18 Differential diagnoses of ST elevation

What is ECG?

What is ST segment in an ECG?

What are causes of ST Segment elevation?

Should I get an ECG done to check ST segment elevation?

What is an 12 lead ECG? 

What is position of leads in 12 lead ECG?

What is knee jerk?

How does knee jerk work?

Question for practice

Delayed relaxation of ankle jerk is seen in:

Explanation

MCQ 2:

A 60-year-old male presents with weakness in both lower limbs and increased knee jerk reflexes. Which of the following is the most likely cause?

A) Guillain-Barré syndrome

B) Diabetic neuropathy

C) Spinal cord injury (above L2)

D) Cauda equina syndrome

Answer: ✅ C) Spinal cord injury (above L2)

Explanation:

• The knee jerk reflex (L2-L4) is exaggerated (hyperreflexia) in UMN lesions.

• Spinal cord injury above L2 disrupts the descending inhibitory control from the brain, leading to increased reflexes (hyperreflexia).

• Guillain-Barré syndrome (A) and diabetic neuropathy (B) cause LMN lesions, leading to absent or reduced reflexes (hyporeflexia).

• Cauda equina syndrome (D) affects the lumbar and sacral nerve roots, causing flaccid paralysis and absent knee jerk reflex.

Thus, the most likely diagnosis is spinal cord injury above L2, causing bilateral weakness with hyperreflexia.

Why is my baby’s heart rate fast? 

A childs health conccern is the most priority for most parents. Especially
mothers who have caring nature and are more caring and notics small changes
in thei childs health.

Why do babies have high heart and respiratory rate?

According to Pediatricians and neonantologists, vital signs of neonates and
children are different than that of Adult humans. This is because of their
small organ size and increased metabolic need for fast growth and
development.

Normal Heart rate  for adults is 60-100 bpm while normal respiratory
rate is  12-18 breaths per minute.

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What is the normal heart rate for my baby?

There are several different ranges of resting heart rates to consider for
patients under 10 years of age. Those ranges include:

• Newborns up to one-month-old: 70-190 bpm

• Infants 1-11 months: 80-160 bpm

• Children 1-2 years: 80-130 bpm

• Children 3-4 years: 80-120 bpm

• Children 5-6 years: 75-115 bpm

• Children 7-9 years: 70-110 bpm

What is normal respiratory rate for my baby?

Here’s the
correct respiratory rate (RR) ranges
for children:

• Newborns (0-1 month):
  30-60 breaths per minute

• Infants (1-12 months):
  30-50 breaths per minute

• Toddlers (1-2 years):
  24-40 breaths per minute

• Preschoolers (3-5 years):
  22-34 breaths per minute

• School-age children (6-12 years):
  18-30 breaths per minute

• Adolescents (13-18 years):
  12-20 breaths per minute

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Causes of Fast Heart rate in Children:

An increased heart rate (tachycardia) in babies and children can be caused by a variety of factors, ranging from temporary conditions to more serious medical concerns. Here’s a list of potential causes:

1. Fever

• A rise in body temperature can cause an increased heart rate as the body tries to regulate itself.

2. Physical Activity or Exercise

• Just like in adults, physical exertion or exercise in children leads to an elevated heart rate, which typically returns to normal after rest.

3. Stress or Anxiety

• Emotional distress, anxiety, or fear can cause an increase in heart rate as part of the body’s “fight-or-flight” response.

4. Pain

• Acute pain, such as from an injury or illness, can result in tachycardia.

5. Dehydration

• When the body is dehydrated, blood volume decreases, causing the heart to pump faster to maintain adequate circulation.

6. Anemia

• In cases of low red blood cell count, the heart compensates for the reduced oxygen-carrying capacity by increasing its rate to supply tissues with oxygen.

7. Infections

• Systemic infections such as sepsis or localized infections can trigger a rapid heart rate as part of the body’s response to infection.

8. Respiratory Issues

• Conditions like asthma, bronchiolitis, or pneumonia, where oxygen levels are compromised, can lead to tachycardia as the body works harder to circulate oxygen.

9. Hyperthyroidism

• Overactivity of the thyroid gland can cause an elevated heart rate, as it increases the metabolism and the heart’s workload.

10. Congenital Heart Conditions

• Some heart defects, such as atrial or ventricular septal defects, congenital heart failure, or arrhythmias, can cause the heart to beat abnormally fast.

11. Caffeine or Stimulants

• Consumption of caffeine or other stimulants, such as certain medications or energy drinks, can cause an increase in heart rate.

12. Electrolyte Imbalance

• An imbalance in electrolytes, such as potassium, calcium, or sodium, can disrupt the normal electrical activity of the heart, leading to tachycardia.

13. Shock

• Conditions such as hypovolemic shock, cardiogenic shock, or septic shock can cause a rapid heart rate as the body tries to compensate for a lack of blood flow or oxygen.

14. Hypoxia

• Low oxygen levels due to lung disease or high altitudes can cause tachycardia as the body attempts to increase oxygen delivery.

15. Medications

• Some medications, including those used to treat respiratory conditions or other chronic illnesses, may increase heart rate as a side effect.

16. Hyperventilation

• Rapid breathing can sometimes cause an increased heart rate as the body tries to balance oxygen and carbon dioxide levels.

17. Electrocardiographic Abnormalities

• Conditions such as supraventricular tachycardia (SVT) or ventricular tachycardia are abnormal electrical rhythms of the heart, leading to excessively fast heart rates.

18. Hypoglycemia (Low Blood Sugar)

• Low blood sugar levels can stimulate the release of stress hormones (like adrenaline), which can increase heart rate.

19. Toxin or Drug Poisoning

• Ingestion of certain toxic substances or drugs (e.g., alcohol, drugs, or poisons) can lead to tachycardia as part of the body’s response.

20. Heat Stroke or Heat Exhaustion

• Extreme heat can cause the body to work harder to cool down, leading to an elevated heart rate.

21. Severe Allergic Reactions (Anaphylaxis)

• In anaphylaxis, the body’s extreme response to an allergen can include rapid heart rate along with other symptoms like swelling, rash, or difficulty breathing.

In cases where a child has an increased heart rate along with other symptoms such as difficulty breathing, chest pain, fainting, or fatigue, it’s important to seek medical care immediately.

Causes of Fast breathing rate in Children:

Fast breathing in babies and children can have various causes, ranging from normal responses to stress or physical activity to more serious medical conditions. Here’s a list of potential causes:

1. Respiratory Infections

• Bronchiolitis: Often caused by viruses like RSV, leading to inflammation in the small airways of the lungs.

• Pneumonia: Infection in the lungs that causes rapid breathing, fever, and cough.

• Croup: Inflammation of the upper airway, leading to a characteristic barky cough and fast breathing.

• Whooping Cough (Pertussis): A bacterial infection that leads to coughing fits and rapid breathing.

2. Asthma

• A chronic condition that causes the airways to constrict, leading to wheezing, difficulty breathing, and fast breathing.

3. Allergic Reactions

• Severe allergic reactions (anaphylaxis) can cause difficulty breathing and rapid respiratory rate due to swelling of the airways.

4. Fever

• Fever in children can lead to faster breathing as the body works to regulate temperature.

5. Congenital Heart Conditions

• Conditions such as heart defects can cause difficulty in oxygenating the blood, leading to rapid breathing (tachypnea).

6. Anemia

• Low red blood cell count can cause the body to breathe faster in an attempt to deliver more oxygen to tissues.

7. Dehydration

• Dehydration can lead to fast breathing due to decreased blood volume and body stress.

8. Foreign Body Aspiration

• When a child inhales a small object, it can block the airways, leading to difficulty breathing and increased respiratory rate.

9. Metabolic Disorders

• Conditions like diabetic ketoacidosis can cause fast, deep breathing (Kussmaul respiration) in response to the metabolic imbalance.

10. Pain

• Severe pain can cause increased respiratory rate as the body reacts to distress.

11. Exercise or Physical Activity

• Children may breathe faster during or after physical activity, which is a normal response.

12. Environmental Factors

• Exposure to smoke or pollution can irritate the airways, leading to rapid breathing.

13. Sepsis

• A severe infection in the body that can cause a rapid breathing rate as the body tries to cope with systemic infection.

14. Sleep Apnea

• Children with sleep apnea may have episodes of rapid breathing during sleep, often accompanied by snoring and gasping.

15. Psychological Factors

• Anxiety or panic attacks can lead to fast, shallow breathing (hyperventilation).

If a baby or child is experiencing fast breathing with additional symptoms like fever, bluish skin, trouble feeding, or lethargy, it’s crucial to seek medical attention immediately.

When to visit a dctor if my baby if breathing fast or heart beat is too
fast?

Here are the steps to know if your baby is breathing too fast or has heart
beating too fast:

1. Ensure that your baby is properly resting and placed in comfortable
   bed or mother’s arms.
2. expose the chest area and abdomen to see properly.
3. Make sure that baby is not crying or playing.
4. Now count respiratiry rate by cound one cycle of inspiration and
   expiration (noticed by chect movement)
5. Record for Complete one minute.
6. Check against above data.

Follow same steps for heart rate too. Heart rate can be detected by
using your had or putting head in baby’s chest or using Stethoscope.

More than above your baby should also be sick or not behaving well like
not feeding well, crying, coughing, wheezing, blue lips limbs, or face,
lose stool, vomiting, not actively playing well or drowsy.

Disclaimer: These Information are for educational purpose only and
intended for education of healthcare provider students. Please consult
your doctor for diagnosis and treatment of your problem. Information in
my website does not establish doctor-patient relationship.

Table of Contents(toc)

Beau line

Beau’s lines are horizontal grooves or ridges that appear on fingernails or toenails, indicating a temporary disruption in nail growth, often caused by illness, injury, or certain medications.

What they are:

Beau’s lines are transverse depressions or grooves that run across the nail plate, appearing as indentations or ridges.

They are named after French physician Joseph Honoré Simon Beau, who first described them in 1846.

They are a sign that nail growth was temporarily stopped or slowed due to a specific event or condition.

Causes:

• Illness: Systemic diseases, infections, or high fevers can disrupt nail growth.
• Injury: Trauma to the nail or nail bed can cause Beau’s lines.
• Medications: Certain medications, particularly chemotherapy, can interfere with nail growth.
• Other factors: Malnutrition, stress, and certain skin conditions can also be associated with Beau’s lines.
• Specific conditions: Uncontrolled diabetes, thyroid problems, and Kawasaki disease have been linked to Beau’s lines.
• Pemphigus
• Viral infections (eg, hand, foot, and mouth disease)
• Local cutaneous disease (eg, dermatitis, paronychia)

Beau line

Appearance:

Beau’s lines typically appear as a groove or indentation that runs horizontally across the nail plate.

They start at the base of the nail (proximal nail fold) and grow out as the nail grows.

The width of the line can indicate the duration of the underlying condition.

Treatment:

Beau’s lines themselves are not harmful and will disappear as the nail grows out.

The focus of treatment is to address the underlying cause of the nail growth disruption.

Once the underlying condition is resolved, new, smooth nail growth will resume.

Nails grow slowly, so it can take several months for Beau’s lines to completely grow out.

What are Red blood cells?

The most prevalent type of blood cell in the human body are red blood cells,
or erythrocytes. 

They primarily carry carbon dioxide back to the lungs so that it can be
breathed, as well as oxygen from the lungs to the body’s tissues and organs.

Red Blood cells are produced in bone marrow and circulate in blood.

Lifespan of RBCs

RBCs are made in the bone marrow and have a 120-day average lifespan.

 Due to their small size, flexibility, and biconcave disk-like form, they
may easily fit into constricted blood arteries and effectively transfer
oxygen.

A hormone called erythropoietin, which the kidneys generate in reaction
to low blood oxygen levels, controls the maturation and synthesis of RBCs.

What do RBCs do?

RBCs  play vital role in our body and life as a whole

Here is a list of RBC’s functions in our body:

• Oxygen transport
• Carbon dioxide transport
• Acid-base balance maintenance
• Hemoglobin synthesis and function
• Regulation of blood viscosity
• Contribution to blood osmolarity
• Facilitation of nitric oxide transport
• Scavenging of free radicals
• Participation in immune modulation
• Maintenance of redox balance

Video lecture in Anemia in Nepali

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थाईराइड  भनेको के हो? के हुन्छ थाईराइड हर्मोनको कमी वा बढि
भएमा? थाइराइडको लक्षण र कारणहरु Thyroid In Nepali

हाइपोथाइरोइडिज्मको लक्षणहरु:

Thyroid gland

यो पनि पढ्नुहोस्: How to lose weight

हाइपोथाइरोइडिज्मको लक्षणहरु:

हाइपरथाइरोइडिज्म का संकेत हरु

यो बाहेक माथिका समस्याहरू अन्य थुप्रै कारणले समेत हुन सक्दछन्।

Read: World Thyroid day

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“@type”: “Answer”,
“text”: “थकान
कमजोरी
शरीर गलेको महशुस हुने
स्मरण शक्तिमा कमि
अनिन्द्रा
मुड तलमाथि हुने
स्रवण शक्तिमा ह्रास
तौल बढ्ने
३ PM crash
निद्रा बिग्रने
नङ टुट्ने, खुइलिने
जोर्नी र मासु दुख्ने
कपाल खस्ने
कब्जियत
महिनावारि मा गडबडि, रगत कम वा बढी जाने
चिसो सहन नसक्ने, बढि चिसो लाग्ने
शरीरको तापक्रम कम हुने
जिउ झमझमाउने
कोमा”
}
},{
“@type”: “Question”,
“name”: “हाइपोथाइरोइडिज्मको चिह्नहरु के के हुन?”,
“acceptedAnswer”: {
“@type”: “Answer”,
“text”: “कपाल र आखीभौ पातलो हुने
जिउ सुनिएको हुने, सुजन
आखाको रोग
स्वरमा परिवर्तन
मुटुको चाल कम हुनु
खुट्टा सुन्निएको
जिउ चिसो हुने
मानसिक समस्या
सुस्त चाल
डर अनुभव”
}
},{
“@type”: “Question”,
“name”: “हाइपरथाइरोइडीजमका लक्षण हरु के के हुन?”,
“acceptedAnswer”: {
“@type”: “Answer”,
“text”: “छट्पटी
डर महसुस
पसिना खलखली आउने
शरीर काम्ने, एक्टिभिटी बढ्ने
मुटु ढुकढुक हुने, धड्कन बढ्ने”
}
},{
“@type”: “Question”,
“name”: “हाइपरथाइरोइडिज्म का संकेत हरु के के हुन?”,
“acceptedAnswer”: {
“@type”: “Answer”,
“text”: “मुटुको चाल बढ्ने, चाल गडबडी हुने
रक्तचाप बढ्ने, pulse pressure वढी हुने
जिउ धेरै ततिने
आँखा सुन्निने आँखामा समस्त देखिने
हात काप्ने
मासु कमजोर हुने
थकान लाग्ने
तौल घट्ने
भोक बढ्ने
धेरै खाएर पनि तौल घट्ने
महिनावारीमा गडबढी, रगत कम बग्ने
घाँटी सुनिने
गलगाँड आउने”
}
}]
}

World Thyroid Day 2025: Empowering Thyroid Health for a Vibrant Future

Table of Contents (toc)

Introduction:

Every year on May 25th, World Thyroid Day is observed worldwide to raise awareness about thyroid-related disorders and promote the importance of thyroid health. In 2023, the theme for World Thyroid Day revolves around empowering individuals to take charge of their thyroid health and ensure a vibrant future. 

This article aims to shed light on common thyroid disorders, prevention strategies, treatment options, and the significance of this year’s theme.

Thyroid gland anatomy

Theme of world thyroid day 2023:

Empowering Thyroid Health for a Vibrant Future

World thyroid day 2022 theme 

It was: “It’s not you. It’s your thyroid”

Slogan of world thyroid day 2023: 

“Thyroid Health Matters: Empower Yourself!”

Common Thyroid Disorders:

The thyroid gland, located in the neck, plays a vital role in regulating various bodily functions. Thyroid disorders occur when the thyroid gland produces an excessive or insufficient amount of thyroid hormones. The two most prevalent thyroid disorders are:

1. Hypothyroidism: 

This condition occurs when the thyroid gland fails to produce enough thyroid hormones. Symptoms may include fatigue, weight gain, depression, dry skin, and sensitivity to cold.

2. Hyperthyroidism: 

In contrast to hypothyroidism, hyperthyroidism refers to the overproduction of thyroid hormones. Common symptoms include weight loss, rapid heartbeat, anxiety, insomnia, and increased sensitivity to heat.

Prevention Modalities:

While some thyroid disorders may be caused by genetic factors or other underlying conditions, several preventive measures can help maintain a healthy thyroid:

1. Iodine Intake: 

Adequate iodine consumption is crucial for proper thyroid function. Including iodine-rich foods such as seafood, dairy products, and iodized salt in your diet can help prevent thyroid disorders.

2. Balanced Diet: 

Following a balanced diet with sufficient levels of vitamins, minerals, and antioxidants supports overall thyroid health. Foods like fruits, vegetables, lean proteins, and whole grains should be incorporated into daily meals.

3. Stress Management: 

Chronic stress can adversely affect thyroid health. Practicing stress-reduction techniques such as meditation, yoga, or engaging in hobbies can help maintain a healthy thyroid.

Treatment Options:

Treatment for thyroid disorders depends on the specific condition and its severity. Common approaches include:

1. Medication for thyroid disorders: 

Thyroid hormone replacement therapy is typically prescribed for individuals with hypothyroidism to restore hormone levels. Anti-thyroid medications, beta-blockers, or radioactive iodine may be used to manage hyperthyroidism.

2. Thyroid surgery: 

In cases where medication or other treatments are ineffective, surgical intervention may be necessary. Partial or total thyroidectomy (removal of all or part of the thyroid gland) can be performed to treat thyroid disorders.

3. Radioactive Iodine Therapy: 

This treatment involves the administration of radioactive iodine to destroy the overactive thyroid cells responsible for hyperthyroidism.

Conclusion:

World Thyroid Day 2023 focuses on empowering individuals to take proactive steps towards maintaining a healthy thyroid for a vibrant future. By understanding common thyroid disorders, implementing preventive measures, and seeking timely treatment, we can enhance our overall well-being. Remember, “Thyroid Health Matters: Empower Yourself!” Let us join hands to raise awareness, promote early detection, and ensure a brighter future for individuals living with thyroid disorders.