I still remembered during my 2nd year as medical student that one of my lecturer who was an Anaesthesiologist(Dr. Murthy) who took us for Respiratory system showed us one case in Sarawak General Hospital.
His words : Look at this patient and remember this forever because you may not see it for a long time to come
He performed the Pemberton sign by asking the patient to lift his arms and immediately, the patient's face became plethoric and his voice became rather hoarse that he had to immediately put down his arms.
You may be asked to examine the respiratory system and you'll find
1) Dilated veins over the chest
2) Plethoric face, occasionally with congested eyes
3) Non-pulsatile raised JVP
4)Pemberton sign positive (you may not want to perform this but offer to the examiner because you may distress the patient which will then cause you to fail)
5) Talk to the patient to notice the hoarseness of voice
You are also expected to find the cause for this which almost always caused by lymph node compression due to malignancy.
The above patient has Non-Hodgkin's lymphoma with SVC obstruction and is in respiratory distress.
1 comment:
hello, so u r unimas graduate?
nice blog u have!
Post a Comment