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​Symptoms and Signs – Differential Diagnosis of  Non Traumatic Cardiac Arrest
• Toxins (carbon monoxide, cyanide)
• Respiratory (upper airway obstruction, hypoventilation, pulmonary embolism, asthma, COPD exacerbation, pulmonary edema)
• Medications (tricyclic antidepressants, digoxin, theophylline, calcium channel blockers)
• Environmental (drowning/near-drowning, electrocution, lightning, hypothermia or hyperthermia, venomous snakes)
• Electrolyte abnormalities (hypokalemia or hyperkalemia, hypomagnesemia or hypermagnesemia, hypocalcemia)
• Drug abuse (cocaine, heroin, amphetamines)
• Circulatory (tension pneumothorax, pericardial tamponade, pulmonary embolism [PE], hemorrhage, sepsis)
• Cardiac (coronary artery disease, cardiomyopathies, structural abnormalities, valve dysfunction, arrhythmias)
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​Symptoms and Signs – Differential Diagnosis of Cardiac Death, Sudden1
NONCARDIAC
• CNS hemorrhage
• Massive pulmonary embolus
• Drug overdose
• Hypoxia secondary to lung disease
• Aortic dissection or rupture
CARDIAC
• Ventricular tachycardia
• Bradyarrhythmia, sick sinus syndrome
• Aortic stenosis
• Tetralogy of Fallot
• Pericardial tamponade
• Cardiac tumors
• Complications of infective endocarditis
• Hypertrophic cardiomyopathy (arrhythmia or obstruction)
• Myocardial ischemia
• Atherosclerosis
• Prinzmetal’s angina
• Kawasaki’s arteritis
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​Symptoms and Signs – Differential Diagnosis of Cardiac Enlargement
CARDIAC CHAMBER ENLARGEMENT
• Chronic volume overload: mitral or aortic regurgitation, left-toright shunt (patent ductus arteriosus [PDA], ventricular septal defect [VSD], arteriovenous [AV] fistula)
• Cardiomyopathy: ischemic, nonischemic
• Decompensated pressure overload: aortic stenosis, hypertension
• High-output states: severe anemia, thyrotoxicosis
• Bradycardia: severe sinus bradycardia, complete heart block

LEFT ATRIUM
• Left ventricular (LV) failure of any cause
• Mitral valve disease
• Myxoma

RIGHT VENTRICLE
• Chronic LV failure of any cause
• Chronic volume overload: tricuspid or pulmonic regurgitation, left-to-right shunt (atrial septal defect [ASD])
• Decompensated pressure overload: pulmonic stenosis, pulmonary veno-occlusive disease, pulmonary artery hypertension: primary, secondary (pulmonary embolism [PE], chronic obstructive pulmonary disease [COPD])

RIGHT ATRIUM
• Right ventricular (RV) failure of any cause
• Tricuspid valve disease
• Myxoma
• Ebstein’s anomaly

MULTICHAMBER ENLARGEMENT
• Hypertrophic cardiomyopathy
• Acromegaly
• Severe obesity

PERICARDIAL DISEASE
• Pericardial effusion with or without tamponade
• Effusive constrictive disease
• Pericardial cyst, loculated effusion

PSEUDOCARDIOMEGALY
• Epicardial fat
• Chest wall deformity (pectus excavatum, straight back syndrome)
• Low lung volumes
• Anteroposterior (AP) chest radiograph
• Mediastinal tumor, cyst
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​Symptoms and Signs – Differential Diagnosis of Cardiac Murmurs
SYSTOLIC
• Mitral regurgitation (MR)
• Tricuspid regurgitation (TR)
• Ventricular septal defect (VSD)
• Aortic stenosis (AS)
• Hypertrophic obstructive cardiomyopathy
• Pulmonic stenosis (PS)
• Innocent murmur of childhood
• Coarctation of aorta
• Mitral valve prolapse (MVP)

DIASTOLIC
• Aortic regurgitation (AR)
• Atrial myxoma
• Mitral stenosis (MS)
• Pulmonary artery branch stenosis
• Tricuspid stenosis (TS)
• Graham Steell murmur (diastolic decrescendo murmur heard in
severe pulmonary hypertension)
• Pulmonic regurgitation (PR)
• Severe MR
• Austin Flint murmur (diastolic rumble heard in severe AR)
• Severe VSD and patent ductus arteriosus

CONTINUOUS
• Patent ductus arteriosus
• Pulmonary arteriovenous (AV) fistula
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​Dermatology - Hypersensitivity vasculitis
Hypersensitivity vasculitis refers to a diverse collection of vasculitides that are linked to an exaggerated immune response to antigens derived from infectious organisms, medications, or other external or internal causes. Prior to the commencement, a recently introduced medication is a probable cause, along with the possibility of an infection, a recognized vascular/connective tissue disorder, or paraproteinemia.
The onset and duration can be categorized as acute (occurring within days, such as in cases of drug-induced or idiopathic causes), subacute (lasting for weeks, particularly in urticarial kinds), or chronic (recurring over a period of years).

Systemic vascular involvement mostly affects the kidney, muscles, joints, GI tract, and peripheral nerves. Common symptoms of this condition include itching and a sensation of burning pain. However, it is possible for individuals to have no symptoms at all. In some cases, there may also be other symptoms such as fever, general discomfort, signs of nerve damage in the limbs, abdominal pain due to reduced blood flow to the intestines, joint pain, muscle pain, presence of blood in urine, and involvement of the central nervous system.
Abnormalities
The defining characteristic is palpable purpura, which refers to visible petechiae that appear as bright red, well-defined macules and papules with a central, dot-like bleeding. This is in contrast to petechiae caused by coagulation abnormalities or thrombocytopenia, which are flat and hence not able to be felt. The lesions are distributed sporadically, either separate or merging together, and are mainly confined to the lower extremities and ankles but can extend to the buttocks and arms. Stasis exacerbates or triggers lesions. The lesions do not lose their color, remaining red, and may even darken to purple or black. During severe inflammation, purpuric papules transform into hemorrhagic blisters, undergo necrosis, and may even develop ulcers.

The diagnosis relies on the observation of clinical features and the examination of tissue samples under a microscope. The possible causes of the condition include thrombocytopenic purpura, exanthematous drug eruption accompanied by thrombocytopenia, disseminated intravascular coagulation with purpura fulminans, septic vasculitis (such as rickettsial spotted fevers), septic emboli (related to infective endocarditis), bacteremia (including disseminated gonococcal infection and acute/chronic meningococcemia), pigmented purpura, and other noninfectious vasculitides.


Administer antibiotics to patients who develop vasculitis subsequent to a bacterial infection. Administer prednisone to patients with moderate-to-severe disease, along with cytotoxic immunosuppressants such as cyclophosphamide or azathioprine, or cyclosporine and intravenous immunoglobulin for severe disease.
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Kembara Xtra 

Facts about medicine and its subtopic such as anatomy, physiology, biochemistry, pharmacology, medicine, pediatrics, psychiatry, obstetrics and gynecology and surgery.