Tuesday 10 July 2018

DEMENTIA

Dementia + sensory Ataxia + PNP(polyneuropathy) + UMN(babinski's sign) = B12 deficiency

Dementia + cerebellar ataxia + ophtalmoplegia = B1 def (Wernicke's syndrome)

Dementia + high cholesterol = hypothyroidism

Dementia + myoclonus = Creutzfeldt-Jakob disease

Dementia + gait apraxia + urinary incontinence = NPH (non-pressure hydrocephalus)

Dementia with stepwise progression + pseudobulbar palsy(PBP) = Binswanger's disease (vascular dementia)

Dementia + PBP + gaze abnormality + torticollis = PSP (progressive supranuclear palsy)

Dementia + chorea= Huntington's disease

Dementia + Parkinsonism + syncopal attack = Shy-Drager syndrome (multiple system atrophy)

Dementia that is fluctuating + Parkinsonism= Lewy body dementia

Dementia with sparing visuospatial skills + personality change = Frontotemporal dementia

WOUND

Definition
A wound occurs when the integrity of any tissue is compromised (e.g. skin breaks, muscle tears, burns, or bone fractures). A wound may be caused by an act, such as a gunshot, fall, or surgical procedure; by an infectious disease; or by an underlying condition.

Surgical Wound classification

Class I
Clean
An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tract is not entered. In addition, clean wounds are primarily closed and, if necessary, drained with closed drainage. Operative incisional wounds that follow nonpenetrating (blunt) trauma should be included in this category if they meet the criteria.

Class II
Clean-contaminated
An operative wound in which the respiratory, alimentary, genital, or urinary tracts are entered under controlled conditions and without unusual contamination. Specifically, operations involving the biliary tract, appendix, vagina, and oropharynx are included in this category, provided no evidence of infection or major break in technique is encountered.

Class III
Contaminated
Open, fresh, accidental wounds. In addition, operations with major breaks in sterile technique (e.g., open cardiac massage) or gross spillage from the gastrointestinal tract, and incisions in which acute, nonpurulent inflammation is encountered are included in this category.

Class IV
Dirty-infected
Old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera. This definition suggests that the organisms causing postoperative infection were present in the operative field before the operation.