29
November
2008
Congestive heart failure: acute decompensation causes shortness of breath. Fluids builds up in the lung. Usually CHF from left ventricle disease so doesn’t pump well. Also from fluid overload (like in blood transfusions or IV fluids), severe high blood pressure, severe kidney disease, renovascular HTN. CHF from acute heart attack. Atrial fibrillation with fast heart beat can cause it. Shortness of breath is main symptoms. blood pressure can drop and kidneys function drops. Legs can become very swollen. From fluid build up, there is acute weight gain. Often requires hospitalization to improved blood pressure, reduce fluid, improve heart function, help oxygenation.
drjohnhong 
cardiovascular 
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19
November
2008
JUPITER: Randomized Clinical Trial, double blinded, placebo controlled. 1315 sties in 26 countries. To see if cardiovascular naïve people with high hsCRP will have less CV events on Crestor.
drjohnhong Uncategorized, medicines, cardiovascular Comments (0) » |
15
November
2008
Endometriosis: endometrial glands and stroma that is present outside the uterus. Prevalence not known. Can be asymptomatic and found on autopsy and incidentally during surgery. But prevalence when involved with other diseases are such: 1% all women undergoing major gynecologic surgery; 1-7% tubal ligation; 12-32% reproductive age with pelvic pain undergoing laparoscopy; 9-50% laparoscopy for infertility; 50% teenagers laparoscopy for chronic pelvic pain or dysmenorrhea.
Risk factors: delayed pregnancy (so professional women might have it more). 25-35yo. Taller, thinner women. Ovarian steroids needed so rare in those menopausal or pre-menarche. Endometriosis might be a risk factor for developing ovarian cancer. The ovarian cancer risk is reduced with OCP but higher with HRT or tamoxifen.
Endometrial tissue goes on in descending order: ovaries, anterior and posterior cul-de-sac, posterior broad ligaments, uterosacral ligaments, uterus, oviducts, sigmoid colon and appendix, round ligament. Appendix in 2-4% cases. Has even been reported in breasts, spine, lungs, and extremities. Can cause adhesions.
Pain usually with menstrual period, but it can be continuous. Pelvic pain, dysmenorrheal, subfertility, deep dyspareunia, cyclical bowel or bladder symptoms, chronic fatigue. If under skin, bruising from the bleeding can be seen! On exam can mimic PID. The endometriosis tissue unlike that in the uterus contains fibrous tissue, cysts, and blood.
drjohnhong women_issues Comments (0) » |
15
November
2008
Caffeine stimulates the brain. Commonly found in coffee, tea, cola, chocolate. But it also stimulates the nervous system and can cause shakiness, nervousness, and fast heart beat. Nervousness, overly excited, irritable, insomnia. Has been consumed since ancient history. 80% the world consumes caffeine.
5oz of the following drinks have caffeine: drip coffee 146mg, percolated coffee 110mg, instant coffee 53mg, espresso (1-2oz) 45-100mg, Starbuck Venti 415-550mg. 1 min brew tea 9-33mg, 3min brew tea 20-46mg, Canned ice tea 12oz 22-36mg. 12oz diet or regular cola 46mg. Chocolate: milk 1oz 6mg, 6oz cocoa mix 10mg, baking 1oz is 35mg.
drjohnhong cardiovascular, diet Comments (0) » |
11
October
2008
Faking illness just to have attention
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2
October
2008
Gambling problem
drjohnhong Uncategorized Comments (0) » |
10
September
2008
Don’t get caught with False Hope Syndrome. Losing weight takes time…and discipline.
drjohnhong Uncategorized Comments (0) » |
14
August
2008
Asthma is chronic inflammatory disorder of the airways of the lungs. 75% cases diagnosed before age 7. For many, remission occurs during puberty but comes back later. Usually doesn’t develop after age 50. The airways close up so exhaling becomes difficult. Symptoms: intermittent sob, cough, wheezing, chest tightness. Usually worse at night and/or early a.m. Symptoms go away after time or with treatment, so reversibility is easier than with COPD. Wheezing usually occurs exhaling, not as much with inhaling (this is called stridor), that is a high-pitched whistle sound. Cough is dry or wet (pale yellow or mucoid). Chest tightness from the airways closing up: band-like constriction. Exacerbating factors cause the inflammation of the airways. Allergens are a big factor: mold, pollen, dust, furry animals, cockroaches, smoke, fumes, mite poop. Cold air can trigger off asthma attack. Exercise induced asthma – 10-15min after exercise asthma attack occurs. Change in weather. Viral and bacterial illness. Postnasal drip and GERD. Many will have allergies of the skin (eczema) and/or allergic rhinitis (nose allergies). Nasal polyps can be a sign person has asthma, and in this aspirin can make it worse. Occupational exposures.
drjohnhong pulmonary, Allergies Comments (0) » |
7
August
2008
Myocardial Infarction (MI) is a “heart attack” in which heart muscle doesn’t get enough blood/oxygen and dies. Main cause is from a coronary artery getting blocked by a clot that forms on an atherosclerotic plaque (called acute coronary syndrome (ACS) that occurs abou 1,200,000 times a year). 38% die each year from ACS (450,000 people). That is 1 in every 5 deaths making coronary heart disease (CHD) #1 cause of death in USA. 16 million Americans have CHD. ½ millions new cases of stable angina a year.
ACS: Chest pains aren’t pain – squeezing of the chest, heaviness like an elephant standing on the chest. Under the sternum more than 15 minutes. 20min heart muscles die. Radiation of discomfort like a numbness to neck, jaw, shoulder, down left arm, maybe back. N, SOB, palpitations, lightheadness, sweating. Often occurs with exertion though can occur at rest especially with h/o angina.
drjohnhong cardiovascular Comments (0) » |
30
July
2008
Menopause: cessation of menstrual periods. For 12 months. Mean age 51.4 years old. 5% start 40-45yo & 5% after 55yo. <40yo premature ovarian failure. STRAW staging system: -5 to +2. -5 to -3 is reproductive stage. Menopause transition: -2 early, -1 late. 0 is menopause . +1 early postmenopause. +2 late postmenopause. Early menopause transition: variable cycle length greater than 7 days change from normal (which is 21-35d). Follicular phase shortens, inhibin B falls, FSH rises. Estradiol is normal to high still from increased aromatase activity but lower progesterone in luteal phase.Late menopause transition: 2 or more skipped cycles and no periods 60 or more days. Often hot flashes occur. FSH spikes but then drops to normal.Menopause: 12mo no periods after the final period. Ovaries stop ovulating and secreting estrogen. Early menopause: first 5 yrs after final menstrual period. Accelerated bone loss and ovarian failure. hot flashes common. Late menopause: after 5 years to death.
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