Medical Books and Lectures notes - Free downloads

Objectives •    Be knowledgeable of the causes of and risk factors associated with sinusitis •    Differentiate acute from chronic sinusitis •    Evaluate patients by history, physical exam, appropriate laboratory and imaging studies, and when indicated screen patients for allergy •    Prescribe appropriate medication regimens for acute and chronic sinusitis •    Know of the relationships between upper airway (rhinosinusitis) and lower airway disease (asthma) Rhinosinusitis May be Better Term Because •    Allergic or nonallergic rhinitis nearly always precedes sinusitis •    Sinusitis without rhinitis is rare •    Nasal discharge and congestion are prominent symptoms of sinusitis •    Nasal mucosa and sinus mucosa are similar and are contiguous Development of Sinuses •    Maxillary and ethmoid sinuses present at birth •    Frontal sinus developed by age 5 or 6 •    Sphenoid sinus last to develop, 8-10 Physiologic Importance of Sin

Harper's Illustrated Biochemistry, 28th Edition Publisher: McGraw-Hill Medical 2009 | 704 Pages | ISBN: 0071625917 | CHM | 22 MB Comprehensive, concise, and up-to-date, Harper's is unrivaled in its ability to clarify the link between biochemistry and the molecular basis of health and  disease .The Twenty-Eighth Edition has undergone sweeping changes -- including a conversion to full-color artwork and the substantial revision and updating of every chapter -- all to reflect the latest advances in knowledge and technology and to make the text as up-to-date and clinically relevant as possible. Combining outstanding full-color illustrations with integrated  coverage  of biochemical diseases and clinical information, Harper's Illustrated Biochemistry offers an organization and clarity not found in any other text on the subject. NEW to this edition: * Full-color presentation, including 600+ illustrations * Every chapter opens with a Summary of the Biomedical Importance and conclud

Carbohydrates, also known as  saccharides , are classified according to the number of single carbohydrate molecules in each chemical structure. Carbohydrate compounds having just one carbohydrate molecule are called  monosaccharides ; compounds with two carbohydrate molecules are called  dissarcharides ; and those compounds containing more than two carbohydrate molecules are named  polysaccharides . All carbohydrates either are monosaccharides or can be hydrolyzed (broken down) into two or more monosaccharides.

•    Etiology: the electrical impulse is formed in the SA node and conducted normally. •    This is the normal rhythm of the heart; other rhythms that do not conduct via the typical pathway are called arrhythmias. NSR Parameters •    Rate                60 - 100 bpm      •    Regularity            regular •    P waves            normal •    PR interval            0.12 - 0.20 s •    QRS duration        0.04 - 0.12 s Any deviation from above is sinus tachycardia, sinus bradycardia or an arrhythmia Arrhythmia Formation Arrhythmias can arise from problems in the: •    Sinus node •    Atrial cells •    AV junction •    Ventricular cells SA Node Problems The SA Node can: fire too slow--- Sinus Bradycardia fire too fast--- Sinus Tachycardia Atrial Cell Problems Atrial cells can: •    fire occasionally from a focus ---Premature Atrial Contractions (PACs) •    fire continuously due to a looping re-entrant circuit ----Atrial Flutter   Atrial Cell Proble

• Step 1: Calculate rate. • Step 2: Determine regularity. • Step 3: Assess the P waves. • Step 4: Determine PR interval. • Step 5: Determine QRS duration. Step 1: Calculate Rate • Option 1 – Count the # of R waves in a 6 second rhythm strip, then multiply by 10. – Reminder: all rhythm strips in the Modules are 6 seconds in length. Interpretation? 9 x 10 = 90 bpm • Option 2 – Find a R wave that lands on a bold line. – Count the # of large boxes to the next R wave. If the second R wave is 1 large box away the rate is 300, 2 boxes - 150, 3 boxes - 100, 4 boxes - 75, etc.   – Memorize the sequence: 300 - 150 - 100 - 75 - 60 - 50 Step 2: Determine regularity • Look at the R-R distances (using a caliper or markings on a pen or paper). • Regular (are they equidistant apart)? Occasionally irregular? Regularly irregular? Irregularly irregular? Interpretation? Regular Step 3: Assess the P waves • Are there P waves? • Do the P waves all look alike? • Do

Normal Impulse Conduction Sinoatrial node--AV node--Bundle of His--Bundle Branches--Purkinje fibers The “PQRST” ►    P wave - Atrial   depolarization         QRS - Ventricular    depolarization           T wave - Ventricular   repolarization The PR Interval Atrial depolarization   + delay in AV junction  (AV node/Bundle of His)  (delay allows time for the atria to contract before the ventricles contract) Pacemakers of the Heart ►    SA Node - Dominant pacemaker with an intrinsic rate of 60 - 100 beats/minute. ►    AV Node - Back-up pacemaker with an intrinsic rate of 40 - 60 beats/minute. ►    Ventricular cells - Back-up pacemaker with an intrinsic rate of 20 - 45 bpm. The ECG Paper ►    Horizontally     One small box - 0.04 s     One large box - 0.20 s   ►    Vertically     One large box - 0.5 mV ►    Every 3 seconds (15 large boxes) is marked by a vertical line. ►    This helps when calculating the heart rate.