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Articles by Dr. Mahesh Shrestha

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Alcoholic Liver Disease or ALD

Alcoholic Liver Disease or ALD

Alcoholic Liver Disease
Alcohol is a toxic substance to the liver and remains one of the most common causes of chronic liver disease.
The spectrum of ALD is broad and a single patient may be affected by more than one of the following conditions;fatty liver, alcoholic hepatitis or alcoholic cirrhosis.
EPIDEMIOLOGY

ALD does not occur below a threshold of 21 units/week in women and …

Non Cardiogenic Pulmonary Edema

Non Cardiogenic Pulmonary Edema

NONCARDIOGENIC PULMONARY EDEMA
Noncardiogenic pulmonary edema(NCPE) results from

elevated pulmonary capillary hydrostatic pressure
damage to vascular endothelium by factors that disrupt pulmonary surfactant and decrease lung compliance.

CAUSES:

drug overdose
near drowning
thermal injury
inhalation of toxic gases
trauma
sepsis
shock
high altitude illness
pulmonary embolism
ARDS
pulmonary lymphatic obstruction
aspiration of gastric contents
disseminated intravascular coagulation

CLINICAL PRESENTATION:

Main symptoms are dyspnea and tachypnea.
On physical examination- presence of bilateral rales

DIAGNOSTIC TESTS:
ABG – used to assess the need …

CARDIOGENIC PULMONARY EDEMA

CARDIOGENIC PULMONARY EDEMA

CARDIOGENIC PULMONARY EDEMA
DEFINITION:
Interstitial edema, including fluid engorgement of the perivascular and peribronchial spaces and the alveolar wall interstitium.
ETIOLOGY:
Arrhythmias , MI , severe systemic hypertension
Pulmonary embolism , valvular heart disease
Increased pulmonary capillary wedge pressure
PATHOPHYSIOLOGY:
Cardiogenic pulmonary edema occurs when the pulmonary capillary pressure exceeds the forces that maintain fluid within the vascular space (serum oncotic pressure and interstitial hydrostatic pressure).
Increased pulmonary …

Acute Myocardial Infarction, AMI or ‘Heart Attack"

Acute Myocardial Infarction, AMI or ‘Heart Attack"

Acute Myocardial Infarction
Definition:

Myocardial infarction (MI) or acute myocardial infarction (AMI), is the interruption of blood supply to part of the heart, causing heart cells to die, commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids and white blood cells in the wall of an artery. …

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