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6
45

Rectal And Perianal Bleeding

Rectal And Perianal Bleeding Ben Savage  
Dr Ben Savage
about 9 years ago
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4
140

Haemothorax

This image displays a large left sided haemothorax with mediastinal displacement to the opposite side. Clinically the patient would be in respiratory distress - percussion of the left side of the chest would be dull and breath sounds and vocal resonance would be reduced. A Haemothorax such as this falls into the category of life threatening chest injuries (ATOMFC) and requires emergent treatment using a chest drain in the 5th intercostal space, mid-axillary line and treatment according to ALS or ATLS protocols. ATOMFC = A = airway obstruction, T = tension pneumothorax, O = open pneumothorax, M = massive haemothorax, F = flail chest, C = cardiac tamponade.  
Rhys Clement
almost 9 years ago
10
1
25

Focus On: Treatment of Epistaxis

Epistaxis is one of the most common ear, nose, and throat emergencies, with an estimated 60% lifetime incidence rate for an individual person.  
American College Of Emergency Medicine
about 8 years ago
12
0
137

Priapism and Hematuria

<p>Why is a 12 hour erection a bad thing? How should we manage the patient with bloody urine? A curbside consult with urologist Brian Shaffer, MD.&nbsp;</p <p>Your emails</p <p>An unusual southern accent</p <p>and much more...</p <p>&nbsp;</p <p><em><strong><span style="font-size: x-large; color: #0000ff;">Urology Primer</span></strong></em></p <p>&nbsp;</p <p><strong><span style="font-size: large;">Priapism<span style="font-size: 10px; font-weight: normal;">&nbsp;a rare condition that causes a persistent, and often painful, penile erection.</span></span></strong></p <p>&nbsp;</p <p>Priapism is drug induced, injury related, or caused by disease, not sexual desire. As in a normal erection, the penis fills with blood and becomes erect. However, unlike a normal erection that dissipates after sexual activity ends, the persistent erection caused by priapism is maintained because the blood in the penile shaft does not drain. The shaft remains hard, while the tip of the penis is soft. If it is not relieved promptly, priapism can lead to permanent scarring of the penis and inability to have a normal erection.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Clot retention</span></strong></p <p>blood clots in the bladder prevent urine emptying</p <p>&nbsp;</p <p><span style="font-size: large;"><strong>Coude Catheter</strong></span></p <p>a semi-rigid catheter that has a curve or bend at the tip. The curved tip allows it to navigate over the curvature of the prostate or any other urethral obstruction it may encounter. A Coude catheter is specifically designed for this purpose. Coude catheters are available in size 8 French to size 26 French.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">De Novo</span></strong></p <p>The Latin expression de novo literally means something akin to "from the beginning" or "anew"</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Interstitial cystitis</span></strong></p <p>also called painful bladder syndrome &mdash; is a chronic condition characterized by a combination of uncomfortable bladder pressure, bladder pain and sometimes pain in your pelvis, which can range from mild burning or discomfort to severe pain.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Cystoscopy</span></strong></p <p>the use of a scope (cystoscope) to examine the bladder. This is done either to look at the bladder for abnormalities or to help with surgery being performed on the inside of the urinary tract (transurethral surgery).</p <p>&nbsp;</p <p><strong><span style="font-size: large;">CT Urogram</span></strong></p <p>A urogram is a radiograph, or X-ray image, of the urinary tract.&nbsp;</p <p>&nbsp;</p <p><strong><span style="font-size: large;">TURP</span></strong></p <p>transurethral resection of the prostate</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Foley catheter</span></strong></p <p>a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also called an indwelling catheter. It is held in place with a balloon at the end, which is filled with sterile water to hold it in place. The urine drains into a bag and can then be taken from an outlet device to be drained</p <p>&nbsp;</p <p>&nbsp;</p>  
Rob Orman, MD
about 8 years ago
0
3
43

Obstetrical Hemorrhage

Topics This afternoon, I&#8217;d like to talk about obstetrical hemorrhage. Free Links: OBGYN-10 OBGYN-101 Gray Haired Note Brookside Associates Medical Education Division  
Mike Hughey, MD
about 8 years ago
13
2
154

Evaluation of Hematuria

This podcast addresses the topic of hematuria in children. The podcast helps students develop an approach to the evaluation of hematuria. There is a brief overview of common causes of hematuria in children. This podcast was written by Peter Gill and Dr. Verna Yiu. Peter is a medical student at the University of Alberta. Dr. Yiu is a pediatric nephrologist at the Stollery Children’s Hospital in Edmonton, Alberta, Canada. These podcasts are designed to give medical students an overview of key topics in pediatrics. The audio versions are accessible on iTunes. You can find more great pediatrics content at www.pedscases.com.  
Pedscases.Com
about 8 years ago
2
1
15

MTPB3 2007 | Case 08 presented by Michael A Schwartz, MD

www.MeetTheProfessors.com – Case from the practice of Michael A Schwartz, MD; postmenopausal 57-year-old reporting a 2y history of gradual right breast hardening w/ulcerating and bleeding lesion spanning both breasts presented to Drs Schwartzberg, Seidman  
Dr Neil Love
about 8 years ago
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158

How to manage epistaxis

A practical guide to managing epistaxis, both simple and severe.  
Dr Garry Pettet
over 7 years ago
29749
7
306

Cranial Nerve Examination - Abnormal

Cranial Nerve 1- Olfaction This patient has difficulty identifying the smells presented. Loss of smell is anosmia. The most common cause is a cold (as in this patient) or nasal allergies. Other causes include trauma or a meningioma affecting the olfactory tracts. Anosmia is also seen in Kallman syndrome because of agenesis of the olfactory bulbs. Cranial Nerve 2- Visual acuity This patientâs visual acuity is being tested with a Rosenbaum chart. First the left eye is tested, then the right eye. He is tested with his glasses on so this represents corrected visual acuity. He has 20/70 vision in the left eye and 20/40 in the right. His decreased visual acuity is from optic nerve damage. Cranial Nerve II- Visual field The patient's visual fields are being tested with gross confrontation. A right sided visual field deficit for both eyes is shown. This is a right hemianopia from a lesion behind the optic chiasm involving the left optic tract, radiation or striate cortex. Cranial Nerve II- Fundoscopy The first photograph is of a fundus showing papilledema. The findings of papilledema include 1. Loss of venous pulsation 2. Swelling of the optic nerve head so there is loss of the disc margin 3. Venous engorgement 4. Disc hyperemi 5. Loss of the physiologic cup an 6. Flame shaped hemorrhages. This photograph shows all the signs except the hemorrhages and loss of venous pulsations. The second photograph shows optic atrophy, which is pallor of the optic disc resulting form damage to the optic nerve from pressure, ischemia, or demyelination. Images Courtesy Dr. Kathleen Digre, University of Uta Cranial Nerves 2 & 3- Pupillary Light Refle The swinging flashlight test is used to show a relative afferent pupillary defect or a Marcus Gunn pupil of the left eye. The left eye has perceived less light stimulus (a defect in the sensory or afferent pathway) then the opposite eye so the pupil dilates with the same light stimulus that caused constriction when the normal eye was stimulated. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Inspection & Ocular Alignmen This patient with ocular myasthenia gravis has bilateral ptosis, left greater than right. There is also ocular misalignment because of weakness of the eye muscles especially of the left eye. Note the reflection of the light source doesn't fall on the same location of each eyeball. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Versions • The first patient shown has incomplete abduction of her left eye from a 6th nerve palsy. • The second patient has a left 3rd nerve palsy resulting in ptosis, dilated pupil, limited adduction, elevation, and depression of the left eye. Second Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Duction Each eye is examined with the other covered (this is called ductions). The patient is unable to adduct either the left or the right eye. If you watch closely you can see nystagmus upon abduction of each eye. When both eyes are tested together (testing versions) you can see the bilateral adduction defect with nystagmus of the abducting eye. This is bilateral internuclear ophthalmoplegia often caused by a demyelinating lesion effecting the MLF bilaterally. The adduction defect occurs because there is disruption of the MLF (internuclear) connections between the abducens nucleus and the lower motor neurons in the oculomotor nucleus that innervate the medial rectus muscle. Saccades Smooth Pursui The patient shown has progressive supranuclear palsy. As part of this disease there is disruption of fixation by square wave jerks and impairment of smooth pursuit movements. Saccadic eye movements are also impaired. Although not shown in this video, vertical saccadic eye movements are usually the initial deficit in this disorder. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Utah Optokinetic Nystagmu This patient has poor optokinetic nystagmus when the tape is moved to the right or left. The patient lacks the input from the parietal-occipital gaze centers to initiate smooth pursuit movements therefore her visual tracking of the objects on the tape is inconsistent and erratic. Patients who have a lesion of the parietal-occipital gaze center will have absent optokinetic nystagmus when the tape is moved toward the side of the lesion. Vestibulo-ocular refle The vestibulo-ocular reflex should be present in a comatose patient with intact brainstem function. This is called intact "Doll’s eyes" because in the old fashion dolls the eyes were weighted with lead so when the head was turned one way the eyes turned in the opposite direction. Absent "Doll’s eyes" or vestibulo-ocular reflex indicates brainstem dysfunction at the midbrain-pontine level. Vergenc Light-near dissociation occurs when the pupils don't react to light but constrict with convergence as part of the near reflex. This is what happens in the Argyll-Robertson pupil (usually seen with neurosyphilis) where there is a pretectal lesion affecting the retinomesencephalic afferents controlling the light reflex but sparing the occipitomesencephalic pathways for the near reflex. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerve 5- Sensor There is a sensory deficit for both light touch and pain on the left side of the face for all divisions of the 5th nerve. Note that the deficit is first recognized just to the left of the midline and not exactly at the midline. Patients with psychogenic sensory loss often identify the sensory change as beginning right at the midline. Cranial Nerves 5 & 7 - Corneal refle A patient with an absent corneal reflex either has a CN 5 sensory deficit or a CN 7 motor deficit. The corneal reflex is particularly helpful in assessing brainstem function in the unconscious patient. An absent corneal reflex in this setting would indicate brainstem dysfunction. Cranial Nerve 5- Motor • The first patient shown has weakness of the pterygoids and the jaw deviates towards the side of the weakness. • The second patient shown has a positive jaw jerk which indicates an upper motor lesion affecting the 5th cranial nerve. First Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 7- Motor • The first patient has weakness of all the muscles of facial expression on the right side of the face indicating a lesion of the facial nucleus or the peripheral 7th nerve. • The second patient has weakness of the lower half of his left face including the orbicularis oculi muscle but sparing the forehead. This is consistent with a central 7th or upper motor neuron lesion. Video Courtesy of Alejandro Stern, Stern Foundatio Cranial Nerve 7- Sensory, Tast The patient has difficulty correctly identifying taste on the right side of the tongue indicating a lesion of the sensory limb of the 7th nerve. Cranial Nerve 8- Auditory Acuity, Weber & Rinne Test This patient has decreased hearing acuity of the right ear. The Weber test lateralizes to the right ear and bone conduction is greater than air conduction on the right. He has a conductive hearing loss. Cranial Nerve 8- Vestibula Patients with vestibular disease typically complain of vertigo – the illusion of a spinning movement. Nystagmus is the principle finding in vestibular disease. It is horizontal and torsional with the slow phase of the nystagmus toward the abnormal side in peripheral vestibular nerve disease. Visual fixation can suppress the nystagmus. In central causes of vertigo (located in the brainstem) the nystagmus can be horizontal, upbeat, downbeat, or torsional and is not suppressed by visual fixation. Cranial Nerve 9 & 10- Moto When the patient says "ah" there is excessive nasal air escape. The palate elevates more on the left side and the uvula deviates toward the left side because the right side is weak. This patient has a deficit of the right 9th & 10th cranial nerves. Video Courtesy of Alejandro Stern, Stern Foundatio Cranial Nerve 9 & 10- Sensory and Motor: Gag Refle Using a tongue blade, the left side of the patient's palate is touched which results in a gag reflex with the left side of the palate elevating more then the right and the uvula deviating to the left consistent with a right CN 9 & 10 deficit. Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 11- Moto When the patient contracts the muscles of the neck the left sternocleidomastoid muscle is easily seen but the right is absent. Looking at the back of the patient, the left trapezius muscle is outlined and present but the right is atrophic and hard to identify. These findings indicate a lesion of the right 11th cranial nerve. Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 12- Moto Notice the atrophy and fasciculation of the right side of this patient's tongue. The tongue deviates to the right as well because of weakness of the right intrinsic tongue muscles. These findings are present because of a lesion of the right 12th cranial nerve.  
Neurologic Exam
over 7 years ago
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2
47

Epistaxis

An overview of the anatomy, aetiology and management of epistaxis  
Jason Fleming
over 7 years ago
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3
114

GI bleeding & Intestinal Obstruction

Slides from my groups' presentation. Any mistakes, I'd appreciate it if you can alert me. :)  
Nadia Rahim
about 7 years ago
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10
219

Initial Assessment of a Trauma Patient - Pelvic Fracture Scenario.wmv

This video - produced by students at Oxford University Medical School in conjunction with the faculty - demonstrates how to perform the initial assessment of a patient with suspected traumatic injury.<br>This scenario is of a patient with a suspected pelvic fracture and internal haemorrhage.  
Hussam Rostom
about 6 years ago
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12
227

Initial Assessment of a Trauma Patient - Multi-System Injury (Part 2).wmv

This video - produced by students at Oxford University Medical School in conjunction with the faculty - demonstrates how to perform the initial assessment of a patient with suspected traumatic injury.<br>This video is part 2 of a muti-system injury scenario (airway compromise, tension pneumothorax, bleeding and head injury).  
Hussam Rostom
about 6 years ago
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9
178

Initial Assessment of a Trauma Patient - Multi-System Injury (Part 1).wmv

This video - produced by students at Oxford University Medical School in conjunction with the faculty - demonstrates how to perform the initial assessment of a patient with suspected traumatic injury.<br>This video is part 1 of a muti-system injury scenario (airway compromise, tension pneumothorax, bleeding and head injury).  
Hussam Rostom
about 6 years ago
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4
150

Stroke: Hypertensive haemorrhage - radiology video tutorial (MRI, CT)

"Stroke Series" video 1 of 7: Hypertensive haemorrhage and lobar haemorrhage are two distinct forms of haemorrhagic stroke. This video discusses the imaging characteristics of hypertensive haemorrhage, the underlying pathology (Charcot-Bouchard aneurysms) and the relevant differential diagnosis.  
Radiopaedia
over 5 years ago
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4
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Stroke: Lobar haemorrhage - radiology video tutorial (MRI, CT)

"Stroke Series" video 2 of 7: Lobar haemorrhage and hypertensive haemorrhage are two distinct forms of haemorrhagic stroke. This video discusses the imaging characteristics of primary lobar haemorrhage, the underlying pathology (cerebral amyloid angiopathy) and the relevant differential diagnosis.  
Radiopaedia
over 5 years ago
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9
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Post Partum Haemorrhage - A Summary of Management

A powerpoint presentation made for 4th year medical students summarising the management of PPH  
Adam Collins
over 4 years ago
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0
1

Too much bleeding

Medical Protection Society Website  
medicalprotection.org
over 4 years ago
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2
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Henoch Schonlein Purpura (HSP)

This is a vasculitis that most commonly occurs in children. It tends to only affect the small vessels, and typically presents with: Palpable purpura – red/purple discolorations in the skin, often on the extensor surfaces of the feet, legs, arms, or sometimes on the buttocks. The rash may initially resemble urtricaria, but later becomes palpable. GI disturbance – may include colicky abdominal pain, abdominal tenderness, melena – occurs in 50% of patients  
almostadoctor.com - free medical student revision notes
over 4 years ago
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Anaemia of Chronic Disease

This is common, particularly in the hospital setting. It occurs as a result of: Chronic infection Chronic inflammation Neoplasia The anaemia is not related to bone marrow, bleeding or haemolysis, and is generally mild (Hb of 8.5-11.5g/dl).  
almostadoctor.com - free medical student revision notes
over 4 years ago