Forums » Open clinical » General clinical » D2D contribution to 'Medicine'
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D2D contribution to 'Medicine'
posted at 11/10/2012 9:52 PM BST
on bmj.com
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Posts: 3045
First: 27/3/2012 Last: 20/5/2013 |
I am sure every d2d colleague has have acquired special clinical skills during their clinical life. I would like to request all the esteemed d2d members to share their practical/ clinical, self acquired & confident secret tips from all the medical specialities like surgery, obstetrics, gynecology, general medicine, oncology, odontology, anesthesiology etc. It would pave a concrete way to the development of medicine as well as review the medicine with personal sound experiences. Please do share the clinical secrets! |
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Re: D2D contribution to 'Medicine'
posted at 11/10/2012 9:54 PM BST
on bmj.com
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Posts: 3045
First: 27/3/2012 Last: 20/5/2013 |
A review of clinical skills: ‘Percussion’ Apart from what is classically described by Hutchinson what I think of ‘percussion’ is it is not to make sounds or to hear but it is what we perceive. Example being the feel of fluid thrill while purcussing a patient with pleural effusion or ascites. It is for the purpose of perception or feel that I do practice a modified way to percuss. The middle finger not necessarily perpendicular & with gentle taps, with the thumb resting on the body to feel or perceive the rebound sensation like thrill as well as serving to stabilize and target the finger strokes with accuracy. |
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Re: D2D contribution to 'Medicine'
posted at 12/10/2012 9:48 PM BST
on bmj.com
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Posts: 322
First: 12/11/2010 Last: 20/5/2013 |
The most important clinical skill is listening to the patient - even when what they are telling you initially seems to be irrelevant, it may turn intosomething reslly important... |
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Re: D2D contribution to 'Medicine'
posted at 12/10/2012 9:50 PM BST
on bmj.com
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Posts: 3045
First: 27/3/2012 Last: 20/5/2013 |
Association of malaria & tuberculosis?
It has been a ‘peculiar’ but consistent finding that the cause of acute onset fever in diagnosed patients of pulmonary or extra-pulmonary tuberculosis is mostly malarial infestation! Conversely it would also be interesting to know that many times patients with recurrent malarial fever are associated with concurrent tubercular infection & should be carefully examined for evidence of tuberculosis, the chest should be carefully examined. It would be interesting to discuss this peculiar association of malarial infestation with tuberculosis, what should be the cause?
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Re: D2D contribution to 'Medicine'
posted at 12/10/2012 9:52 PM BST
on bmj.com
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Posts: 3045
First: 27/3/2012 Last: 20/5/2013 |
In Response to Re: D2D contribution to 'Medicine': The most important clinical skill is listening to the patient - even when what they are telling you initially seems to be irrelevant, it may turn intosomething reslly important... Posted by TimReynolds A very important aspect! Many thanks. |
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Re: D2D contribution to 'Medicine'
posted at 13/10/2012 2:14 PM BST
on bmj.com
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Posts: 1790
First: 7/3/2009 Last: 24/5/2013 |
Examination of the abdomen is important. Do not neglect palpation of all quadrants, both superficial and deep. Examine liver and spleen even if your initial palpation has disclosed nothing. I also like to add percussion. It definitely helps in cases there is too much resistance from the patient for palpation, or in cases the abdomen is "large"  .Auscultation may reveal not just peristalsis sounds, but murmurs associated with the vasculature. In males examination of genitalia is important for finding hernias, varicocele, hydrocele,cysts, tumors, various skin findings, excretions etc. You might also make a rule to examine femoral pulses. Of course genital examination of females is better left for gyaenacologist. However, do insist a woman periodically visit a gyanecologist, so early detection of various problems can be carried out.
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Re: D2D contribution to 'Medicine'
posted at 13/10/2012 6:28 PM BST
on bmj.com
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Posts: 1790
First: 7/3/2009 Last: 24/5/2013 |
Many times occupational anamnesis is neglected. There are many medical conditions that are associated with exposures at work. Don't forget that your patient can spend hours at work, therefore exposure is significant. So, don't forget to ask about present occupation and previous occupation.You might find out that the disease is occupational related. |
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Re: D2D contribution to 'Medicine'
posted at 13/10/2012 7:52 PM BST
on bmj.com
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Posts: 3045
First: 27/3/2012 Last: 20/5/2013 |
Use of Thiamine in Alcohol withdrawal syndrome The alcohol withdrawal syndrome is largely due to the central nervous system being in a hyper-excitable state , loss of inhibition . The withdrawal syndrome can include seizures and delirium tremens and may lead to neurotoxicity due to hyper-excitation of CNS. The prophylactic administration of thiamine (vitamin B1-Berin) intravenously or per-oral is recommended before starting any carbohydrate containing fluids or food or IV glucose. Alcoholics are often deficient in various nutrients which can cause severe complications during alcohol withdrawal such as the development of Wernicke syndrome. Another important complication of alcohol withdrawal being ‘hypokalaemia’
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Forums » Open clinical » General clinical » D2D contribution to 'Medicine'
