Healthy MeDico

Enteric Fever (Typhoid Fever) Chief complaints: Fever that is gradually increasing to 104.9 F Headache  Vomiting  Weakness  Fatigue Loss of appetite Muscle pain Relative bradycardia Loss of appetite Abdominal pain Rash (2 to 4 mm , Rose spots) Diarrhoea Hepatomegaly Splenomegaly  Treatment duration: 7 to 14 days Diagnosis: (BASU) Blood culture: 1st week (Most Important test at disease onset) Antigen test(widal test): 2nd week Stool culture: (3rd week) Urine Culture: (4th week) Bone marrow culture: (Gold standard) Investigations:   Full blood count (CBC)    Anemia Leukopenia or leukocytosis (Absolute eosinopenia, Relative lymphcytosis) Liver Function Tests (LFTs) Ultrasonography Whole Abdomen: Hepatosplenomegaly Treatment: (1 Teaspoonful = 5ml) Syp. Cefixime 100mg/200mg (Brands: Cefspan/Cefiget= 100mg/5ml, Cefspan DS/Cefiget DS=200mg/5m) X BD Syp. Paracetamol (Panadol=160mg/5ml, Calpol=120mg/5ml, Calpol 6Plus/Panadol forte=250mg/5ml) Syp. Multivitami...

Acute Cholangitis: Symptoms Plus Management Symptoms: Charcoat’s Triad: Right Upper Quadrant Pain Fever  Jaundice  Reynolds Pentad: Right Upper Quadrant Pain Fever  Jaundice  Sepsis (Hypotension) Mental Disturbances Tokyo Criteria A = clinical inflammation Fever CRP raised  TLC raised B= Evidence of obstruction By CT or Ultrasound: stone, stricture, CA Pancrease. C= Biochemical evidence: Bilirubin raised ALP raised  GGT raised A+B+C= definitive A+C/B+C=Suspected. Management: Conservative Treatment: IV fluids (Ringer lactate/NS) Analgesics(Tramol plus metomide, Ketorolac, Nelbin) Anti-pyretics(Paracetamol) IV antibiotics(Cefrriaxone) If itching: → Anti-histamine. → Questeron sachet (Cholestyramine) → Ursu sachet - Ursodeoxycholic acid Specific Treatment: Biliary drainage by *ERCP *PTBD *Surgical