December 2020 ~ Medical diseases and trems ,symptoms causes TREATMENT

Medieducator.com

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INTUSSUSCEPTION, CAUSES, SIGN AND SYMPTOM , DIAGNOSIS , TREATMENT

                  

 

                        INTUSSUSCEPTION

      Telescoping of one prat of intestine into another part of intestine is called intussusception. 

         * It is acquired condition.

         * The causes of this disease is unknown .

         * The most common effected location is ileocecal junction .

         * Obstruction in the intestine occur due to the telescoping .

SIGN AND SYMPTOM

    ➤  Severe colic abdominal pain . { During pain the child flex his legs over the abdomen and appear like fetal position }.

     ➤  Abdominal distention .

     ➤ Bilious vomiting .

     ➤ Currant jelly like stool - stool appear red and it contain the blood and mucus .

     ➤  Sausage shaped mass palpated .

DIAGNOSIS

             ➤    USG

            ➤     CT - SCAN. 


       ➤ If treatment is not provided then two situation can be possible .

1. Self resolving condition-

                                  The pain is relived and the patient passage normally formed brown colour stool.

2. Intestine rupture -

                                  In this condition the pain is suddenly relived and then after some time more severe pain occur due to generalise peritonitis .

        * shock will occur due to internal bleeding .

 TREATMENT

    1. Hydrostatic reduction 

                                An intestinal tube is inserted up to the level of obstruction . Then forcefully water is applied through the tube so condition can be resolve by the force of water .

  2. SURGERY 

                       If hydrostatic reduction is not effective then surgery should be perform , in this surgery the telescope part is reduced by open surgery .



ABDOMINAL WALL DEFECT ,causes ,diagnosis ,treatment , sign and symptom

                                  ABDOMINAL WALL DEFECT

    Abnormal opening in the abdominal wall is called abdominal wall defect . It is congenital abnormality .

CAUSE / RISK FACTOR

                    Exposer of the mother to teratogenic substance such as rediation , TORCH infection , smoking , drug abuse , alcohol use during pregnancy .


TYPE OF ABDOMINAL WALL DEFECT

          

 1. OMPHELOCELE                                                    2. GASTROSCHISIS

 ➤ Abnormal opening is present at the            ➤ Abnormal opening is present lateral to the umbilicus.

      level of umbilicus.                                      ➤ Organ are protrusions.

 ➤ Organ are protrusions.                             ➤ Protrused organ are directaly expose to the environment.

 ➤ Protrused organ are covered by                        and transparent membrane is absent .

      transparent membrane


DIAGNOSIS

         *    Antenatal Diagnosis - Maternal serum alfa fetoprotein {MSAFP} test should be                done.

         * If the level increase it indicate abdominal wall defect or neural tube defect.

         * If the level is decrease it indicate down syndrome { trisomy 21 chromosome}

         * Physical examination .

TREATMENT / MANEGEMENT             

       Initial treatment - 

                  * Provide supine position .

                  * Cover the defect with a non - adhesive dressing .

                  * A sterile normal seline dipped gauze piece can be used.

                  * Apply plastic dript over the gauze piece to prevent  evaporation .

  Surgical treatment - the surgery should be perform as early as possible .

                               - The protrused organ should be reverted back and then abnormal                                              opening should be closed .  

LIVER CIRRHOSIS, liver cirrhosis cause liver cirrhosis symptoms liver cirrhosis treatment stages of liver cirrhosis

                           


                                               LIVER CIRRHOSIS

         It is define as permanent distraction of hepatocyte or necrosis of liver tissue with scar formation .

      It is irreversible condition .

TYPES AND CAUSES OF LIVER CIRRHOSIS

        A. ALCOHOL CIRRHOSIS -   

                                                            Due to the excessive use of alcohol , Most common type of cirrhosis .

        B. POST NECROTIC CIRRHOSIS 

                                            Due to hepatitis B,C, AND D infection and excessive use of hepatotoxic drug.

        C. BILIARY CIRRHOSIS 

                                              Due to any obstruction in biliary system.

        D. CARDIAC CIRRHOSIS 

                                             Due to right side heart failure .


   CLINICAL SYMPTOM -

                      *  Anorexia , Nausea , vomiting , Primary symptom of liver cirrhosis.

                      * Jaundice .

                      * Peripheral oedema .

                      * Epistaxis .

                      * Recurrent infection.

                      * Factor hepaticus - Bad breath or bad small from patient mouth.

                      * Liver Asterixis - Abnormal involuntary movement of finger due to ammonia in brain and dysfunction in basal ganglia.


Complication 

                  - Portal hypertension .

                  - hepatic encephalopathy

                  - Hepatorenal syndrome 

DIAGNOSIS

                History .    

                physical examination 

                USG 

                CT Scan

                MRI 

                ERCP

                Blood investigation 

                                              CBC , PANCYTOPENIA , CT BT , PT INR {Priority},LFT.

               Liver biopsy - [ confirmative test ]

TREATMENT 

     Liver cirrhosis is an irreversible condition only symptomatic management  has been made .

    - Nil per mouth 

    - Fowlers position { if respiratory difficulty}.

    - Monitor intake output chart and vital sign.

    - Fluid maintenance DNS AND RL.

    - Manage A N V 

    - Paracentesis    remove of fluid from abdominal cavity.

    - To control the bleeding by coagulant ,FFP , inj. vitamin K, RDP/SDP

                TRANEXA , PROTAMINE SULFAT

    - BT transfusion .

    - administer IV Albumin 

    - administer Lasix 

    If hepatic encephalopathy develop - provide protein free diet , neomycin , lactulose.

 At the time of discharge 

                      Low fat diet 

                      Avoid alcohol , avoid hepatotoxic drug 



GIGANTISM CAUSE SIGN AND SYMPTOM DIAGNOSIS TREATMENT


DEFINITION

                  This situation occur due to excessive secretion of growth hormone.

CAUSE

               Adenoma of pitutory gland .

SIGN AND SYMPTOM 

              Hight 7 to 8 feet .

              Hyperglycemia 

              Glycosuria    

             headache 

              Visual disturbance 

             organomegaly    

             In let condition diabetes mellitus can occur.

TREATMENT

SURGICAL MANAGEMENT 

                         HYPOPHYSECTOMY 

                                                             It should be perform by two procedure 

                    1. Craniotomy   { chances of bleeding are present }

                    2. Trance nasal Hypophysectomy { chances of CSF leakage are present}

   After the surgery life time hormonal replacement therapy is require .

What to do in case of symptomatic person in the family?

SELF ISOLATION 

                     Self isolation is when you do not leave your home because you have or might have viral infection such corona virus or other contagious viral disease,

This help to stop the virus  spreading to other peoples.

SOCIAL DISTENCING
                      General advise to everyone to avoid close contact with other peoples.
SHILDING 
                   Advise for peoples at high risk from corona virus.

It's a legal requirement to self isolate if your test positive or are told to self isolate by ICMR guideline.

* you have any symptoms of corona virus {a high gread temperature . respiration difficulty ,throat pain , chest pain etc]

WHEN GET TEST 

                      1. A high temperature .
                      2. a new , continuous cough
                      3. a loss or change your sense of smell or teste.
HOW LONG YOU HAVE ISOLATE
              If you have symptoms or have tested positive for coronavirus , you'll usually need to self isolate for at least 10 to 14 days.
* someone you live with has symptoms or test positive.
* Someone in your support bubble has symptom or tested positive.


PRE ECLAMPSIA CAUSES || SIGN AND SYMPTOM || DIAGNOSIS || TREATMENT



 DEFINITION

                    It is a multi system disorder, in which hypertension develop after 20 week of gestation previously normotensive , non protein urine mother.

characteristics by

                                      1. protein urea 1+ = preeclampsia 

                                                              3+ = ECLAMPSIA

                                      2. Rise in BP - It is first observation .Range of BP is 140/90 mm/hg , diagnosis is more important ,variation about 30/15 mm/hg , MABP ˃20 MM/HG , BP monitoring 6th hourly.

          EDEMA less or physiology in pre eclampsia.

                         More or pathology eclampsia .

CLINICAL SIGN AND SYMPTOM 

      SIGN    

                  1. Most common sign increase BP 

                  2. Edema 

                  3. protein urea 

                  4. IUGR , oligohydramnios , abnormal weight gain .

  SYMPTOM 

                 1. Most common patient complain headache 

                 2. Epigastric pain 

                 3.oliguria , blurred vision , insomnia .

  In complicated condition hypertension develop haemorrhage develop HELLP Syndrome 

                     H- haemolysis  

                     E - Elevated liver enzyme 

                     P - LOW PLATELATE COUNT 

Serum uric acid is biochemical marker of pre eclampsia .

 DIAGNOSIS 

                - Physical examination {BP , Edema , weight }

                - Blood test { RBC , LFT , PLETLETE ,RFT,CBC}

                -USG 

                - ophthalmoscopy for vision 

                - protein urea { urine 24 hours } 

                - Roll over test { 28-32 week} {˃20 mm/hg}.

TREATMENT 

           * Rest to decrease oxygen demand and promote blood circulation

          * provide oxygen therapy if required .

          * Provide sedative for emotional stability .

          * High calorie high protein diet .

          * Do not use aspirin for the management .

 * DRUG OF CHOICE 

                Pre eclampsia management MgSo4 {magnesium sulfate }

                Chronic hypertension methyldopa

               hypertensive crisis   Labetalol

COMPLICATION 

            Eclampsia 

            CVA

           Acute renal failure 

         abruptio placentae

          Intra uterine death