Lower Limb Amputation



1) Hemipelvectomy
     Also called hindquarter amputation, which involves the excision of part of the pelvic bone

2) Hip disarticulation 

    Which is the amputation of the limb at the hip level

3) Transfemoral amputation (Above Knee Amputation)


4) Knee disarticulation


5) Transtibial amputation (Below Knee Amputation) 


6) Syme amputation 

     Amputation at the level of the ankle joint, where the heel pad is preserved to provide 
     a platform for weight bearing

7) Amputation of the foot: 

    Amputation is performed at the mid-foot, it is called a Chopart 
    Amputation near the metatarsal is called a Lisfrance
    Amputation through the metatarsal bones is called a Transmetatarsal amputation
    Amputation of toe(s) plus part of metatarsal bone(s) is called Ray Amputation

8) Disarticulation of Toe(s)

Algorithm Management of Diabetic Foot Patient

* cut & paste from Malaysian Diabetic Foot CPG

Types of Brian Herniation


Supratentorial herniation

1-Uncal 
2-Central (transtentorial) 
3-Cingulate (subfalcine) 
4 Transcalvarial 

Infratentorial herniation

5-Upward (upward cerebellar or upward transtentorial) 
6 Tonsillar (downward cerebellar)


Proper X-Ray of Fractured Bone Must Have?

* Rules of 2

1) 2 View --> AP & Lateral View
2) 2 Joints --> prox & distal
3) 2 Limbs --> in children particularly
4) 2 Injuries --> exclude injuries elsewhere
5) 2 Occasion --> repeat 1/ 2 weeks later

Obstetric Ultrasound

1st Trimester (10-14 weeks)
-          Viability
-          Dating scan (CRL)/ REDD (if diff > 7)
-          Gross anatomy – anencephaly, cystic hygroma, bladder outflow obstruction
-          Multiple pregnancy – chorionicity, amnionicity

2nd Trimester (18-24 weeks)
-          Dating Scan (Biparietal diameter/ Head circumference)/ REDD (if diff >14)
-          Structural anatomy – brain, face, heart, kidneys, abdomen, spine, hands, feet, genitalia, bladder
-          Fetal growth – IUGR/PE/Oligo
-          Fetal Sex – 99% accuracy
-          Placental site – recheck @ 34 weeks

3rd Trimester
-          EFW: FL, AC, BPD
-          Fetal Progression, well being, presenting part
-          Placenta Location (> 28 weeks) 

List Of Medical Problems in Preterm Baby

1) BRAIN
    - Interventricular Hemorrhage


2) EYE
    - Retinopathy of Prematurity

3) RESPI
    - ARDS
    - Pneumothorax
    - Bronchopulmonary Dysplasia

4) CVS
    - PDA

5) GIT
    - GERD
    - Jaundice

6) METABOLIC
    - Hypoglycemia
    - Hypothermia
    - Hypocalcemia
    - Malnutrition --> Need more
    - Anemia



7) IMMUNOSUPRESSED
    - Risk of Infection

HyperKalemia VS HypoKalemia

* Normal Serum  K: 3.5 - 5.0 mmol/L 

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This is all a collection of what I have learnt during my medical student years, most of them are already a simplified version, very clinical, and comes from what my Lecturer had thought.... I love to make notes in my own way, so that I can have a better understanding on what I have seen.... I hope, this will benefit all people, especially medical students... so that you will get this right... but just bear in mind... I'm a human too... so, mistakes is still in my dictionary of life.... so, please correct me if I'm wrong... Really2x appreciate that....

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Just a simple guy with a lot of things going on his mind... love to please others and help others who in need... Hoping that every nice moment in his life could be shared with others as well...(coz it's not much)