Inadequate tissue perfusion. Cells switch from aerobic to anaerobic respiration. Lactic acid – – > Metabolic Acidosis (will cause tachypnoea) Autodigestion. Release of K+ into blood. Types of shock HCODE Continue reading Shock

Symptoms Bleeding PR Altered bowel habits : frequency, quantity, consistency Constipation : reduced frequency, quantity and increased consistency Need to investigate after 6 weeks of persistent symptoms. Chronic Constipation : less than 3 bowel movements per week and all 4 laxatives have failed (Osmotic:lactulose, Bulking : Fibrous, Softner : Cremaffin, Autonomic : Dulcolax) Anaemia Unexplained weight loss Lower ab pain more than 6 weeks Mass … Continue reading Colorectal ; Dr. MP

Streptococci Grp A beta haemolytic streptococci : S. pyogenus – Cellulitis S. pyogenus and faecalis – infections in large bowel surgery Sensitive to penicillin and erythromycin Cephalosporins can also be given Staphylococci S. aureus : suppuration Flucloxacillin Vancomycin – MRSA S. epidermidis : biofilms in prosthetics Clostridia Continue reading Microbiology

Incompetence of LOS Symptoms – Heartburn, Epigastric pain and regurgitation worsened when lying. Gold standard – 24H pH Complications Strictures – close to GE juction unlike malignant strictures. Managed with PPI and dilataion. Barret’s Oesophagus Metaplastic change to GORD. Intestinal metaplasia is a risk factor for adenoCA. GORD – – > Barret’s Oesophagus DDs – Sliding hiatus hernia Hiatus hernia Sliding – cardia moves. Rolling … Continue reading GORD

Read Churchills Continue reading Lymphoedema