Ward Round Notes

Definition and demographics heart failure occurs when the heart function fails to perfuse the body adequately under normal physiological conditions. Heart failure can be divided into acute or chronic heart failure, may be caused by reduction of ejection fraction (systolic failure) or failure for the heart to fill (diastolic heart failure or heart failure with preserved ejection fraction), affect the left heart or the right heart, or both sides. It can also be divided into heart failure caused by an intrinsic disease of the heart(high output), or due to increased demands of the body (low output).  There is an increasing prevalence of heart failure patients due to the increase in older individuals and better outcomes for other cardiovascular diseases. The prevalence of heart failure is around 2-3% in the general population, with increasing incidence amongst older people. There is a slightly higher incidence amongst men compared to women, especially in the middle aged populat...

Acute abdomen is defined as any episode of abdominal symptoms, usually abdominal pain, presenting acutely, potentially as a surgical emergency, with no history of trauma. Acute abdominal pain is a common presentation. There are multiple causes of severe abdominal pain. These may be differentiated by the nature of the pain, and the area the pain typically presents in. It is important to take a clear history and do a thorough examination with patients with acute abdominal pain. Are there signs of shock/organ rupture requiring urgent surgery? A rupture of an organ such as the spleen, aorta or an ectopic pregnancy may cause massive blood loss requiring resuscitation and surgery to repair the ruptured part or to stop the bleeding. In additional to abdominal pain, a patient with shock may have altered vital signs such as tachycardia, tachypnoea, or dropping blood pressure. In addition, they may show signs of reduced end-organ perfusion. The skin, kidneys and the brain are usually t...

Type Names Main diseases HHV – 1 Herpes simplex virus 1 Genital herpes Oral herpes Herpes simplex eye infection and enchephalitis Cold sores HHV - 2 Herpes simplex virus 2 Genital herpes Oral herpes Herpes simplex eye infection and enchephalitis Cold sores HHV- 3 Varicella zoster virus Chicken pox Shingles Ramsay hunt syndrome HHV – 4 Epstein Barr virus Infectious mononucleosis (glandular fever) Linked with burkitt’s lymphoma, hodgkin’s disease B lymphoproliferative disease, X- linked lymphoproliferative syndrome, nasopharyngeal carcinoma and oral hairy leukoplakia. HHV – 5 Cytomegalovirus Assymptomatic in immunocompetent people but can affect multiple organs if it manifests. Mononucleosis syndrome (febrile illness, impaired liver function and s...

Definition and demographics Acute Kidney Injury (AKI) formerly known as acute renal failure, refers to the deterioration of renal function acutely over hours or days. It is characterised by a rise in plasma urea and creatinine ratios. This may occur without clinical symptoms, however tends to be associated with oliguria (urine output less than 400ml/day or 0.5ml/kg/h). Acute kidney injury is common amongst people admitted to hospital. Causes and risk factors The causes of acute renal failure may be divided into pre-renal, renal and post renal causes.

Demographics: Acute urinary retention is a medical emergency . It is relatively common occurring in 7/1000 men. It is more common in men than women, and incidence is higher in men over 70. Causes: The most common cause of acute urinary retention is benign prostatic hypertrophy. Other causes include: structural changes near the bladder and urethra in men ·       Meatal stenosis ·       Penile constricting bands ·       Phimosis ·       Urethral strictures In women ·       Prolapse ·       Urethral strictures