Clinical Consequences of Vomiting

In this article, we will discuss the Clinical Consequences of Vomiting. So, let’s get started.

Clinical Consequences (Complications)

Repeated vomiting, if forceful may lead to pressure rupture of the esophagus (Boerhaave’s syndrome).

It may cause a linear mucosal tear at or near the cardioesophageal junction leading to hematemesis (Mallory-Weiss syndrome).

Prolonged vomiting may lead to fluid loss (dehydration), loss of HCL (metabolic alkalosis), loss of potassium ions K+ (hypokalemia), and loss of nutrients (malnutrition).

Vomiting in an unconscious patient or in patient with depressed consciousness may result in aspiration pneumonia.


Components of a Single Exercise Session

In this article, we will discuss the various Components of a Single Exercise Session. So, let’s get started.


Warm-up: At least 5-10 minutes of low to moderate-intensity aerobic exercise or resistance exercise with lighter weights.

Conditioning: 0-60 minutes of aerobic, resistance, neuromuscular and/or sports activities.

Cool-down: At least 5-10 minutes of low to moderate-intensity aerobic exercise or resistance exercise with lighter weights.

Stretching: At least 10 minutes of stretching exercises performed after the warm-up or cool-down phase.

Clinical Features of Cor Pulmonale

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

Clinical Features

Productive cough


Chest discomfort


Abdominal pain

Lower extremity swelling


Physical Signs include:


The patient sits with elbows supported on a table and legs dangling by the side of the chest

Pursed lip breathing and cyanosis (presents in patients with COPD with acute exacerbation)

Periorbital edema

Jugular venous distention (raised JVP) and ‘VY’ (wave) collapse due to tricuspid regurgitation

Peripheral edema

Systemic Signs

Respiratory system may show signs of COPD (barrel-shaped chest, restricted chest movements and expansion, hyper-resonant note and vesicular breathing with prolonged expiration, muffled breath sounds)

Signs of RV hypertrophy or failure e.g. parasternal heave, loud P2, midsystolic and early diastolic (Graham-steel) murmur and pansystolic or holosystolic murmur of tricuspid regurgitation (Carvallo’s sign) may be present.

Abdominal distention may be present along with tender hepatomegaly. Hepatojugular reflex may be present.

The Principles of Training (Exercise)

In this article, we will discuss the Principles of Training and The FITT Principle of Prescribing Aerobic Exercise. So, let’s get started.


Overload principle: An exercise overload specific to the activity must be applied to enhance the physiological improvement and bring a training response e.g. athletes, cardiac patient training program.

Specificity principle: Specific adaptations bring specific training effects e.g. swimming, bicycling, running, etc.

Individual difference principle: A person’s relative fitness level is important at the start of training and it is unrealistic to expect the same outcome for everyone with particular training.

Reversibility principle: Detraining occurs if a person terminates exercise program.

The FITT Principle of Prescribing Aerobic Exercise

Frequency: Number of days per week dedicated to exercise sessions.

Intensity: It determines how hard a person works in order to do then activity. It can be defined on the basis of either absolute or a relative scale. Absolute intensity refers to the amount of energy expended per min of activity while relative intensity takes a person’s level of exercise capacity or cardiorespiratory fitness into consideration to assess the level of effort.

Time: The length of time in which an activity or exercise is performed. Duration is generally expressed in minutes.

Type: The mode of exercise performed.



Pathology and Clinical Features of Acute Empyema Thoracis

In this article, we will discuss the Pathology and Clinical Features of Acute Empyema Thoracis. So, let’s get started.


In acute empyema, there is accumulation of large amount of pleural fluid with many polymorphs, bacteria, and cellular debris. Fibrin gets deposited on both layers of pleura (visceral and parietal) and there is a tendency towards loculation. Later, as the disease progresses (empyema becomes chronic), fibroblasts grow from both the layers into the exudate resulting in adhesions of both the surfaces of pleura and form an inelastic membrane called thickened pleura or pleural peel.

Clinical Features

Patients with aerobic infection (parapneumonic pleural effusion) present with acute onset of fever with chills, productive cough with mucopurulent expectoration (bronchopleural fistula), dyspnea and chest discomfort.

Patients with anaerobic infection present with subacute illness with non-specific signs and symptoms such as weight loss, leucocytosis, mild anemia and history of predisposing factor for aspiration from the oral cavity. Tubercular empyema presents with long-standing (for weeks and months) low-grade fever along with weakness and cough.

In acute phase, there are signs of toxemia such as fever, tachypnea, tachycardia, and pleural effusion. Presence of tenderness on percussion with some edema of the chest wall. Clubbing of fingers and toes are usually seen. Rarely there is a sign of empyema necessitans (empyema may track into the subcutaneous tissue of chest wall and presents as a localized swelling with positive cough impulse, and is mostly seen with actinomycotic infections).

Chronic cases present with pleural thickening and loculation of pus will show significant deformity with retraction of chest on the same side of empyema and even scoliosis. The signs will be dull percussion note with diminished breath sounds. extensive pleural calcification may occur. Tubercular empyema is often chronic and present with thickened pleura.

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