DEFINITION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) According to GOLD, COPD is a common preventable and treatable (not curable) disease characterized by: Persistent airflow limitation (Post-bronchodilator FEV1/FVC < 0.7), usually progressive (excludes Asthma) Due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. Chronic…
Author: Epomedicine
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Medial Medullary (Dejerine’s) Syndrome : Anatomical basis mnemonic
As already discussed in the previous section about Lateral Medullary (Wallenberg) Syndrome: 6 “S” pass/lie on the Side (latetral) of Medulla Except the anteromedian part supplied by vertebral artery, rest of the medulla is supplied by PICA Let us now review the relevant anatomy and physiology of the medial portion…
Clinical Skills and Approaches 
Pronator Drift (Barre’s sign) : Neurological Examination
Components of pronator drift Progress from distal to proximal: Downward arm drift Forearm pronation Flexion of the wrist and elbow Method of assessment for pronator drift When the patient extends both arms upright in the supinated position and hold them at shoulder height for atleast 10 seconds (Patients should be…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Anatomical basis of Wallenberg (Lateral Medullary) Syndrome : Mnemonic
Before proceeding into the disease itself, let’s review – relevant anatomy of the medulla with a simple mnemonic. The Side (lateral) part of Medulla contains 6 “S“ 1. Spinocerebellar tract Posterior spinocerebellar tract: Ascends and enters to ipsilateral cerebellum via ipsilateral inferior cerebellar peduncle Anterior spinocerebellar tract: Ascends and enters…
Clinical Skills and Approaches 
Clonus : Clinical Examination and Mechanism
Definition of clonus Clonus is a rhythmic sustained involuntary muscular contraction (generally 5-8 Hz) evoked by sudden passive stretch of the muscle and tendon. Eliciting Clonus Clonus is commonly elicited in gastrocnemius (ankle clonus). Other sites where clonus can be elicited are quadriceps (patellar clonus), finger flexors and jaw. 1….
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Radiation cystitis : Diagnosis, prevention and management
Cause of radiation cystitis: Bladder in the radiation field (treatment of pelvic malignancies like prostate, cervical, colorectal) Epidemiology of radiation cystitis: Incidence: 23% to 80% (variability due to variability in type and dosing of radiotherapy among different medical subspecialities) Incidence of severe hematuria: 5-8% Mean duration for developing radiation cystitis:…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Surgical Anatomy of Stomach
GASTROESOPHAGEAL JUNCTION (CARDIA) It is the junction between esophagus and cardia of stomach Histologically: Mucosal transition from squamous to columnar epithelium Functionally: High pressure zone (Lower esophageal sphincter or LES) – Normally, LES is intraperitoneal, >2 cm long, and has a resting pressure >6 mmHg; not an anatomical sphincter but a…
Clinical Skills and Approaches 
Head trauma fluid resuscitation
Peculiarities of cerebral circulation: 1. Brain and spinal cord is isolated from endothelium by BBB composed of continuous capillaries that limits movement of proteins and electrolytes 2. Fluid movement is primarily determined by osmolar gradient (in contrast to peripheral tissues – transcapillary gradient of large macromolecules) 3. Hence, administration of…