…biliary cholangitis, drugs Mixed Both raised Drug induced liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The…

…saturation, chest movement and a blood gas. Ventilate by mask in opioid induced respiratory depression while naloxone is prepared C Pulse, blood pressure, peripheral perfusion…

…Constipation Contra indications Bradycardia. Caution • Clonidine may induce severe hypotension. • Clonidine is not recommended in most patients with severe cardiovascular disease or in those who…

…myocarditis, sarcoidosis, rheumatic heart disease, connective tissue disease, eosinophilic myocarditis), toxins (alcohol, cocaine, cancer therapies), or physical reactions (radiation therapy), frequently involves the conduction system…

…mastering the nuances of anticoagulation requires an intimate understanding of the underlying pathophysiology, which is classically framed by Virchow’s triad: blood stasis, endothelial dysfunction…

…hanging or strangulation. Drug overdose Intentional or accidental overdose of medications, drugs or other substances (including alcohol) causing cardiac arrest. Table 1. Classification of causes…

…a sustained release formulation. Note: activated charcoal is ineffective against alcohols, lithium, and heavy metals. Enhance elimination Induce diuresis through urine alkalinization, contingent upon renal…

…times given are approximate. Symptoms can begin before the blood alcohol concentration has reached zero, and several syndromes can overlap [1,4]. Time after a…

Cardiology Clinical medicine Definition and scope Alcohol has dose , pattern , duration , sex , and genetically influenced effects on the cardiovascular system. Acute exposure produces transient haemodynamic…

…8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in…

…blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with the needle stings. Needles of…

…Preparation and equipment Chlorhexidine in alcohol 5 mg/mL: clean with 3–4 swabs in wide circles and let it dry for a couple of…

…Alcohol consumption may increase the risk of gastrointestinal bleeding. Serious skin reactions (e.g., Stevens Johnson syndrome, toxic epidermal necrolysis, DRESS syndrome) have been rarely…

…age 65, and concomitant drug/alcohol use. Some studies suggest HAS BLED has comparable or slightly superior predictive capability for major bleeding compared to ATRIA…

…liver function S troke B leeding history or predisposition L abile INR (International Normalized Ratio) E lderly (age 65 years) D rugs/alcohol concomitantly Each…

…Recognised causes include: Diabetes and insulin resistance Thyroid disease Kidney disease Excessive alcohol consumption Diets high in carbohydrate or fat Glucocorticoids Beta blockers Oestrogen therapy…

…status, body weight, smoking, diet, physical inactivity, and alcohol consumption. Additional considerations include psychosocial stress, obstructive sleep apnoea, social determinants of health, air pollution, family…

…with AF. Stroke risk is heterogeneous and is determined principally by the patient’s underlying clinical risk factors rather than by the AF pattern. Important…

…atrial flutter, AVNRT and AVRT (pre excitation, WPW syndrome) being the most common. Atrial fibrillation with onset during hyperthyroidism (thyrotoxicosis), alcohol overdose, thoracic surgery, acute…

…anemia, myocardial ischemia/infarction, pulmonary embolism, pheochromocytoma, hyperthyroidism, hypovolemia, pharmacological substances (alcohol, amphetamine, coffee, anticholinergic drugs, beta adrenergic agonists). In all of these conditions, sinus…

…infarction, intoxication, Wernicke's encephalopathy, other central disease Neurological examination, gait and truncal stability, often MRI Episodic triggered vestibular syndrome Brief attacks, usually lasting seconds…

…Insufficient collateral circulation to the hand. Vascular disease in the limb: marked peripheral arterial disease, Raynaud's phenomenon, thromboangiitis obliterans. An arm with an AV…

…one or more cell lines. Suspected acute leukaemia, myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma. Suspected bone marrow metastasis…

…make sure that never happens, and to make sure the catheter does not become the patient's next focus of infection. Indications Infusion of vesicant…

…The condition occurs above all in: treatment with SGLT2 inhibitors pregnancy prolonged fasting or a very low carbohydrate intake excessive alcohol consumption vomiting or othe

…neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome, autoimmune encephalitis. Meningeal carcinomatosis and CNS involvement in haematological malignancy. Investigation…

…melanoma (a pigmented longitudinal nail band that is widening, with pigment in the cuticle — Hutchinson's sign). An open fracture of the distal phalanx with…

…insertion site Change the puncture site Preparation and equipment Ultrasound with a curved array probe. Sterile preparation (chlorhexidine in alcohol 5 mg/mL), sterile gloves…

…is a clinical diagnosis supported by echocardiography: Finding Comment : : Hypotension, distended neck veins, muffled heart sounds Beck's triad; complete in a minority Tachycardia, tachypnoea…

…reaches the patient. Preparation and equipment Cannulae in several sizes, a tourniquet, chlorhexidine in alcohol 5 mg/mL, gauze, a transparent dressing, an extension set…

…cap, mask, fenestrated drape. Chlorhexidine in alcohol 5 mg/mL. Local anaesthesia: lidocaine 10 mg/mL, 10–20 mL, a 25 G needle for the…

…from a fresh blister (routine), one from perilesional skin (immunofluorescence) The immunofluorescence biopsy goes into Michel's medium, not formalin Suspected vasculitis 4 mm punch…

…origin Avoid the ulnar nerve Carpal tunnel syndrome The carpal tunnel An acceptable bridge to surgery De Quervain's tenosynovitis The first dorsal compartment A…

…through a 20 mL syringe and a large bore needle. Chlorhexidine in alcohol to the skin around the wound — not into the wound. Sterile gloves…

…Psychosocial stress. Alcohol abuse. Physical inactivity. Unhealthy diet. Cerebral / peripheral vascular disease. Cancer. Acute coronary syndromes cause symptoms already at rest. Stable ischemic heart disease…

…et al ). Blood pressure is positively correlated with societal economic development, age, alcohol intake, body weight, male sex and salt intake. Population blood pressure increases…

…salts Iron, lithium, potassium, lead, mercury Alcohols and glycols Ethanol, methanol, isopropanol, ethylene glycol Corrosive substances Strong acids and alkalis Petroleum products Lamp oil, petrol…