…men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism. Alcohol dehydrogenase converts ethanol to acetaldehyde, which is subsequently converted…

…Heart failure, hypertension, diabetes and vascular disease. Age and sex category. Renal and hepatic function. Previous bleeding, bleeding predisposition, alcohol use and concomitant drugs that…

…alcohol and illicit substances weight, age, pregnancy and comorbidity renal and hepatic function regular medication and drug dependence epilepsy or previous seizures suicidal intent packaging…

…vital functions artificially until the substance undergoes renal elimination, hepatic elimination or is removed by means of dialysis. Substance Antidot e Paracetamol (Acetaminophen) N Acetylcysteine…

…with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the severity of withdrawal…

…Ischemic cardiomyopathy Alcoholic cardiomyopathy Diabetic cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced cardiomyopathy Non compaction cardiomyopathy Peripartum cardiomyopathy Cardiomyopathy secondary to valvular heart disease Long term prognosis…

…pattern Pattern Predominant Consider : : : Hepatocellular ALT and AST ↑↑, ALP normal Viral hepatitis, drugs, alcohol, autoimmune hepatitis, ischaemic hepatitis, steatohepatitis Cholestatic ALP and GGT ↑↑…

…administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below…

…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…

…or soft tissues over the puncture site — use another approach or refrain. Bacteraemia without suspicion of joint infection (relative; aspiration can seed a sterile joint)…

…Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial…

…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…

…24hrs) • Catapress TTS 3 (0.3 mg/24hrs) Dosage in renal failure and renal replacement therapy: Dose as in normal renal function Adverse effects Excessive…

…leeding history or predisposition L abile INR (International Normalized Ratio) E lderly (age 65 years) D rugs/alcohol concomitantly Each component is assigned 1 point…

…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…

…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…

Cardiology Clinical medicine Definition and Scope Primary prevention aims to prevent the clinical manifestation of cardiovascular disease (CVD) in individuals without established clinical CVD. It…

…left ventricular dysfunction, valve disease, coronary artery disease, cardiomyopathy, congestive heart failure, congenital heart disease, diabetes mellitus (both type 1 and type 2), obesity, smoking…

…tachycardia; e.g congestive heart failure, lung disease (e.g COPD), fever, infections, anemia, myocardial ischemia/infarction, pulmonary embolism, pheochromocytoma, hyperthyroidism, hypovolemia, pharmacological substances (alcohol…

…present, neurological examination, gait and truncal stability Acute balance syndrome Acute persistent unsteadiness or ataxia without clear spontaneous nystagmus Cerebellar or brainstem infarction, intoxication, Wernicke…

…easy to trust too much. Two errors make the reading useless without anyone noticing: the transducer is at the wrong height , and the system is…

…fields. Preparation and equipment Informed consent, current full blood count and coagulation screen, medication list. Chlorhexidine in alcohol, sterile gloves, fenestrated drape, sterile gauze. Local…

…the use of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts. The most common serious error is dilating a vessel that turns…

…pH and bicarbonate. An arterial blood gas is needed mainly when concomitant respiratory failure or an exact assessment of oxygenation requires it [3]. Calculation of…

…preparations. Contraindications Measure Contraindication : : Medicinal charcoal A reduced level of consciousness without a protected airway — a risk of aspiration Medicinal charcoal A corrosive substance (acid…

…history of gastrointestinal bleeding Refeeding syndrome There is a risk in starvation, alcoholism, anorexia nervosa, or more than 5 days without nutrition. Check the phosphate…

…Informed consent, coagulation status and an up to date medication list. A sterile fenestrated drape, chlorhexidine in alcohol, sterile gloves, a face mask. An atraumatic…

…Preparation and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL without adrenaline for the block (adrenaline is safe in fingers and…

…often lacks abdominal pain and peritonism and instead presents as encephalopathy, renal failure or simply deterioration. The procedure itself is straightforward: ultrasound to find the…

…and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation Strongly suggests a raised filling pressure Marked respiratory variation in…

Procedurer In acute circulatory failure it is not the number of cannulae that matters but the flow per unit time . A large bore, short cannula…

…aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure must be aspirated. Suspected empyema or complicated parapneumonic effusion…

…cutaneous vasculitis, lymphoma or granulomatous disease. A treatment resistant rash without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma…

…acting, not a depot preparation, and gives a shorter duration of effect. Lidocaine 10 mg/mL without adrenaline , 2–5 mL. Needles: 21–25 G…

…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…

…Concurrently, the atrial myocardium undergoes structural remodeling driven by aging, hypertension, heart failure, and the arrhythmia itself. This remodeling manifests as interstitial fibrosis, atrial dilation…

…conditions listed above. It is important that history taking and physical examination is carried out systematically and carefully without delaying time to treatment. History taking…

…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…

…also referred to as primary hypertension . Essential hypertension is defined as hypertension without an identifiable underlying cause. Researchers previously believed that this form of hypertension…