Sunday, January 2, 2022

High anion gap metabolic acidosis mnemonic.

High anion gap metabolic acidosis mnemonic.

(RUSH Kill ME)

Renal tubular acidosis (distal), Rhabdomyolysis (massive)

Uremia

Salicylate ingestion

Hypovolemia, Heart failure

 

Ketoacidosis (diabetic, starvation)

Inborn error of metabolism, Iron, Isoniazid ingestion

Lactic acidosis

Late metabolic acidosis of prematurity

 

Mitochondrial diseases, Methanol ingestion

Ethanol, Ethylene glycol ingestion

Saturday, January 9, 2021

Modes of infectious disease transmission

 Modes of infectious disease transmission

An infectious agent may be transmitted from its natural reservoir to a susceptible host in different ways.

There are different classifications for modes of transmission. 

Here is one classification:

A.   General transmission

B.   Human-to-human transmission:


  • Direct
    • Direct contact
    • Droplet spread
  • Indirect
    • Airborne
    • Vehicleborne
    • Vectorborne (mechanical or biologic)

 more in this file


Monday, December 28, 2020

Growing pains in children

Growing pains in children

Episodes of generalized pain in the lower limbs, referred to as ‘growing pains’ or nocturnal idiopathic pain, are common in preschool and school-aged children.

The pain often wakes the child from sleep and settles with massage or comforting.

The condition is poorly understood. Features to be fulfilled for this diagnosis are often referred to as the ‘Rules of Growing Pains’, which are:

- Age: range 3–12 years

- Pains symmetrical in lower limbs and not limited to joints.

- Pain often follows a day with exercise or other physical activities.

- pains never present at the start of the day after waking up

- physical activities not limited; no limp

- Physical examination normal (including pGALS), with the exception of joint hypermobility in some, and otherwise well.

Monday, December 21, 2020

OMPHALOMESENTERIC (VITELLINE) REMNANT

 

OMPHALOMESENTERIC (VITELLINE) REMNANT

Partial or complete failure of involution of the omphalomesenteric duct can lead to a spectrum of anomalies in the newborn infant due to varying degrees and location of duct patency:

A.   An umbilical cyst containing intestinal tissue.

B.   Umbilical sinus with a band.

C.   A persistent omphalomesenteric duct at the umbilicus with no intestinal connection results in an umbilical polyp.

D.   Patent mid-duct with closure at both the umbilical and ileal ends of the omphalomesenteric duct results in an omphalomesenteric duct cyst. Because the two ends are fixed, this can lead to small bowel obstruction if loops of bowel twist around the cyst.

E.   Persistent tissue at the ileum, with no connection to the umbilicus results in Meckel's diverticulum.

F.   Complete patency results in the omphalomesenteric duct directly connecting the umbilicus to the terminal ileum. This can lead to intermittent drainage from the umbilicus " omphalomesenteric fistula". These infants will often appear to have a "stoma" in the umbilicus after cord separation.

G.  Persistent fibrous cord (band)  between the umbilicus and the ileum, which can lead to small bowel obstruction.