Ward Round Notes

Causes of stridor and management of acute stridor (click to enlarge):

A basic guide to drawing pedigree trees: Basic symbols  

Type Mediators Timing Examples Type I Hypersensitivity Allergy Exogenous antigen binding to IgE bound to Mast cells leading to degranulation Within minutes to an hour, rarely delayed onset (10-12 hours) Asthma Anaphylaxis Hayfever Type II Hypersensitivity Cytotoxic Caused by endogenous antigens which bind to cells. Antibodies IgM and IgG bind to these cells causing apoptosis Minutes to hours Autoimmune haemolytic anaemia, thrombocytopenia, Goodpasture’s syndrome Type III Hypersensitivity Immune complex (autoimmune) Caused by endogenous or exogenous antigens bound to IgG forming immune complexes which causes activation of the complement system and neutrophils causing systemic or organ specific damage. 3-8 hours SLE, Aspergillosis, Rheumatoid arthritis, Type IV Hypersensitivity ...

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...