Sexually Transmitted Infections
Top 10 Posts of 2016
10. All Shock Explained
9. Priapism
Non-ischemic (high-flow) | Ischemic (low-flow) | |
Physical Exam | Typically painless, not fully tumescent | Painful, fully tumescent with corpus cavernosa rigidity without involvement of corpus spongiosum and glans penis |
Aetiology | High-flow priapism is extremely rare and most commonly associated with antecedent trauma including blunt trauma, or resulting from needle injury of the cavernosal artery. | Low-flow priapism is caused by impaired relaxation and/or paralysis of cavernosal smooth muscle and in sickle-cell disease |
Management | NOT Emergency | Emergency |
8. 2016 Guidelines
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Current criteria for the diagnosis of diabetes (2016 guidelines)
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CDC Sexually Transmitted Diseases (STDs) Treatment Guidelines 2015
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Latest guidelines for the management of Hypertension – JNC VIII
7. Sepsis Six in 60 Minutes: World Sepsis Day – September 13th
NEW SEPSIS PATHWAY
FLUIDS
ANTIBIOTICS
…for every hour you delay, the patient has a 33% increased risk of death!
LACTATE
6. Did you know about the RULE OF TENS for Fluid Resuscitation in Burns?
Burns Rule of TENS:
1. Estimate burn size (TBSA) to the nearest 10%.
2. Multiply %TBSA x 10 = Initial fluid rate in mL/hr (for adult patients weighing 40 kg to 80 kg).
3. For every 10 kg above 80 kg add 100 mL/hr to the rate.
5. New 2015 Resuscitation Guidelines Compedium
4. LFTs explained
- LFTs = ‘hepatocellular’ or ‘cholestatic’ arrangement based on the pattern of elevation.
- Hepatocellular pattern = transaminases > ALK
- ALT is generally considered to be more specific to liver damage
- Magnitude of aminotransferase elevation => guide initial diagnosis: mild (<5x), moderate (5-10x), or marked elevation (>10x)
- Mild = NAFLD, Drug Induced Liver Injury, Alcohol-Induced Liver Injury
- Moderate = Alcoholic Hepatitis, Biliary Tract Disease
- Severe = Acute Viral Hepatitis, Ischemic Injury, Acetaminophen Toxicity
3. The GCS is out-of-stock
Contrary to common belief, The Glasgow Coma Scale (GCS) is NEVER out-of-stock and the lowest score possible is 3.
- An intubated patient still gets 1 point for verbal meaning they score 3T…there is nothing like a 2T score (at least not in human beings)
- The phrase ‘GCS of 11’ is essentially meaningless, and it is important to break the figure down into its components, such as E3V3M5 = GCS 11.
- The Scale was described in 1974 by Graham Teasdale and Bryan Jennett (Assessment of coma and impaired consciousness. A practical scale. Lancet 1974; 2:81-4.) and is the most reference paper in medical literature
2. Nairobi Accident Hotspots
The most dangerous time to walk on Nairobi’s streets is on a Friday, around 7am, particularly along Mombasa Road.
1. Salter-Harris Fracture (remember the mnemonic SALTR)
- Slipped (i.e., through growth plate and not involving bone) / Type I
- Above growth plate (i.e., through metaphysis) / Type II (most common)
- Lower growth plate (i.e., through epiphysis) / Type III
- Through (i.e., through metaphysis growth plate and epiphysis) / Type IV
- Rammed (i.e., Crush injury) / Type V (worst prognosis)