The bleeding in hemophilia has been divided into serious and life threatening.
Serious Bleeding
- Joints (hemarthrosis)
- Muscle/soft tissue
- Mouth/gums/nose
- Hematuria
What Are Sites Of Bleeding In Hemophilia
August 27, 2010 By Leave a Comment
What Is Addisonian Crisis?
August 7, 2010 By Leave a Comment
Addisonian crisis is also called adrenal crisis. It is a constellation of symptoms that indicate severe adrenal insufficiency.
It may occur in either previously undiagnosed Addison’s disease due to a disease process suddenly affecting adrenal function. It may also due to an intercurrent problem like infection or trauma in the setting of known Addison’s disease.
The situation may also develop in those on long-term oral glucocorticoids who have suddenly stopped taking their medication. [Read more...]
What Are Symptoms of Addison Disease?
August 6, 2010 By Leave a Comment
Addison’s disease is also called as chronic adrenal insufficiency, hypocortisolism or hypocorticism. It is a rare disorder where the adrenal glands are not able to produce glucocorticoids and less often mineralocorticoids in sufficient quantity. The condition was first described by Dr Thomas Addison, the British physician who first described the condition.
Causes of Addison disease
Adrenal dysgenesis
This means adrenal glands which produce glucocorticoid are absent. [Read more...]
Differential Diagnosis of Abdominal Lump In Right Hypochondrium
July 3, 2009 By Leave a Comment
Swellings in the Abdominal Wall
Cold Abscess
1. Fluctuant swelling with no signs of inflammation
2. Swelling becomes prominent when the abdominal muscles contract
3. Irregularity in the affected rib or deformity of the spine
Intra-abdominal Swellings
Hepatic
1. It moves with respiration but is not mobile sideways
2. The swelling is continuous with the liver dullness without a band of colonic resonance
Gall Bladder
1. Oval smooth swelling, the size of an egg
2. Moves with respiration, can be moved sideways but cannot be pushed down into the loin (like kidney swelling) [Read more...]
What Is Spider Nevi?
June 8, 2009 By Leave a Comment
It is also known as Arterial spider, Spider telangiectasis, Spider angioma
Definition:
An arterial spider is a central arteriole, from which numerous small vessels radiate resembling a spider’s legs.
Sites:
Arterial spiders are found in the territory of the superior vena cava. They are commonly seen on the face, neck, forearm and shoulder.
Appearance:
They range in size from 3 to 15 mm in diameter. They are pulsatile and blanch on pressure. When the skin is stretched or compressed they fill from the centre to the periphery. [Read more...]
Examination Of Abdomen-Inspection
June 1, 2009 By Leave a Comment
Examination of the abdomen begins with inspection. 
The shape of the abdomen in most normal persons with normal musculature is boat-shaped i.e. the abdominal wall sinks slightly within the bony margins of the abdominal surface.
In a very muscular person, the lateral margin of the rectus muscle is visible in the center. Usually the medial edges of both the recti are contiguous. However they may be separated as a congenital defect, after pregnancy or with obesity and ascites. This is called divarication of recti.
Scaphoid or sunken abdomen is seen with starvation and malignancy especially of stomach and esophagus. [Read more...]
How To Examine A Patient of Abdominal Complaints
May 29, 2009 By Leave a Comment
In a patient with an abdominal disorder, the following points must be asked whilst taking the history and noted on examination.
History
History is of paramount importance in clinical examination. It enables you to narrow your examination to a region and also guides you about the likelihood of particular disorder. Following points should be asked in patient of abdominal complaints. These points cover whole abdomen in general and can be individualized depending upon the complaint. [Read more...]
Jugular Venous Pulse – JVP
December 20, 2008 By Leave a Comment
Normal Jugular Venous Pulse (JVP):
The normal JVP consists of three positive pulse waves a, cand v and two negative pulse waves x and y.
The ‘A’ Wave: The ‘a’ wave is produced by retrograde transmission of the pressure pulse produced by right atrial contraction. In normal subjects the ‘a’ wave is often the largest positive wave visible, coinciding with the fourth heart sound.
1. ‘a’ wave is absent in atrial fibrillation
2. ‘a’ wave is diminished in
- Tachycardia
- Prolonged PR interval [Read more...]
Hypotension -Types and Causes
December 6, 2008 By Leave a Comment
Hypotension is diminished blood pressure. This could be acute or chronic.
Acute Recumbent Hypotension
Causes
- Cardiovascular: Acute myocardial infarction, pulmonary embolism, dissecting aneurysm, ventricular tachycardia, cardiac rupture.
- Intravascular volume contraction: Hemorrhage, vomiting, diarrhea, burns, intestinal obstruction, periotonitis, etc.
- Anaphylaxis
- Gram negative septicemia
Clinical Features
- Due to shock: Tachycardia, vomiting, fainting
- Due to causative disease
- In vasovagal attacks, hypotension with brady-cardia
- In postural hypotension, fall of BP occurs on suddenly assuming erect posture from supine posture.
Treatment
- Of the cause
- Posture: The patient should be in lying position with legs raised.
- For vasovagal attacks: Atropine 0.6 mg IV
- For anaphylaxis: Hydrocortisone hemisuccinate 100mg IV, repeated as required
- For postural hypotension: This is best treated by advising the patients to assume the erect posture slowly and to wear elastic stockings and abdominal binder.
- Vasoconstrictors: Dopamine, nor-epinephrine and ephedrine have been tried.
- Salt: Adequate amount of salt (NaC1) in diet helps to expand the plasma volume.
- Fludrocortisone Acetate: (0.1 – 0.2 mg) causes fluid retention and avoids postural fall of BP. [Read more...]