SA Medical - General Medicine And Imaging of Disease

The ELBOW 2 joints Humero-Ulnar - most important - takes priority in treatment Humero-Radial -  Traumatic Fractures of the distal humerus Dislocation and fracture dislocations of the elbow Fractures of the Olecranon Fractures of the radial head CHILDREN: CRITOE - Ossific centre and age of appearance CAPITELLUM - 2m-2yr HEAD OF THE RADIUS:  4yr INTERNAL - MEDIAL EPICONDYLE: 6yr TROCHEA: 8yr OLECRANON: 10yr EXTERNAL LATERAL EPICONDYLE: 12yr Deformities Cubitus valgus Cubitus varus Arthritis Pyogenic Arthritis Rheumatoid Arthritis Tuberculosis arthritis Osteoarthritis Haemophillic arthritis Neurophillic arthritis Mechanical Derangements Osteochondritis dissecans Loose bodies in the elbow Extra-articular disorders Tennis elbow Olecranon bursitis Ulnar neuritis

Surgical Anatomy of the Hand Neurovascular Exam of the Hand Functional Anatomy Congenital Deformities of the Hand Hand Infections The Shoulder and the elbow Shoulder pain can arise from Extrinsic  Intrinsic causes  Shoulder pain is explained by clinical exam and not CT Physiotherapy has a significant contribution to the management if shoulder pathology Shoulder disorders are causes by: Traumatic Fractures of the proximal humerus Children Epiphyseal injuries are common Considerable potential for modelling exists - therefore closed treatment may be sufficient. Consider surgery when:  the bony fragments threaten to puncture skin, or  irreducible, severe displacement Surgery Open reduction and internal fixation with Kirschner wires for fixation Adults (NEER Classification) Is the head of the humerus dislocated? Is the anatomical or surgical neck fractured? Have the soft tissue attachments - lesser and greater tuberosities been avulsed or broken off? Asses

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4 Signs of Sleep Deprivation in Teens Signs of insufficient sleep may include the following: Memory lapses and inattention Irritability, depressed mood, being overly emotional Falling asleep spontaneously during quiet times Needing catch-up slee on the weekends

PALLIATIVE MANAGEMENT OF OTHER SYMPTOMS IN HIV PATIENTS Page 6 ORAL PROBLEMS Oral Candida Oral Ulcers: Herpes simplex and Aphthous ulcers Oral Malignancies: Kaposi’s sarcoma and lymphoma Xerostomia (Dry mouth) Page 7 ORAL KAPOSI’S SARCOMA AND LYMPHOMA Management: • Surgery • Radiotherapy • Chemotherapy • Analgesia • Oral hygiene Page 8 XEROSTOMIA Management Attend to any reversible causes: drug side effects dehydration mouth breathing • Good oral hygiene improves comfort • Chewing stimulates production of saliva • Increase fluid intake where possible • Frequent sips of water and sucking ice chips • Saliva substitutes Page 9 OESOPHAGEAL SYMPTOMS Oesophageal candida Ulcers: Aphthous, herpes simplex and cytomegalovirus Malignancies: Kaposi’s sarcoma and lymphoma Management Treat specific infections (If painful swallowing + oral candida, treat empirically for oesophageal candidia) Antacids (used after meals) mucosal coating agents such as sucralfate Page 10 Often result of opioid medicatio