Hypoaldosteronism
Hypoaldosteronism causes poor sodium and water reabsorption leading to hypovolemic hyponatremia. It is commonly caused by Addison disease (autoimmune) and Waterhouse-Friderichsen Syndrome (infectious)
Renal Artery Stenosis
Renal artery stenosis is narrowing of the renal artery, commonly due to atherosclerotic disease (80% ) or bilateral fibromuscular dysplasia in young women.
Renal Replacement Therapy
Renal replacement therapy is used to replace the filtering function of the kidneys during acute kidney injury or chronic kidney disease.
Haemorrhagic Stroke
Haemorrhage accounts for ~ 20% of strokes. It is divided into intracerebral haemorrhage (ICH) and subarachnoid haemorrhage (SAH). Haemorrhagic stroke is more severe than ischemic stroke since it creates mass effect faster than ischemic stroke (where edema peaks in 3 – 5 days). Aggressive blood pressure control…
Ischaemic Stroke
Ischaemic stroke is the most common cause of stroke (78%). For a patient who presents with stroke, thrombolysis +/- thrombectomy should be considered as soon as hemorrhagic stroke is ruled out. Presentation of ischemic stroke (in order of increasing severity) Cause Presentation Thrombotic…
Thromboprophylaxis in Pregnancy
Thromboprophylaxis can be started at 28 weeks if there are at least three risk factors. It can also be started as soon as the first trimester if there are 4 or more risk factors. Women with increased risk of VTE receive prophylaxis with low molecular weight heparin (LMWH)…
Iron Deficiency Anaemia (IDA) in Pregnancy
The total iron requirement in pregnancy is 1200 mg. Iron is needed for expansion of the maternal red cell mass, foetal growth, placental growth, and blood loss at delivery. Daily iron requirement Trimester Requirement 1st ~0.8 mg/day 2nd 4–5 mg/day 3rd…
Cephalopelvic Disproportion (CPD)
Cephalopelvic disproportion occurs when the fetal head is too large to pass through the maternal pelvis, due to a mismatch between the fetal head and pelvic dimensions. It can lead to obstructed labour. Cephalopelvic disproportion occurs either at the pelvic inlet or at the mid-cavity. The…
Twin-Twin Transfusion Syndrome (TTTS)
Twin-twin transfusion syndrome (TTTS) is a serious complication that occurs in monochorionic diamniotic (MCDA) twins. It is caused by unequal blood flow due to abnormal vascular connections in the shared placenta. The donor twin experiences hypovolemia, growth restriction and oligohydramnios while the recipient twin experiences hypervolemia, polyhydramnios and the…
Peripartum Cardiomyopathy
Peripartum cardiomyopathy is a dilated cardiomyopathy which occurs in the last month of pregnancy and may last up to 5 months post-partum. It is characterised by left ventricular systolic dysfunction – LVEF < 45% – in the absence of any other possible…