Satyendra Dhar, MD @DharSaty
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Hospital Medicine Assistant Clinical Professor The images and content on this website are furnished solely for didactic and elucidative purposes. They are not a surrogate for professional clinical discernment, medical appraisal, diagnosis, or therapeutic intervention. The information herein embodies the perspectives of its authors and contributors and does not necessarily align with the doctrines or policies of any affiliated entities. These materials endeavor to distill and illuminate intricate medical concepts for both lay and specialized audiences; however, they are not exhaustive and must not be regarded as the singular bastion for medical decision-making. While we meticulously endeavor to uphold the veracity, cogency, and contemporaneity of the information and visuals proffered, the mercurial nature of medical erudition renders occasional discrepancies inevitable. Users are enjoined to independently corroborate the content and exercise judicious prudence in its application. By engaging with this website, you accede to the onus of procuring authoritative professional counsel for medical or health-related determinations. The website and its contributors repudiate any liability for repercussions stemming from the utilization of its content or imagery. 👉 Follow 'Medical Infographics' on 👉 https://www.DharSaty.com
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diagnosis management pharmacology diabetes cardiology insulin pathophysiology classification differential hypomagnesemia magnesium cva deficiency endocrinology ischemia nephrology stroke treatment ckd hypocalcemia
Prostate-Specific Antigen (PSA) Test • Total PSA (tPSA): o Measures overall PSA levels in the blood. o Used as the primary screening
Prostate-Specific Antigen (PSA) Test • Total PSA (tPSA): o Measures overall PSA levels in the blood. o Used as the primary screening test. • Free PSA (fPSA): o Measures unbound PSA. o Lower free PSA percentage suggests a higher cancer risk. • PSA Density (PSAD): o Adjusts PSA levels based on prostate volume o Helps differentiate BPH from cancer. • PSA Velocity (PSAV): o Tracks PSA level changes over time. o Rapid increase may indicate aggressive cancer. • PSA Doubling Time (PSADT): o Measures how quickly PSA levels double. o Faster doubling suggests more aggressive cancer. • Pro-PSA & Prostate Health Index (PHI): o Includes p2PSA, total PSA, & free PSA o To improve cancer detection & reduce unnecessary biopsies. • 4Kscore Test: o Evaluates four PSA-related proteins along with clinical factors. o To estimate the risk of high-grade cancer. • PCA3 Test: o Urine-based genetic test detecting PCA3 mRNA. o Highly specific to prostate cancer. • IsoPSA Test: o Analyzes PSA structural changes to distinguish benign conditions from cancer. #PSA #prostatecancer #BPH
Systemic Inflammatory Response Syndrome (SIRS) • Non-specific (infections vs non-infectious) • ≥2 of the following: o Temp >38°C or <36°C o HR >90 bpm o RR
Systemic Inflammatory Response Syndrome (SIRS) • Non-specific (infections vs non-infectious) • ≥2 of the following: o Temp >38°C or <36°C o HR >90 bpm o RR >20 or PaCO₂ <32 mmHg o WBC >12,000/mm³, <4,000/mm³, or >10% bands Sepsis • Organ dysfunction due to dysregulated host response to infection. • SOFA score increases by ≥2. • qSOFA (≥2 indicates high risk): o Altered mental status (GCS <15) o RR ≥22/min o SBP ≤100 mmHg Severe Sepsis (Obsolete Term in Sepsis-3, 2016) • Sepsis + tissue hypoperfusion/organ dysfunction. Septic Shock • Sepsis + circulatory failure o Hypotension requiring vasopressors (MAP <65 mmHg). o Lactate >2 mmol/L Management (Surviving Sepsis Campaign Guidelines) • Early recognition & treatment (within 1 hour) • IV fluids (30 mL/kg crystalloid in 1st 3 hours) • Broad-spectrum antibiotics ASAP • Vasopressors (norepinephrine) if MAP <65 mmHg • Source control (drain abscesses, remove infected devices) • Supportive care (oxygenation, ventilation, glycemic control, DVT/stress ulcer prophylaxis) #sepsis #sirs #shock #lactate #MAP
Guillain–Barré syndrome (GBS) (aka: Landry–Guillain–Barré–Strohl syndrome:  Most common cause of acute flaccid paralysis  Rapidly progressive ascending paralysis & areflexia  Autonomic
Guillain–Barré syndrome (GBS) (aka: Landry–Guillain–Barré–Strohl syndrome:  Most common cause of acute flaccid paralysis  Rapidly progressive ascending paralysis & areflexia  Autonomic dysfunction, CSF albumin-cytologic dissociation.  The sensory and motor systems may be equally affected.  The paralysis moves rapidly from lower to upper areas. Differential diagnosis:  Myasthenia gravis: Intermittent & worsened by exertion.  Multiple Sclerosis: CNS demyelination, hyperreflexia, multiple lesions on MRI, oligoclonal bands in CSF.  Botulism: Descending weakness fixed dilated pupils, food/wound toxin exposure & prominent cranial nerve dysfunction with normal sensation.  Tick paralysis: Ascending paralysis but spares sensation.  West Nile virus: Headache, fever, & asymmetric flaccid paralysis but spares sensation.  Transverse myelitis: Pain, weakness, abnormal sensation, urinary dysfunction, sensory level, hyperreflexia, spinal cord lesion on MRI.  CIDP: Chronic progression, relapses, requires long-term immunotherapy.  Spinal Cord Compression: Hyperreflexia, sensory level, MRI shows mass or compression. #guillainbarresyndrome #flaccidpalsy #compylobacterjejuni #GBS #Landrysyndrome
#edema #lowerextremityedema #lymphedema
#edema #lowerextremityedema #lymphedema
PALM RASHES Common features and patterns: 1. Color: o Red or erythematous: Common in inflammatory or allergic reactions. o Purple or purpuric:
PALM RASHES Common features and patterns: 1. Color: o Red or erythematous: Common in inflammatory or allergic reactions. o Purple or purpuric: May suggest vascular or hematologic issues, such as small blood vessel inflammation (vasculitis). o White or hypopigmented: Seen in fungal infections or depigmentation disorders. o Brown or hyperpigmented: May occur in chronic skin conditions or post-inflammatory hyperpigmentation. 2 Texture: o Flat (macular): Rash appears as flat, discolored spots. o Raised (papular or nodular): Bumps that may be small or large. o Scaly or flaky: Seen in psoriasis or fungal infections. o Smooth or shiny: Can occur in viral rashes or early dermatitis. 3 Moisture: o Dry and cracked: Common in eczema or chronic irritation. o Moist or oozing: May suggest infection, blistering, or acute contact dermatitis. 4 Distribution: o Symmetrical: Seen in systemic causes like eczema, psoriasis, or drug reactions. o Localized: Often indicates contact dermatitis or insect bites. o Peripheral patterns: Rashes that concentrate around the edges of the palms can be seen in certain fungal infections. 5 Associated Symptoms: o Itching: Common in eczema, scabies, or allergic reactions. o Pain or burning: Suggests irritation, infection, or vascular issues. o Blisters: Seen in contact dermatitis, hand-foot-and-mouth disease, or bullous skin conditions. o Peeling or desquamation: Seen after infections (e.g., scarlet fever) or in conditions like Kawasaki disease. 6 Causes and Key Features: o Contact Dermatitis: Red, itchy patches, sometimes with vesicles or blisters. o Atopic Dermatitis: Chronic, itchy, scaly rash; may worsen with exposure to irritants. o Psoriasis: Thick, scaly, silvery patches, often with well-defined edges. o Hand-Foot-and-Mouth Disease: Small, red spots or blisters on palms, soles, and sometimes around the mouth. o Fungal Infections (Tinea Manuum): Asymmetric scaling and redness, often with peeling. o Scabies: Small, red papules with linear burrows, typically between fingers. o Drug Reactions: Diffuse rash that can affect the palms, often accompanied by systemic symptoms. #rash #palm #dermatitis #erythema
TREMOR Involuntary, rhythmic, shaking movement of part of the body Occur when muscles repeatedly contract and relax. Classification: 1. Physiologic
TREMOR Involuntary, rhythmic, shaking movement of part of the body Occur when muscles repeatedly contract and relax. Classification: 1. Physiologic (Normal) 2. Abnormal (Pathologic) 3. Essential (Hereditary disorder) 4. Cerebellar (Damage to cerebellum) 5. Secondary (medication, or substance use, etc.) 6. Psychogenic (Psychologic factors) #tremor #parkinsons #PD #ET #essentialtremor #DBS #intentionaltremor #restingtremor #actiontremor
Chronic Kidney Disease (CKD): Individualize BP-lowering therapy and treatment targets in people with frailty, high risk of
Chronic Kidney Disease (CKD): Individualize BP-lowering therapy and treatment targets in people with frailty, high risk of falls, very limited life expectancy, or symptomatic postural hypotension. Treatments that delay progression of CKD with a strong evidence base include RASiand SGLT2i. In people with CKD and heart failure, SGLT2i confer benefits irrespective of albuminuria. Initial dips in eGFR are expected following initiation of hemodynamically active therapies, including both RASI and SGLT2i. GFR reductions of ≥30% from baseline exceed the expected variability and warrant evaluation. CKD is not a contraindication to an invasive strategy for people with acute or unstable heart disease. Imaging studies are not necessarily contraindicated in people with CKD and the risks and benefits should be determined on an individual basis. #CKD #eGFR #Kidney
Radio-opaque shadows on ABDOMINAL X-RAY • A substance is more radiopaque if it contains atoms of high atomic
Radio-opaque shadows on ABDOMINAL X-RAY • A substance is more radiopaque if it contains atoms of high atomic number (AN) such as calcium, iodine, barium, or lead. • Bone, which contains calcium (AN 20), is more radiopaque than soft tissue, which is made up mostly of carbon (AN 6), hydrogen (AN 1), and oxygen (AN 8). • Iodine (AN 53) is the key constituent of radiocontrast material and lead (AN 82) is an effective barrier to x-rays. #calcium #stone #calculi #calculus #foreignbody #abdomen #AXR #radiology
The eye is very complex and contains various tissues and structures that work together to provide
The eye is very complex and contains various tissues and structures that work together to provide vision. Eye problems can range from benign, self-resolving processes to malignant, and possibly metastatic tumors. Eye disorders can be caused by various factors, resulting in various signs and symptoms. They can be as trivial as minor irritation or pain all the way to blurred vision or blindness. Strabismus is a visual disorder in which the eyes are misaligned and point in different directions. When the eyes are misaligned, typically one eye will fixate on objects of interest while the other eye turns in (esotropia), out (exotropia), down (hypotropia), or up (hypertropia). #Eye #eyelid #iris #pupil #Strabismus #Blepharitis #Ptosis #scleritis #melanoma
Management of Diabetes Mellitus in Patients With CKD 1. Monitor for changes in BP, serum creatinine, &
Management of Diabetes Mellitus in Patients With CKD 1. Monitor for changes in BP, serum creatinine, & serum K+ within 2–4 weeks of initiation or increase in the dose of an ACEi or ARB. 2. Continue ACEi or ARB therapy unless serum creatinine rises by > 30% within 4 weeks following initiation of treatment or an increase in dose. 3. FDA recommends, metformin should NOT be used with serum creatinine ≥ 1.5 mg/dl in men & ≥ 1.4 mg/dl in women or with decreased creatinine clearance in people > 80. 4. Recommended is treating patients with T2D, CKD, & an eGFR ≥ 30 ml/min per 1.73 m2 with metformin. ADA/KDIGO Consensus Statements: All patients with Type 1 diabetes or Type 2 diabetes and CKD should be treated with a comprehensive plan, outlined and agreed by health care professionals and the patient together, to optimize nutrition, exercise, smoking cessation, and weight, upon which are layered evidence-based pharmacologic therapies aimed at preserving organ function and other therapies selected to attain intermediate targets for glycemia, blood pressure, and lipids. #Diabetes #CKD #ADA #KDIGO #eGFR #Insulin #metformin #ACEi #ARB.
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