Inflammation of the Appendix is one of the most common causes of Pain Abdomen presenting in the Emergency Room. Since its first description in the texts, there has been a lot of improvement in the quality of management due to the availability of resources and technology. Appendix, in the initial…
Tag: Gastrointestinal system
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Amylase and Lipase in Acute Pancreatitis
Test Rise Peak Return to baseline Lipase 4-6 hours 48 8-14 days Amylase 2-4 hours 24-48 5-7 days Serum lipase elevation has a better diagnostic value as compared to serum amylase due to its superior specificity. Amylase has a low molecular weight and as a result can easily pass through…
Emergency Medicine 
Acetaminophen (Paracetamol) Poisoning: Mnemonic Approach
Rule of 150 and 4 a. Begin treatment if: Paracetamol is ingested at a dose >150 mg/kg Threshold to begin treatment is half the dose (75 mg/kg) in high risk cases: 1. Regular ethanol consumption: >21 Units/week in male and >14 Units/week in female 2. Regular use of enzyme inducing…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Maddrey Score (Discriminant Function) and Lillie Model : Alcohoic Hepatitis
The severity of alcoholic hepatitis can be assessed using a number of simple quantitative indices (Maddrey score, Meld score, Combined clinical and laboratory index). Of these, the Maddrey Discriminant Function (MDF) is the simplest. Maddrey score = 4.6 X (prolongation of prothrombin time above control in seconds) + Total bilirubin…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Clinical Criteria for Diagnosis of Enteric Fever
In the Absence of Microbiological Confirmation, these case defintions and criteria may be helpful. Case definitions of Typhoid Fever a. Confirmed enteric fever: A patient with persistent fever (38 °C or more) lasting 3 or more days, with laboratory-confirmed S. typhi organisms (blood, bone marrow, bowel fluid) A clinical compatible…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
ORS and ReSoMal – Mnemonic
Oral Rehydration Solution (ORS) Grams per litre: SoDIum C-hloride: 2.6 gm SoDIum Ci-Trate: 2.9 gm Potassium chloride: 1.5 gm Glucose anhydrous: 13.5 gm Mnemonic: DI = 2 and C = 6Ci-Trate = Rotate 6, i.e. 9For Potassium chloride: Deduct 1 from the whole number and decimal both, i.e. (2-1).(6-1) =…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Why is hepatitis E dangerous during pregnancy?
Hepatitis E Virus (HEV) infection is usually a self-limiting disease with a low rate of fulminant hepatic failure but maternal hepatitis E during the third trimester of pregnancy is a cause of fulminant hepatic failure with a mortality rate of upto 20%. Severe liver injury due to HEV in pregnancy…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Orexigenic and Anti-orexigenic peptides : Mnemonic
Orexigenic (Appetite stimulant) peptides Mnemonic: When you see MANGOEs, you feel like eating. MCH (Melanocyte Conentrating Hormone) AGRP (Agouti Related Peptide) NPY (Neuropeptide Y), Noradrenaline GnRH, GABA, Galanin, Ghrelin Orexins A and B Endorphins, Endocannabinoids Anti-orexigenic (Appetite supressant) peptides Mnemonic: NO BLACk PIGS Neurotensin Oxytocin, Oxyntomodulin Bombesin Leptin Alpha-MSH (POMC derivative), Amylin,…