Leduc Healthcare Consulting Group

Dr. Seuss's Guide to Shock

The fish looks pale, with a fin hanging low.
But four different reasons can make it look so.

Some tanks are too empty. Some water's misplaced.
Some pipes are all blocked. Some pumps can't keep pace.

STEMI vs NSTEMI/Unstable Angina.

🫀 Top Section – Clinical Features

It shows a man clutching his chest, representing acute coronary syndrome (ACS).
Typical symptoms listed are:
• Heavy, pressure-like chest pain
• Substernal pain radiating to left shoulder
• Nausea and vomiting
• Sweating (diaphoresis) and anxiety
• Dizziness, lightheadedness, or fainting
• Pain may improve with nitroglycerin

👉 ANSWER: https://manualofmedicine.com/spot-diagnosis/fever-rash-tongue-changes/
An 8 y/o girl with 7-day hx of fever, diffuse macular rash, conjunctival injection in both eyes, a few enlarged cervical lymph nodes, erythema of the palms and soles.
- What's the diagnosis ?

Human Glands, Quick Function Guide for Students

This visual guide summarizes the major human endocrine glands with one clear function each. Designed for quick revision, concept clarity, and exam recall. Useful for students, lab professionals, and anyone revising the endocrine system in a short time.

Wound Healing
Johns Hopkins Diabetes Guide

🟦 What is Wound Healing?
• Wound healing is a regulated biologic process of tissue regeneration
• Occurs in 3 phases:
Inflammation → Proliferation → Remodeling
• Requires coordinated activity of:
keratinocytes, fibroblasts, macrophages, platelets & endothelial cells
• Successful healing =
new epithelium + smaller wound + no drainage 

🟦 Why Diabetic Wounds Heal Poorly
• Impaired wound healing (IWH) is linked to:
• Hyperglycemia & advanced glycation end-products (AGEs)
• Reduced growth factor response
• Endothelial dysfunction & poor angiogenesis
• Diabetics have:
• Fewer endothelial progenitor cells (EPCs)
• Reduced keratinocyte & fibroblast migration
• Excess matrix metalloproteinases (MMPs) that degrade healing tissue 

🟦 The Diabetic Foot

A syndrome of multiple interacting problems:
• Neuropathy
• Ischemia
• Ulceration
• Infection
• Charcot foot
• Gangrene

➡ The Diabetic Foot Ulcer (DFU) is the most characteristic and dangerous lesion 

🟦Epidemiology & Risk Factors
• 81% of amputations follow failure of wound healing after ulcers
• Predisposing factors:
• Abnormal inflammatory response
• Peripheral neuropathy
• Ischemia
• Additional factors that delay healing:
• Diabetes, aging, obesity
• Malnutrition
• Smoking
• Renal disease
• Poor oxygen delivery 

🟦 Wound Assessment (PEDIS)

Every diabetic wound must be assessed for:

P – Perfusion
E – Extent (size)
D – Depth
I – Infection
S – Sensation

Also evaluate:
• Wound location, color, odor, temperature, pus
• Use sterile probe to detect:
• Sinus tracts
• Abscess
• Bone or tendon involvement
• Depth predicts outcome 

🟦 Infection Severity
• Uninfected wounds → often painless due to neuropathy
• Painful wounds → suggest ischemia or infection

Moderate infection signs
• Cellulitis >2 cm
• Abscess
• Gangrene
• Bone, joint or tendon involvement

Severe infection
• Fever, tachycardia, hypotension
• Confusion, vomiting
• Leukocytosis, acidosis
• Severe hyperglycemia or renal failure 

🟦 Core Principles of Treatment

Every diabetic wound requires:
1. Clean wound (saline or wound cleanser)
2. Sharp debridement
3. Appropriate dressing
4. Off-loading (total contact cast = gold standard)
5. Infection control
6. Glycemic & metabolic control
7. Revascularization if ischemic