A 2-year old male presents with febrile seizure lasting ~10 minutes. 10 minutes after cessation IV access is established and a VBG is taken Results: pH: 7.28 (Reference range: 7.31 – 7.41) pCO2: 60 mmHg (Reference range: 35 – 45 mmHg) HCO3: 18 mmol/L (Reference range: 22 – 29 mmol/L) Base Excess: -8 mmol/L (Reference […]
Read More »Classic histories and their microbes Click here to start quiz[qwiz random=”true” align=”center”] [q unit=”Infectious_Diseases” topic=”Classic_Histories”] Seafood poisoning; fishermen, “coastal slipways”, wounds inflicted by angry sea organisms. [c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq] [f]IFZpYnJpbyB2dWxuaWZpY2Fucw==[Qq] [q unit=”Infectious_Diseases” topic=”Classic_Histories”] Abattoir workers, cattle farmers; haemoptysis, pneumonia, heart failure and infective endocarditis. [c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq] [f]IENveGllbGxhIGJ1cm5ldGlpIEFLQSAmIzgyMjA7USBmZXZlciYjODIyMTs=[Qq] [q unit=”Infectious_Diseases” topic=”Classic_Histories”] Encephalitis following a flying fox bite […]
Read More »Next time I think I’ve got some in a drain, I’m asking for a Sudan III stain immediately. More pertinent information will follow at a later date
Read More »Syndromes, causes and clinical signs Syndrome Causes Clinical Features Complete transection TraumaInfectionTransverse myelitisTumour Complete loss of motor and sensory function below the level of the lesion Hemisection TraumaMSAbscess Ipsilateral loss of motor function and light touch below the lesionContralateral loss of pain/temperature below the lesionipsilateral loss of pain/temperature AT the level of the lesion Central […]
Read More »I’m going to focus on Arterial blood gases here. Venous gases are close enough in well people, but beware in critical illness there is divergence between arterial and venous samples, particulary in CO2, lactate and pH. Method FiO₂ Calculator 713 x 0.21 = 150 mm Hg Differential Diagnosis HAGMA (CATMUDPILES or LTKR) NAGMA (CAGE, ABCD, […]
Read More »Failing to oxygenate/ventilate(any invasive vent, not just traches) DOPES Displacement too deep (unlikely, unless all of: small patient, low puncture site, and adjustable flange trache) too shallow – opening may be against posterior wall in soft tissue – rapidly expanding subcutaneous emphysema completely out Obstruction sputum plug blood/clot plug inner cannula blockage only kinking speaking […]
Read More »Transjugular Intrahepatic PortoSystemic Shunt Flash Cards! Click here to start flashcard deck[qdeck] [q unit=”Procedures” topic=”TIPSS”] Mechanism of action of TIPSS [a] TIPSS involves accessign the internal jugular vein and IVC to place a stent between hepatic and portal veins using a needle. – High pressure in portal system contributes to major complications of liver […]
Read More »Compare and contrast Acute Fulminant Liver Failure (AFLF) and Chronic Decompensated Liver Disease (CDLD) History AFLF CDLD – Acute ingestion (eg paracetamol)– Drug interactions– Viral– Ischaemic– Post-operative– Herbal / alternative Rx eg St John’s Wort – Chronic liver disease– Encephalopathy– Hepatitis (eg chronic Hep C)– GI bleeds Examination AFLF CDLD Jaundice YES YES Coma YES […]
Read More »Here’s a flash card version of the WTET post on Dexmedetomidine Click here to start flashcard deck[qdeck] [q unit=”Pharmacology” topic=”Dexmedetomidine”] Rationale for Dexmedetomidine [a] Sedation practice varies widely around the world. Propofol and Midazolam are the mainstays of sedation, in addition to an opiate as an antitussive. Traditional first line agents act mainly via GABA. […]
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