Anesthesia Wall Charts

Anesthesia Wall Charts 

I usually like to get maximum knowledge within a short time, so i practice to refer these kind of docs rather than reading lot of books. Also it is easy to memorize. So today i am going to publish some wall charts. It will give you quick review and help you to get an idea to manage these conditions.

Note,

 Do not save as pictures. Open the document and download. 

1.  Acute Post Operative pain
2. Anaphylaxis
3. Difficult Airway In Obstetrics
4. Intra-operative Fluid Management In Magor Surgery.pdf
5. Major Obstetric Hemorrhage.pdf
6. Peri-operative feeding.pdf
7. Primary Survey ABCDE.pdf
8. Routine Preoperative Investigations For Elective Surgery.pdf
9. Sepsis.pdf

Credits:- Ministry of healthcare and nutrition, Sri Lanka for preparation of these Guidelines.

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Merit order list of MBBS graduates in Sri Lanka. Final MBBS repeatExamination for 2006/2007 intake

Merit order list of MBBS graduates in Sri Lanka. Final MBBS repeat Examination for 2006/2007 intake 

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Constipation - How to relieve - Easy Tips

Constipation define as infrequent bowel moments (</= 3 time per week) or passing stools less often than the person's own normal habit, or with difficulty staining, or pain. Constipation is not an uncommon condition in population. It is two time common in female than male.

 

Causes of  Constipation

• Poor  diet
• Lack of exercise
• Old age
• Reduced water intake
• Fearsome, dirty toilets  

Although there are many benign causes, some disease condition and drugs also cause constipation.

• Intestinal obstruction
• Anal fissure
• Rectal prolapse
• Bowel strictures
• Hypothyroidism
• Drugs (opiates, iron, anticholinergics)

But constipation is unlikely to be the only feature of some serious illness. 

1. Drink plenty of water

You should drink ten or more glasses of water per day. It will moisten your stools and lubricate your intestine.  Drink plenty of water also a good health habit.

2. More fiber foods

You should eat 25g -40g of fibers per day. The next question 
is what are the foods which have lot of fibers.  Generally these are cereals, fruits and vegetables. The high fiber foods are wheat germ, barley, bran; mangoes, raspberries, pears, apples; green peas, beans, chickpeas. Fiber do not digested by intestinal enzymes so it cannot absorb. It increases the bulk of the stool and absorb fluids to moist the stool. Not only in constipation high fiber diet helpful in several disease conditions like diabetes mellitus and hyperlipidaemia.

3. Reduce the stress

Anxiety and depression can cause constipation. If you are in an upset mood or have some features of depression like loss of appetite, lose of energy and reduce sleep better to consult a doctor, because early treatment lead to better outcomes. Do not forget depression is common in normal population.

4. Do it regularly

The most important thing is you must go to the bathroom when you have urge. It is important to have a regular time (better in morning) in your time table. Do not forget to do it daily and regularly. If you allow stool to stay lot of time in your body, the water get absorbed and make stool more harder. 

5. Exercise daily

Better to do 4 to 5 times per week for 30 minutes. It will stimulate your intestinal muscles and increase food passage though intestine.    

 

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Chest x-ray - mnemonics - Pulmonary edema

Alveolar edema (bat's wing or butterfly)

These are pulmonary opacities seen in bilateral perihilar areas. Outer third of the lung usually spared in pulmonary edema.

Kerley B lines

Kerley B lines are short (1-2 cm) horizontal linear shadows, perpendicular to the pleura, seen close to costo pherenic angles caused by thickened interlobular septae, due to accumulation of fluid (transudate). Other than pulmonary edema rare causes of kerley B lines are lymphangitis carsinomatosis, sarcoidosis, viral and mycoplasmal pneumonia.

 Cardiomegaly

In normal individuals cardio thoracic ratio(CTR) is less than 50%. CTR is the maximum transevers diameter of the heart divided by the greatest internal diameter of the thoracic cage. In cardiomegaly CTR is more than 50%.

Dilated prominent upper lobe vessels

In a patient with congestive heart failure, the pulmonary capillary wedge pressure rises  and the upper zone veins dilate and are equal in size or larger than lower zone pulmonary veins, also termed as cephalization.In normal individuals, the lower zone pulmonary veins are larger than the upper zone veins due to gravity.

Pleural effusion

Thia is due to increase hydrostatic pressure in pulmonary vasculature so it is a transudate.

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Would your child be able to survive if he/she fell into water

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Snake Bite.....Prevention and First Aid

Most snakes avoid people if possible and bite only when threatened or surprised and most of snakes are not poisons.

To prevent snakebite

• Avoid places where snakes may live. (tall grass or brush, rocky areas, bluffs, marshes, and deep holes in the ground)
• When moving through places where snakes may live, poke at the ground in front of you with a long stick to scare away snakes. 
• Watch carefully your step and where you sit when outdoors.
• Wear long trousers, boots and gloves when necessarily. Snake fans does not directly contact with you. So chance of poisoning is less after a snake bite.
• Use a torch when walking outside at night.
• Do not touch a snake, even if you think it is dead.
• Reduce rubbish materials where a snake could shelter.

 

If a snake bites you 

• Note the Snake's Appearance. Do not try to catch them. It can cause further bites.
• Remain calm.
• Reassure the patient.
• Immobilize the bitten part and keep it below the heart. It will keep the poison from spreading through your body.
• Apply a splint to reduce movement of the affected area, but keep it loose enough and to see the toes.
• Remove rings and anklets before you start to swell.
• Wash the wound with a clean cloth soaked in water and covers it with a clean, dry dressing.
• Seek medical advice as soon as possible.  

Do not

•  use a tourniquet or apply ice after a snake bite.
•  cut the wound or attempt to suck out venom.
•  give alcohol, aspirin or caffeinated drinks.
•  clean wound with flushed water or condys.

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Dancing doctors making ill children smile at Sydney Children's Hospital

Post by So You Think You Can Dance Australia.

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Delusional Perception

Delusional Perception Delusional perception is the misinterpretation of the significance of something perceived normally. For example, a person may be convinced that the particular color of books on a table indicates that he is going to die.
Delusional perception is a symptom that come under Schneider's first rank symptoms of schizophrenia. Having this symptom push the diagnosis more toward the schizophrenia. 
  

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Hypersensitivity Reaction - Mnemonic

Hypersensitivity

Excessive, undesirable reactions produced by the normal immune system.There are four type of

hypersensitivity reactions.

Type 1 – Anaphylaxis reaction

Occur after ten to fifteen minutes of exposure. Primary involve cellular component in this type is basophil or mast cell and involve antibody is IgE.

eg: - allergy, asthma, anaphylaxis

Type 2 – Cytotoxic reaction

This is an antibody mediated reaction and mainly involves IgG and IgM.

eg: - Blood transfusion reaction, Hemolytic disease of new born, Autoimmune hemolytic anemia….

Type 3 – Immune complex mediated reaction.

This is due to deposition of antigen –antibody complex in tissues.

eg: - Systemic lupus erythematosus, Serum sickness, Arthus reaction, Post Streptococcal Glomerulonephritis. 

Type 4 – Delayed type reaction

This is a cell mediated reaction and activated T lymphocytes are mainly involved.

eg: - Contact dermatitis, Multiple sclerosis, Type 1 diabetic, Rheumatoid arthritis…..

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How to use a insulin pen.

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Mnemonic for social history

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Thought Block

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Respiratory system Examination

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Catatonia, Waxy flexibility, Opposition, Negativism

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Acute dystonia, Extrapyramidal side effect of antypsychotic

Sustained, often painful muscular spasms,producing twisted abnormal postures. This usually occur within few hours to few days. Reversible and self limiting.
Management 
 Reduce the dose or change to a atypical antypsychotic.
 Emergency treatment with IM or IV anticholinergic (benzatropine)

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