scilearner

Hello everyone, This has bothered me for sometime now. Ok Pulmonary embolism , now decreased perfusion into a part of lung. No blood available for oxygen from lung to diffuse into. Blood has decreased oxygen. That is fine but since no blood is reaching the lungs, the carbon dioxide should also be retained in blood, shouldn't this elevate carbon dioxide in blood. Ok I understand body now goes into relfex tachypnoea to get more oxygen in mean time, and this will also push carbon dioxide out. But how can this reduce carbon dioxide level, if the lung is not receiving carbon dioxide from blood anyway, due to decrease perfusion. Thanks

Hello everyone, I did an internet search on these terms, but I want to make sure if I understood this properly. These are the biopsies I know 1. FNAC: You get a needle and aspirate cells 2. True cut (core) biopsy: You get a bigger needle and aspirate tissue rather than cells. 3. Incisional biopsy: You take a piece of the tissue of interest. Eg if there is an ulcer, you take a wedge shape part of it for histopathology. 4. Excisional biopsy: You take the whole tissue of interest. Eg removing whole lobe of thyroid, to look for follicular carcinoma. Questions 1. Did I understand these terms properly, my biggest confusion is incisional and excisional biopsy, did I get that right? 2.. Are there any other biopsy types I don't know of. Thank you so much

Hello everyone, I thought I understood these terms, but got confused lately . My understanding Congenital- Present at birth Familial: Occuring in family or its members Hereditary: Transmitted or capable of being transmitted genetically from parent to offspring My questions 1. Ok congenital means disease it present at birth. In familial and hereditary also the abnormal genes are present at birth if so why don't their diseases present at birth, why do they manifest later in life? 2. Are all familial diseases hereditary? I really can't differentiate these. Any examples 3. Also aren't some congenital diseases, hereditary/familial? Any examples. 4. Also in some classifications I have seen in textbooks. They take familial causes, under acquired causes section.How is familial and acquired cause, when it is genetic? Thanks

Hello everyone, Charcot's triad is there to describe the clinical features of acute cholangitis. They are 1.Fever 2. Right upper quadrant pain 3. Jaundice 2 and 3 in charcot's triad is confusing to me. As I want to know if they occur due to cholangitis (infection) or due to gall stone obstructing common bile duct and then getting infected causing cholangitis. Is this charcot's triad made assuming that a gall stone causes cholangitis, or even without a stone would 3 features mentioned in Charcot's triad occur in acute cholangitis. Thanks

Hello everyone, How does this occur. I'm talking about retention (eg urine stuck in bladder) not the pre renal failure which myocardial infarction can obviously cause. Also while we are at it, I also read diuretics can cause retention of urine also. That's interesting because that defeats their purpose in the first place. So how do diuretics also cause urine retention. Thanks

I found the answer why urine and faecal retention cause delirium. Answer is if anyone interested cystocerebral syndrome

Hello everyone, I'm talking about retaining urine in the bladder,not renal failure, so I can't think of uraemia as a course. So what is the reason behind this. Thanks

Why is that usually, Diarrohea due to large intestine problems usually cause blood and mucus diarrohea While diarrhoea due to small intestine problems usually cause watery diarrohea. Thanks

Thanks Bells nicely answered

Let's say there is a bowel perforation and this results in sepsis, I know surgery would have to be done or else the person would die. But my question is , is the person first given aggresive IV antibiotics first and when infection is controlled only surgery done, or in emergency situations like this it is done asquickly as possible as there is no time to wait. Why I ask is wouldn't general anaesthesia be hazardous in a sepsis patient. Also can't the surgery further disseminate the infection if it not resolved first. Do they just take the risk because there is no choice?

Thanks pwagen

Hello everyone, Lets say there is a guy with colorectal carinoma and he developed metastasis in liver. 1. My question is now this guy has a liver cancer as well. Does this liver cancer contain dysplastic cells from colon or does it contain dysplastic hepatocytes. In simple words what I'm asking is in metastatic liver cancer is it the liver cells that are growing out of control or is it in this case cells from the colon has got implanted in liver and this colon cells are growing out of control in the liver. 2. If it is colon cells, does that mean metastatic cancer of liver would not affect the function of liver that much because liver cells are still normal. As opposed to a primary liver cancer where liver cells itself grow out of control and function is bound to be affected. Thanks a lot

Hello everyone, From what I have read I have deduced that both bowel peforation and strangulation have same clinical features, which are fever, leukocytosis, pain, tenderness, increase in vital signs (eg tachycardia) 1. Why is this? Is it becase strangulation bowel (which means necrosis really) eventually lead to peforation. If not how do you differentiate between the two? 2. If bowel peforation occurs, peritonitis is bound to happen, so are these clinical features due to peritonitis. If not why do these two things cause these clinical features. Eg why cause fever? 3. If some abdominal organ burst, peritonitis can occur. If a thoracic organ occurs infection of thoracic cabity can occur, what do you call that? Thanks a lot

Hello everyone, How does Lymphoedema cause ulcers? Example people with filiariasis having skin ulcers.

Hello everyone, 1. I know 5% dextrose is isotonic outside body 2. Also 10% dextrose is hypertonic outside body 3. Also (5% dextrose + Normal saline) is also hypertonic However if we consider that once inside the body all dextrose gets metabolised by body, leaving only water. Then once inside the body these become 1.Hypotonic 2.Hypotonic 3. Isotonic Respectively. Then if a question comes about the tonicity of these solutions. Which one should I pick for example (5% dextrose + Normal saline) , I choose hypertonic or isotonic for that one. Thanks

Thanks for the reply String Junky. I thought that too, but I was wondering if there was some other phenomenon beside the obvious. Something to do with rectal sphincter may be. Did you just think and give the answer or is this from some reference. You might well be right may be there is no serious phenomenon, I just asked to check. 1. Also while we are at it. Why does alteration of bowel habits occur in rectal carcinoma? What I think is, due to the colon lumen obstruction by the cancer first you get constipation and faeces build up. The bacteria work on this faeces and break them in to liquid, causing diarrhoea. Am I right?

Hello everyone, I was wondering what is the exact mechanism that rectal cancer gives a sense of incomplete evacuation after defecation (Tenesmus in scientific language). Also why is this is not present in colon cancer higher up eg in ascending colon cancer and only lower down like rectal cancer? EditReport + Q

After some thinking I have come to this conclusion. Surgery is risky in metastatic disease as 1. Patient is not suitable to endure a major surgery when there is systemic metastasis, as his body would not be able to handle it. 2. Doing the surgery could accidentally create more pathways for metastasis to spread. 3. As you said systemic problems caused by metastasis takes precedence and must be treated first. Thanks for the help

Thanks for the reply pwagen. But what I don't understand is But since the primary tumour is still there, wouldn't it keep producing metastastasis even though we are removing them at the same time. Eg a water bucket, and some guy pouring a cup of water in (tumour) as another guy pour a cup out (chemotherapy), so there is no net gain and task is futile.

Hello everyone, Let's take a woman with a breast lump for example and it is malignant. I know that stage 3 and 4 disease, eg advanced/metastatic disease treatment is chemotherapy/radiotherapy. Then after it is downgraded they surgically resect the lump (stage 1 and 2). While this makes sense my question is why don't they still remove the lump in advanced disease and then give chemotherapy/radiotherapy. Reason been if the tumour is not resected and you give chemotherapy, since the primary tumour is still there it would keep producing metastasis. Is the reason that surgical resection is too dangerous when metastasis present. Why is that? Thanks

Thanks for all the replies. Charony answer was more what I was after

Hello guys, I have few questions 1. I know MRI is best for soft tissue masses? What does soft tissues mean? I searched on the internet and the definition is vague. Is it simply all the tissue apart from bone in the body, which means its includes organs such as liver. Or is it all supporting tissue in the body such as connective tissue. 2. If soft tissue includes organs such as liver, pancreas. Does this mean since MRI is best for soft tissue masses, it is always the best investigation for liver pathologies when given the choice of performing CT or MRI. I know this depends on the disease and in some cases biopsy, USS may be better options but I'm just asking if given the choice between CT and MRI. 3. I know CT is good for bones. But I read somewhere MRI spine is better than CT spine when detecting spinal fractures. 4. Also is MRI or PET scan better when finding for metasates of certain cancers. 5. Also is CT or MRI better for bones. Thanks a lot

Hello everyone, I have this friend who has a slight strabismus. His eyes look away from me when speaking, but that means he is actually looking at me. I can understand how these people, brains may learn to ignore certain images and adapt to this condition. But how can his eyes physically look away from me, and still see me. Also in a case where both eyes are crossed, wouldn't it be almost impossible to see properly. Thank you

Hello everyone, I don't understand sepsis. Ok I know Sepsis is SIRS (Systemic inflammatory response syndrome) to an infection. But I'm confused with these scenarios. 1) Lets say I have a UTI in kidney. The immune system localises the infection to kidney and causes massive inflammation in that area and fights the disease, with out allowing it to spread to otherarea. Now is this Sepsis? If it is not what do you call it? Here also inflammation towards infection occurs so why is it not called sepsis? Does CRP increase in this scenario? 2) Lets say I have a UTI in kidney. It spreads to all areas in body. Massive systemic inflammation occurs towards the infection. I'm assuming this is sepsis?, then what do you call scenario 1 I described. What happens to CRP in this condition. 3) You want inflammation and immune response against infections to fight them. So why is sepsis bad? Thanks

Another question Ok if we consider solution with an equal concetration of H+ and OH- ions as neutral. What if there is a solution like this X<----> H+ + OH- Hydrogen ion concentration= 10 -2 Hydroxide ion concentration= 10 -2 Then if I use PH equation = -log [10 -2] = I get an acidic PH. But in this case both hydrogen ions and hydroxide ions concentration is same, but PH is acidic instead of neutral. How is that possible. I just made up this equation, is it impossible for something like this to exist? Does this mean that the definition of neutral is not actually equal concentration of hydrogen ions and hydroxide ions, but simply the PH of water? Thanks