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Offlinemorrowasted
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Morrow teaches medicine: Basic lessons in medicine to empower yourself * 8
    #26672353 - 05/15/20 10:06 AM (3 years, 8 months ago)

I need to find a more creative way to use my free time so if this is popular I will write a series of similar lessons.

https://medium.com/@w6152238/basic-medicine-shock-b4c25df75d5c

#1 Basic Medicine: Shock

Quote:

Key Terms:
Perfusion: The extent of oxygen and nutrient delivery to tissues
Syndrome: A set of signs and symptoms
Edema: accumulation of fluids outside of the blood vessels

If you’ve ever watched a medical drama, you’ve probably heard them say “the patient is going into shock”. The purpose of this article is to explain what exactly shock is in the briefest but most informative way possible.

Shock is defined as “a syndrome characterized by decreased tissue perfusion and impaired cellular metabolism”. Basically, the cells in your body are not receiving enough oxygen to create energy in the way that they typically do, using what is called aerobic metabolism. When there is insufficient oxygen to perform aerobic metabolism, cells switch to a form of energy generation called anaerobic metabolism. This enables the cell to continue functioning for a time, but the byproducts of this kind of metabolism are acidic. Over time, the blood becomes increasing acidic, which can lead to death.

There are many different reasons that shock can occur, but they fall into three broad categories: cardiogenic shock, hypovolemic shock, and distributive shock. What is common to all forms of shock is that insufficient levels of oxygenated blood are reaching the various organs/tissues.
In cardiogenic shock, the reason is that the heart is not pumping enough blood to the other organs. The most well-known cause of cardiogenic shock is a heart attack. Heart failure is a condition where the heart muscle cannot effectively pump blood throughout the body. Severe forms of heart failure also lead to cardiogenic shock.

Hypo- means low, and volemia means level of fluid in the blood vessels; therefore hypovolemic shock means that insufficient levels of oxygenated blood are reaching tissues because there simply isn’t enough fluid in the blood. With low fluid levels, the pressure against the capillary wall drops, and the fluid doesn’t cross the membrane. The most obvious causes of hypovolemic shock are extensive bleeding and dehydration, but it can also be caused by conditions where fluid leaks into various body cavities.

Distributive shock can be divided into three subtypes: Neurogenic, anaphylactic, and septic. Neurogenic shock is caused by spinal cord injuries and spinal anesthesia. Anaphylactic shock is a type of widespread, life-threatening allergic reaction. Septic shock is caused by the presence of microorganisms in the body that cause the immune system to release massive amounts of inflammatory chemicals throughout the circulation. In all three cases, the blood vessels dilate, blood pressure drops, and tissue perfusion goes down.

Shock takes place in stages. In the initial stage, cells switch to anaerobic metabolism. In the compensatory stage, the heart rate increases to compensate for the reduced level of O2 in the blood, and the blood vessels in the vital organs constrict, which shifts the balance of tissue perfusion in their favor. Blood is first shunted away from the skin, then the GI tract, then the kidneys and liver. In the progressive stage, these compensatory mechanisms start to fail. The amount blood the heart can pump decreases, and blood pressure begins to fall. Sustained inflammation of the blood vessels allows fluid to leak out, causing edema. This is especially problematic in the lungs, and the first signs of progressive shock are usually observed as respiratory distress due to the accumulation of fluid therein. Lack of oxygen to the GI tract leads to widespread bleeding and ulceration, which can worsen shock by causing anemia and hypovolemia. The kidneys begin to fail, which leads to the accumulation of minerals like potassium that can cause heart attacks in high levels. The liver begins to fail, leading to jaundice and the creation of blood clots within the blood vessels. This set of conditions is called Multi-System Organ Failure. Finally, in the refractory stage, perfusion of the brain cannot be maintained, and recovery is unlikely.

Treatment of shock depends on the cause. A universal treatment for shock is supplemental oxygen. Fluid is given by IV to treat increase blood pressure with most kinds of shock. Red blood cells are also commonly given to improve oxygen delivery. Proteins like albumin are used to pull fluids out of the capillary beds and back into the veins. Drugs to constrict the blood vessels are given when blood pressure drops. Drugs that dilate the arteries of the heart are given for cardiogenic shock. Antibiotics, antivirals, and antifungals are given for septic shock.




Edit: Forgot to mention that epinephrine is used to treat anaphylactic shock.


Edited by morrowasted (05/15/20 10:19 AM)


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Offlinemorrowasted
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: morrowasted] * 1
    #26672367 - 05/15/20 10:12 AM (3 years, 8 months ago)

.
What would you like to learn about next?
You may choose only one


Votes accepted from (05/15/20 10:12 AM) to (No end specified)
View the results of this poll



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InvisibleTantrika
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: morrowasted] * 1
    #26672376 - 05/15/20 10:16 AM (3 years, 8 months ago)

voted common blood laboratory testing, due to going through so much of it myself but not knowing what goes on after the blood gets into the tubes

:threadmonitor:


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OfflineLogicaL ChaosM
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: morrowasted]
    #26672400 - 05/15/20 10:32 AM (3 years, 8 months ago)

This is so cool! Like free school! :popcorn: I voted intracranial pressure cause I like Psychology and brain-related stuff.


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Offlinegopher
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: LogicaL Chaos] * 1
    #26672483 - 05/15/20 11:28 AM (3 years, 8 months ago)

I want to learn about fasting and taking cold showers


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InvisibleONE OZ SLUG
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: gopher] * 5
    #26672693 - 05/15/20 01:43 PM (3 years, 8 months ago)

Quote:

gopher said:
I want to learn about fisting and taking gold showers




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InvisibleAsante
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: ONE OZ SLUG] * 3
    #26672712 - 05/15/20 01:55 PM (3 years, 8 months ago)

Morrowasted, please make a series out of this.


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Offlinetosatori
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: Asante]
    #26672813 - 05/15/20 02:56 PM (3 years, 8 months ago)

Bump


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InvisibleCrazy_Horse
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: morrowasted]
    #26673022 - 05/15/20 04:39 PM (3 years, 8 months ago)

Why do I have occasional hypercalcemia?


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:cliffroll:

RXB


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InvisibleAsante
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: Crazy_Horse]
    #26673049 - 05/15/20 04:47 PM (3 years, 8 months ago)

Morrowasted, I as you know am obese.

If I eat 125 grams of sugar (I stopped doing that) I hold over a liter of water for several days.

Is this due to excess glycogen production, necessitating water to bind it?

Common sense would dictate conversion to fat and storage thereof, but that does not account for the bloating effect.

Glycogen?


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InvisibleCrazy_Horse
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: Asante] * 1
    #26673088 - 05/15/20 05:05 PM (3 years, 8 months ago)

Quote:

Water retention or edema occurs when excess water builds up in our body’s circulatory system, tissues, or body cavities. Often this extra water is due to allergies, food intolerances, a lack of protein in your diet, vitamin deficiencies, or the biggest culprit – your menstrual cycle.




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Offlinemorrowasted
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: tosatori] * 2
    #26673104 - 05/15/20 05:11 PM (3 years, 8 months ago)

Basic Medicine: Common Labs Part one — CBC

https://medium.com/@w6152238/basic-medicine-common-labs-part-one-cbc-93161431be93
Quote:

Key terms:
thromboctye — Cells involved in blood clotting
penia — A suffix indicating a low level of some constituent of the blood
-emia- a suffix meaning “blood”; hence “anemia” means “no” blood, “bacteremia” means bacterial in the blood

Everyone is familiar with having their blood drawn at the clinic. Generally you get a phone call a week later with someone telling you someone either is or isn’t abnormal. The purpose of this article is to explain commonly performed labs in a way that is easy to understand. Some of the figures that represent a normal count (reference values) may vary according to the laboratory procedure, so this article will simply refer to low and elevated counts without using reference values.

The complete blood count (CBC) is an extremely common test that measures 6 values: White blood cells (WBCs), Red blood cells (RBCs), Hemoglobin, hematocrit (commonly called H&H), platelets, and mean corpuscular volume (MCV).

Elevated or low white blood cells are typically indicative of infection. Elevated WBCs are also present in leukemia. Low WBCs are seen with the use of certain medications and diseases of the bone marrow, such as aplastic anemia.

Hematocrit is a measure of the percentage of RBCs in the total volume of fluid in the blood. Hemoglobin is a measure of the specific oxygen carrying chemical in blood. MCV is a measure of the mean size of the RBC. RBC count, H&H, and MCV together provide information useful for differentiating between causes of blood disorders. A low level of all values indicates bone marrow disease. A normal RBC and H&H with an elevated MCV indicates a condition called megaloblastic anemia, which is caused by deficiency of vitamins B9 and B12.
Reduced RBCs and hemoglobin may reflect many disease processes. The most obvious ones are massive bleeding and inherited anemia in which blood cells are misshaped or destroyed too quickly. Iron deficiency can also caused reduced RBCs. Kidney disease, either acute or chronic, can also cause anemia because the kidneys are responsible for releasing a hormone called erythropoietin that signals the bone marrow to create new RBCs. An increased RBC and H&H are referred to as polycythemia, and they are generally the result of chronically low blood oxygen levels causing the body to produce more RBCs in an attempt to compensate.

Platelets are chemicals that help the blood clot correctly. When there aren’t enough platelets in the blood (a condition called thrombocytopenia), the patient is at risk of bleeding. Low platelet levels can be caused by many conditions, such as leukemia, hepatitis, chirrosis, and with the use of chemotherapy medications.

Anemia is treated in a variety of ways. The treatment may be as simple as iron or B vitamin supplementation, or may require regular blood transfusions or self-administration of the hormone erythropoeitin. People with low WBCs should be very cautious to avoid getting infections.




Edited by morrowasted (05/15/20 05:27 PM)


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Offlinemorrowasted
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: Asante] * 1
    #26673142 - 05/15/20 05:24 PM (3 years, 8 months ago)

Quote:

Asante said:
Morrowasted, I as you know am obese.

If I eat 125 grams of sugar (I stopped doing that) I hold over a liter of water for several days.

Is this due to excess glycogen production, necessitating water to bind it?

Common sense would dictate conversion to fat and storage thereof, but that does not account for the bloating effect.

Glycogen?



I don't know the answer to your question, but I will speculate.  One liter of fluid weighs 2lbs. What I can tell you for sure is that weigh gain of 2lbs in one day generally indicates congestive heart failure. Weight gain of 5lbs in 2 days is something we are require to report to the doctor because it almost always means congestive heart failure is worsening. Generally, people will excrete what they drink. In some people, the heart doesn't pump effectively enough to move fluid out of the veins into the right atrium. When those people consume fluids too quickly, they develop HYPERvolemia, and then edema, as the fluid pools in the capillary beds and spaces between the cells.

In the hospital, we will generally give a diuretic like furosemide to pull the fluids.

The typical capacity of the kidneys to process glucose is 180 grams per day. With Chronic Kidney Disease, the rate of filtration is reduced. The increased blood glucose will increase the osmolality of the fluid in the blood vessels. Thus, since the glucose isn't passing through the kidneys, it's remaining in the blood vessels.

The space in which it accumulates will increase the workload of the left ventricle and cause it to grow over time (if I could listen your chest I could tell you whether it's grown or not). The difference between the pressure in the arteries and the pressure in the veins will cause edema and weight gain.

Eventually that glucose gets processed out and the fluid follows it.

Just a guess. Stay healthy, friend.


Edited by morrowasted (05/15/20 05:31 PM)


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Offlinemorrowasted
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: Crazy_Horse]
    #26673159 - 05/15/20 05:30 PM (3 years, 8 months ago)

Quote:

Crazy_Horse said:
Why do I have occasional hypercalcemia?



Hah, I couldn't tell ya. You could be getting too much vitamin D without enough vitamin k2. You could have a little tumor on your parathyroid glands.


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InvisibleCrazy_Horse
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: morrowasted]
    #26674324 - 05/16/20 07:37 AM (3 years, 8 months ago)

I get a routine blood test and its hypercalcemic, then the doc retests and its normal. Happened a few times.
I was thinking it could be dehydration. My doc wants me to go to a specialist if it continues.


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Offlinemorrowasted
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: Crazy_Horse]
    #26674367 - 05/16/20 08:17 AM (3 years, 8 months ago)

So it's not unusual for blood electrolytes to fall slightly outside of normal ranges. The only one that is of immediate concern if it is even slightly out of range is potassium. If the elevated calcium were high enough to be of immediate concern your doc would have ordered rule out tests immediately. The fact that they are taking a "watch and wait" approach basically means the level wasn't so far out of range that the doctor is worried about catching a lawsuit for not giving you a referral. It's financially unreasonable for every single person with slightly abnormal labs to see a specialist and receive additional diagnostics, it's just too common.

You could try to schedule an appointment independently with an endocrinologist. Not sure how your insurance works.


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Offlinemorrowasted
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: morrowasted]
    #26676405 - 05/17/20 07:32 AM (3 years, 8 months ago)

which labs next?
Next topic
You may choose only one


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View the results of this poll



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Offlinegopher
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: morrowasted]
    #26676464 - 05/17/20 08:30 AM (3 years, 8 months ago)

when you do metobolic panel, include wether you think C reactive protein is a usefull marker or you think its bunk, Ive seen people argue both sides


--------------------
For most of the normies out there, an operating system is just a bootloader for Google Chrome.

Since Disney has obtained tremendous value from the public domain, knows how important the public domain is, and is firmly determined to never contribute anything to it.

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InvisibleGrateful Dead
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: gopher]
    #26676495 - 05/17/20 08:53 AM (3 years, 8 months ago)

:threadmonitor:

Also, if I recall about C reactive protein levels, it's a well known marker of inflammation and is sensitive but not specific to any one disease.

Correct me if I'm wrong.


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OfflinePsion
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Re: Morrow teaches medicine: Basic lessons in medicine to empower yourself [Re: Grateful Dead]
    #26678092 - 05/18/20 02:53 AM (3 years, 8 months ago)

i saw this thread title and thought it meant "morrowwind teaching medicine" as in how to mix things like fly agaric and other random deadly ingredients on your lawn to make potions to empower your self. :rofl:


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