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MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk
Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.
Examiner: Jonathan Round
Candidate: Amitav Parida
Filming: Mary Chesshyre, Huey Miin Lee, Chris Kelly
Thank you to the Evelina Children's Hospital for allowing us to film during their MRCPCH Revision Course (https://www.guysandstthomaseve....nts.co.uk/mrcpch-cli
Lipid-Lowering Agents HMG-CoA reductase inhibitors (statins) These agents inhibit the rate-limiting step in cholesterol biosynthesis by competitively inhibiting HMG-CoA reductase. Note the following: Low-density lipoprotein (LDL) reduction of 25%-60% Examples include Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin Contraindications include hypersensitivity, active liver disease, pregnancy, lactation, coadministration with strong CYP3A4 inhibitors (selected statins) Vitamin B3 Vitamin B3 inhibits very-low-density lipoprotein (VLDL) synthesis. Note the following: LDL reduction of 10% High-density lipoprotein (HDL) increase of 20% Example includes Niacin (nicotinic acid) Contraindications include hypersensitivity, liver disease, active peptic ulcer, severe hypotension, arterial bleeding Fibrates Fibrates enhance lipoprotein lipase, resulting in increased VLDL catabolism, fatty acid oxidation, and triglycerides elimination. They decrease hepatic extraction of free fatty acids. Note the following: LDL reduction of 15% Triglyceride reduction of 35% Examples include Gemfibrozil, fenofibrate, fenofibrate (micronized), fenofibric acid Contraindications include active liver disease, renal disease, primary biliary cirrhosis, gallbladder disease 2-Azetidiones These agents inhibit sterol transporter at brush border and, consequently, intestinal absorption of cholesterol. LDL reduction of 15% Example includes Ezetimibe Contraindications include hypersensitivity, coadministration with statins (if active liver disease) Bile acid sequestrants These agents lower cholesterol and LDL via bile duct sequestration. Note the following: LDL reduction of 15% Examples include Cholestyramine, colesevelam, colestipol Contraindications include biliary/bowel obstruction, serum triglycerides >300-500 mg/dL, history of hypertriglyceridemia-induced pancreatitis
Today I'm using the best 3D animation to explain WHAT IS DIASTASIS RECTI and what you need to know about diastasis recti after pregnancy! Grab the Complete Diastasis Recti Healing Guide: https://landing.mailerlite.com..../webforms/landing/n0
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How I healed my 4-finger diastasis recti gap:
Jessica Pumple is a registered dietitian, and pre & postnatal fitness instructor and certified pregnancy and postpartum core exercise specialist (CPES). She helps pregnant women stay fit, have healthy babies, and easier labors. She helps new moms with postpartum recovery, to heal and strengthen their core and feel energized after pregnancy!
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Disclaimer: This is general postnatal fitness only. Please check with your doctor or health care provider to see if this video is safe for you. Wait until you get clearance (usually 4-6 weeks or 6-8 weeks after a c-section).You are responsible for your own safety. Don’t do anything that feels unsafe for you or baby. Stop if you have any pain or discomfort, bleeding, chest pain or shortness of breath, dizziness or if you feel unwell. P&P Health Inc., Pregnancy and Postpartum TV and Jessica Pumple are not liable in any way for any injury, loss, damages, costs or expenses suffered by you in relation to this video or its content.
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#diastasisrecti #whatisdiastasisrecti #3danimation
Music: Epidemic Sound
This video has been updated to include an alternate name for the internal thoracic arteries. View the updated video here: https://youtu.be/kxc22Fjd1NQ
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This video, created by Nucleus Medical Media, shows a coronary artery bypass graft (CABG) procedure used to combat coronary artery disease. Beginning with a midline sternal incision, the heart is connected to a perfusion machine which will take over the duties of the heart while the surgery takes place. Two different grafts are used to bypass the blocked coronary arteries: the internal thoracic artery from inside the chest wall, and the saphenous vein from the leg. After the procedure, the heart is shocked to restart its beating. A drainage tube is left at the incision site to drain away excess fluid. The animation continues to show two other types of approaches to a coronary artery bypass graft, off-pump bypass surgery and minimally invasive bypass surgery.
This is similar to the procedure performed on former president Bill Clinton and former California governor Arnold Schwarzenegger.
#HeartBypassSurgery #CABG #heart
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Thoracic outlet syndrome affects the space between the collarbone and first rib (thoracic outlet). Common causes include trauma, repetitive injuries, pregnancy, and anatomical defects, such as having an extra rib. Symptoms include pain in the shoulders and neck and numbness, weakness, and coldness in the fingers. Treatment involves physical therapy and pain relief. In rare cases, surgery may be needed to relieve the compression.
Neurosurgeon Sujit Prabhu, M.D., discusses what happens after surgery and how a patient recovers.
Learn more: http://www.mdanderson.org/educ....ation-and-research/d
Request an appointment at MD Anderson by calling 1-877-632-6789 or online: https://my.mdanderson.org/requestappointment
Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail. If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death. Anyone can develop sepsis, but it's most common and most dangerous in older adults or those with weakened immune systems. Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival. Symptoms & causes Symptoms Many doctors view sepsis as a three-stage syndrome, starting with sepsis and progressing through severe sepsis to septic shock. The goal is to treat sepsis during its early stage, before it becomes more dangerous. Sepsis To be diagnosed with sepsis, you must exhibit at least two of the following symptoms, plus a probable or confirmed infection: Body temperature above 101 F (38.3 C) or below 96.8 F (36 C) Heart rate higher than 90 beats a minute Respiratory rate higher than 20 breaths a minute Severe sepsis Your diagnosis will be upgraded to severe sepsis if you also exhibit at least one of the following signs and symptoms, which indicate an organ may be failing: Significantly decreased urine output Abrupt change in mental status Decrease in platelet count Difficulty breathing Abnormal heart pumping function Abdominal pain Septic shock To be diagnosed with septic shock, you must have the signs and symptoms of severe sepsis — plus extremely low blood pressure that doesn't adequately respond to simple fluid replacement. When to see a doctor Most often sepsis occurs in people who are hospitalized. People in the intensive care unit are especially vulnerable to developing infections, which can then lead to sepsis. If you get an infection or if you develop signs and symptoms of sepsis after surgery, hospitalization or an infection, seek medical care immediately. Causes While any type of infection — bacterial, viral or fungal — can lead to sepsis, the most likely varieties include: Pneumonia Abdominal infection Kidney infection Bloodstream infection (bacteremia) The incidence of sepsis appears to be increasing in the United States. The causes of this increase may include: Aging population. Americans are living longer, which is swelling the ranks of the highest risk age group — people older than 65. Drug-resistant bacteria. Many types of bacteria can resist the effects of antibiotics that once killed them. These antibiotic-resistant bacteria are often the root cause of the infections that trigger sepsis. Weakened immune systems. More Americans are living with weakened immune systems, caused by HIV, cancer treatments or transplant drugs. Risk factors Sepsis is more common and more dangerous if you: Are very young or very old Have a compromised immune system Are already very sick, often in a hospital's intensive care unit Have wounds or injuries, such as burns Have invasive devices, such as intravenous catheters or breathing tubes Complications Sepsis ranges from less to more severe. As sepsis worsens, blood flow to vital organs, such as your brain, heart and kidneys, becomes impaired. Sepsis can also cause blood clots to form in your organs and in your arms, legs, fingers and toes — leading to varying degrees of organ failure and tissue death (gangrene). Most people recover from mild sepsis, but the mortality rate for septic shock is nearly 50 percent. Also, an episode of severe sepsis may place you at higher risk of future infections.
Dr. Jeffrey Ojemann, director of epilepsy surgery at Seattle Children's Hospital, explains a cutting-edge treatment for epilepsy: minimally invasive MRI-guided laser ablation surgery. Laser ablation surgery is much safer and more precise than other treatments, with fewer side effects.
A special thanks to patient Keoni Giauque.
For more information, visit: http://www.seattlechildrens.or....g/clinics-programs/n
"One Last Look" music rights via RoyaltyFreeMusic.com
A VCUG (Voiding Cystourethrogram) is a test that looks at how well your child's kidneys, ureters and bladder are working. Your child's kidneys make urine. The urine flows from the kidneys through thin tubes (called ureters) into your child's bladder.