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Channel Posts
| 2 | Tension pneumothorax established.
Large venule placed in second intercostal space midclavicular line. After thoracic drainage, the lung is re-inflated.
In case of COPD exacerbation please think about tension pneumothorax | 191 |
| 3 |  50 year old patient with COPD exacerbation. Suddenly he had developed tachypnea and tachycardia up to 160/min SR with saturation drop to 75%. BGA showed PH of 7.1 and pco2 110, he was connected to NIV and treated with 100 mg prednisolone, 10 mg morphine, salbutamol/atrovent and adrenaline inhalation, 1 gm magnesium. Nevertheless BGA control was still worse with PH 6.9, pco2 150 mmHg. therefore he was intubated emergency. With V.a. tension pneumothorax, an X-ray was requested.
See Below. | 202 |
| 4 | X-Ray follow up 2 days later after pleural catheter insertion | 188 |
| 5 | After laboratory investigation, it’s just Smofkabiven ( parenteral nutrition) in the Pleura. No bleeding and no Pneumothorax !
Smofkabiven Thorax ! | 139 |
| 6 | Ultrasound shows big pleural effusion so pleural catheter was inserted and that’s what came out | 145 |
| 7 | X-Ray 2 days later | 126 |
| 8 | X-Ray after inserting CVC | 139 |
| 9 | 60 years old male patient coming to ER due to recurrent vomiting after eating. Vitally was stable und laboratory investigations showed nothing valuable. So he was admitted to the Ward for further investigations. Gastroscopy was done which showed Achalasia. CVC was inserted to give Parenteral nutrition. Everything was ok but after 2 days started to complain of shortness of breath and tachypnea. | 140 |
| 10 | Classic Wenckebach-Block ( AV Block grade II Mobitz I) | 245 |
| 11 |  No text... | 197 |
| 12 | في نوعين من digitalis ممكن نستخدمهم و هما
Digoxin و Digitoxin
و ده الفرق بينهم | 249 |
| 13 | No text... | 274 |
| 14 | No text... | 254 |
| 15 | No text... | 238 |
| 16 | 70 years old female coming to ER because of general deterioration and DLC. clinically the patient had BP of 60/30 mmHg despite 1 Liter Ringer given. ABG shows PH 7.2, PCo2 28, Po2 78 und HCo3 6 with BE of -17 und Lactate 12 mmol/l.
According to husband she had recurrent diarrhoea and vomiting in the last 2 days but she has been constantly deteriorating.
By thinking of hypovolumic Schock, she was directly transferred to ICU. Arterial line and CVC were emergent inserted. Bleeding tendency was remarkable.
Labor: WBC 3, CRP 229 and PCT >100
coagulation profile: INR 2.2, PTT 112 and Quick 27%.
Ultrasound Abdomen: no free abdominal fluids, Kidneys and liver not congested and IVC were about 1.5 cm respiratory modulated.
Chest X-Ray: nothing important
What is the actual diagnosis, what more investigations are importantly required and what is the management plan ? | 299 |
| 17 | This is how CT shows | 256 |
| 18 | This is a case of right spontaneous Pneumothorax with pre existing Emphysema in context of COPD | 237 |
| 19 | No text... | 248 |
| 20 | 83 years old male patient coming to ER with progressive shortness of breath since 1 week with no history of Trauma. He is a smoker with known history of COPD on home Oxygen therapy and silicosis.
Chest X-Ray as shown below: | 244 |
