Category: Thundernotes

Flail Chest

7/28/2016

Right-sided multiple rib fractures and flail chest, right pulmonary contusion and subcutaneous emphysema.

Flail chest is defined as fracture of 2 or more adjacent ribs at 2 different points on each rib.
Flail chest can cause paradoxical bleeding, chest pain, pneumothorax with or without hemothorax, pulmonary contusion, cardiac contusion (causes arrhythmia and death) and aortic dissection.
The patient is emergently managed by placing chest tube on both sides of the lung at 5th intercostal space on anterior axillary line, then do positive pressure ventilation. Adjust the ventilator setting to avoid high pressure associated lung trauma.
Pain is controlled by epidural anesthesia. Nerve block is appropriate when only 1 rib is fractured but flail chest have multiple rib fractures.

Adapted from: Fundamentals of Cardiology: Concise Review for USMLE and General Medical Boards
Image source: www.trauma.org
You can also review all up-to-date materials in our book "Fundamentals of Cardiology".

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Calciphylaxis

7/26/2016

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Calciphylaxis is also called calcific uremic arteriolopathy.
It is generally seen in the last stage of chronic kidney disease.
Calciphylaxis results in chronic non-healing wounds and is usually fatal. Calciphylaxis is a rare but serious condition.
Extraskeletal calcifications are also observed in some patients with hypercalcemic states, including patients with the milk-alkali syndrome, sarcoidosis, primary hyperparathyroidism, and hypervitaminosis D.
Patients with calciphylaxis have small vessel calcification and a netlike pattern of calcifications and may result in end-organ necrosis.

Adapted from: Fundamentals of Cardiology: Concise Review for USMLE and General Medical Boards
Image source: www.wikipedia.org
To review any cardiac condition, just search on google followed by 'medrx education'. For example: Atrial fibrillation medrx education. You can also review all up-to-date materials in our book "Fundamentals of Cardiology".

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Dystrophic and Metastatic Calcification

7/26/2016

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DYSTROPHIC CALCIFICATION

Calcification occurs in degenerated/necrotic tissue, hyalinized scars, degenerated foci in leiomyoma and caseous nodules.
It occurs as a reaction to tissue damage.
Blood calcium level is usually normal.
Dystrophic calcification is a localized process.

METASTATIC CALCIFICATION

Deposition of calcium occurs in normal tissue, because of an increase in the level of calcium.
It can occur because of a defect in metabolism or increased absorption or decreased excretion of calcium and related minerals, as seen in hyperparathyroidism.
Metastatic calcification is a generalized process (multiple tissues can be affected at one time).

It typically involves interstitial tissues, especially of kidney, lung, gastric mucosa and vasculature.

Next: Arteriosclerosis

Adapted from: Fundamentals of Cardiology: Concise Review for USMLE and General Medical Boards
To review any cardiac condition, just search on google followed by 'medrx education'. For example: Atrial fibrillation medrx education. You can also review all up-to-date materials in our book "Fundamentals of Cardiology".

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FUNDAMENTALS OF CARDIOLOGY

Flail Chest

Calciphylaxis

Dystrophic and Metastatic Calcification

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﻿FUNDAMENTALS OF CARDIOLOGY

Flail C﻿hest

Calciphylaxis

Dystrophic and Metastatic Calcification

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FUNDAMENTALS OF CARDIOLOGY

Flail Chest