Definition and Causes of Atrial Flutter

In this article, we will discuss the Definition and Causes of Atrial Flutter. So, let’s get started.

Definition

It is a supraventricular arrhythmia characterised by rapid atrial rate (250-350/min) due to intra-atrial re-entry (circus movement), involves commonly the right atrium. The arrhythmia occurs commonly in patients with organic heart disease. Flutter may be paroxysmal induced by pericarditis, acute respiratory failure or it may be persistent. Atrial flutter if lasts for more than a week, it will eventually convert into atrial fibrillation.

Causes

The causes of atrial flutter are more or less same as that of atrial fibrillation with the exception that pericardial disease, severe pulmonary disease commonly lead to atrial flutter than atrial fibrillation.

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Differentiation between Cardiac Dyspnea and Bronchial Asthma (Physical Signs)

In this article, we will discuss the Differentiation between Cardiac Dyspnea and Bronchial Asthma (Physical Signs). So, let’s get started.

Physical Signs

Cardiac Dyspnea (asthma)

  • Tachypnea, tachycardia, cyanosis (central, peripheral)
  • Trachea central, normal in length
  • No retraction of supraclavicular fossae or intercostal spaces
  • Percussion note is dull at the bases
  • Crackles at the bases
  • Apex beat is normal or displaced
  • Breath sounds are normal
  • 3rd heart sound (gallop rhythm) may be present

Bronchial Asthma (dyspnea)

  • They are less marked
  • Trachea is central but palpable part is decreased
  • Retraction of supraclavicular fossae and/or intercostal spaces is marked
  • Hyper-resonant note may be present
  • Both crackles and rales throughout the lungs
  • Apex beat may not be normal
  • Normal breath sounds with prolonged expiration
  • No 3rd heart sound

Classification of Guillain-Barré Syndrome

In this article, we will discuss the Classification of Guillain-Barré Syndrome. So, let’s get started.

Classification

Subtype

1. Acute inflammatory demyelinating polyradiculopathy (AIDP)

Characteristics

  • Demyelinating
  • Adults affected more than children
  • Anti-GM antibodies present (>50%)
  • Recovery rapid

Subtype

2. Acute motor axonal neuropathy (AMAN)

Characteristics

  • Axonal damageChildren and young adults affected
  • Prevalent in China and Mexico
  • Anti-GD1a antibodies present
  • Recovery rapid

Subtype

3. Acute motor-sensory axonal neuropathy (AMSAN)

Characteristics

  • Axonal damage
  • Uncommon, adults affected
  • Closely related to AMAN
  • Recovery slow

Subtype

4. Miller-Fisher Syndrome

Characteristics

  • Demyelinating, uncommon
  • Affects children and adults
  • Ophthalmoplegia, ataxia and areflexia occur
  • Anti GQ-1b antibodies present (>90%)

Clinical Features of Barbiturates Poisoning

In this article, we will discuss the Clinical Features of Barbiturates Poisoning. So, let’s get started.

Clinical Features

The clinical features are mainly due to CNS depression followed by features of respiratory depression and hypotension.

  • CNS depression: Confusion, lethargy, depressed mental activity, decreased responsiveness to external stimuli, dilated pupils, depressed tendon reflexes and extensor plantar response are seen.
  • Respiratory depression: It causes Cheyne-stoke’s respiration, apnea, aspiration pneumonia and respiratory acidosis
  • Other features include hypotension, shock, hypothermia, acute renal failure and a characteristic bullous rash seen on pressure points like elbow or malleolus after 2-3 days

10 MCQs on Biomechanics (Part-II)

In this article, we will solve 10 MCQs on Biomechanics (Part-II). So, let’s get started.

Questions and Answers (Correct answers in bold)

Q1. The specific gravity of the human body is:

  • 1.995
  • 0.095
  • 0.95
  • 9.05

Q2. Normally in the standing position the centre of gravity lies:

  • 5 cms anterior to second sacral vertebrae
  • 5 cms posterior to second sacral vertebrae
  • Around umblicus
  • 5 cms anterior to second sacral vertebrae

Q3. Vector is a physical force that has:

  • Magnitude
  • Direction
  • Both magnitude and direction
  • Fixed point of application of force

Q4. In second order level the arrangement is:

  • Weight in middle, fulcrum and effort point on either end
  • Fulcrum in middle, weight and effort point on either end
  • Effort point in middle, weight and fulcrum on either end
  • None of the above

Q5. The body’s center of gravity in an adult normally has up and down movements of:

  • 1.5 inch
  • 2.5 inch
  • 3.5 inch
  • 4.5 inch

Q6. A therapist examines joint play movement by placing the joint in resting position. The position is best described as:

  • Maximal congruency between the articular surfaces and joint capsule
  • Minimal congruency between the articular surfaces and the joint capsule
  • Passive separation of the joint surfaces is limited
  • Parallel to the joint treatment line

Q7. If a plumb line is positioned laterally to a patient so it runs along the line of gravity, where should the line fall with respect to the midline of the knee:

  • Anterior
  • Posterior
  • Directly through the knee joint
  • Posterior and medial

Q8. A physical therapist instructs a patient to move her lower teeth forward in relation to the upper teeth. This motion is termed as:

  • Protrusion
  • Retrusion
  • Lateral deviation
  • Occlusal position

Q9. Tests for the length of the hamstrings typically involve stabilisation of the uninvolved leg while raising the leg to be tested. It is important to stabilise the uninvolved leg because it:

  • Prevents excessive posterior pelvic tilt and excessive flexion of lumbar spine
  • Prevents excessive posterior pelvic tilt and excessive extension of lumbar spine
  • Prevents excessive anterior pelvic tilt and excessive flexion of lumbar spine
  • Prevents excessive anterior pelvic tilt and excessive extension of lumbar spine

Q10. A physical therapist consistently falls behind with his documentation due to an excessive patient load. The most appropriate action is:

  • Discuss the situation with other staff (physical therapists)
  • Ignore the situation and attempt to complete the documentation in a timely fashion
  • Discuss the situation with immediate supervisor
  • Discuss the situation with the Director of rehabilitation

(Note: Correct answer in bold)