema of the […]
Introduction • Injury to the alveolar capillaries, without any tear or cut in the lung tissue → accumulation of blood and other fluids within the lung tissue → excess fluid interferes with gas exchange leading to hypoxia Further Reading • Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course, by NLM• https://www.researchgate.net/figure/The-normal-alveolus-Left-Hand-Side-and-the-injured-alveolus-in-the-acute-phase-of-acute_fig5_230654786
Head CT is required in minor head injury if patient has any of these signs: High risk (for neurological intervention) Age ≥65 years GCS <15 at 2 hours after injury Suspected open or depressed skull fracture Any sign of basal skull fracture Vomiting ≥2 episodes Medium risk (for brain injury on CT) Amnesia before impact […]
Introduction / Definition • Cerebral contusion = traumatic brain parenchymal injury caused by rapid tissue displacement, disruption of vascular channels, and subsequent haemorrhage, tissue injury and oedema • Cerebral concussion = reversible from head injury in the absence of contusion Notes • Subarachnoid haemorrhage is due to trauma Related Posts Canadian CT Head rule
Presentation • Patient presented to ED post trauma History Taking Chest pain • Site: at the site of rib fracture post trauma• Onset: post trauma • Severity: pain score Relevant history • Is patient a smoker? Physical Examination • Is patient tachypnoeic? • Chest spring positive at rib fracture site Investigations Blood • ABG Imaging […]