Soalan mr azim. Kot kot la aokmer nak caei kan. Nanti koi cari ya
1- staging of hemorrhoids
2- how PR being done
3- causes of bilateral ankle edema
4- mechanism of edema / pitting / non pitting
5- extrinsic and intrinsic pathway relate with PT and APTT
6- aspirin. Mechanism and effects
Monday, 21 December 2015
Elective splenectomy vaccines
Maryam: Elective splenectomy vaccines:
On admission ensure the patient has had the following at least 2 weeks (ideally 4-6 weeks) prior to surgery:
Pneumococcal vaccine
Meningococcal vaccine
Haemophilus influenza B vaccine
Influenza vaccine
If these vaccines haven’t been given, please follow guidelines below for emergency procedures.
Emergency procedures vaccines:
All the above vaccinations should be given at least 2 weeks POST surgery (the response to Pneumococcal vaccine is poorer if given within 2 weeks of splenectomy).
Abd Halim: Post splenectomy ade 3. Pneumococcal, Meningococcal ngan hemophilus influenza.
Sumber: paeds protocol
On admission ensure the patient has had the following at least 2 weeks (ideally 4-6 weeks) prior to surgery:
Pneumococcal vaccine
Meningococcal vaccine
Haemophilus influenza B vaccine
Influenza vaccine
If these vaccines haven’t been given, please follow guidelines below for emergency procedures.
Emergency procedures vaccines:
All the above vaccinations should be given at least 2 weeks POST surgery (the response to Pneumococcal vaccine is poorer if given within 2 weeks of splenectomy).
Abd Halim: Post splenectomy ade 3. Pneumococcal, Meningococcal ngan hemophilus influenza.
Sumber: paeds protocol
Ocp/hrt ~ breast cancer
Zaim: Salam, Dr.. How long is the usage of ocp/hrt that is significant to be considered as risk for breast cancer ?
Dr Shaiful Ehsan: Wsalam zaimah....
Regarding OCP....it is not directly will cause breast cancer...findings from previous studies have shown that even in patient taking ocp for 10 years the risk of breast ca is still same as in those patient not taking ocp....so it is still grey area....
However, if u talking about those patient who already had potential of breast ca, eg strong family history with undiagnosed mass....the ocp may expedite the presentation and clinical manifestation of breast ca....
My conclusion:
Ocp is still safe and not proven yet to increase risk of breast ca. Therefore breast examination is not indicated even before u wanna start ocp...however, as general rule, each woman is advised for self breast examination as early as possible plus mammogram starting age 40....
Dr Shaiful Ehsan: Regarding hrt, estrogen replacement therapy alone GENERALLY not going to increase risk of breast Ca...though some studies may have mix findings especially those taking more than 10 years...but USUALLY we are not going to give hrt more than 5 years...
But combine estrogen and progesteron therapy....there is a risk of increase breast ca if taken more than 5 years......
Tq.
Dr Shaiful Ehsan: Wsalam zaimah....
Regarding OCP....it is not directly will cause breast cancer...findings from previous studies have shown that even in patient taking ocp for 10 years the risk of breast ca is still same as in those patient not taking ocp....so it is still grey area....
However, if u talking about those patient who already had potential of breast ca, eg strong family history with undiagnosed mass....the ocp may expedite the presentation and clinical manifestation of breast ca....
My conclusion:
Ocp is still safe and not proven yet to increase risk of breast ca. Therefore breast examination is not indicated even before u wanna start ocp...however, as general rule, each woman is advised for self breast examination as early as possible plus mammogram starting age 40....
Dr Shaiful Ehsan: Regarding hrt, estrogen replacement therapy alone GENERALLY not going to increase risk of breast Ca...though some studies may have mix findings especially those taking more than 10 years...but USUALLY we are not going to give hrt more than 5 years...
But combine estrogen and progesteron therapy....there is a risk of increase breast ca if taken more than 5 years......
Tq.
DYSPHAGIA
DYSPHAGIA : impairment of swallowing (involve lips to LES)
Can be classified into 2: (high dysphagia or low dysphagia)
A. High (involve oral, pharyngeal, upper oesophagus)
I. neurological/neuromuscular
-CVA
-parkinsons disease
-motor neurone disease
-muscular dystrophy
Ii. Mechanical or structural
-zenkers diverticulum
-pharyngeal pouch
-oropharyngeal tumour
B. Low (involve lower oesophagus and LES)
I. Motility disorder
-primary (Achalasia, diffuse oesophageal spasm, nutcracker oesophagus)
-secondary (multiple sclerosis, SLE, Chagas disease)
Ii.mechanical
-intrinsic/intraluminal (oesophageal CA, benign stricture, CA of cardia, GERD)
-extrinsic or extraluminal (bronchogenic CA, thoracoaortic aneurysm, goitre, TB, hodgkin or nonhodgkin lymphoma)
#source: nota Dysphagia Mr Faiz Idris + BST Prof Saufi
#kikilala
Can be classified into 2: (high dysphagia or low dysphagia)
A. High (involve oral, pharyngeal, upper oesophagus)
I. neurological/neuromuscular
-CVA
-parkinsons disease
-motor neurone disease
-muscular dystrophy
Ii. Mechanical or structural
-zenkers diverticulum
-pharyngeal pouch
-oropharyngeal tumour
B. Low (involve lower oesophagus and LES)
I. Motility disorder
-primary (Achalasia, diffuse oesophageal spasm, nutcracker oesophagus)
-secondary (multiple sclerosis, SLE, Chagas disease)
Ii.mechanical
-intrinsic/intraluminal (oesophageal CA, benign stricture, CA of cardia, GERD)
-extrinsic or extraluminal (bronchogenic CA, thoracoaortic aneurysm, goitre, TB, hodgkin or nonhodgkin lymphoma)
#source: nota Dysphagia Mr Faiz Idris + BST Prof Saufi
#kikilala
Bucket's List Mr Faidzal
🌵Bucket's List Mr Faidzal
Oncall 14/12
1. How to read a normal chest x- ray
2. Abnormal features in chest x- ray
3. Carbuncle- organism, complication, relation to diabetes
4. Breast ca metastasize to other parts, what do we call them?
Eg: bone- osteoclastic, lung- consolidation
5. Central venous cannulation
- difference between central and peripheral cannulation
- feature in x ray
Shbt2 lain boleh tmbah2
#kikilala
Oncall 14/12
1. How to read a normal chest x- ray
2. Abnormal features in chest x- ray
3. Carbuncle- organism, complication, relation to diabetes
4. Breast ca metastasize to other parts, what do we call them?
Eg: bone- osteoclastic, lung- consolidation
5. Central venous cannulation
- difference between central and peripheral cannulation
- feature in x ray
Shbt2 lain boleh tmbah2
#kikilala
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