Renal stone

 Renal stone

Definition:-

Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposited made of minerals and salts that from inside your kidneys. Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.

symptoms of Renal stone:-

• Severe pain in your back or side that will not go away.
• Blood in your urine.
• Fever and chills.
• Vomiting.
• Urine that smells bad or looks cloudy.
• A burning feeling when you urinate.

Differential diagnosis of renal stone:-

• Appendicitis
• Urinary tract infection (UTI)
• Cholecystitis
• Diverticulitis
• Pancreatitis
• Gallstones
Ovarian or testicular conditions
Gastritis

Prevention of Renal stone:-

1. Drink enough fluids: Drink at least 2–3 liters of fluids per day, depending on your activity level and how much you sweat. This can help you avoid dehydration and produce enough urine to lower your risk of kidney stones. 
2. Limit salt: Limit your salt intake to 2,300 milligrams or less per day. 
3. Eat less animal protein: Eating too much animal protein can make it harder for your kidneys to excrete substances that help prevent kidney stones. 
4. Limit foods high in oxalate: Avoid foods like spinach, rhubarb, wheat bran, tree nuts, and peanuts. 
5. Eat enough calcium: Eat calcium-rich foods like dairy products, soy products, beans, seeds, fortified tofu, and some green vegetables. However, be careful with calcium supplements and antacids with calcium, as they can increase your risk of kidney stones. 
6. Avoid sugary drinks: Some studies have linked sweetened drinks, especially those with high-fructose corn syrup, to kidney stones. 
7. Take probiotics. 

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appendicitis

 appendicitis

Definition:-

Appendicitis occurs when the appendix becomes inflamed and filled with pus. Appendicitis is an inflammation of the appendix.

Diagnostic tools:-

History:-

• Right iliac fossa (RIF) pain for x hours.
• Vomiting for same duration.
• Fever for same duration.

Symptoms:-

• Migratory RIF pain.
• Anorexia.
• Nausea and vomiting.

Sign:-

• Tenderness(RIF).
• Rebound tenderness.
• Elevated temperature.

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Acute abdomen

 

Acute abdomen/ Abdominal pain

Definition:-

Sudden or gradual onset of severe abdominal pain that may persist for several hours. Pain may be located in any quadrant of the abdomen. Other symptoms include Nausea, vomiting and appearing ill.

Causes:-

Infections, inflammation, bleeding, blood flow blockages, obstructions, perforations, endocrine and metabolic issues, and hematologic problems.

Gastrointestinal causes

• Sudden onset of diffuse abdominal pain.
• Nausea, vomiting.
• Constipation/obstipation.
• Diffuse abdominal guarding, rigidity, and rebound tenderness.
• Absent bowel sounds.
• Loss of liver dullness on RUQ percussion.

Common causes of acute abdomen:-

1. appendicitis, 

2. diverticulitis,

3. cholecystitis,

4. constipation, 

5. diarrhea, 

6. food allergies, 

7. food poisoning,

8. Gallstone and

9. Renal stone etc.

Symptoms of acute abdomen:-

·         Sudden and severe abdominal pain

·         Nausea and/or vomiting

·         Fever

·         Bloating

·         Diarrhea or constipation

·         Changes in bowel habits

·         Abdominal tenderness

·         Rapid heart rate

·         Difficulty passing stool or gas

·         Sweating

Complication of acute abdomen:-

• Organ dysfunction

Damage to organs like the liver, kidneys, pancreas, or intestines can lead to acute liver failure, acute kidney injury, or pancreatic necrosis.

• Bowel obstruction

A partial or complete blockage of the intestines can lead to vomiting, dehydration, abdominal distension, and ischemia of the intestines.

• Hemorrhage

Internal bleeding can be associated with severe abdominal pain. Untreated hemorrhage can lead to organ damage and hypovolemic shock.

• Organ perforation

A rupture or perforation of organs like the gallbladder, appendix, or intestines can lead to sepsis, peritonitis, or abscess formation.

• Chronic abdominal pain

Acute abdomen can sometimes lead to chronic abdominal pain or functional gastrointestinal disorders.

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COPD (chronic obstructive pulmonary disease)

COPD (chronic obstructive pulmonary disease)

Definition of COPD:

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases.

Disease under COPD:

1.  Chronic bronchitis.  

2.    Emphysema.

 

What are the Obstructive pulmonary diseases:

Risk Factors for COPD:
1.    Cigarette smoking ( Most important risk factor; 95% in UK)
2.    Indoor air pollution ( Cooking with biomass fuels)
3.    Occupational exposure ( Coal dust, Silica & cadmium)
4.    Recurrent infection.
5.    Low socioeconomic status.
6.    Cannabis smoking.
7.    Childhood infection.
8.    Maternal smoking.
9.    Low birth weight.
10.  Alfa 1-antiproteinase deficiency.
11.  Airway hyper-reactivity.

 

Clinical Feature of COPD:

History:

·         Age (COPD is a disease of old age).

·         Duration of cough, sputum and breathlessness.

·         Smoking.

·         Family history (positive).

·         Exacerbating factors such as cold weather, smoking, exercise.

 

Symptoms:

·         Cough.

·         Sputum production.

·         Breathlessness.

·         Haemoptysis.

·         Morning headache (indicative of hypercapnia)

·         Features of complications- e.g. features of heart failure, pneumothorax etc.

 

Differential diagnosis of COPD:

1.    Chronic bronchial asthma.

2.    Bronchiectasis.

3.    Congestive cardiac failure.

4.    Pulmonary tuberculosis.

 

Complication of COPD:

1.    Pneumothorax- due to rupture of emphysematous bulla into pleural space.

2.    Recurrent pulmonary infections.

3.    Pulmonary hypersensitivity.

4.    Cor-pulmonale.

5.    Congestive cardiac failure.

6.    Type-2 respiratory failure.

7.    Secondary polycythaemia- due to chronic hypoxia.

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Bronchial asthma

 

Bronchial asthma

Definition:

Asthma is a chronic inflammatory disorder of the airways, associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night and in early morning. These episodes are usually associated with widespread but variable airflow obstruction within the lung that is often reversible, either spontaneously or with treatment.

Classification of Bronchial asthma:

• 1.    Extrinsic asthma
• 2.    Intrinsic asthma.

Which is responsible for asthma?

1.    IgE( Immunoglobuline E)

It is type-I hypersensitivity reaction

Precipitating factors of bronchial asthma:

1.   Allergen exposure, e.g. House dust mite, household pets.

2.   Indoor pollution.

3.   Exposure to pets in early life.

4.   Childhood infections, e.g. respiratory syncytial virus.

5.   Dietary deficiency of anti-oxidant.

 

Symptoms of Bronchial asthma:

Typical symptoms are recurrent episodes of-

1.    Breathlessness.

2.    Chest tightness.

3.    Wheezing

4.    Cough( may be dominant feature in ‘cough-variant asthma’).

 

Complication of asthma:-

Asthma can cause a number of complications, including:

1.   Lung damage: Poorly controlled asthma can lead to a decline in lung function. 
2.   Infections: People with asthma are more likely to develop pneumonia and other lung infections. 
3.   Lifestyle issues: Poorly controlled asthma can lead to fatigue, poor sleep, and physical inactivity. It can also cause people to miss work or school, or fall behind in schoolwork. 
4. Mental health: Asthma can lead to stress, anxiety, depression, or other mood disorders. 
5. Oral health: Asthma can cause oral ulcers, bad breath, and changes in taste. 
6. Gastroesophageal reflux disease (GERD): Asthma flare-ups can increase the risk of GERD. 

·         Hospitalization: Severe asthma attacks may require emergency treatment or hospitalization. In some cases, untreated asthma can lead to respiratory failure or death. 

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