Medicine Hack

COPD is a preventable and treatable systemic disease state characterized by a progressive airflow limitation that is not fully reversible and associated with an abnormal inflammatory response of the lungs to noxious particles and gas. Note that the new definition according to GOLD/ATS and ERS does not talk anything about the disease being a mixture of chronic bronchitis and emphysema, though these conditions are very frequently encountered in COPD and also the fact of being 'not fully reversible' distinguishes this disease from the other chronic obstructive condition which is bronchial asthma.

This test was first described by Bors and Blinn in 1957. The authors did this test to check if there are any temperature receptors in the bladder, how they work and whether the test can have a diagnostic purpose. Procedure: (originally done by Bors and Blinn) 60 mL of ice cold water is instilled in the bladder in 30 seconds and patient is requested to try to retain the fluid. Results: If water is expelled in less than 1 minute, the test is said to be positive. Interpretation: The rapid evacuation of the fluid is due to the reflex contraction of the detrusor muscle. The authors also found that this test was positive in patients having an upper motor neuron lesion. The physiology behind is that there are cold receptors in the bladder wall. From there, the impulses travel through the afferent C fibers to the spinal cord and return via the motor nerves to the detrusor muscle thereby completing the reflex arc. This reflex is normally present in children up to the age of 4. After

In a classical lesion, dilated and destroyed respiratory bronchioles coalesce in series and in parallel to produce sharply demarcated emphysematous spaces. They are separated from the acinar periphery (the  lobular septa) by intact  alveolar ducts and sacs of normal size, as shown by the diagram below.  The lesions vary in quality and quantity even within the same lung. There is striking irregularity of involvement of lobules, and even within the same lobule. The lesions are usually more common and become more severe in the upper than in the lower zones of the lung. Most affected are the upper lobe, particularly the posterior and apical segments, and the superior segment of the lower lobe as depicted below.  This type of emphysema is commonly seen in chronic cigarette smokers. For classification of emphysema, follow this link:  Emphysema

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are measured by the serum glutamic-oxaloacetic  transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT) respectively. They are important markers of hepatocellular injury. Normal values:   (varies from lab to lab but on average) ALT : 7-41 U/L AST: 12-38 U/L AST can be found in various tissues like cardiac/skeletal muscles, kidney, brain and liver. ALT is limited primarily to the liver and thus ALT is a more specific reflection of hepatocellular disease than AST. The highest elevations of both enzymes are seen in viral, toxin-induced and ischemic hepatitis.  On the other hand, alcoholic hepatitis usually gives a lower raise of around < 300 U/L.  AST/ALT ratio is a useful indicator. a) A ratio of > 2 is highly suggestive of alcohol-induced hepatic injury. b) A ratio of > 1 and cirrhosis is often seen in patients of chronic hepatitis B infections. c) A ratio of < 1 is commonly seen in

Frontal sinuses (coronal and axial views) Ethmoidal sinuses Below is a sagittal section of the frontal and ethmoidal sinuses. Maxillary sinuses

It is also known as the Common/Purple Foxglove or the Lady's Glove. The flowers are typically purple in colour but they can be pink or even white in some cultivations. At the end of the 18th century,  William Withering  introduced digitalis leaves as a tea into  the treatment of “cardiac dropsy” (edema  of congestive heart failure) and it helped many people . The active principles in these  plants are steroids with one or more sugar  molecules attached at C3. Proven  clinically , digoxin continues  to be obtained from the plants Digitalis  purpurea or D. lanata because its chemical  synthesis is too difficult and expensive.

Definition: Delirium is defined by the acute onset of fluctuating cognitive impairment and a disturbance of consciousness. Cognition includes memory, language, orientation, judgement, conducting interpersonal relationships, performing actions (praxis), and problem solving. Delirium is thus marked by short-term confusion and changes in cognition. There is also rapid improvement in most cases when the causative factor is identified and eliminated. Abnormalities of mood, perception, and behavior are common psychiatric symptoms. Tremor, asterixis, nystagmus, incoordination, and urinary incontinence are common neurological symptoms. Common causes of delirium: 1) Central nervous system disorder Seizure (postictal, nonconvulsive status, status) Migraine Head trauma, brain tumor, subarachnoid hemorrhage, subdural, epidural hematoma, abscess, intracerebral hemorrhage, cerebellar hemorrhage, nonhemorrhagic stroke, transient ischemia 2) Metabolic disor