Blog »

nde white tunnel

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 …

Read the full story »
Clinical Cases

Medical case reviews and peer comments, discussions and hot debates, Spot medical case diagnosis and interesting case pictures and videos.

Clinical Medicine

Diseases and medical conditions that we face in clinical practice, Bedside classes,clinical skills and approaches to diagnosis and management.

Emergency Medicine

The Real Emergency Room scenarios, cases and topic reviews. Medical emergency conditions – approach to diagnosis and management.

Medical Students

Medical topics- easy to understand, conceptualize and remember through simplified texts, mnemonics, images, flowcharts and tutorial videos


Between life and death- Your success stories, writings, experience, ideas, innovations and medical life. Interviews, news reviews and analysis.

Medical Students »

Respiratory Examination – Hemoptysis

April 9, 2015 – 5:13 am |

Definition: Expectoration of blood or bloody sputum


  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


  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


  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

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 |

Definition: Breathlessness inappropriate to the level of physical exertion or even occurring at rest (subjective and not a sign)
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
a. Shape or Deformity:
– Wrist:

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