These guidelines from NHS England are excellent and cover triage, METHANE, blast injury and more. They say everything you need to know in one document - read them.
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Portal vein problems might be caused by portal hypertension - cirrhosis, malignancy or hypercoagulable - prothrombotic conditions, malignancy, oral contraceptive pill, pregnancy, trauma.
Portal vein thrombosis may present with many things including abdominal pain, nausea and fever, variceal bleeding, and encephalopathy - or be completely asymptomatic.
Treatment includes observation, anticoagulation, thrombectomy and shunts. Need to prevent thrombus extension and mesenteric ischaemia. May present as an acute ischaemic bowel.
Renal vein thrombosis in adults is normally triggered by infection (glomerulonephritis, renal sepsis), amyloidosis, SLE, diabetes, urinary obstruction, tumour thrombus.
The passive congestion causes the kidney to swell and become engorged and nephrons degenerate causing flank pain, haematuria and decreased urine output.
Treat by treating cause, and anticoagulation therapy.
Mostly from non UK sources, with incubation 5-30 days, but maybe up to 6 months. Comes from unpasteurised dairy products - eating or inhaling airborne components. Take a thorough travel history.
Previously called Maltese fever.
May be asymptomatic.
Fever (74%) may wax and wane
Constitutional (26%) - fever, malaise, weakness, fatigue, headache, dizziness, myalgia, arthralgia and night sweats.
Hepatomegaly and splenomegaly (33%)
Maloderous perspiration - almost pathognomic
Peripheral neuropathy, pleural effusions, pneumonia and endocarditis can also be present.
Blood culture in 20-80%
Serology, PCR testing
Leucocytopenia, lymphocytosis, thrombocytopenia or anaemia
Gentamycin for 7 days + doxycycline
Rifampin + doxy
Cipro + doxy
Investigations:With the temperature dropping recently I thought it might be a good time to retweet the first infographic from my #infographic challenge. Hypothermia, the correlation of core temperature and physiological changes. I hope it's useful. More at https://t.co/Bvm7MMLro2 #FOAMed pic.twitter.com/udjKgDuPlE— Strata5 (@Nrtaylor101) November 20, 2019