SHOCK
DEFINITION:-
Shock is an acute clinical syndrome characterized by poor tissue perfusion with impaired cellular metabolism, which is manifested as different serious pathophysiological abnormalities.
 
CLASSIFICATION OF SHOCK
Hypovolaemia
Cardiogenic
Intrinsic
Compressive
Septic
Hyperdynamic
Hypodynamic
Anaphylactic
Traumatic
Neurogenic
Hypoadrenal
CAUSES OF SHOCK

Hypovolaemia shock:- due to reduction in total Blood volume.
Loss of blood:- hemorrhagic shock, RTA, major surgeries.
Loss of plasma:- burn shock, pancreatitis.
Loss of fluid:- diarrhea, vomiting , …

AN APPROACH TO A CHILD WITH WHEEZE

WHEEZES OR RONCHI:
Wheeze is a dry musical sound associated with airway narrowing.
The expiration is prolonged.
WHEEZING:
Common in infants and young children because of unique age specific anatomic and physiologic properties and gender specific intrinsic lung characteristics.
By year 1- 20 % children.
By 3 years- 33% children.
By 6 year- 50% children.
< 15% children are …

Alcohol  are hydroxy derivatives of aliphatic hydrocarbons.
Manufacture:
C6H12 O6 (sugar) —-zymase—-> 2 CO2+ 2C 2 H 5 OH
Metabolism of Alcohol:

Alcohol is metabolized in liver by alcohol dehydrogenase
90% – processed in liver
10% – excreted (eliminated unchanged from kidneys and lungs)
Absorption mostly from small intestine and only 10% from stomach.
Peak effect in 30 to 90 min (30 to 60 min in empty stomach)
Depends  upon:

time …

DISSOCIATIVE DISORDER

Dissociative disorder:- (conversion disorder)
is a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements.
Previously known as conversion hysteria.
EPIDEMIOLOGY:-
According to DSM-IV-TR ( 11 to 500 cases per 100,000 population)
Women :men (adult ) 2-10:1 and among children there is higher predominance in girls.
Most common …