Boerhaave Syndrome- Spontaneous rupture of esophagus. Meckler Triad: Hamman’s sign: Crunching sound on auscultation, suggestive of air in the mediastinum Diagnosis: Gastrograffin swallow study -Water soluble solution, non-toxic to mediastinum unlike Barium. Treatment: Nil per orally (NPO) Left thoracotomy with immediate primary repair Cervical esophagectomy Antibiotics Read More »
Author Archives: Himanshu Deshwal- Assistant Editor
Feed SubscriptionThyroid Complications
In this quick review, we will discuss salient features of two complications of thyroid disorders Myxedema coma, a complication of hypothyroidism Thyrotoxic crisis (thyroid storm), a complication of hyperthyroidism A. Myxedema Coma It is a medical emergency and a rare presentation of severe hypothyroidism. Depressed levels of consciousness in elderly who appear myxedematous/ obese should raise suspicion for ... Read More »
Human Immunodeficiency Virus
HIV virion contains: Enveloped truncated conical capsid (type D) 2 copies of single stranded (+) RNA RNA dependent DNA Polymerase (Reverse Transcriptase) Integrase Protease Gp 120 interacts with CD4+ co-receptors on T-cells Gp 41 is a fusion protein that fuses with cell membrane to allow entry of the virus. Gp 24 Capsid- First Antibody detected in HIV infection ... Read More »
Facts about Hypercalcemia
Hypercalcemia can manifest as: Osteitis fibrosa cystica Cystic and hemorrhagic bone lesions due to increased osteoclastic activity. Most commonly involves the Subperiosteal bone resorption of phalanges and tooth sockets. Salt and pepper appearance of the skull on X-ray. Primary Hyperparathyroidism- Causes: 80%- Adenoma (Right Inferior Parathyroid- most common) 20%- Primary Hyperplasia (All 4 Parathyroid glands are involved) (Clear cell hyperplasia- ... Read More »
Normal Pressure Hydrocephalus
Normal Pressure Hydrocephalus — CSF is not absorbed- A form of communicating hydrocephalus, where CSF pressure is normal. Ventricles are chronically dilated. Clinical symptoms– Triad Diagnosis: Exclude treatable causes of dementia (e.g. Vitamin B12 deficiency, Hypothyroidism) Screening Test: CT Scan, MRI Scan Confirmatory Test: (Gold Standard) Ventricular Shunting- Diagnostic and therapeutic. Improvement of symptoms on removal of CSF- Not generally ... Read More »
Whipple’s Triad
Whipple’s triad Whipple’s Triad is a triad of symptoms suggestive of hypoglycemia. It includes: Spontaneous hypoglycemia with blood sugar levels less than 50mg/100ml CNS or vasomotor symptoms that may range from excessive sweating, dizziness, syncope to odd behavior and seizures Relief of symptoms by oral or intravenous administration of glucose. Chronic hypoglycemia leads to attenuated autonomic response. Therefore, it may ... Read More »
The Pathogenesis of Addiction
“What fascinates me about addiction and obsessive behavior is that people who would choose an altered state of consciousness that’s toxic and ostensibly destroys most aspects of your normal life, because for a brief moment you feel okay.”- Moby (musician) Introduction Addiction is the need to do something repetitively in order to attain a hedonic/ pleasure state. ... Read More »
Vaccines: The importance of a great discovery
Introduction In medieval times, infectious epidemics have run riot killing thousands of people. On instances, entire tribes were wiped out and lost with them were their traditions and cultures forever. The great epidemics of measles, smallpox and influenza, have killed more than half of population of many countries back then. Every year the deadly epidemics would recur in different ... Read More »
USMLE Step 2 Clinical Skills Exam- My preparation experience
Phase I: My first journey to The US Anxious, petrified and perturbed I was, sitting in the Terminal 3 of Indira Gandhi International Airport, New Delhi, India, ready to board my first flight outside the country. It also happened to be the day my USMLE Step 2 CK result would be declared while I would be in mid-air over the ... Read More »