Massive blood transfusion Massive blood transfusion may be defined as the replacement of one blood volume (equivalent to 10 units of blood) in any 24 hour period or half of the volume ( 5 units of blood) in any four hour period in an adult. Replacemnt of a blood volume equivalent within 24 hours. 10 units within 24 hours Transfusion 4 units in 1 hour Replacemnt of 50% of blood volume in 3-4 hours A rate of loss 150ml/hour Example: Masive blood transfusion occurs in settings such as trauma, ruptred aortic
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Clinical assessment of carcinoma Head of the Pancreas operability?
General examination: Deep jaundice. Sign of cirrhosis. Virchow's gland Local Examination: Hepatomegaly irregular nodule. Lump in abdomen. Ascites. Sister marry joseph nodule. Severe pain due to involvment of posterior structure. Involved duodenum: Vomiting, Malena. Severe weight loss. Severe anorexia. Investigation findings: Altered liver function. CT scan 1.Mass more than 4 cm than beyond pancreas. 2.Peripancreatic structure involvment 3.Peri pancreatic lymphnode 4.Portal vein involvment 5.Liver Mets 6.Ascites Per operative: Peritoneal seedling. But can be seen in PET CT scan. Portal vein involvment. #Mass in the head, how we can take tissue from mass USG CT guided FNAC. Endoluminal USG. Difficult part of dissection Uncinate process. Third part of duodenum.
Septic shock {Phase A Written}
Septic shock: Definition It may be defined as a shock that is associated with sepsis or infection by microbes resulting in release of bacterial endotoxin and the activation of cellular and humeral components of immune system. Causes: 1. Surgical causes- a. Bowel preparation and peritonitis b. Strangulated intestine c. Soft tissue infection, abscess, gangrene d. Suppurative biliary condition e.g. empyema of Gall bladder e. Major trauma, burn etc. f. Gas gangrene g. Following operation of large gut 2. Non-surgical causes a. Pneumonia b. Endocarditis c. Meningitis d. Hospital infection e. ...