📖 General Medicine
Budd-Chiari & Wilson Disease
General Medicine- Budd-Chiari:
- Cause: PNH or Polycythemia vera
- Common site: Hepatic veins
- Wilson Disease:
- Autosomal recessive < age 40
- Excess copper in liver + brain
Hematology
General Medicine🔻 Anemia Types
🔸 Microcytic
| Type | Features |
|---|---|
| Thalassemia | Microcytic hypochromic RBCs |
| IDA | ↓ ferritin, ↑ TIBC; ↓ bone marrow iron first |
| Hemochromatosis | ↑ ferritin, ↑ iron, ↑ transferrin sat |
| HUS | Fragmented RBCs |
🔸 Macrocytic
- Pernicious anemia: ↓ intrinsic factor
- MCH ↑, MCHC normal
- Hypokalemia during treatment
- Causes: Dietary folate deficiency, celiac disease
- Thiamine deficiency → Lactic acidosis
🔸 Sideroblastic
- Causes: Hypothyroidism, INH therapy
- Treatment: Pyridoxine
- Genetic variant: Pearson syndrome
Emergency and Management in Dentistry
General Medicine1. Anaphylaxis
- Adrenaline (epinephrine) injection 1:1000, 1 mg/ml
- Intramuscular adrenaline (0.5 ml of 1 in 1000 solution)
- Repeat at 5 minutes if needed
2. Hypoglycaemia
- Oral glucose solution/tablets/gel/powder
- Glucagon injection 1 mg Intramuscular
- Proprietary non-diet drink or 5 g glucose powder in water
3. Acute exacerbation of asthma
- (Beta-2 agonist) Salbutamol aerosol inhaler 100 mcg/activation
- Salbutamol aerosol Activations directly or up to six into a spacer
4. Status epilepticus
- Buccal or intranasal midazolam 10 mg/ml
5. Angina
- Glyceryl trinitrate spray 400 mcg/metered activation
6. Myocardial infarct
- Dispersible aspirin 300 mg
Tuberculosis
General Medicine🔬 Key Features & Forms
- Most infective form: Cavitary lesion
- Primary TB Presentation: Unilateral hilar lymphadenopathy
- Rich focus: Meninges (associated with TB meningitis)
- Cavitation: Absent in HIV-associated or primary TB
💡 Special Manifestations
- Hypersensitivity to Mycobacteria: Phlyctenular conjunctivitis
- Poncet’s disease: Joint pains without active arthritis
- Miliary TB: Mantoux test negative
- Recurrent hemoptysis source: Bronchial artery
💊 Drug Details
- Streptomycin: Not used in TB meningitis
- Bedaquiline: New drug for MDR-TB