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7 reasons of false elvated potassium ....should think about when u have unexplained hyperkalemia noticed  Excessive vacuum of the blood draw (hemolysis) A collection needle that is of too fine a gauge (hemolysis) Excessive tourniquet time or fist clenching during phelobotomy, which leads to efflux of potassium from the muscle cells. A delay in the processing of the blood specimen. Thrombocytosis (Platelet count >500,000/mm³),  Leucocytosis  (WBC count > 70 000/mm³),  Erythrocytosis (hematocrit > 55%). 

Hepatopulmonary syndrome: Due to vascular dilation at the pre- and post-capillary level therefore decreased VQ ratio  Intrapulmonary vasodilation with R to left shunting mainly affecting the basal area,so it worsen with  sitting up due to increas basal blood flow  Diagnostic criteria: Chronic liver disease +\- chirosis  Arterial hypoxaemia PaO2 < 75 or Aa gradient > 20 Intrapulmonary vascular dilation Diagnose with contrast echo. Agitated saline injected IV. Immediate visualisation in L heart intracardiac shunt. Delayed visualisation means intrapleural shunt Medical management disappointing  It s indication for transplant with resolution usual in the months afterwards. However, the more hypoxic the greater the perioperative risk Porto-pulmonary hypertension:  Diagnostic criteria: Portal hypertension Mean pulmonary artery pressure > 25 Pulmonary...

When was diabetes first recognized? The ancient Egyptians first described diabetes around 1500 BC.  It was described as a condition in which a person urinated excessively and lost weight. How was the term  diabetes mellitus  coined? The urine of diabetics was noted to be copious and sweet.  The Greek physician Aretaeus (80-138 C.E.) noted that the syndrome manifested as polyuria, and used the term, διαβήτης (diabetes), which means “a siphon, a passer through.” In 1675, the English physician Thomas Willis added “mellitus” to the designation when he noticed that the urine of diabetics had a sweet odor.  Mellitus comes from the Latin root for “honey.” When was the concentration of glucose in the urine first measured? Matthew Dobson documented elevated glucose levels in the urine of diabetics in 1776. What was the first evidence that the pancreas played a role in diabetes? In 1889, Joseph von M...

ST: Subcutaneous Tissue;  EO: External Oblique; IO: Internal Oblique; TA: Transversus Abdominus; LD: Latissimus Dorsi; QL:Quadratus Lumborum Authors Carney J,   et al.  Journal Anaesthesia. 2011 Nov;66(11):1023-30. doi: 10.1111/j.1365-2044.2011.06855.x. Epub 2011 Aug 18. Affiliation Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland. Abstract The extent of analgesia provided by transversus abdominis plane blocks depends upon the site of injection and pattern of spread within the plane. There are currently a number of ultrasound-guided approaches in use, including an anterior oblique-subcostal approach, a mid-axillary approach and a more recently proposed posterior approach. We wished to determine whether the site of injection of local anaesthetic into the transversus abdominis plane affects the spread of the local anaesthetic within that plane, by studying the spread of a local anaesthetic and contras...