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Acute kidney injury

Acute kidney injury

2023-06-0318:26

a sudden deterioration in the function of the kidneys is known as an acute kidney injury sometimes also called acute renal failure to measure this reduction in kidney function glomerular filtration rate or GFR is normally used which is a measurement of how well the kidneys are filtering the blood the functional unit of the kidney that actually does this is the Nephron made up of the glomerulus which is a modified capillary and as blood passes through it the waste is filtered into the Bowman's capsule GFR is the volume filtered through the glomerulus into the Bowman's capsule and through the Nephron in a given unit of time the filtrate passes along through the proximal convoluted tubule Loop of henle distal convoluted tubule and the distal collecting duct undergoing secretion and reabsorptionas it travels ultimately it forms urine and collects into the renal pelvis and passes into the bladder through the ureter to directly measure this process is difficult we instead use creatinine clearance to estimate the GFR creatinine is a normal breakdown product of creatine released from muscle tissue and this is freely filtered by the glomerulus and is not reabsorbed so fits the kind of substance we need however creatinine is secreted into the filtrate by the peritubular capillaries so it does tend to overestimate the GFR slightly the cockcroft and Gault formula is a famous formula used to estimate the creatinine clearance and therefore GF are taking into account age Mass gender and the serum creatinine as it travels ultimately it forms urine and collects into the renal pelvis and passes into the bladder through the ureter to directly measure this process is difficult we instead use creatinine clearance to estimate the GFR creatinine is a normal breakdown product of creatine released from muscle tissue and this is freely filtered by the glomerulus and is not reabsorbed so fits the kind of substance we need however creatinine is secreted into the filtrate by the peritubular capillaries so it does tend to overestimate the GFR slightly the cockcroft and Gault formula is a famous formula used to estimate the creatinine clearance and therefore GF are taking into account age Mass gender and the serum creatinine Learn more about your ad choices. Visit megaphone.fm/adchoices
polycystic kidney disease is a condition characterized by the development of multiple cysts within the renal tubules of the kidney and is the most common hereditary renal disease the normal functional unit of the kidney is the nephron made up of a glomerulus and Bowman's capsule proximal convoluted tubule Loop of henle distal convoluted tubule and the collecting duct blood filters through the glomerulus forming filtrate which then passes through the tubules undergoing see and reabsorption eventually forming urine and passing into the ureter and bladder overall there are around 1 million of these nephrons in each kid in polycystic kidney disease these tubules develop into cysts which become filled with fluid and can range in size from being microscopic to several centimeters in size the process can start even in utero meaning in the womb as the tubules become cysts they cannot carry the normal filtering function therefore the number of functioning nephrons begins to decrease this is worsened by the fact that as the cysts grow they compress nearby nephrons also making them dysfunctional initially this may not be seen to have any clinical impact as the remaining number of nephrons may increase there to maintain the glomerular filtration rate but as the disease progresses and more nephrons are affected the remaining ones cannot make up the difference overall renal function then deteriorates eventually reaching end-stage renal disease by definition the presence of structural injury makes polycystic kidney disease a form of chronic kidney disease with end-stage renal disease being defined as needing renal replacement therapy like dialysis or transplant or a GF far below 15 ml per minute there are two main types of polycystic kidney disease both caused by genetics the first is autosomal dominant with two main types one coming from mutations in P KD 1 on a chromosome 16 which codes for the protein polycystic in this is affected in around 85% of cases and is involved in cell to cell or cell Matrix interaction cell cycle regulation and calcium transport the second coming from mutations in PKD to on chromosome for coding for Polly system to which codes for Learn more about your ad choices. Visit megaphone.fm/adchoices
Nephritic Syndrome

Nephritic Syndrome

2023-05-2919:01

Nephrotic syndrome is a collection of signs and symptoms that result from damage to the kidneys and is often confused with nephritic syndrome in fatigue syndrome there is a substantial amount of protein being lost through the kidneys in the urine defined as more than 3.5 grams per day this leads to hypoalbuminemia a low level of albumin in the blood as albumin is the most abundant protein normally in the blood these two are defining features in nephrotic syndrome nephritic syndrome is different in that there is less proteinuria but also the presence of hematuria and red blood cell or white blood cell casts in the urine hypertension and oliguria which is a reduced urine output typically between 80 and 400 ml per day the unit of the kidney is the nephron and normally in the glomerulus of the Nephron there is a specialized membrane that forms the filter made up of a fenestrated endothelium the Maryland basement membrane and the foot processes of podocytes which are cells that wrap around the capillary giving this additional filtration layer all together these structures normally act as a filter and prevent large molecules from passing through into the Bowman's capsule and renal tubules they have a net negative charge which may mean that they can repel other negatively charged molecules albumin is negatively charged in the fatigue syndrome there is sufficient injury to these structures to change the permeability and allow albumin and other molecules to pass into the urine leading to hypoalbuminemia the signs and symptoms linked to hypoalbuminemia which includes peripheral edema and fluid overload particularly in children this can be evident as facial swelling but can also occur in adults particularly around the eyes fluid overload can mean weight gain peripheral edema and even the development of ascites or pleural effusion which can manifest as shortness of breath known as this near the reduction in the blood levels of albumin causes the oncotic pressure of the blood 24 meaning fluid will more readily leak into the surrounding tissues causing edema this is sensed as hypovolemia because less fluid is in the vessels which then triggers the renin-angiotensin-aldosterone system causing retention of salt and water this is known as the underfill hypothesis while another is the Learn more about your ad choices. Visit megaphone.fm/adchoices
Chronic kidney disease

Chronic kidney disease

2023-05-2722:24

"...chronic kidney disease or chronic renal failure is a progressive irreversible condition characterized by either a reduction in kidney function or kidney damage as a result of any cause that a present for more than 3 months it is divided into stages based on the glomerular filtration rate which is a measure of how well the kidneys are functioning it shows the flow rate of filtrate through the glomerulus of the Nephron into the Bowman's capsule and ultimately through the renal tubules the stages are labeled 1 to 5 with 2 groups in stage 3 the definition of a reduced GFR is below 60 milliliters per minute but in groups 1 and 2 the GFR may actually be above 60 but there is evidence of kidney damage end-stage renal disease is classed as a GF are below 15 or the need for renal replacement therapy like dialysis or renal transplant kidney damage can be defined as signs of damage seen on Imaging or on testing such as a high albumin to creatinine ratio which is a measurement of the amount of protein lost in the urine in fact in combination with GFR these patients are divided into three food groups based on the albumin creatinine ratio with higher values indicating more damage and an increased likelihood of progression initially chronic kidney disease may not cause many problems and it is often asymptomatic however as it progresses it brings with it several significant complications these can include an elevated cardiovascular risk with patients are 5 to 10 times more likely to die from cardiovascular disease than end-stage renal disease the risk of stroke has been found to increase as the GFR lowers around seven percent for every 10 ml per minute lost this may also be the result of CKD contributing to hypertension as well as being caused by it this can be due to activation of the renin-angiotensin-aldosterone system and can also be because as the disease progresses the kidney is less able to excrete leading to retention and subsequent fluid overload signs of fluid overload could be dismissed near due to pulmonary edema or a fusion and peripheral edema or ascites anemia is also common which contributes to disappear and can come from a reduction in erythropoietin from the..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...nephritic syndrome is a collection of signs and symptoms that result from glomerulonephritis which is inflammation of the kidney specifically the glomerulus this could be remembered because it means inflammation rather than being a disease itself nephritic syndrome is the manifestation of an underlying disease that causes the inflammation and there are many of these causes it is easily confused with nephrotic syndrome which instead is a collection of signs and symptoms resulting from a high amount of protein being lost through the kidneys in the urine this leads to hypoalbuminemia meaning low levels of albumin in the blood these are the two defining features in nephrotic syndrome there is some overlap but nephritic syndrome is different in that the degree of proteinuria is lower and there is the dozens of hematuria meaning blood in the urine which could be microscopic or macroscopic red blood cell casts in the urine sterile / urea which is the presence of white blood cells without evidence of bacteria hypertension and oliguria which is a reduced urine output typically between 80 and 400 ml per day the functional unit of the kidney is the Nephron which includes the glomerulus and modified capillary surrounding this there are multiple layers which together form a filter these include a fenestrated endothelium the glomerular basement membrane and the foot processes of podocytes which are cells that wrap around the capillary in most cases of nephritic syndrome there is a trigger causing inflammation in this area overall featuring cellular proliferation complement activation recruitment of leukocytes and production of proteases and free radicals that ultimately lead to injury of the kidney this then leads to the characteristic features for example injury to the glomerular filtration membrane allows protein to leak into the urine though not as much as is seen in nephrotic syndrome red blood cells can also pass through causing hematuria and they can be dysmorphic with a camping sites in particular suggesting glomerular injury red blood cells can also Clump together within the tubules forming cylindrical structures called castes in fact this is considered suggestive of glomerulonephritis the injury and inflammation means white blood cells are recruited and can pass into the urine and as we said it's termed sterile pyuria because there..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...tricky to remember but this pneumonic will help you remember not only the names but also their positions the rest is made up of eight bones roughly in two rows of four the pneumonic starts as some lovers try positions s is for the scaphoid L flew name T4 triquetrum and P Pi is a form to remember the position you can use the letter P because the Paisa form is on the same side as the pinky the scaphoid and the lunate articulate with the and the radius is always on the same side as the thumb the second half of the pneumonic is that they can't handle which is for the trapezium trapezoid capitate and hamate the scaphoid is the most commonly injured bone of the wrist usually from a fall onto an outstretched hand and it is associated with pain in the anatomical snuffbox and with axial pressure applied on the thumb it is also famous for having a risk of a vast necrosis because it has a retrograde blood supply meaning blood flow from its distal end towards its proximal end this is mostly from the dorsal branch of the radial artery if the scaphoid is fractured blood might not be able to reach the proximal end giving avascular necrosis of the proximal part of the scaphoid at the metacarpals numbered 1 to 5 from the thumb which is easy to remember because each hand only has one thumb a famous fracture of the metacarpal is the boxer's fracture which is on the fifth metacarpal after striking with a closed fist this can lead to misalignment of the knuckle as the metacarpal makes up the now you then have the phalanges there are three in each finger called the proximal middle and distal phalange but only two in the thumb the proximal and distal phalanges we take this few seconds off to inform you are valued loyal listener about the best health and fitness podcast shows from the nest Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic health problems classic functional medicine Back to Basics health tips and special best doctors in the United States of America check out this health and wellness podcast shows explore Health talk weekly healthy lifestyle matters excellent Health digest healthy and free and last but not least weekly health and fitness Corner also check out nasty Boise see the truest story never told Fiction podcast for that real-life on the..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...tennis elbow and golfer's elbow a to similar conditions causing pain in the elbow and a medically know is lateral and medial epicondylitis respectively this means inflammation of the epicondyles which are bony protuberance has on the distal of the humerus the elbow is made up of the humerus articulated with the radius and ulna and allows for flexion and extension of the forearm however there are muscles that attach to the epicondyles that allow for wrist hand and finger movements like grasping and twisting and repetitive use of these muscles is thought to lead to micro attendance generating pain for this reason the conditions are known as enter Sapa these-- which means attachment point disease in act more recently it has been recommended that the conditions be referred to as tendinosis or epicondyle Alger rather than epicondylitis as histologically there is usually granulation tissue and a lack of traditional inflammatory cells suggesting that degeneration of the tendon maybe more an inflammation in the pathogenesis Motions like using handheld tools or even drawing are associated with the conditions and the names are slight misnomers is playing tennis can give you golfer's elbow and vice versa over all the movements causing the conditions do not necessarily need to be sports-related in some cases they can be triggered by a sudden contraction possibly from trauma elbow pain is the primary symptom in each lateral like this is 7 to 10 times more common and the pain is on the lateral or outer part of the elbow usually on the dominant hand it is generally worsened by extension of the wrist or fingers as the muscles responsible for these movements attached to the lateral epicondyle collectively known as the extensor tendons in particular the extensor carpi radialis brevis is commonly affected in lateral epicondylitis there is typically worsening of the pain with wrist extension against resistance when the is extended known as cozens test medial epicondylitis is less common but features pain on the medial or inner of the elbow it comes from tendinosis of the flexor and pronate attendance which originate from the medial epicondyle in particular the carpi radialis and the pronator teres and most commonly affected the pain is usually reproduced when the wrist is flexed and pronated against resistance well the is flexed called the reverse cozens test overall it is usually a gradual onset of pain that progressively get worse and can persist at night it also tends to be worsened by use of the forearm such as grasping and the pain may also be elicited by palpating several millimeters distal to the air condyles which corresponds with the location of the tendons people may also experience weaker grip strength the diagnosis is largely meaning no specific test or Imaging is required to make a diagnosis however Imaging like x-ray may be done to rule out arthritis of the elbow..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...Osgood-Schlatters disease also known as tibial tubercle apophysitis is a condition characterized by the anterior knee due to inflammation of the apophysis and apophysis is a normal developmental protuberance from a bone that provides an insertion site for tendons in this case the patellar tendon on to the tibial tubercle it primarily affects children and adolescents because by adulthood the apophysis will fuse with the rest of the tibia it is weaker than 10 and so is prone to injury Osgood-Schlatters disease is a stress or traction injury that occurs due to repetitive Force being applied through the strong patellar tendon on to the tibial tubercle typically from movements involving leg extension such as running or jumping but also during growth spurts the force can lead to small avulsion fractures of the tibial tubercle apophysis generating and pain and in rare cases a complete avulsion of the tibial tubercle knee pain is the most common symptom which is on the anterior portion of the knee just below the patella in most cases it is unilateral but both sides are affected in around 30 percent of cases in general it has an Insidious gradual onset with no trauma and may initially be episodic but go on to become continuous the tibial tubercle itself can be tender to touch and may have some Associated enlargement which can be felt as a prominent lump males in particular are up to seven times more likely to be affected..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...a shoulder dislocation is when the humerus separates from the shoulder joint and is the most common of the large joint dislocation normally the shoulder joint is made up of the head of the humerus articulated with the glenoid fossa of the scapula which is why it is known as the glenohumeral or joint it is a synovial ball and socket joint with a large range of motion but at the cost of being more unstable the head of the humerus is around four times larger in the shallow surface area of the glenoid fossa which contributes to the large range of motion but also to the instability the joint is stabilized by surrounding the glenoid labrum is a bring of fibrocartilage around the glenoid fossa that better anchors the humerus and glenoid and there are also a number...arm in an anterior dislocation due to the posterolateral portion of the humeral head being compressed against the anterior part of the glenoid labrum they can be compression fractures on the humerus known as Hill Sachs lesions they are closely linked with bankart lesions which is a rupture in the glenoid labrum these can also be accompanied by avulsion fractures which are then termed bony bankart lesions the arm is typically held in external rotation with some abduction and all movements are painful there is a loss of the normal Contour of the deltoid and the acromion can be particularly prominent posterior dislocation 's make up only two to four percent of all shoulder dislocations and occur due to the head of the humerus being forced posteriorly while..." Learn more about your ad choices. Visit megaphone.fm/adchoices
Ankle Fractures

Ankle Fractures

2023-05-1316:57

"...ankle fractures a common injuries involving a break in one or more of the bones that make up the ankle joint there are three bones that make up the ankle the tibia fibula and tailless specifically the medial and posterior malleolus by the and the lateral malleolus of the fibula there is an additional joint between the tibia and fibula called the tibiofibular syndesmosis this is a fibrous structure made up of the anterior and posterior inferior tibiofibular ligament and the interosseous membrane the ankle is a hinge primarily allowing supplanter and dorsiflexion and is at its least stable in plantarflexion it is described as a mortise and Tenon joint which are essentially a hole and the that fits that hole in this case the space formed by the tibia and fibula and the projection which is the Dome of the talus bone ligaments helped provide more stabilization there is the medial or deltoid ligament coming from the medial malleolus which branches into four ligaments and is mostly involved in preventing / e-version while the lateral ligament comes from the lateral malleolus and is made up of three ligaments with the main function of preventing over inversion of the foot in 70% of cases there is an isolated fracture of either the medial or lateral malleolus if both the fractured this is termed a bye the fracture seen in twenty percent of cases and if the posterior malleolus is also fractured this is called a try malleolus fracture but this is only the case in fewer than ten percent of patients in roughly 10% of cases the syndesmosis is also injured there are multiple classifications of ankle weather is used in the lateral malleolus fractures based on the location of the fracture relative to the syndesmosis generally with more proximal fractures indicating a higher risk of instability a is below the syndesmosis B is at its level and see is proximal to it the log handsome classification is more detailed considering also the position of the anchor during injury and the forces sustained during it other types of fractures include Amazon nerve injury where there is a proximal fibula fracture with syndesmosis and deltoid ligament injury this is an unstable injury that will need surgical intervention this is..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...for those of you who have not tuned in to us we run essentially a chronic pain practice board Gates is board certified functional neurologist I'm a board-certified functional medicine practitioner we melded those two disciplines into a model of care to address a substantial portion of chronic conditions chronic Jesus and and although we cure few we're able to help most get under some some control quite considerable control and be able to manage their case and the properly selected and the properly cite the patient the reason we cure for you is because pretty much everybody walks in here ends up having an autoimmune problem and they also usually walk in here under a chronic stress with a chronic stress response usually we caught a sympathetic dominance or fight-flight system is engaged and it doesn't tend to let go these things can lead to anxiety Sia T panic attacks depression things of that nature and I lead off with that to say one of my one of my one of my points with people when they come in and I address this with them is my observation based on watching what happens with the brain rehab exercises that we do in certain other types of supplementation is that these are not necessarily personality disorders their poor frontal lobe this sort of and there's a lot of things that add to causing your frontal lobe to not work properly poor poor lack of blood supply to your Bruno lobe from anemias be your frontal lobe needs oxygen inflammation which are probably going to talk about a little bit blood sugar stress hormones and and so but lately we've been seeing last couple of years maybe we've been even seeing little kids come in we're stressed out of their minds and like two or three years old and say what's going on with that and then other people who've had just this kind of stress responses that seemed to be like even a little bit over a top for what we see and and dr. Gates is going to share with you some of the things that he's come across in that in the literature that we've been implementing and what are our Protocols are and kind of giving you the understanding that I know stress hormones now can cross the placenta from the stressed mother into the young person but there's even more to it than that our genetic components that need to be considered if they're there and that oftentimes respond well to the types of things that can be done wow without drugs frankly so yeah we treat a lot of patients with fibromyalgia in our clinic at least we have and that's actually started off with yeah that's kind of how we got into depression because a lot of patients were coming in with their fibromyalgia and they didn't want to take medications for the depression so they said well can you handle what could you do so that started us on this quest in this journey of..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...so we're going to talk about Hashimoto and Plastics today Hashimoto's is a subject that we've been long associated with frankly probably for most people are associated with and we're taking quite a bit of use for even diagnosing people at and so and getting heat on it and the point from that is that Hashimoto is the understanding of what's going on with Hashimoto's is the number of things it's related to the things that can create a Hashimoto's isn't it is an immune attack on your thyroid primarily and so you're always looking for the things that are creating the immune attack and and and it can be a multitude of things and I was just mentioning to dr. Gates we're talking about Plastics that I remember reading about that at like 10 years ago but wondering is actually something that has something to do with it because back then it was I was everything was Metals was right it was it was is there anything you could think of the alternative groups were putting out as yet avoid all of this which is basically everything in life it seemed like but it turns out that Plastics do create a negative effect on the condition of Hashimoto's and so we're going to discuss that this probably fairly briefly it's not a long topic I would assume and so and if it's not brief then that's fine too so so Plastics as the famous gentleman in the Dustin Hoffman movie from many years ago The Graduate said to Dustin Hoffman when he had him in his graduate courses okay so I'm 65 days going to be people more my age The Graduate it was the famous line for the decade when people would say what are you going to do with your life and people Go Plastics because the gentleman at his college graduation party pulled him over and he was wondering what he was going to do for a because back in 1965 r68 Plastics were just coming into that was the whole point of plastics were done where Evolution just coming in and nobody knew anything about them they were going to save the world now we've got some mass of plastics I guess twice the size of Texas under the Pacific Ocean from what I read in the the other day and the National Geographic so could be a problem that was the whole point of that that aside that I was warned not to do yesterday but I did so good so the whole question is why is Hashimoto's so much more common and..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...and today we're going to talk about a concept that has time so I think been controversial I think at times been considered theoretical when I first got into functional medicine years ago is actually a prominent Conrad of the immune system and because what we started to realize was in chronic pain we have a chronic pain practice for those of you who haven't watched us before and we treat just about anything that won't go away and we've combined two disciplines functional neurology and functional medicine to address fibromyalgia and periphery often chronic fatigue and chronic got problems chronic thyroid problems and dizziness vertigo balance things that won't go away people get things they go away B they don't go away you need to know why and the immune system was an obvious first place to start I think for those in the field at that time that there must be something with the immune that's causing the problem there's a concept called th1 th2 shifts th1 th2 balance I've drawn the little seesaw picture of it and I think a thousand times and try and explain to people and and and I think it's I don't I think dr. Gates is going to explain to me today whether it's getting more credibility or just something that you're using more because you see it's a valuable tool because it is affecting people frequently will talk about that Gates does all the treatment now and he's always researching and frequently will tell talk to me about how this was a that this was a shift during pregnancy this is the mystical why do I get pregnant and then I feel good and then all sudden I don't after I deliver the child it's this is the if you have allergies you have a shift more towards one side than the other so and certain autoimmune problems have a certain quality..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...Serotonin syndrome also known as serotonin toxicity is a potentially life-threatening condition due to excessive serotonin levels in the body this can come from using the medication as a therapy due to drug interactions recreational drug use or even intentional overdoses the end result is an increased in the amount of serotonin in the synaptic cleft able to bind serotonin receptors, for example, selective serotonin reuptake Inhibitors like Citalopram inhibit the reuptake of Serotonin into the presynaptic neuron meaning more is available to bind the postsynaptic receptors monoamine oxidase Inhibitors likes alleged lean prevent the breakdown of Serotonin so more is available SSRIs tend to be the most common cause was because of their widespread use while monoamine oxidase Inhibitors tend to produce the more severe cases other medications include serotonin noradrenaline reuptake it is tricyclic antidepressants serotonin modulators and tryptophan supplementation as it is converted and leads to serotonin formation opioids amphetamines and cocaine also increase serotonin release serotonin is found mostly in the gastrointestinal system it is carried by platelets and also exerts a acts on the central nervous system within the CNS it has rules in attention mood sleep cognition and thermoregulation in the other systems it is involved in vasoconstriction gastrointestinal motility uterine contraction and..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...schizophrenia is a mental disorder characterized by impairments in the way reality is perceived with Associated changes in schizo means split and free Nia means mind in Greek but it's important to remember it is not meant to mean split personality which is a condition schizophrenia affect how people think to feel and behave and the symptoms are divided into three main types Karthik or positive symptoms negative symptoms and cognitive symptoms psychotic symptoms include hallucinations meaning sensing something that there and auditory hallucinations are particularly common thought to occur in 80% of patients at some point delusions are fixed belief that something is true despite having evidence that it is not in schizophrenia paranoid delusion is a common for believing the FBI is following them or that they're being poisoned delusions of reference are also common in schizophrenia where a person believes messages and meant for them for example believing a newsreader on TV is talking directly to them they can be delusions of control where a person believes that someone else is controlling their thoughts such as the FBI placing thoughts in their minds they can be delusions of grandeur meaning being a figure of great importance and delusions of erotomania meaning believing a person typically of higher status is in love with them another positive symptom is disorganized..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...today we're going to talk about pots and why it is becoming more common prevalent rights becoming more prevalent so we are seeing more pots aren't we're seeing more pots and I had noticed that we were seeing more pots we were giving more pots diagnosis pots postural orthostatic tachycardia syndrome we get a zillion people okay exaggeration we so many people that come in here with heart palpitations and I bend over and I get lightheaded and by the time people most people get here with those symptoms they've usually been evaluated for like trans ischemic attacks and and and pretty much give it a clean bill of and we see it a lot because we see we see a lot of thyroid problems that can heart palpitations we see a lot of stress responses that can cause tachycardia like issues like like more than that walks in the door but pots rear its ugly head in here every now and then and it's got a lot more unique to get some more unique features to it that it's diagnosis and dr. Gates is going to talk with you about that because spoiler alert the reason they were seeing it in a number of patients is that it's getting diagnosed more Amy's reason you're seeing it be diagnosed now you're seeing people will have it and so on and so forth it's being diagnosed more and I can totally understand that from the from what's actually causing pots and and and the fact that even though people have been..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...today we're going to talk about pots and why it is becoming more common prevalent rights becoming more prevalent so we are seeing more pots aren't we're seeing more pots and I had noticed that we were seeing more pots we were giving more pots diagnosis pots postural orthostatic tachycardia syndrome we get a zillion people okay exaggeration we so many people that come in here with heart palpitations and I bend over and I get lightheaded and by the time people most people get here with those symptoms they've usually been evaluated for like trans ischemic attacks and and and pretty much give it a clean bill of and we see it a lot ..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"All right so say keycap is a mnemonic to remember the DSM-5 criteria for depression or depressive disorder remember the patient needs to have five of the following symptoms within the same two-week period and these must include either a depressed mood or a loss of interest or pleasure is anhedonia the possible features RS4 sleep disturbances I for interest diminished also known as anhedonia G4 guilt and or for energy decreased so fatigue C stands for concentration problems and stands for appetite or weight changes which includes significant weight loss without dieting or weight gain P is for psychomotor agitation or retardation Foundation which is the slowing down of thoughts and movement and that's not just a subjective slowing down but it also something that's noticed by other people finally Suicidal Thoughts to reach a diagnosis of depression these symptoms must have a significant effect on everyday functioning and must not be the result of substance abuse or..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...Bulls could be often overlooking details or making careless mistakes difficulty maintaining focus on tasks or during a conversation even when there's no obvious others are failing to follow instructions complete tasks organize tasks losing items and forgetfulness females tend to display more symptoms of inattention and distractibility then hyperactivity and impulsivity the hyperactive-impulsive features include trouble sitting still fidgeting talking constantly including others or even being unable to wait turns such as Inner Line as patients get older the symptoms become less evident poor handwriting and dyslexia have also been found to be more prevalent in patients with ADHD additionally emotional dysregulation..." Learn more about your ad choices. Visit megaphone.fm/adchoices
"...obstructive sleep apnea is a breathing disorder characterized by recurrent episodes of Airway obstruction during sleep leading to periods with breathing stops known as apnea moving from wakefulness to sleep causes relaxation of muscle tone including the muscles of the upper Airway this allows the soft palate and the tongue to relax and to create an obstruction that reduces the patency of the respiratory tract rapid eye movement or REM sleep, in particular, is known to feature this reduction in muscle tone but it can happen throughout the Sleep Cycle there is snoring when some still enter but as the obstruction progresses the airflow can be severely reduced causing apnea the reduction in the ventilation of the lungs causes a reduction in blood oxygen levels and as a result there is an interruption in sleep known as neurological arousal with a partially awakens in order to restore muscle tone and therefore oxygenation but this isn't necessarily perceived by the person partial collapses with reduced oxygen or arousals a termed hypo apneas while apnea is defined as over a 90% airflow obstruction lasting 10 longer a cycle is there for generated alternating between periods of deeper sleep and higher wakefulness with a typical sleep cycle is which ultimately disrupts the quality of sleep and can cause sleep deprivation risk factors are thought to be obesity as it increases the amount of soft tissue around the airway..." Learn more about your ad choices. Visit megaphone.fm/adchoices
Comments (1)

ID26678854

Very good I enjoyed it

Sep 17th
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