Topic:Haemothorax, stones of Gall bladder, Peripheral arterial diseases
Question: Write short notes on the following topics, a) Tension pneumothorax b) Intermittent claudication
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detailed notes on tension pneumothorax and intermittent claudication:
A) Tension Pneumothorax
– Definition: Accumulation of air under pressure in the pleural space leading to collapse of the lung on the affected side.
– Causes: Trauma, mechanical ventilation, COPD exacerbation, ruptured bulla
– Pathophysiology: One-way valve effect allows air to enter pleural space but not exit during inspiration. Progressive air accumulation leads to increased intrapleural pressure.
– Clinical features:
– Dyspnea, tachypnea
– Hypotension, tachycardia
– Tracheal deviation away from affected side
– Hyperresonant percussion note
– Diminished/absent breath sounds on affected side
– Diagnosis: Clinical suspicion, chest X-ray shows collapsed lung, mediastinal shift
– Treatment: Needle decompression, insertion of chest tube to evacuate air and allow lung re-expansion
– Needle decompression – Use 16 or 18 gauge over the top angiocatheter inserted in the 2nd intercostal space, midclavicular line. Allows release of trapped air.
– Chest tube insertion – 28-32 French sized chest tube inserted in 5th intercostal space, midaxillary line. Connect to underwater seal drain. Allows drainage of air and fluid from pleural space. Analgesia required. Post-procedure CXR to confirm lung expansion.
B) Intermittent Claudication
– Definition: Cramping leg pain on exertion due to arterial insufficiency, relieved by rest.
– Causes: Atherosclerosis leading to stenosis of arteries supplying the lower limbs. Commonly seen in peripheral vascular disease.
– Pathophysiology: Inadequate blood supply to calf muscles during activity. Pain relieved by rest.
– Clinical features:
– Occurs after walking certain distance
– Pain in calves, resolve within few minutes of rest
– Weak/absent peripheral pulses
– Pallor, dependent rubor
– Diagnosis: Clinical findings, Ankle-Brachial Index, Imaging – CT angiography, MR angiography
– Treatment: Risk factor modification, Supervised exercise program, Antiplatelets, Smoking cessation. Revascularization procedures if conservative treatment fails – angioplasty, stenting, bypass grafting.
– Medical management:
1. Cilostazol 100 mg twice daily, increases walking distance
2. Pentoxifylline 400 mg three times daily, antiplatelet, vasodilator
3. Antiplatelets like Aspirin 75-100 mg daily or Clopidogrel 75 mg daily
4. Statin therapy for atherosclerosis – Atorvastatin 40 mg daily
5. Smoking cessation
– Revascularization procedures:
1. Angioplasty – Endovascular dilatation of the stenotic artery using a balloon catheter.
2. Stenting – Deployment of a mesh metal stent across the arterial stenosis to maintain patency.
3. Surgical bypass graft – Using a vein or artificial graft to bypass the occluded segment of artery above and below the knee.
– Supervised exercise program – Treadmill exercise under supervision 3 times a week for 30-45 mins to improve symptoms.
Medicivils Medical Science Optional Test Series: Better Than UPSC Medico? Introduction The UPSC Civil Services Examination (CSE) is one of the most competitive exams in the world. The Medical Science optional is a popular choice for many candidates, as it covers a wide range of topics that are relevant to the UPSC syllabus. There are many different test series available for the Medical Science optional, but one of the most popular is the Medicivils test series. Medicivils is a coaching institute that specializes in the Medical Science optional, and their test series is known for its high quality and comprehensive coverage of the syllabus. In this article, we will compare the Medicivils Medical Science Optional Test Series to the UPSC Medico Test Series, and discuss why Medicivils is the better choice for UPSC CSE aspirants. Quality of Questions The quality of the questions in the Medicivils test series is very high. The questions are well-drafted and cover a wide range of topics from the syllabus. The questions are also challenging enough to test the candidates’ knowledge and understanding of the subject. The UPSC Medico test series, on the other hand, has been criticized for the quality of its questions. Some candidates have complained that the questions are too repetitive and do not adequately cover the syllabus. Comprehensiveness The Medicivils test series covers the entire Medical Science syllabus in great detail. The test series includes full-length tests, subject-wise tests, and topic-wise tests. This ensures that the candidates are thoroughly prepared for all aspects of the exam. The UPSC Medico test series, on the other hand, is not as comprehensive. The test series does not cover all of the topics in the syllabus in equal detail. Additionally, the test series does not include any topic-wise tests. Model Answer Sheets The Medicivils test series provides high-quality model answer sheets for all of its tests. The model answer sheets are written by experienced faculty members and provide detailed explanations for all of the questions. The UPSC Medico test series, on the other hand, does not provide model answer sheets for all of its tests. Even for the tests that do have model answer sheets, the quality is often not up to par. Personal Mentorship Medicivils offers personal mentorship to all of its students. The students can get their papers evaluated by experienced faculty members and receive personalized feedback. This helps the students to identify their strengths and weaknesses and to improve their performance. The UPSC Medico test series does not offer personal mentorship to its students. The students do not have the opportunity to get their papers evaluated by experienced faculty members and receive personalized feedback. Video Solutions Medicivils provides video solutions for all of its subject-wise tests. The video solutions are taught by experienced faculty members and provide detailed explanations for all of the questions. The UPSC Medico test series does not provide video solutions for its tests. Evaluation Medicivils evaluates the students’ papers within 7 days. The students’ papers are evaluated by experienced faculty members and they receive a detailed evaluation report. The UPSC Medico test series takes longer to evaluate the students’ papers. The students often have to wait for 10-15 days to receive their evaluation reports. Conclusion Overall, the Medicivils Medical Science Optional Test Series is the better choice for UPSC CSE aspirants. The Medicivils test series offers high-quality questions, comprehensive coverage of the syllabus, model answer sheets, personal mentorship, video solutions, and prompt evaluation. The UPSC Medico test series, on the other hand, has been criticized for the quality of its questions, lack of comprehensive coverage of the syllabus, lack of model answer sheets, lack of personal mentorship, lack of video solutions, and delayed evaluation. If you are serious about cracking the UPSC CSE with the Medical Science optional, then the Medicivils Medical Science Optional Test Series is the best choice for you.
