…a large change in TSH. During acute illness the TSH can be falsely low or high in the absence of thyroid disease; repeat it once…

…There are in practice no absolute contraindications; suspected spontaneous bacterial peritonitis carries more weight than a deranged coagulation profile . Avoid or modify in: Situation Management…

…Hypocalcaemia , symptomatic. Alkalosis increases the binding of calcium to albumin and lowers ionised calcium further; risk of tetany and seizures. Anuria or established renal failure…

…Notably, 31.2% of patients discharged with intact neurological function were observed to lack a pupillary reflex upon their initial presentation. An absent pupillary reflex…

…same actions (1 through 3) can be carried out by anyone, including laymen without prior training in cardiopulmonary resuscitation (CPR). Prompt delivery of chest compressions…

…traumatic aortic injury. In classic dissection, an intimal tear permits blood to enter the diseased aortic media. Blood then propagates along the wall, creating a…

…reperfusion therapy. This approach fails to identify a substantial proportion of patients with acute coronary occlusion (ACO) who present without diagnostic ST elevation, often resulting…

…is needed for the test to be conclusive. For assessment of function and prognosis, arrhythmia evaluation, known coronary artery disease and evaluation of treatment effect…

…2,3]. Respiratory complications occur, but untreated convulsive status itself carries a considerable risk of hypoxia and respiratory failure. In placebo controlled trials, respiratory depression…

…permanent part of the programme and is widely used — a woman who does not attend for a gynaecological examination, or who prefers to take the…

Myocardial ischemia and infarction Definition and Pathophysiology Left main coronary artery disease (LMCAD) refers to atherosclerotic narrowing of the left main coronary artery, which supplies…

…coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb threat

…whereas heterozygous carriers of an X linked condition may develop a phenotype later and require delayed or individualized assessment. Disease specific genetic architecture HCM is…

…non HDL C primarily reflect cholesterol content. The amount of cholesterol carried by individual particles varies according to particle size and composition. As a result…

…epilepticus should raise strong suspicion of another or an additional cause [1]. Delirium tremens most often begins after one to three days but can start…

…element The diagnosis and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury…

…chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: Ischemic heart disease : stable angina pectoris…

…to treat heart failure, they were met with skepticism. Their landmark studies proved that beta blockers prolong life, alleviate symptoms and reduce the risk of…

…to treat heart failure, they were met with skepticism. Their landmark studies proved that beta blockers prolong life, alleviate symptoms and reduce the risk of…

…Note that 10% of wide complex tachycardias actually originate from the atria but the QRS complexes become wide due to abnormal ventricular depolarization (e.g…

…Expand it with 5–10 mL of saline through an intravenous cannula. 4. Tape the drawstring to a gauze pad against the cheek so that…

…total of 4 6 mEq/L in 24 hours may be targeted. Chronic Hyponatremia ( 48 hours duration): Due to cellular adaptations, rapid correction carries the…

…history of high Lp(a); individuals with cardiovascular disease that is not explained by major conventional risk factors; patients at moderate risk or close to…

…before starting treatment. Clinical assessment History that affects the level of risk Ask briefly and to the point: When did the deterioration begin, suddenly or…

…scar tissue, a tattoo or skin disease at the injection site. Known hypersensitivity to the preparation. Intramuscular injection in marked coagulopathy or thrombocytopenia (< 50…

…vasopressor to maintain a MAP of at least 65 mmHg and at the same time has a lactate above 2 mmol/L. This combination carries…

…may indicate underlying arrhythmias. Age : Younger patients are generally at higher risk of SCD due to the progressive nature of HCM. By combining these factors…

…High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease…

…of LDL C reduction. Thus, even a modest absolute reduction may be clinically important in individuals at high or very high risk. Prolonged exposure to…

…ACC) discourage the use of exercise stress testing for the evaluation of coronary artery disease, which is due to the low sensitivity of the method …

…sensitive to a rapid increase in extracellular tonicity. This explains why acute hyponatraemia chiefly carries a risk of cerebral oedema, while rapid correction of chronic…

…accounts for a minority of cases Hypoactive Lethargy, slow responses, reduced speech, immobility, poor food intake, reduced eye contact Common and particularly easy to miss…