-Guillain Barré syndrome.

Guillain Barré syndrome

Aetiology(theories):-

• Postinfection:50% of cases have preceding respiratory or GIT viral infection.
• Post vaccination:following vaccination against swine flu virus.
• Lymphoma.
• Autoimmune theory.

Clinical Picture:-
1-Initial febrile illness.
2-Motor affection:-

• Bilateral symmetrical ascending affection of both lower limbs,trunk,upper limbs,Bulbar muscles,facial muscles then diphragm and respiratory muscles.
• The Affection is proximal more than distal in adult.
• The Affection is proximal more than distal in infant and childrens.
• Weakness is associated with hypotonia and areflexia.
  

-Lambert-Eaton syndrome.

Lambert-Eaton syndrome
or
Myasthenic-myopayhic syndrome.

*Pathophysiology:-

• a myasthenic syndrome due to autoimmune orocess targeting the mechanism of releasing A.CH from nerve terminals.
• It often associated with bronchogenic carcinoma or other malignancies.

*Clinical picture:-
Proximal weakness,wasting and fatigue but with less common ocular and bulbar affection than Myasthenia.

*Diagnosis:-

• EMG:- shows paradoxical increase  in successive muscle contractions.
• No significant response to prostigmine,but respond to guanidine HCL 20 mg/Kg/day or prednisolone+imuran.
• No acetylecholine receptor antibodies.
• CXR to determine if associated with bronchogenic carcinoma or not.

*Treatment:-

• Treatment of the underlying neoplasm.
• Plasmapheresis.
• Immunosuppression.

Dr Ibrahim

Return to list of medical syndromes here

-Vircow's triad.

Vircow's triad is the aetiology of thrombosis which is composed of :-

1-Damage of vascular endothelium(Vascular trauma):-
this damage expose the endothelial collagen which is rough surface to which platelets can stick firmly and release thromboxane A2 that help more platelet aggregation.

2-Slowing(Reduced)in the blood flow (stasis):-
these changes help thrombosis by allowing the platelets to deviate from the axial stream and cross the peripheral plasmatic zone to stick to the vascular endothelium.

3-Change in blood composition(Increased coagulability ):-
a-Increase number of blood elements.
-Increase platelets so become more sticky and agglutinate in small masses and adhere to vascular endothelium.
-Increase WBCs and RBCs increase viscosity of blood and stasis.
b-Biochemical changes that cause systemic activation of the cloting system.

"VIR chow"

Vascular trauma
Increased coagulability
Reduced blood flow (stasis)

Dr Ibrahim

Return to other triads here.

- Grades in medicine.

Grades in medicine 

In many branches of medicine we meet what is called "grades" this grades were put to classify certain conditions. Here I will put the grades what i had found as they meet me in books in simple way......... so you can share us.

• Grading of Murmurs (click here).
• Grading of Vesicoureteric Reflux (click here).
• Grades of Dyspnea (click here).
• Grades of respiratory distress. (click here).
• Grades of splenomegaly. (click here).
• Grading of hypertensive retinopathy (click here).
• Grades of binocular single vision. (click here).
• Grades for quantitative assessment of muscle power (click here).
• Deep tendon reflex grading (click here).
• Poisoning severity grading (click here).
• Grading of function in rheumataid disease(click here).
•  ASA Grading system (click here).
• Renal trauma grading scale (click here).
• Compound fracture grading- Gustilo-Anderson grading (click here).
• Sperm Motility grading.(click here).
• Wagner Grading System for Diabetic Foot Infections.(click here).
• Savary miller endoscopic grading of GORD.(click here).
• Sher's grading of abruptio placentae.(click here).
• Modified Canadian Cardiovascular Society grading of angina pectoris
• Varicocele grading (click here) 
  

Dr Ibrahim