Baker cyst: aka popliteal cyst, is an extrusion of synovial fluid from knee joint space into the gastrocnemius/semimembranous bursa. Precipitated by
- Increased production in synovial fluid such as during inflammation states or any intra-articular pathology
- A communication formation between the joint and bursa
Continue reading “Baker Cysts”
Hyponatremia is excess of water relative to sodium and almost always due to increased ADH.
- SIADH: inappropriate increase (Conrad: any lung, brain, drugs and cancer)
- SADH: appropriate increase such as in hypovolemia or hypervolemia with decreased effective arterial volume
Evaluation of hyponatremia begins with the following laboratory datas
- Plasma osmolality: to determine if the patient really has hyponatremia
- Pseudohyponatremia: will be high in patients with osmotic substances that draw water to dilute the concentration of sodium
- Urine osmolality: useful in limited circumstances -> Uosm will be < 100
- malnutrition(decrease solute intake)
- primary polydipsia(increase water intake)
- Urinary sodium: used to determine the kidney’s concentrating capabilities(basically how the body is responding to this state, or did it cause it)
- Normally should be low < 20
Continue reading “Hyponatremia: Primary polydipsia”
Symptoms and signs:
- GI: abdominal pain, constipation, anorexia, lead lines on gum(Burton’s lines)
- Neurological : headache, neurocognitive deficits(forgetfullness, encephalopathy, behavior problems, language regression; childrens especially susceptible due to incomplete BBB maturation), motor/sensory peripheral neuropathies(stocking-glove pattern ddx with GBS, DM… etc, extensor weakness)
- Hematologic:al microcytic anemia(99% bound to erythrocytes and can disrupt heme synthesis)
- Nonspecific signs: fatigue, irritability, insomnia,
- Chronic s/s: hypertension, nephropathy
Continue reading “Lead poisoning”
Peripheral aretery disease, previously known as peripheral arterial occlusive disease, one of the most typical presentation is intermittent claudication. As a coronary artery disease risk equivalent, medical therapies should include risk factors modification such as
- Smoking cessation
- Lipid lowering therapy
- Evaluation of HTN and DM.
Continue reading “Peripheral Artery Disease”
Major Depressive Disorder
Criteria: 2 or more weeks of >= 5/9 of the following(M SIGE CAPS) that must include patient-reported depressed mood or anhedonia(inability to feel pleasure in normally pleasurable activities)
Continue reading “Depression”
Cardiotocography aka electronic fetal monitor, monitors the fetal heartbeat and uterine contractions during pregnancy – main purpose is for peripartum fetal heart rate monitoring.
Besides accelerations, there are 3 types of decelerations that need to be differentiated as they have different etiologies, prognosis and managements – Early, Late and Variable.
Continue reading “Intrapartum fetal heart rate monitoring”
Pathogenesis: Increased NO generation in splanchnic circulation secondary to portal HTN. This causes systemic vasodilation, which reduces PVR and BP, causing renal hypoperfusion. In turn, compensatory mechanisms such as RAAS, SANS and ADH increase water and sodium retention worsen volume overload.
Risk factor: Severe cirrhosis with portal HTN and edema
Continue reading “Hepatorenal Syndrome”