Medicine Hack

The double-ring test is clearly shown in this photo. It is also known as the ring sign or halo sign. The patient was brought following an injury to the head and was bleeding moderately from the nose but the blood was more watery than normal. CSF rhinorrhea was suspected. The dextrose stick test was positive to the sample and when placed on a filter paper, we got an inner ring of blood and a halo, followed by an outer ring of CSF. Though this has been a classical medical test, it is not 100% reliable.

Battle sign refers to the post auricular ecchymosis that occurs following trauma to the middle cranial fossa of the skull. It may indicate underlying brain trauma. The picture above shows one patient who came to the emergencies few hours after the head injury while in the one below it, patient was brought in a confused state few days after trauma to his head. The sign was named after William Henry Battle, who was a English professor of surgery and pathology.

It is a diarrheal disease and is commonly seen in cases of food poisoning. Pathogenesis: Man acquires this infection by ingesting contaminated water or food. Water is usually infected by feaces from an infected animal or human. Poultry and eggs also comprise an important source of salmonella. The organisms may be present on the outer shell or even in the yolk. The clinical syndromes that can occur in man includes gastroenteritis, enteric fever and septicaemia. In the case of enterocolitis, the salmonella bacilli attach themselves to the microvilli of the ileal mucosa by means of adhesins and then invade the cells. They cause massive efflux of fluids and electrolytes. Clinical presentaion: There is large volume watery diarrhea, fever, headache, chills, abdominal pain and tenesmus. In simple uncomplicated cases, the diarrhea will last for 3-7 days. Diagnosis is made by stool culture. The disease is self limited. Treatment consists only of correcting any fluid and electrolyte

1. For adults requiring a peripheral catheter, upper extremity site is preferred. If it is for a child, then we can use both upper or lower extremities as well as scalp sites. 2. The catheter site should be evaluated everyday and if there is any sign of phlebitis, the catheter should be removed immediately. 3. For central catheters in adults, it is better to use the jugular or subclavian route rather than the femoral one. 4. Systemic antimicrobial prophylaxis is not essential when using I.V catheters.

It is a fracture that occurs not because of a single violent injury but results from repeated stress. It is commonly seen in athletes and new military or police force recruits. The pathology here is that the rate of microdamage from repeated stress exceeds the rate of repair. Thus there is accumulation of these microdamages and there is eventually a complete fracture across the full width of the bones. Majority of stress fractures occurs in the bones of the lower limbs, notably the metatarsals. Other sites may be the shaft of the tibia or the neck of femur.

ECG shows an inferior wall infarct i.e ST segment elevation in leads II, III and aVF. The precordial V leads are actually right sided on this ECG. This is evident because the tracing in V6 does not resemble lead I and aVL. Also the P waves in V4 to V6 are flat. ST depression in I and aVL along with ST elevation in right sided V3-V6 indicates right ventricular infarct.

Depression is a mood disorder whereby mood is sad. About 30% of psychiatric cases deal with depression. Both males and females are affected but females are slightly more prone to be depressed. Cause: The biological cause is that there is a decrease in the serotonin neurotransmitter. Signs and symptoms: A simple mnemonic to remember is SIPS CAGE. 1) Sleep - There is late onset of sleep, intermittent awakening and early morning awakening i.e. around 2 hours before the normal waking up time. Rarely, the patient may over sleep. 2) Interest - Patient will have a decrease interest in the daily activities. This can result in social withdrawal, decreased ability to function in occupational and interpersonal areas. At times there is the inability to experience pleasure aka anhedonia . 3) Psychomotor activity - In younger patients, there is slowness in the thinking process and activities also are carried out at a slow pace. In elderly on the other hand, there is restlessness and inc