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…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Respiratory Examination – Dyspnea
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 pH of CSF) a. Increased work of breathing: Airflow obstruction: Bronchial…
Clinical Skills and Approaches 
Examination of Hands
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): Radial nerve injury Prominent dorsal ulnar and radial…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Mendelian Inheritance : Basis of Genetics
Some important terminologies Gene: a functional part of the DNA molecule of a chromosome which directs the synthesis of a specific polypeptide chain. Allele (allelomorph): alternative form of a gene found at the same locus on a pair of homologous chromosomes. Homozygous: the presence of two identical alleles at a…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Text Presentation on Empyema Thoracis
A) INTRODUCTION Empyema (aka Empyema Thoracs or Empyema of the chest) is an accumulation of pus in the pleural space that occurs when an infection spreads from the lungs. It comes from the Greek word empyein, which means : pus–producing (suppurates). Empyema itself is not a disease but it is actually a condition complicated by another disease….
Clinical Skills and Approaches 
Approach to hypertension in pregnancy
Hypertension in pregnancy is one of the major cause of maternal, fetal and neonatal mortality and morbidity in both the developing and developed nations. About 10-15% of pregnancies are accompanied by hypertension and if these are detected early and effective interventions are performed, the prognosis is good. A. HISTORY FOR…