Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…

…conditions characterized by a recent change in symptoms or signs, with or without electrocardiographic changes, and with or without acute elevations in cardiac troponin concentrations…

…shortening (FS) is calculated by measuring the percentage change in left ventricular diameter during systole. It is measured in parasternal long axis view (PLAX) using…

…just proximal to the orifice. The change in flow profile results in the formation of a hemisphere with several layers. Flow velocity is equal within…

…subacute worsening of dyspnoea, cough and sputum in particular that exceeds the patient's normal variation and requires a change of treatment. Common precipitants are…

…attacks of vertigo, seconds to a minute or so, that are provoked by a change of position — turning over in bed, lying down, standing up…

…if in doubt Cellulitis over the insertion site Change the puncture site Preparation and equipment Ultrasound with a curved array probe. Sterile preparation (chlorhexidine in…

…not met with statins alone. PCSK9 Inhibitors: Added in cases where LDL C remains above the goal despite statin and ezetimibe therapy. Goal: Achieve LDL…

…cm 1.5–2.1 2.2–2.5 2.6–2.9 3.0 RV SIZE AND FUNCTION (MEASURED IN A4C) RV diastolic area…

…patients with recent changes in symptoms or clinical signs, with or without diagnostic electrocardiographic abnormalities and with or without an acute rise in cardiac troponin…

…temporal pattern. Change in frequency, severity, or exercise threshold. Potential anginal equivalents include: Dyspnoea on exertion. Fatigue. Dizziness during exertion. Discomfort in the arm, jaw…

…myocardial injury, demonstrated by a rising and/or falling troponin pattern with at least one value above the assay specific 99th percentile upper reference limit;…

…must be incorporated. In symptomatic individuals without known CAD, newer clinical prediction algorithms are preferred over older approaches based solely on age, sex and typicality…

…conducted with right bundle branch block morphology. This is an example of how changes in the length of the cardiac cycle causes aberration. Figure 1…

…reflector is in motion, however, then the frequency of the reflected sound waves will differ from the emitted sound waves. The change in frequency is…

…bacteria. Endocarditis can lead to the destruction of the valvular apparatus, as well as to embolization in the systemic circulation. The complications can be fatal…

…branch blocks and alter their appearance. Some patients develop nonspecific intraventricular conduction defects without any change in their QRS appearance. Such conduction delays may be…

…9. Request ultrasound of the kidneys and urinary tract when a postrenal cause cannot confidently be excluded. 10. Contact nephrology early in severe, progressive or…

…vestibular syndrome Brief attacks, usually lasting seconds, reproducibly triggered by a particular change in position Benign positional vertigo, orthostatic hypotension Dix Hallpike, supine roll test…

…two adequate intramuscular doses of adrenaline and initial fluid treatment Adrenaline infusion and advanced resuscitation in a monitored setting The grade can change within minutes…

Klinisk kemi & laboratoriemedicin Akutsjukvård Lathundar Basic principle Interpret the blood gas in the same order every time. Skipping a step is a common reason why…

…previous punctures: change side, and avoid irradiated fields. Preparation and equipment Informed consent, current full blood count and coagulation screen, medication list. Chlorhexidine in alcohol…

…a small change in T4 produces a large change in TSH. During acute illness the TSH can be falsely low or high in the absence…

…Statements made verbally to the next of kin. Since the change in the law in 2022, the next of kin no longer have a right…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

…not routinely marketed in Sweden and may require a named patient licence, among them clevidipine, nicardipine, fenoldopam, enalaprilat, phentolamine and sodium nitroprusside. Availability may change…

…crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure…

…corticosteroid is tapered. The dose must come down in parallel, otherwise hypoglycaemia will follow. Discharge without a plan. Document what has been changed, who is…

…or nerves, and the landmark — the posterior corner of the acromion — is easy to palpate even in a large patient. The anterior approach, just lateral…

…otoscopy: a slight change of pressure with the bulb shows whether the tympanic membrane is mobile — an immobile membrane suggests fluid in the middle ear…

…anaesthesia. Bladder washout and continuous irrigation in macroscopic haematuria with clots (a three way catheter). Instillation therapy and contrast studies of the urinary tract. Wound…

…dose change can reach the patient the same day the result arrives. 3. Reduce to 5 mg (two tablets) on days 1 and 2 in…

…de Pointes severe ziprasidone mesylate ZIPRASIDONE MESYLATE ZIPRASIDONE MESYLATE Arrhythmia wp less change in QTc from baseline mild PENICILLIN G PROCAINE PENICILLIN G PROCAINE PENICILLIN…

…and hemodynamic instability. Evaluation and physical examination The objective of decongestion is clinical euvolemia rather than an isolated numerical change in weight. Assessment should integrate…

…suppression is maintained. A change in antiretroviral therapy is not recommended in individuals with previous virological failure if it risks loss of suppression. Clinical presentation…

…more events than a major reduction in risk among a small number of high risk individuals. This principle underlies the population approach to cardiovascular prevention…

…cardiogenic shock. UA itself is defined by a recent change in the pattern of myocardial ischaemia rather than by a particular symptom intensity alone. The…

…independent risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk…

…gradient. Pathophysiology of aortic stenosis As aortic stenosis progresses, pressure conditions on the left side change dramatically, including in the left ventricle, left atrium, aorta…

…function. EAT = v max /time Fractional shortening (FS) Fractional shortening (FS) is calculated by measuring the change (% reduction) in left ventricular diameter during systole…

…ECG changes were previously referred to as strain pattern because it was believed that they indicated left ventricular exhaustion. However, this term is not in…

…the motion and deformation (change in shape) of the myocardium during systole and diastole. Deformation imaging has been implemented in clinical practice and is now…

…prolonged. Arrhythmia Flecainide may induce Brugada syndrome in individuals with underlying genetic susceptibility. If ECG changes consistent with Brugada syndrome develop during treatment with flecainide…

…V6, aVL, I). ECG in moderate hyperkalaemia Previously mentioned ECG changes becomes more pronounced. P waves become wider. P wave amplitude decreases. The P wave…

…of the ECG changes or arrhythmias are unique to digoxin. One should always suspect digoxin as the trigger of an arrhythmia (in patients using digoxin…

…be increased in order to suggest ischemia. Inverted U waves are even more typical of ischemia (but the sensitivity is low). U wave changes always…

…of the ECG – from heart rhythm to QTc interval – the most prominent and reliable ECG changes occur in the ST segment and the T wave…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

Referensvärden A child's ECG changes continuously with age: the heart rate, the electrical axis and the waveform in the newborn differ markedly from adult…

ECG Myocardial ischemia and infarction T wave changes in acute myocardial infarction & ischemia A thorough discussion regarding the physiology of the T wavewas previously provided…

…myocarditis and perimyocarditis: ECG changes and clinical features The pericardium is a double walled sac in which the heart and the roots of the great…

Njurmedicin Akutsjukvård Lathundar Emergency management in brief The intensity of treatment is governed by ECG changes, symptoms, the rate of rise, renal function and the…

…types of cardiomyopathies Cardiomyopathy implies that the myocardium is structurally and functionally altered, and the pathological changes are not explained by coronary heart disease, hypertension…

…the most common causes. ECG changes in right ventricular hypertrophy V1 and V2 shows larger R waves and smaller S waves. The R wave may…

…in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes…

ECG Exercise stress test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually…

…Meanwhile, deoxygenated blood in the superior vena cava (which returns blood from the head and upper limbs) also enters the right atrium. Oxygenated and deoxygenated…

…ST segment elevation in the standard 12 lead ECG. Instead, the infarct related electrical changes may be recorded indirectly as reciprocal abnormalities in the anterior…

…cardiac output . Systolic blood pressure increases when cardiac output increases. Diastolic blood pressure is not affected by changes in cardiac output. Hence, diastolic blood pressure…

…Meanwhile, deoxygenated blood in the superior vena cava (which returns blood from the head and upper limbs) also enters the right atrium. Oxygenated and deoxygenated…