Management Of COPD

It’s always the greatest when mnemonics match the thing they’re relating to.

Even if it does involve a couple of extra Ps.

COPPPPD

Inhaled Corticosteroids if FEV1>50% with 2+ exacerbations/year and a short course of systemic corticosteroids for severe exacerbations

Home Oxygen and oxygen during exacerbations to maintain SpO2 at 88-92%

Prevention with smoking cessation and immunisations against influenza and pneumococcus

Physical activity

Pulmonary rehabilitation

Penicillin, meaning amoxycillin or the non-penicillin doxycycline for severe exacerbations

Inhaled bronchoDilators

References

  1. Chronic obstructive pulmonary disease. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited (eTG July 2018 edition); 2015 Mar.
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Light’s Criteria For Pleural Effusions

If any of the following conditions are met, it is an exudate, full of protein and turbid, unclear fluid. Think malignancy or certain infections.

Light’s Criteria

  1. Pleural fluid protein / serum protein > 0.5
  2. Pleural fluid LDH / serum LDH > 0.6
  3. Pleural fluid LDH > 2/3 x upper limit of normal serum LDH

Memory Aid

  • Pleural
    • Criterion 1 = protein
    • Criterion 2 = LDH
    • Criterion 3 = LDH again
  • Increasing numbers
    • 0.5
    • 0.6
    • 0.666666 to infinity

References

  1. MDCalc. (2018). Light’s Criteria for Exudative Effusions. [online] Available at: https://www.mdcalc.com/lights-criteria-exudative-effusions [Accessed 14 Sep. 2018].
  2. Exeter Clinical Laboratory International. (2018). Transudate or Exudate / Blood Sciences Test. [online] Available at: https://www.exeterlaboratory.com/test/transudate-or-exudate/ [Accessed 14 Sep. 2018].

Podcast 024: Orthopaedic Surgery With Dr Saqib Noor

Bones are the putative skeleton of the human body, so it’s important that they’re not broken. Hold on! They actually are the skeleton! That means we need orthopaedic surgery to fix them.

In this episode, Dr Saqib talks about orthopaedic surgery, charitable work and international inequalities in health care.

Podcast

About the guest speaker

Dr Saqib Noor is an orthopaedic surgeon and creative genius.

Dr Saqib has written a book, Surgery on the Shoulders of Giants, describing his life changing experiences as a surgeon in austere settings (http://mybook.to/SotSog) and has used these experiences to help start a new project dedicated to improving global surgery worldwide – One Surgery (https://one.surgery).

Music credits

Opening and closing themes by Lily Chen.

Cardiac Valves

Which side of the heart does each atrioventricular valve correspond to? Memory aids enlighten us all!

Atrioventricular Valves

  • Tricuspid is in the right heart
  • Mitral is in the left heart

What about the semilunar valves? They must not be forgotten! And so they shan’t be!

Semilunar Valves

  • Pulmonary goes to the lungs and is on the right
  • Aortical goes to the rest of the body and is on the left

Broca And Wernicke Memory Aids

Facebook and Twitter! Two important procrastination tools of our time! Many a student has suffered gloriously from these distractions. Finally, they help us to learn medicine, just like you’ve always wanted.

Broca’s Area

Location

  • In the frontal lobe of the brain
  • Facebook
    • Frontal Broca
    • FB

Lesion

  • Broca’s aphasia is expressive aphasia
    • Patient understands things but cannot talk well

Wernicke’s Area

Location

  • In the temporal lobe of the brain
  • Twitter
    • Temporal Wernicke
    • TW

Lesion

  • Wernicke’s aphasia is receptive aphasia
    • Affectionately known as “word salad”
    • Patient says fluent gibberish but does not understand things

Unity

  • Both are usually on the left side
  • Connected by the arcuate fasciculus nerve fibres

References

  1. THE BRAIN FROM TOP TO BOTTOM. (n.d.). BROCA’S AREA , WERNICKE’S AREA, AND OTHER LANGUAGE-PROCESSING AREAS IN THE BRAIN. [online] Available at: http://thebrain.mcgill.ca/flash/d/d_10/d_10_cr/d_10_cr_lan/d_10_cr_lan.html [Accessed 26 Aug. 2018].