Clinical Correlation in the Cardiovascular Examination

On last august 25, 2011, I've been posting about Clinical correlation that we can find in the abdominal examination. Now I'll show you some CC that usually found in the cardiovascular examination:

1. Some abnormal heart sounds are loud enough that they can be heard without a stethoscope. Examples include an artificial valve or grade 6 murmur.

2. A JVP of 10 or greater is considered elevated and, among other things, may indicated heart failure, specifically right heart failure.

3. Pitting edema is a result of a transudate, where as non-pitting edema is a common sign in congestive heart failure, hepatic cirrhosis, or nephrotic syndrome.

4. If the point of maximal impulse is lateralized it may be indicated left ventricular hypertrophy.

Jaundice: The History of Disease and Related Things

Some things can be related to the mechanism of occurrence of jaundice. Then as a doctor we should ask questions related to several things, such as:

• Age. The older patient, carcinoma is more often the cause of jaundice, While the hepatitis, less frequent in old age.
• Injection or transfusion within the last 6 months (characterizing viral hepatitis), including drug addiction. You also have to looking for evidence of injection site.
• Contact with the patient's jaundice and a history of living abroad
• Jobs. farm employment and work in sewers at risk of leptospirosis.
• History of dark urine and pale stools in biliary obstruction.
• Drugs taken recently, especially phenothiazines and the contraceptive pill.
• Onset of illness until it becomes the main symptom of jaundice. hepatitis Agenerally lasts 1-3 weeks, carcinoma is 1-2 months, hepatitis B 6 weeks-6months, cirrhosis hepatic are usually very long.
• Alcohol consumption
• Abdominal pain which was recently, or dyspepsia may be a sign of chroniccholecystitis, cholangitis, gallstones, or pancreatic carcinoma.
• Recent surgery, anesthesia (halothane).
• Family history, if suspected of having Gilbert's syndrome.

Jaundice: The Causes and Cases

Jaundice is a yellow color to the skin and sclera. Usually only visible when bilirubun serum levels above 35 mol / L. Sclera is not colored in yellow skin due to hiperkeratonemia. The three basic causes: hemolytic, hepatocellular, obstructive. It's how to remember: H2O --> Hemolytic, Hepatocellular, Obstructive
Some of diseases that jaundice as the clinical sign are:

• Acute viral hepatitis, because the recovery is slow, or there is persistent intrahepatic cholestasis.
• Bile duct obstruction due to gallstones or carcinoma of the head of the pancreas.
• Jaundice due to drugs
• Multiple secondary deposits in liver carcinoma (clinical jaundice is rare but often increased bilirubin)
• intrahepatic cholestasis
• Mononukleus infectious
• Gilbert syndrome

Clinical Correlation in The Abdominal Examination

I've been posting about Abdominal Examination on last June, now I'll show you about some clinical correlation that we usually found in the abdominal examination. I hope this article will be worth,, ^___^

1. Abdominal Bruits. During Auscultation you listen to normal active bowel sound or some normal bruits (like bruits in the epigastric area from abdominal aorta, and the upper quadrants from renal arteries. But in some case you may listen to abnormal bruits. The abdominal bruits may be due to atherosclerotic lession, or masses that may be impinging on the abdominal aorta or renal arteries.
2. Rebound Tenderness. Begin palpating the abdomen very gently in all four quadrants. Look at the patient's face to see any signs of pain or discomfort. if there is abdominal tenderness, look for rebound tenderness by slowly pressing into the tender area then quickly releasing. Rebound tenderness may indicate peritonitis (inflammation of the peritoneum), which is classically seen in appendicitis.