Normally, the pathological reflexes are not evident because they are suppressed by cerebrum at brainstem or spinal cord level by 6 months of age. Importance: Up-going (dorsiflexion) toe can be elicited at various sites and all indicated Upper Motor Neuron (UMN) lesion. Use a blunt-pointed object like fingernail or tip…
Author: Epomedicine
Emergency Medicine
The Continuum: SIRS, Severe Sepsis and Septic Shock
SIRS criteria are mostly used as a screening tool to identify patients that may need further workup for sepsis and severe sepsis. In the emergency department it is a triage tool that helps determine patient acuity and identify patients that are potentially septic and in need of further screening. Septic…
Clinical Skills and Approaches
Hematological Signs – Angular Stomatitis and Atrophic Glossitis
ANGULAR STOMATITIS/CHEILITIS Definition: Maculopapular and vesicular lesions grouped on the skin at the corners (or ‘angles’) of the mouth and the mucocutaneous junction. It is made worse by licking the lips. Causes: 1. Oral candidiasis 2. Poorly fitting dentures 3. Bacterial infection 4. Less common Nutritional deficiencies (especially riboflavin, iron and pyridoxine) Iron…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Strawberry Gallbladder (Cholesterolosis)
Synonyms: Strawberry gallbladder is also known as hyperplastic cholecystoses. Hyperplastic cholecystoses are a spectrum of non-neoplastic proliferative disorders caused by deposition of cholesterol-laden macrophages within the wall of the gall bladder. The cholecystose range from abnormalities of the gallbladder wall (adenomyomatosis and strawberry gall bladder) to gallbladder polyps extending into…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Cutaneous manifestation in thyroid disorders
Skin – Systemic Disease Connection “When a man has on the skin of his body a swelling or an eruption… and the disease appears to be deeper than the skin it is a leprous disease.” – Leviticus 13: 2-3 In ancient times changes in skin were taken to indicate the…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Hemoptysis – Examination and Evaluation
Synonym: Haemoptysis Definition of Hemoptysis Simple definition: Expectoration of blood or bloody sputum Hemoptysis is defined as the expectoration of blood from the respiratory tract, a spectrum that varies from blood-streaking of sputum to coughing up large amounts of pure blood. True hemoptysis is expectoration of blood from the lower respiratory tree, below…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Respiratory Examination – Relevant Anatomy and Physiology
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 of Louis: Junction of body of sternum to manubrium (2nd costal cartilage…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Respiratory Examination – Noisy Breathing
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 longer time for alveolar gas exchange STERTOR Definition: Non-musical, low pitched, snoring…