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MCC of temporal lobe abscess in children
Mastoiditis secondary to chronic suppurative otitis media
Causes of ring enhanced lesions on MRI
Abscess, malignancy, subacute infarct, contusion
Most common complication of acute otitis media
acute mastoiditis
RF for acute mastoiditis in children
young age (often>2 years, highest risk <24mo), high fever, alteration of the laboratory findings (very high values of WBC count, absolute neutrophil count and C-reactive protein), while less important are previous antibiotic therapy or previous middle ear infections
main pathogen of the acute mastoiditis
Streptococcus pneumoniae, followed by Streptococcus piogenes, Haemophilus influentiae, and Staphylococcus aureus.
cx of acute mastoiditis
extracranial (subperiosteal abscess, Bezold’s abscess); intratemporal (facial nerve palsy, labyrinthitis) and intracranial (subdural abscess)
subperiosteal abscess clin f
ear pain, persistent high fever, post-auricular tenderness or purulent collection with the displacement of the pinna
tx of acute mastoiditis
ceftriaxone
Pneumococcal vaccine to avoid recurrent acute otitis media
If mastoiditis without spontaneous TM perforation or recurrent otitis media, myringotomy +/- tympanostomy tube placement
Mng of midgut malrotation with volvulus
- IVF nad keeping NBM
- NGT for decompression
CLin f of intestinal malrotaiton with obstruction and/or volvulus
Typically bilious vomits
Abdo pain
Hemodynamic instbaility
Abdo distention, tenderness, peritonitis, hematochezia
function of calcium carbonate in hyperkalemia
stabilise cardiac membrane
Fucntion of insulin with dextrose in managing hyperkalemia
moves K from extracellular to intracellular
Function of salbutamol in hyperkalemia management
shift k into cells
Sodium bicarbonate role in hyperkalemia
promotes exchange of extracellular k for hydrogen ions
Resonium role in hyperkalemia
Ion exchange resin that binds k in the gut
Slower effect than other treatments
strong risk factors for VTE
Major surgery
Major trauma (including hip or leg fracture)
Spinal injury
Hip or knee replacement
MODERATE RISK FACTORS FOR vte
Knee arthroscopy
Central venous lines
Chemotherapy
Congestive heart failure or respiratory failure
Hormone-replacement therapy
Oral contraceptive therapy
Stroke
Pregnancy and puerperium
Previous VTE
Thrombophilia
weak rf for VTE
Bed rest >3 days
Immobility due to sitting (eg. travel)
Increasing age
Laparoscopic surgery
Obesity
Varicose veins
