Upper Gastrointestinal Haemorrhage DDx
Upper gastrointestinal haemorrhage is classically bleeding from above the ligament of Trietz (the suspensory muscle of duodenum that connects to the diaphragm), can is characterised by haemetemesis and melaena.
Bulbar and pseudobulbar palsy
A bulbar palsy is a lower motor neuron lesion of cranial nerves IX, X and XII. A pseudobulbar palsy is an upper motor neuron lesion of cranial nerves IX, X and XII.
Neutropaenic Sepsis
Febrile neutropaenia (or neutropaenic fever) is defined as: a single temperature measurement >=38.5C, or a sustained temperature >=38C for more than 1 hour; in a patient with a decreased absolute neutrophil count (ANC) of either <0.5 x 109/L, or <1 x 109/L with a predicted nadir of <0.5 x 109/L over the subsequent 48h
Hepatorenal Syndrome
Hepatorenal Syndrome = profound oliguria and Na+ retention in the setting of severe liver dysfunction (cirrhosis or fulminant liver failure); usually fatal unless liver transplant performed. RRT can prevent advancement of condition
Surviving Sepsis Campaign Guidelines 2012
Reviewed and revised 8 January 2016 OVERVIEW The Surviving Sepsis Campaign (SSC) is a joint collaboration of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine that seeks to reduce mortality from severe sepsis and septic shock…
Sepsis Pathophysiology
OVERVIEW Organisms Bacteria-> Gram +ve’ cocci (staphylococci, streptococci)-> Gram –ve bacilli (E.coli, Klebsiella, Pseudomonas aeruginosa) Fungi (Candida) Viruses Parasites Complex interaction between inciting microbe host immune response inflammatory pathway coagulation pathway LPS = lipopolysaccharideTRAF6 = TNF receptor-associated factor 6NIK =…
Corticosteroid Therapy for Shock
Corticosteroids are widely used in patients with refractory septic shock, as well as other selected causes of shock. Despite numerous trials, the role of corticosteroids in septic shock remains a controversial issue... still!
Pharmacokinetics and ECMO
ECMO support has potential implications for pharmacotherapy in the critically ill, the significance of which are poorly defined; Pharmacokinetic effects of ECMO vary with different drugs and drug characteristics
Acalculous cholecystitis
Acalculous cholecystitis: pathophysiology: bile stasis + increased viscosity c/o fever, dehydration, no enteral feeding -> CCK induced gall bladder contraction with wall ischaemia
Post hemihepatectomy care
Hemihepatectomy: major surgery; perioperative mortality = 3%; usual indication = metastatic colorectal adenocarcinoma or cholangiocarcinoma
Trauma Scoring Systems
There are various systems available for scoring trauma severity. Some are based on anatomical descriptions of injuries, some on physiological parameters and others use combined data. No ideal trauma scoring system is currently available
Trauma Literature Summaries
Trauma Literature Summaries: Tranexamic acid (TXA) for traumatic haemorrhage; Steroids for acute spinal injury