Posted by Javier on Jun 18, 2026 in Medicine | Comments Off on Different btn wind in high pressure zone and low pressure zone
1. ASTHMA
Diagnosis (Adults)
- First-line tests:
- Blood eosinophils OR FeNO
- Diagnostic thresholds:
- FeNO ≥ 50 ppb OR raised eosinophils → asthma diagnosed
- If unclear:
- Bronchodilator reversibility (BDR)
- If still unclear:
- PEF variability (2 weeks)
- If still suspected but tests negative:
- Bronchial challenge test (specialist)
Severity (Acute Asthma)
- Severe:
- PEFR 33–50%
- RR > 25
- Pulse > 110
- Unable to complete sentences
- Life-threatening:
- PEFR < 33%
- Confusion
- Exhaustion
- Cyanosis
- Silent chest
- Normal or
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Posted by Javier on Jun 16, 2026 in Medicine | Comments Off on Pharmacology of Antihistamines, Antineoplastics, and Diuretics
Antihistaminic Agents
Antihistamines are drugs that inhibit the action of histamine in the human body. Histamine is a chemical substance classified as an autacoid (a local hormone released from tissue that acts at the site of synthesis).
Histamine Overview
- Chemical Name: 2-(1H-Imidazol-4-yl)ethanamine
- Discovery: Sir Henry Dale, 1910.
- Synthesis: Decarboxylation of Histidine, catalyzed by Histidine Decarboxylase (HDC).
- Storage: Primarily in mast cells and basophils, also in enterochromaffin-like (ECL) cells
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Posted by Javier on Jun 12, 2026 in Medicine | Comments Off on Essential Cardiology Clinical Reference and Management
1. Acute Coronary Syndrome (ACS)
Diagnosis Patterns
- STEMI: ST elevation in contiguous leads OR new LBBB.
- Posterior MI: ST depression V1–V3 + tall R waves.
- Inferior MI: II, III, aVF (RCA → AV node → AV block risk).
- Lateral MI: I, aVL, V5–V6 (LCx).
- Wellens: Deep/biphasic T waves V2–V3 → critical LAD stenosis.
- Troponin rise: Not always plaque rupture (can be sepsis, demand ischaemia).
STEMI Management
- PCI if within 12h + within 120 min pathway.
- Otherwise fibrinolysis (within 12h).
- Repeat ECG 60–90
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Posted by Javier on Jun 11, 2026 in Medicine | Comments Off on Gastroenterology Clinical Essentials: Bowel and Liver Pathology
Surgical Management of Colitis
- Ulcerative Colitis (UC): Refractory disease requires panproctocolectomy (removal of colon, rectum, and anus) with a permanent end ileostomy. UC is a continuous disease involving the rectum; leaving the rectum results in persistent active disease.
- Ileostomy vs. Colostomy:
- Ileostomy: Right iliac fossa, spouted, liquid output (due to lack of colonic water absorption). The spout protects skin from digestive proteases.
- Colostomy: Left-sided, semi-solid stool, less spouted.
- Hartmann’s
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Posted by Javier on May 28, 2026 in Medicine | Comments Off on Psychiatry Clinical Reference and Management Notes
Obsessive-Compulsive Disorder (OCD)
Core Concepts
| Term | Definition |
|---|
| Obsession | Intrusive, unwanted thought |
| Compulsion | Repetitive act to reduce anxiety |
- Diagnosis: Symptoms persist >2 weeks
- Usually has preserved insight
- SSRIs: Higher doses needed; response may take ≥12 weeks
Management
| Severity | First-Line |
|---|
| Mild impairment | CBT + ERP |
| Severe / poor CBT response | Add SSRI |
| Severe functional impairment | Refer secondary mental health |
Exposure and Response Prevention (ERP)
- Expose patient to anxiety trigger
- Prevent compulsive behaviour
Pharmacology
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Posted by Javier on May 26, 2026 in Medicine | Comments Off on Gastroenterology and Hepatology Clinical Summary
1. Liver Disease: Patterns, Causes, and Associations
Chronic Liver Diseases
| Condition | Key Features |
|---|
| Haemochromatosis | Fatigue, erectile dysfunction, arthralgia; ↑ ferritin, ↑ transferrin saturation, ↓ TIBC; AR; hypogonadotrophic hypogonadism; ↑ HCC risk |
| Wilson’s Disease | Liver and neuro disease; ↓ caeruloplasmin, ↓ serum copper, Kayser-Fleischer rings, psychosis |
| PBC | Middle-aged women; ↑ IgM; anti-mitochondrial Ab (M2); treat: ursodeoxycholic acid |
| PSC | p-ANCA+, MRCP “beading”; strong UC association; |
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