Medical Notes

Antipsychotic medication in cirrhosis and hepatic encephalopathy ♻️•••Chlorpromazine, clozapine, and olanzapine pose the 👉greatest risk of hepatoxicity; ♻️•••quetiapine and risperidone pose a 👉moderate risk ♻️•••with haloperidol considered to pose 👉low to moderate risk. ♻️•••Paliperidone, aripiprazole, lurasidone, and loxapine are 👉lower-risk agents with 👉no reports of liver failure. But the latest group associated with drug-drug interactions limiting other needed treatment in cases of liver failure/ cirrhosis…. #notes #GIT

Digital Subtraction Angiography (DSA) is the gold standard for diagnosing vascular causes of spontaneous subarachnoid hemorrhage (SAH), specifically to detect intracranial aneurysms, arteriovenous malformations (AVMs), or arteriovenous fistulas. It is primarily indicated when non-contrast CT shows SAH and further, more detailed visualization is required to plan interventions. #neurology #notes #subarachnoid

Sleep disturbances may reduce clearance of toxic proteins such as Aß and tau from the brain. #neurology #notes

Obstructive sleep apnea Is associated with atrial fibrillation and increased stroke risk . Treatment with devices that provide continuous positive airway pressure during sleep may reduce this risk. #neurology #respiratory #notes

* in summary * Beneficial Fruits for Kidney Disease Fruits like berries, lemons, limes, pineapples, apples, cherries, grapes, and watermelon are generally good options for people with chronic kidney disease (CKD) as they are low in potassium and provide important nutrients. * Potassium Management While some fruits are high in potassium, they can still be enjoyed in moderation as part of a kidney-friendly diet. Portion size is key, and consulting a dietitian can help determine the right balance of fruits for individual needs. * Incorporating Fruits Fruits make for healthy, tasty snacks and side dishes, providing fiber, vitamins, antioxidants, and other beneficial nutrients. Incorporating a variety of fruits into the diet, while being mindful of portions, can be an important part of managing CKD. #nephrology #notes

🩺 Differential Diagnosis of Pulsatile Abdominal Mass 1. True Vascular Causes 🫀 Abdominal aortic aneurysm (AAA): classic. 🌐 Iliac or visceral artery aneurysms 2. Transmitted Pulsation (Masses Adjacent to Major Arteries) 🎯 Retroperitoneal tumors or lymphadenopathy 🍃 Pancreatic pseudocyst or tumor, Gastric carcinoma, Colonic carcinoma 💪 Abdominal wall hernia or divarication of recti #oncology #notes

Friedreich's ataxia associated with cardiomyopathy which can be seen in CXR or echocardiogram. #neurology #cardiology

Situations where oxygen therapy should not be used routinely if there is no evidence of hypoxia: *myocardial infarction and acute *coronary syndromes *stroke *obstetric emergencies *anxiety-related hyperventilation #emergency #passmedicine

Frontal lobes lesions : *expressive (Broca's) aphasia: located on the posterior aspect of the frontal lobe, in the inferior frontal gyrus. Speech is non-fluent, laboured, and halting *disinhibition *perserveration *anosmia *inability to generate a list #neurology #passmedicine

Baclofen is an agonist of GABA receptors that acts in the central nervous system. #neurology #passmedicine

Migraine during pregnancy: paracetamol 1g is first-line NSAIDs can be used second-line in the first and second trimester avoid aspirin and opioids such as codeine during pregnancy Migraine and the combined oral contraceptive (COC) pill: if patients have migraine with aura then the COC is absolutely contraindicated due to an increased risk of stroke (relative risk 8.72) Migraine and menstruation: many women find that the frequency and severity of migraines increase around the time of menstruation SIGN recommends that women are treated with mefanamic acid or a combination of aspirin, paracetamol and caffeine. Triptans are also recommended in the acute situation Migraine and hormone replacement therapy (HRT): safe to prescribe HRT for patients with a history of migraine but it may make migraines worse #neurology #passmedicine

The sciatic nerve divides into the tibial and common peroneal nerves. Injury often occurs at the neck of the fibula. The most characteristic feature of a common peroneal nerve lesion is foot drop. Other features include: *weakness of foot dorsiflexion *weakness of foot eversion *weakness of extensor hallucis longus *sensory loss over the dorsum of the foot and the lower lateral part of the leg *wasting of the anterior tibial and peroneal muscles #neurology #passmedicine

The following drugs may exacerbate myasthenia gravis : *penicillamine *quinidine, procainamide *beta-blockers *lithium *phenytoin *antibiotics: gentamicin, macrolides, quinolones, tetracyclines #neurology #passmedicine

Pyridostigmine is a long-acting acetylcholinesterase inhibitor that reduces the breakdown of acetylcholine in the neuromuscular junction, temporarily improving symptoms of myasthenia gravis ( MG ). #neurology #passmedicine

maternal use of sodium valproate is associated with a significant risk of neurodevelopmental delay in children. #neurology #passmedicine

Gerstmann syndrome is a constellation of acalculia, right-left disorientation, finger agnosia and agraphia. #neurology #passmedicine

Gonorrhoea is caused by the Gram-negative diplococcus Neisseria gonorrhoeae . #infection #passmedicine

Calciphylaxis lesion are intensely painful, purpuric patches with an area of black necrotic tissue that may form bullae, ulcerate, and leave a hard, firm eschar. The risk of developing calciphylaxis is linked with hypercalcaemia, hyperphophataemia and hyperparathyroidism. #nephrology #passmedicine

Contralateral hemiparesis and sensory loss with the lower extremity being more affected than the upper - anterior cerebral artery #neurology

Alpha Blocker work as smooth muscle relaxation and dilatation of the ureter. #nephrology