Buy me a Coffee!!

Buy me a Coffee!!
Thank you!

āĻĒ্āĻ°āĻĢেāĻ°_āĻ­াāĻ‡āĻŦাā§Ÿ_Obstructive_Jaundice

#āĻĒ্āĻ°āĻĢেāĻ°_āĻ­াāĻ‡āĻŦাā§Ÿ_Obstructive_Jaundice ❤️


👨đŸģ‍⚕️ : āĻāĻ•āĻŸা patient āĻ†āĻ¸āĻ˛ো āĻ¤োāĻ° āĻ•াāĻ›ে, āĻ–ুāĻļāĻ–ুāĻļে āĻ•াāĻļি , lung āĻ #wheeze āĻāĻŦং āĻ¸াāĻĨে #jaundice  āĻ†āĻ›ে, āĻāĻ•āĻŸা #parasitic infection āĻāĻ° āĻœāĻ¨্āĻ¯ āĻāĻ‡āĻŸা āĻšāĻ‡āĻ›ে। āĻ•ি āĻšāĻ¤ে āĻĒাāĻ°ে āĻ¸েāĻ‡ parasite ?

👩đŸģ‍⚕️ : āĻ¸্āĻ¯াāĻ°, #Ascaris_lumbricoides ! āĻāĻŸা 2nd part of Duodenum āĻĻিā§Ÿে Ampula of vater āĻĻিā§Ÿে Bile Duct āĻ obstruction āĻ•āĻ°ে, āĻ¯াāĻ° āĻĢāĻ˛ে conjugated Bilirubin āĻ†āĻ° intestine āĻ āĻ†āĻ¸āĻ¤ে āĻĒাāĻ°ে āĻ¨া।
āĻ¤াāĻ‡ Bilirubin āĻāĻ° āĻĒāĻ°িāĻŽাāĻ¨ serum āĻ āĻ¯াā§Ÿ āĻŦেā§œে।
āĻ¯েāĻŸা āĻ•ে Obstructive jaundice āĻŦāĻ˛ে।

👨đŸģ‍⚕️ :āĻ•িāĻ¨্āĻ¤ু āĻ•াāĻļি āĻ†āĻ° wheeze ?

👩đŸģ‍⚕️: āĻ¸্āĻ¯াāĻ° parasitic infestation āĻāĻ° āĻœāĻ¨্āĻ¯ Blood āĻ #eosinophil count āĻ…āĻ¨েāĻ• āĻŦেā§œে āĻ¯াā§Ÿ। āĻāĻŦং āĻ¸েāĻ‡ eosinophil āĻ—ুāĻ˛ো āĻ—িā§Ÿে āĻœāĻŽা āĻšā§Ÿ lung āĻ।
āĻāĻŦং āĻ¤াāĻ° āĻ­েāĻ¤āĻ°ে āĻĨাāĻ•া mediators āĻ—ুāĻ˛ো release āĻ•āĻ°ে। āĻ¯াāĻ° āĻĢāĻ˛ে #Allergic menifestation āĻļুāĻ°ু āĻšā§Ÿ।
Asthma āĻāĻ° āĻŽāĻ¤ো āĻ•িāĻ›ুāĻŸা। āĻāĻ‡ āĻœāĻ¨্āĻ¯āĻ‡ āĻ–ুāĻļāĻ–ুāĻļে āĻ•াāĻļি āĻĨাāĻ•ে āĻāĻŦং lung āĻ Wheeze āĻĒাāĻ“ā§Ÿা āĻ¯াā§Ÿ।
āĻāĻ‡ āĻ˜āĻŸāĻ¨া āĻ•ে āĻŦāĻ˛া āĻšā§Ÿ #Loeffler_Syndrome !

👨đŸģ‍⚕️ : āĻ¯াāĻ• KD chaterjee āĻĒā§œেāĻ›িāĻ¸ āĻ¤াāĻšāĻ˛ে! thats Good ! Obstructive jaundice āĻāĻ° cause āĻ—ুāĻ˛ো āĻŦāĻ˛ āĻ—ুāĻ›িā§Ÿে।

👩đŸģ‍⚕️  :  āĻĒ্āĻ°āĻĨāĻŽে āĻ¸্āĻ¯াāĻ° due to obstruction with in

#lumen :
           đŸ’šAscaris
           đŸ’œStone

#in_the_wall_of_Bile_duct

             đŸ’”Cholangiocarcinoma
             đŸ’›Stricture

#Pressure_from_outside_of_bile_duct

           đŸ’™carcinoma Head of the pancrease
           đŸ’šLymphadenopathy

👨đŸģ‍⚕️: āĻĻাāĻ°ুāĻ¨ āĻ—ুāĻ›িā§Ÿে āĻŦāĻ˛েāĻ›িāĻ¸। āĻ†āĻš্āĻ›া āĻŦāĻ˛āĻ¤ো āĻāĻ•āĻœāĻ¨ viral hepatitis āĻ¨িā§Ÿে s. bilirubin 15 mg/dl āĻ¨িā§Ÿে āĻ†āĻ¸āĻ˛ো, āĻ†āĻ° āĻ†āĻ°েāĻ• āĻœāĻ¨ Obstructive jaundice āĻ¨িā§Ÿে 25 mg/dl  āĻ¨িā§Ÿে āĻ†āĻ¸āĻ˛ো। āĻ•াāĻ° āĻŸা āĻŦেāĻļি āĻ–াāĻ°াāĻĒ?

👩đŸģ‍⚕️ : āĻ¸্āĻ¯াāĻ° Viral hepatitis āĻāĻ° 15 mg/dl āĻŸা āĻŦেāĻļি āĻ–াāĻ°াāĻĒ। āĻ•াāĻ°āĻ¨ āĻāĻŸা unconjugated ! #unconjugated bilirubin āĻ˛িāĻĒিāĻĄ soluble āĻšā§Ÿ। āĻ¤াāĻ‡ Blood brain Bareer āĻāĻ° āĻ˛িāĻĒিāĻĄ layer āĻ¸ে cross āĻ•āĻ°āĻ¤ে āĻĒাāĻ°ে। āĻāĻŦং encephalopathy āĻ•āĻ°āĻ¤ে āĻĒাāĻ°ে। āĻ¯েāĻŸা āĻ•ে āĻŦāĻ˛ে #Kernicterus . āĻ•িāĻ¨্āĻ¤ু #Conjugated bilirubin water soluble āĻšāĻ“ā§Ÿাā§Ÿ āĻ…āĻ¨েāĻ• āĻŦেāĻļি āĻšāĻ“ā§Ÿা āĻ¸āĻ¤্āĻ¤্āĻŦেāĻ“ BBB cross āĻ•āĻ°āĻ¤ে āĻĒাāĻ°ে āĻ¨া। āĻ¤াāĻ‡ āĻ¤ুāĻ˛āĻ¨া āĻŽূāĻ˛āĻ• āĻāĻŸা āĻ­াāĻ˛।

👨đŸģ‍⚕️ : āĻ†āĻš্āĻ›া , Obstructive jaundice āĻāĻ° c/f āĻ—ুāĻ˛ো āĻŦāĻ˛।

 đŸ‘ŠđŸģ‍⚕️ : āĻ¸্āĻ¯াāĻ°, Bile obstruction āĻāĻ° āĻœāĻ¨্āĻ¯, bile āĻ¯েāĻšেāĻ¤ু Fat emulsification āĻ•āĻ°ে absorption āĻ āĻšেāĻ˛্āĻĒ āĻ•āĻ°āĻ¤ে āĻ†āĻ° āĻĒাāĻ°ে āĻ¨া। āĻ¤াāĻ‡ Fat āĻ–াāĻŦাāĻ° āĻ—ুāĻ˛ো Digestion āĻšāĻ¤ে āĻšাā§Ÿ āĻ¨া। āĻ¸েāĻ—ুāĻ˛ো stool āĻāĻ° āĻ¸াāĻĨে āĻŦেā§œ āĻšā§Ÿে āĻ¯াā§Ÿ।
āĻāĻŸা āĻ•ে #Steatorrhoea āĻŦāĻ˛ে। foul smelling and frothy in appearance ! āĻāĻ‡ āĻ•াāĻ°āĻ¨ে patient malabsorption āĻāĻŦং Weight loss āĻ¨িā§Ÿে āĻ†āĻ¸āĻ¤ে āĻĒাāĻ°ে।
āĻāĻ›াā§œা #Bleeding ,  #Osteoporosis āĻāĻŦং #itching āĻ¨িā§Ÿে patient āĻ†āĻ¸āĻ¤ে āĻĒাāĻ°ে।

👨đŸģ‍⚕️ : Obstruction āĻšāĻš্āĻ›ে bile , āĻ•িāĻ¨্āĻ¤ু Bleeding āĻšāĻš্āĻ›ে āĻ•েāĻ¨? āĻ•েāĻ¨āĻ‡ āĻŦা Osteoporosis āĻšāĻš্āĻ›ে?

👩đŸģ‍⚕️ :  āĻ¸্āĻ¯াāĻ° #Fat_soluble_vitamin āĻ—ুāĻ˛ো absorption āĻ•āĻ°াāĻ° āĻœāĻ¨্āĻ¯āĻ“ Bile āĻāĻ° āĻĻāĻ°āĻ•াāĻ° āĻšā§Ÿ। āĻ¸েāĻŸাāĻ° āĻ…āĻ­াāĻŦে, Vitamin A,D, E,K absorption āĻšāĻ¤ে āĻĒাāĻ°ে āĻ¨া।
āĻ¤াāĻ‡ Vitamin K āĻāĻ° āĻ…āĻ­াāĻŦে , #Vitamin_K dependent #Clotting factors (ll,Vll,lX,X) āĻ—ুāĻ˛ো āĻ†āĻ° āĻ¤ৈāĻ°ী āĻšā§Ÿ āĻ¨া। āĻ¯াāĻ° āĻ•াāĻ°āĻ¨ে Bleeding āĻĻেāĻ–া āĻĻেā§Ÿ।

āĻ†āĻ° #Vitamin_D āĻāĻ° āĻ…āĻ­াāĻŦে Ca āĻ•āĻŽ absorption āĻšā§Ÿ।
āĻ¯েāĻŸাāĻ° āĻ•াāĻ°āĻ¨ে āĻšā§Ÿ #Osteoporosis .

👨đŸģ‍⚕️ : āĻ•ি āĻŦিāĻš্āĻ›ু āĻ°ে āĻŦাāĻŦা! āĻāĻ•āĻŸা āĻĒ্āĻ°āĻļ্āĻ¨ āĻ“ āĻŽাāĻŸিāĻ¤ে āĻĒāĻ°āĻ›ে āĻ¨া।
itching āĻ•েāĻ¨ āĻšāĻš্āĻ›ে?

👩đŸģ‍⚕️ : āĻ¸্āĻ¯াāĻ° Bile backflow āĻ•āĻ°ে āĻāĻŦং Bile āĻāĻ•āĻ¸āĻŽā§Ÿ āĻ­েāĻ™্āĻ—ে āĻ¯াā§Ÿ, āĻ†āĻ° bile āĻ āĻĨাāĻ•া Bile salt āĻ—ুāĻ˛ো Blood āĻ āĻŽিāĻļে āĻ¯াā§Ÿ। āĻ¸েāĻ‡ bile salt āĻ—ুāĻ˛ো āĻ—িā§Ÿে Deposit āĻšā§Ÿ cuteneous nerve root āĻ। āĻāĻŦং āĻāĻ‡ Cutenous nerve āĻāĻ°  #irritation āĻāĻ° āĻĢāĻ˛ে itching āĻļুāĻ°ু āĻšā§Ÿ।

👨đŸģ‍⚕️ : āĻāĻ­াāĻŦে āĻ¸āĻŦ āĻĒাāĻ°āĻ˛ে āĻ•ি āĻšāĻ˛āĻŦে? 😠 Last āĻĒ্āĻ°āĻļ্āĻ¨ , āĻāĻŸা āĻĒাāĻ°āĻ˛ে āĻ¤োāĻ° honours !
āĻŦāĻ˛ Obstructive jaundice āĻāĻ° āĻ†āĻ°েāĻ• āĻ¨াāĻŽ āĻ•ি?

👩đŸģ‍⚕️ : āĻ¸্āĻ¯াāĻ° #Surgical_Jaundice ! āĻ•াāĻ°āĻ¨ āĻāĻ‡ jaundice āĻ•ে relief āĻ•āĻ°āĻ¤ে āĻšāĻ˛ে āĻ†āĻŽাāĻĻেāĻ° Surgery āĻāĻ° āĻ¸াāĻšাāĻ¯্āĻ¯ āĻ¨িāĻ¤ে āĻšā§Ÿ। āĻ¯েāĻŽāĻ¨ removal of stone , correction of stricture āĻāĻ¸āĻŦ āĻ•িāĻ›ুāĻ‡ surgical procedure ! āĻ¸্āĻ¯াāĻ° āĻ¤াāĻšāĻ˛ে āĻ•ি honours āĻĒেāĻ˛াāĻŽ?☺️

👨đŸģ‍⚕️ : āĻŽা āĻ°ে āĻ•āĻŽ āĻ•āĻŽ āĻĒā§œāĻŦি। āĻŦāĻ¨্āĻ§ুāĻĻেāĻ° āĻ•āĻĨা āĻšিāĻ¨্āĻ¤া āĻ•āĻ°ে āĻšāĻ˛েāĻ“। āĻ¤োāĻ° āĻ­াāĻ‡āĻŦা āĻ¨েāĻŦাāĻ° āĻĒāĻ° āĻ…āĻ§িāĻ• expectation āĻāĻ° āĻ•াāĻ°āĻ¨ে āĻ¤োāĻ° āĻ—াāĻ§া āĻĢ্āĻ°েāĻ¨্āĻĄ āĻ—ুāĻ˛োāĻ°  fail āĻšā§Ÿে āĻ¯াā§Ÿ। āĻ¯াāĻš! āĻ¤োāĻ° Honours āĻšā§Ÿে āĻ—েāĻ›ে।😔

No comments

Theme images by follow777. Powered by Blogger.