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Journey (Near Death Experience) : Poetry

August 23, 2014 – 2:32 am |

 

Blinding white light amidst silence
Her voice constantly echoed my name
In its serenity, slowly turning senseless
Waving goodbye, out of the body I came.
And surrendered myself to her embrace
In the reunion of blood, so divine
Like rain, tears …

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Respiratory Examination – Hemoptysis

April 9, 2015 – 5:13 am |

Definition: Expectoration of blood or bloody sputum

Classification:

  1. Mild: <100 ml/day
  2. Moderate: 100-150 ml/day
  3. Severe: 150-200 ml/day
  4. Massive: >500 ml/day or rate >150 ml/hr or >100 ml/day for 3 days (Pulmonary infarction, Carcinoma)

bloody sputum

Causes:

  1. Infection: TB, Lung abscess, Bronchiectasis, Pneumonia, Fungal
  2. Neoplasm: Carcinoma, adenoma, Metastatic
  3. Congenital: Bronchial cyst, Sequestration of lung
  4. Traumatic, Iatrogenic, Bleeding disorder
  5. Cardiovascular: Mitral stenosis, Pulmonary HTN, Aortic aneurysm, AV malformation, PE
  6. Collagen Vascular Disease: Vasculitis, Wegner’s granulomatosis, Good pasture’s syndrome

hemoptysis causes

In contrast to hemoptysis, hematemesis is:

  • preceded by nausea/vomiting
  • mixed with food particles
  • dark brown (acid hematin)
  • acidic

Mechanisms:

  1. Neoplasms: Invasion of superficial mucosa and erosion of blood vessels; High vascular tumor with fragile walls
  2. Pulmonary venous hypertension: High pressure damage venous walls
  3. Infection: Inflammation and repeated cough disrupts pulmonary vasculature

Respiratory Examination – Relevant Anatomy and Physiology

April 4, 2015 – 5:29 am |
surface lungs

1. Division of Airway:

Extrathoracic (Upper) airway: Nose to Upper trachea
Intrathoracic (Lower) airway: Lower trachea to Alveoli and lungs

Note: Vocal fold is also regarded as the demarcating line between upper and lower respiratory tract
2. Angle …

Respiratory Examination – Noisy Breathing

April 2, 2015 – 2:14 am |
narrowed airway

GRUNTING 
Definition: A short, explosive, moaning or crying sound heard on expiration (Child and neonates)
Cause: Any cause of respiratory distress
Mechanism: In attempt to increase FRC which helps to keep narrowed or collapsing airways open, creating a …

Respiratory Examination – Dyspnea

March 26, 2015 – 2:58 am |
orthopnea

Definition: Breathlessness inappropriate to the level of physical exertion or even occurring at rest (subjective and not a sign)
Mechanisms:
Chemoreceptors:
Peripheral: Carotid and aortic bodies (to pO2, pCO2 and H+)
Central: Medulla (to pCO2, not pO2, change in …

Examination of Hands

March 18, 2015 – 4:05 pm |
hand examination

History: Hand dominance and occupation? Injury? Pain? Paresthesia? Impaired function? Swelling?
Position: Place the patient’s hands on pillow
Look: SEATS
a. Shape or Deformity:
– Wrist:

Radial deviation: RA
Ulnar deviation and flexion deformity: Spastic hemiplegia (CP)
Wrist drop (also finger drop): …