Monday, June 13, 2016
Thursday, October 9, 2014
Wells Score for pulmonary embolism (PE).
Wells Score for pulmonary embolism (PE).
The mnemonic is: Don’t die, tell the team to calculate criteria! The first letters in the saying correspond to a criteria for diagnosis. If the first letters are the same, they also have the same numerical point value for calculating the total sore.
Don’t (DVT symptoms) 3 points
Die (Diagnosis most likely PE) 3 points
Tell (Tachycardia) 1.5 points The Team (Three days [at least] of immobilization, or surgery in the past Thirty days) 1.5 points
To (Thromboembolism in the past [DVT or PE]) 1.5 points
Calculate (Coughing up blood [hemoptysis]) 1 point Criteria (Cancer) 1 point
This is what the scores mean:
> 6 High probability of PE
2-6 Moderate probability of PE
< 2 Low probability of PE
The modified Wells Criteria is a bit simpler:
> 4 PE is likely
≤ 4 PE is unlikely
From: “Well’s Criteria for Pulmonary Embolism / PE.” MDCalc. Web. 11 Nov. 2011
The mnemonic is: Don’t die, tell the team to calculate criteria! The first letters in the saying correspond to a criteria for diagnosis. If the first letters are the same, they also have the same numerical point value for calculating the total sore.
Don’t (DVT symptoms) 3 points
Die (Diagnosis most likely PE) 3 points
Tell (Tachycardia) 1.5 points The Team (Three days [at least] of immobilization, or surgery in the past Thirty days) 1.5 points
To (Thromboembolism in the past [DVT or PE]) 1.5 points
Calculate (Coughing up blood [hemoptysis]) 1 point Criteria (Cancer) 1 point
This is what the scores mean:
> 6 High probability of PE
2-6 Moderate probability of PE
< 2 Low probability of PE
The modified Wells Criteria is a bit simpler:
> 4 PE is likely
≤ 4 PE is unlikely
Picture from: http://doctorstock.photoshelter.com/image/I0000FUaFtGQCIg0
From: “Well’s Criteria for Pulmonary Embolism / PE.” MDCalc. Web. 11 Nov. 2011
SIRS-systemic inflammatory response syndrome
SIRS: At least 2 conditions:
- T>38'C @ <36'C
- Heart rate >90
- Respiratory Rate >20 @ PaCO2<32mmhg
- White cell counts >12k/mm3 @ <4k/mm3, @ >10% immature band form
Pic & further info from: http://nrsged.wikispaces.com/6.+SIRS+vs+Sepsis
Monday, August 11, 2014
Budd Chiari Syndrome atau sindrom budd chiari
Saluran keluar vena hati tersumbat menyebabkan sakit perut, perut kembung berisi air, kekuningan, encephalopati, pendarahan varices dan bengkak hati dan limpa ( disebabkan oleh tekanan darah tinggi di saluran darah sistem porta.
Sebab
Salaur darahvena tersumbat disebabkan oleh tahap beku darah yang tinggi atau malignansi. Jarang-jarang disebabkan oleh rangkaian selaput vena di IVC.
investigasi
Darah: Ujian Fungsi hati (↑transaminases), Ujian Jumlah bilangan sel darah, AIR KENCING DAN ELEKTOLIT, taham pembekuan darah dan ujian saringan kekurangan sel darah kuning
Ultrasound doppler: ↓ Aliran darah dalam vena hepatik . Ujian Hepatic venogram and inferior venacavagram. MRI.
Pengurusan
Rawatan Perubatan (jagaan sokongan, ejen anti pembekuan darah, dan proses pencairan ketulan darah bergumpal dalam peringkat awal ), prosedur radigraphy (angioplasty, TIPS, dan stenting) dan pembedahan (prosedur shunting dan penanaman hati, merawat komplikasi berkaitan dengan cecair yg berkumpul, merawat malnutrisis dan merawat tekanan darah tinggi di salur darah sistem porta.
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