Monthly Archives: January 2017

Neurocysticercosis

Thank you Dr. Rajat Suri for an excellent presentation on neurocysticercosis presenting with new onset seizure

Teaching Points

  • Initial treatment for seizure: IV lorazepam 0.1mg/kg –> IV fosphenytoin –> sedation/intubation
  • Neurocysticercosis  is caused by Taenia Solium
  • Spreads hematogenously to the brain, liver, muscle
  • Diagnosis: presentation+imaging.  serum testing not reliable
  • Treatment: dexamethasone, albendazole, anti-epileptic

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Acute Esophageal Variceal Bleed

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Thank you Dr. Kirollos Zaki for an excellent presentation on UGIB from esophageal varices

Teaching Points

  • Management of GI bleed
    • fluids, goal hg>7, plt >50, INR<1.5.
    • protonix drip if UGIB, add octreotide drip if concern for variceal bleed
  • Endoscopy
    • variceal ligation: using banding, goal is within 12 hours
    • sclerotherapy: usueally epi is used, similar results as ligation but high rebleeding risk
  • TIPS
    • Indications: active hemorrhage despite endoscopic treatment or recurrent bleed

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