Education - mLpenguin (Page 2)

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Education

A collection of 118 posts

6 Causes of Life-Threatening Chest Pain

6 Causes of Life-Threatening Chest Pain

There are 3 heart causes, 2 lung causes, and one esophageal cause ACS/MI Clinical Presentation: * Chest pain (pressure, squeezing), radiates to left arm or jaw * Diaphoresis, dyspnea, nausea, palpitations * May be silent in diabetics or elderly Diagnostic Labs/Imaging: * ECG: ST-elevation (STEMI), ST-depression or T-wave inversion (NSTEMI/UA) * Cardiac

OMM Cranial Techniques and Indications

OMM Cranial Techniques and Indications

V Spread Technique * Acute otitis media and temporal bone dysfunction * Two fingers are required to be on each side of the affected suture. The patient's head is turned next to shift weight onto the practitioner's fingers. * Gentle pressure is then applied with the opposite hand onto

Keratoconus

Keratoconus is a progressive eye condition that affects the cornea, the clear, dome-shaped front surface of the eye. Instead of maintaining its normal round shape, the cornea gradually thins and bulges outward into a cone-like shape. This structural change leads to typical symptoms, including blurred or distorted vision, increased sensitivity

Corneal Cross-Linking

Corneal Cross-Linking

Corneal Cross-Linking (CXL) is a minimally invasive outpatient procedure used to halt the progression of keratoconus and other forms of corneal ectasia, including post-LASIK ectasia (post ectopic ectasia). This innovative treatment works by strengthening the cornea through the formation of new chemical bonds between collagen fibers, which stabilizes the corneal

Types of IOLs

After removing a lens during cataract surgery, an artificial lens called an intraocular lens (IOL) is placed to help patients maintain their vision. Since an artificial lens isn't an exact replica of the natural lens, certain tradeoffs must be considered when choosing the best option for each patient.

Cataracts

Cataracts are the opacification of the lens, a natural component that helps focus light in your eyes. While normally transparent, there are many ways for a lens to become opaque, affecting vision and quality of life. The Lens: Structure and Function The lens is a transparent, biconvex, avascular structure in

Key Clinical Trials in Treating Diabetic Retinopathy

Key Clinical Trials in Treating Diabetic Retinopathy

Understanding the evidence behind diabetic retinopathy treatment decisions is crucial for providing optimal patient care. Three landmark clinical trials published by the Diabetic Retinopathy Clinical Research Network, Protocols S, T, and V, have fundamentally shaped how we approach diabetic retinopathy and diabetic macular edema (DME) treatment today. Protocol S: Revolutionizing

Guide to Grading and Classification of Diabetic Retinopathy

Guide to Grading and Classification of Diabetic Retinopathy

What is Diabetic Retinopathy? Diabetic retinopathy is a serious complication of diabetes that affects the retina: the light-sensitive tissue at the back of the eye. This condition develops when prolonged high blood sugar levels (hyperglycemia) damage the tiny blood vessels in the retina, leading to fluid accumulation in the retinal

Somatic Dysfunctions

Somatic Dysfunctions

Impaired or altered function of related components of the somatic system: skeletal, arthrodial, myofascial structures, and related vascular, lymphatic, and neural elements. Key Features of Somatic Dysfunction * TART findings: * Tenderness * Asymmetry (anatomical or functional) * Restriction of motion * Tissue texture changes Types of Somatic Dysfunction * Acute * Warm, moist skin * Erythema or

Physical Exam Tests

Physical Exam Tests

ACL Injury * Lachman test * Patient lies supine with knee flexed at 20-30° * Stabilize femur with one hand, grasp proximal tibia with other * Pull tibia anteriorly; assess for excessive forward movement or soft endpoint * Anterior Drawer test * Patient lies supine with knee flexed at 90° * Sit on foot to stabilize, grasp

Muscle Energy

Muscle energy is a direct, active technique. Direct means that the physician's motion is applied towards the restrictive barrier, and active means that there is participant involvement. General steps: Assess for somatic dysfunction * T4 F Rr Sr The physician places the patient towards the opposite of the somatic

Rib Dysfunctions

Rib Dysfunctions

Normal rib motions * 1-5 = Pump handle * 6-10 = Bucket handle * 11-12 = Caliper motion Rib dysfunctions are named according to their preferred respiratory motion - position in which the ribs become restricted. Exhaled Rib Dysfunction When a patient's ribs are stuck in the exhaled position (downward), they demonstrate a preference

Burn Fluid Equation and Distribution

Burn Fluid Equation and Distribution

Burn Equation: 4mL * kg * % body burned * 4mL * 75kg * 50% = 15,000mL = 15L With half the fluid given in the first 8 hours and the remainder over the next 16 hours = Total of 24hrs * \(\frac{15}{2} = \text{7.5L}\) given within the first 8hrs * \(\frac{15}{2} = \text{7.5L}

Clinical Trials

Clinical Trials

Phase I - "Is it Safe?" * Purpose: Safety, toxicity, pharmacokinetics, pharmacodynamics * Participants: Small number of healthy volunteers (or patients with the disease if drug is toxic, e.g., chemo) * 20-80 (1 zero) * Key Point: First-in-human → assess safe dosage range and side effects Phase II - "Does it

Temporal Arteritis

Temporal Arteritis

Caused by granulomatous inflammation of medium- and large-sized arteries. Most commonly affects branches of the external carotid artery, especially the temporal artery. Strongly associated with Polymyalgia Rheumatica (PMR) Older woman with headache, jaw pain while chewing, scalp tenderness, and elevated ESR - treat immediately with steroids to prevent vision loss,

Dysmenorrhea

Primary Dysmenorrhea is painful menses due to excess prostaglandin production by the endometrium → uterine contractions and ischemia. There is no identifiable pelvic pathology. Typically begins 6–12 months after menarche (after ovulatory cycles start) Clinical Presentation * Crampy lower abdominal pain that starts 1–2 days before menstruation * Peaks on the

Bronchiectasis

Due to chronic inflammation, this causes permanent dilation of bronchi due to recurrent infections or impaired mucociliary clearance. This trapped mucus further causes the chronic infection cycle and airway damage Etiologies * Cystic fibrosis (most common in U.S.) * Recurrent bacterial or viral infections (e.g. post-TB, pertussis) * Immunodeficiencies (e.g.

Multiple Myeloma

Multiple Myeloma

Caused by malignant proliferation of plasma cells producing monoclonal immunoglobulin (M protein) that usually affects older adults (~60-70 years). This causes bone marrow infiltration and osteolytic bone lesions. Clinical Features (CRAB) * C: HyperCalcemia → confusion, constipation, polyuria * R: Renal failure (due to light chain cast nephropathy) * A: Anemia (normocytic, normochromic) * B:

Ovarian Torsion

Ovarian Torsion

Caused by twisting of the ovary and sometimes fallopian tube around the vascular pedicle. This leads to venous and lymphatic obstruction, then arterial compromise → ischemia. It is most often caused by an ovarian cyst or mass (especially >5 cm) Epidemiology * Mostly affects reproductive-age women * Also can occur in children

Pernicious Anemia

Pernicious Anemia

Caused by autoimmune destruction of parietal cells in the stomach. This leads to decreased Intrinsic factor → ↓ B12 absorption in terminal ileum. * Associated with autoimmune gastritis & other autoimmune diseases (e.g., thyroiditis, vitiligo) Clinical Features * Macrocytic anemia (MCV >100) * Loss of B12 * Neurologic symptoms (specific to B12 deficiency): * Peripheral

Restless Legs Syndrome (RLS)

Restless Legs Syndrome (RLS)

A neurological sensorimotor disorder characterized by uncomfortable urges to move the legs, especially at rest and during the evening/night. Pathophysiology: * Dopamine dysregulation in the CNS * Often associated with iron deficiency (↓ brain iron levels affect dopamine pathways) 1. Urge to move the legs, usually with uncomfortable sensations 2. Worse at

Vomiting vs Laxatives

Vomiting vs Laxatives

* Vomiting = loss of gastric acid → metabolic alkalosis * Laxatives = loss of bicarbonate-rich intestinal fluid → metabolic acidosis Vomiting * Metabolic alkalosis * Increased H+ loss from stomach acid → Retained HCO3- * ↓ Cl- * ↓ Urine Cl- (Kidney tries to retain) * ↓ K+ * Hypovolemia Laxative Abuse * Metabolic acidosis * ↓ HCO3- → lost in diarrhea * ↓ Cl- * ↑ Urine Cl- saline laxatives * ↓ Urine Cl-

Hyperparathyroidism

Hyperparathyroidism

PTH Actions - Core Physiology PTH raises serum calcium and lowers serum phosphate by: * ↑ Bone resorption → ↑ Ca²⁺ and ↑ phosphate * ↑ Activation of vitamin D → ↑ GI absorption of Ca²⁺ and phosphate * ↑ Renal calcium reabsorption (DCT) → ↑ Ca²⁺ * ↓ Renal phosphate reabsorption (PCT) → ↓ phosphate (phosphaturia) * Normal state: ↑ Ca²⁺, ↓ phosphate Primary Hyperparathyroidism * Hyperfunction of parathyroid cells

AML, CML, ALL, CLL

AML, CML, ALL, CLL

Acute Myeloid Leukemia (AML) * Definition: Malignant proliferation of myeloblasts (>20% blasts in bone marrow). * Common in: Adults, especially >60 years. * Risk factors: Previous chemotherapy/radiation, myelodysplastic syndromes, exposure to benzene. * Presentation: Fatigue, anemia, infections, bleeding (petechiae, bruising). * Labs: * ↑ WBC with blasts * ↓ Platelets, anemia * Auer rods (pathognomonic) * Diagnosis: Bone

Neuropathic Arthropathy (Charcot Joint)

Neuropathic Arthropathy (Charcot Joint)

Progressive degeneration and destruction of a joint due to loss of sensory innervation (proprioception and pain). This leads to repeated trauma and joint damage without the patient noticing pain. Causes * Diabetes mellitus (most common cause in the US; affects feet and ankles) * Syphilis (tabes dorsalis) – historically common cause; affects knees,