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Category: Medicine

WHO Criteria for Severe Cerebral Malaria (falciparum malaria)

Posted on by priyeshbanerjeept

In this article, we will discuss the WHO Criteria for Severe Cerebral Malaria (falciparum malaria). So, let’s get started.

WHO Criteria for Severe Cerebral Malaria (falciparum malaria)

  • Cerebral malaria (unexplained unarousable coma)
  • Severe anemia (Hb <5 g/dl or hematocrit <15%)
  • Renal failure (oliguria-urine output <400 ml/day or <12 ml/kg/day plus serum creatinine >3 mg/dl or 265 μmol/L)
  • Non-cardiogenic pulmonary edema (ARDS*, hypoxemia, respiratory failure)
  • Hypoglycemia (whole blood glucose <40 mg/dl or 2.2 mmol/L)
  • Circulatory collapse (systolic BP <70 mmHg with cold clammy extremities)
  • Spontaneous bleeding, DIC** (prolonged PT***, PTT***), and thrombocytopenia
  • Repeated generalized convulsions (>3 in 24 hours)
  • Acidemia (arterial pH <7.25) or acidosis (plasma bicarbonate <15 mmol/L)
  • Hemoglobinuria (not drug-induced)
  • Jaundice (icterus or serum bilirubin >3 mg/dl)
  • Hyperparasitemia (>5% in non-immune patients or >10,000/ml)

Some important medical abbreviations

  • *ARDS: Acute respiratory distress syndrome
  • **DIC: Disseminated Intravascular Coagulation
  • ***PT: Prothrombin time
  • ****PTT: Partial thromboplastin time
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Framingham Criteria for Diagnosis of Congestive Heart Failure (CHF)

Posted on by priyeshbanerjeept

In this article, we will discuss the Framingham Criteria for Diagnosis of Congestive Heart Failure. So, let’s get started.

Framingham Criteria for Diagnosis of Congestive Heart Failure

Major Criteria include:

  • Paroxysmal nocturnal dyspnea
  • Distended neck veins
  • Rales
  • Cardiomegaly
  • Acute pulmonary edema
  • S3 gallop
  • Increased venous pressure (>16 cmH2O)
  • Positive hepatojugular reflux

Minor criteria include:

  • Peripheral edema
  • Nocturnal cough
  • Exertional dyspnea
  • Congestive hepatomegaly
  • Pleural effusion
  • Reduced vital capacity by one third
  • Tachycardia (HR>120/min)
  • Weight loss

For diagnosis: At least one major and two minor criteria are required.

Causes of Cardiac Tamponade

Posted on by priyeshbanerjeept

In this article, we will discuss various Causes of Cardiac Tamponade. So, let’s get started.

It is defined as clinical syndrome occurring due to the rapid accumulation of fluid in the pericardial sac in a quantity sufficient to cause obstruction to the inflow of blood to the ventricles. It is a life-threatening emergency where cure can be achieved by pericardiocentesis (removal of pericardial fluid).

Causes

Acute Cardiac Tamponade

Trauma

  • Penetrating or blunt thoracic injury
  • Iatrogenic e.g. pacing, catheterization, pericardial tapping, post-resuscitation, anticoagulant therapy.

Cardiac rupture

  • Acute MI-free wall rupture
  • Aortic aneurysm rupturing into the pericardium.

Subacute or Chronic Cardiac Tamponade

  • Infection such as Tuberculosis, bacterial, viral, fungal, parasitic, etc.
  • Malignancy
  • Uremic pericarditis
  • Systemic disorders such as SLE, myxoedema, Dressler’s syndrome (post-MI or postcardiotomy), amyloidosis
  • Radiation
  • Idiopathic
  • Drugs e.g. anticoagulants, procainamide, isoniazid, hydralazine, daunorubicin, etc.

Causes of Ulcer

Posted on by priyeshbanerjeept

In this article, we will discuss various Causes of Ulcer. So, let’s get started.

Definition

An ulcer is a shallow destruction of the skin tissues and mucous membrane, which may occur at any part of the body. Various ulcers are the complication of varicose veins, which usually occur on medial aspect of the lower part of the leg as a persistent open wound/sore.

Causes

  • High Venous Pressure ( due to occupation necessitating continuous standing e.g. policeman, nurses, shCausesop assistant, etc)
  • Pregnancy
  • Inflammation of the vein
  • Degenerative disease of the vessel
  • Injury to vessel
  • Valvular insufficiency
  • Obstruction of vessels
  • Heart or lung disease
  • Anemia and debility
  • Trauma followed by infection
  • Diabetes mellitus and obesity
  • Edema/congestion

Edema

Posted on by priyeshbanerjeept

In this article, we will discuss Edema. So, let’s get started.

Edema

Edema is also known as fluid retention or swelling, is the excessive collection of tissue fluid in the interstitial space. The generation of interstitial fluid is regulated by the forces of the Starling equation. The hydrostatic pressure within blood vessels tends to cause water to filter out into the tissue. This leads to a difference in the protein concentration between blood plasma and tissue. As a result, the colloidal or oncotic pressure of the higher level of protein in the plasma tends to suck (draw) water back into the blood vessels from the tissue. Starling’s equation states that the rate of leakage of fluid is determined by the difference between the two forces and also by the permeability of the vessel wall to water, which determines the rate of flow for a given force imbalance.

Factors contributing to the formation of edema or Causes of edema

  • Increased hydrostatic pressure and tissue colloidal or oncotic pressure.
  • Reduced colloidal or oncotic pressure within blood vessels.
  • Increased blood vessel wall permeability.
  • Obstruction of fluid clearance in the lymphatic system.
  • Change in the water-retaining properties of the tissue. Raised hydrostatic pressure often reflects retention of water and sodium by the kidneys.

Types

  • Pitting edema: Watery low protein content.
  • Inflammatory edema: Thick fluid with high protein content.

 

 

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