Procedurer Spirometry is the only investigation that distinguishes obstructive from restrictive impairment of lung function, and COPD cannot be diagnosed without it . The quality of…

…from pulmonary vascular disease, left sided cardiac disease, chronic lung disease or hypoxia, chronic thromboembolic obstruction, or a range of miscellaneous conditions. Because several mechanisms…

…3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg × 3 PO 5–7 days or benzylpenicillin 3 g × 4 IV Pneumonia, suspected atypical pathogen…

…major active metabolite. Both the parent drug and its metabolite accumulate extensively in various tissues, including the liver, lung, fat, and skin, with myocardial concentrations…

…B Breathing Respiratory rate (12–20 / min) Chest wall movements Chest percussion Lung auscultation Pulse oximetry ( 95%) C Circulation Skin color Sweating Capillary refill time…

…related arrhythmias. The clinician must evaluate for the presence of worsening renal function, advanced age, hypokalemia, chronic lung disease, hypothyroidism, and amyloidosis. Furthermore, ongoing ischemia…

…gives 1 point each for age 80 years, cancer, chronic cardiac or pulmonary disease, a pulse ≥ 110/min, a systolic blood pressure < 100 mmHg…

…appropriate for many patients. Long acting nitrates or ranolazine may be added when symptoms persist or when heart rate, blood pressure, left ventricular dysfunction, contraindications…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…and dangerous in a few. The male urethra is about 25 cm long with two curves and a prostate that can grip; the female urethra…

…recurrent atherothrombotic events in chronic coronary disease; preserve the benefit of coronary intervention while limiting major and clinically relevant bleeding. Long term antiplatelet therapy after…

…an advanced version of the original SYNTAX Score, designed to improve the prediction of long term outcomes after revascularization. It incorporates both anatomical (from the…

…extensive MI with necrosis and scar formation Diffuse myocardial fibrosis Reversible ischemic dysfunction Chronic hypoperfusion with hibernating myocardium Post ischemic stunning Adverse left ventricular (LV…

…< 20 kPa (150 mmHg), and permissive hypercapnia as long as the pH stays above about 7.20. Different targets apply when the intracranial pressure…

…including the number of lesions, their location, and specific characteristics such as bifurcations, chronic total occlusions (CTOs), calcification, and thrombus presence. These factors are weighted…

…It is uncommon for chronic pericardial effusions to cause sudden cardiac arrest since these cases tend to be recognized and managed before circulatory collapse occurs…

…2. Aortic Valve Velocity Time Integral (AV VTI) Optimal View : Deep transgastric or transgastric aortic valve long axis (AVLAX) view. Method : Use continuous wave Doppler…

…major or life threatening bleeding. The clinical presentation, whether ACS or chronic coronary syndrome (CCS). Whether and how PCI was performed. The need for non…

…angina caused by disease in the treated segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS)…

…not reverse coronary atherosclerosis. Long term benefit therefore depends on the integration of revascularisation with guideline directed medical therapy and secondary prevention. Clinical Presentation and…

…approximately 30–40% and in death of approximately 35–45%. In chronic coronary syndrome, cessation has been associated with a 36% reduction in premature mortality…

…when marked hormonal changes occur. Hypertension and oestrogen exposure. Emotional or chronic mental stress. Fibromuscular dysplasia (FMD), which may produce arterial wall abnormalities and intramural…

…chronic aortic regurgitation gradually leads to impaired contractile function and the development of myocardial fibrosis. Contractile dysfunction further aggravates the regurgitation (the regurgitation volume increases…

…is age. Other significant risk factors are as follows: male sex, hypertension, left ventricular hypertrophy, left ventricular dysfunction, valve disease, coronary artery disease, cardiomyopathy, congestive…

…Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes…

…in myocardial oxygen consumption associated with exercise. Chronic myocardial injury Long term heavy consumption can produce a cardiomyopathy, although the exact exposure threshold and duration…

…is intensified [1,2]. The evidence that any particular intravenous drug improves mortality or long term functional outcome is limited. A Cochrane review found insufficient…

…Long term pharmacological management of chronic sinus bradycardia with a pacemaker is usually not necessary unless sinus rates are too slow to meet physiologic needs…

…the type of revascularization; stent related risk; whether long term oral anticoagulation is required; tolerance of treatment during the initial months. Patients with HBR are…

…than either drug alone. Long term efficacy data remain limited, and the possibility that chronic If channel blockade could increase sympathetic activity, with adverse remodelling…

…is not an absolute rule. While it often holds true for cardiac arrests caused by chronic or acute ischemic heart disease, it is often not…

…state. Patients may remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical…

…of life. The underlying aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease, hypertension…

Cardiology Nephrology Definition and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months…

Myocardial ischemia and infarction Definition and pathophysiology A chronic total occlusion (CTO) is a complete or nearly complete coronary arterial obstruction that has persisted for…

Cardiology Coronary Atherosclerosis Coronary atherosclerosis is a chronic, progressive, and highly complex lipid driven inflammatory disease of the arterial intima that serves as the fundamental…

…Excess adipose tissue promotes: Chronic, low grade systemic inflammation Insulin resistance Abnormal adipokine signalling Endothelial dysfunction Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular…

Cardiology Evaluation and management of stable coronary artery disease Chronic coronary syndromes (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris…

Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

ECG Evaluation and management of stable coronary artery disease Chronic coronary syndrome (CCS) Stable coronary artery disease (CAD), frequently referred to as stable angina pectoris…

…symptoms of myocardial ischaemia may arise from obstructive atherosclerotic CAD, coronary microvascular dysfunction or vasospasm. A normal or non obstructive coronary anatomy does not necessarily…

Cardiology Clinical medicine Definition and clinical classification Hypertensive disorders of pregnancy comprise chronic or pre existing hypertension, gestational hypertension, and preeclampsia. Collectively, they affect approximately…

…diffuse epicardial disease, chronic total occlusion, incomplete revascularization, or coronary anatomy unsuitable for further intervention. In ANOCA/INOCA, coronary atherosclerosis, endothelial dysfunction, and distinct coronary…

Echocardiography Constrictive pericarditis: the end stage of pericardial inflammation Constrictive pericarditis is the result of chronic inflammation of the pericardium. In principle, all causes of…

CPR It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being…

…how acute the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial…

…inhibitors have consistently shown benefit for patients with symptomatic LV dysfunction, and all placebo controlled chronic HFrEF trials using neurohormonal antagonists have demonstrated a reduction…

…component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS), peripheral artery disease (PAD), and acute coronary syndromes…

…acute when serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic myocardial injury . Myocardial injury is not synonymous with myocardial infarction…

…further reducing myocardial workload. Levosimendan is used in severe acute or chronic heart failure. Consider urgent angiography in patients with unknown etiology for acute severe…

…steroids and controlled oxygen. Acute on chronic hypercapnic failure in obesity hypoventilation and neuromuscular disease. Hypercapnic failure in cardiogenic pulmonary oedema that does not improve…

…ankle brachial index before the first bandage is applied . Indications Venous leg ulcer — about 70% of all leg ulcers. Chronic venous oedema, lipodermatosclerosis, stasis dermatitis…

…for pain). An opioid is rarely the right choice in nociplastic or neuropathic pain, in chronic non cancer pain, or in headache. A failure to…

…risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity…

…1.73 m². Advantages of MDRD eGFR Clinical utility: The MDRD equation has been instrumental in identifying and staging chronic kidney disease (CKD), facilitating early…

…HF), acute Heart failure (HF), chronic Bradycardia (second line alternative) Medium dose : 3.0 10.0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1…

…infarction. It may be acute, when serial troponin values show a dynamic change, or chronic, when troponin elevation persists without such a change. Myocarditis, sepsis…

…circumstances where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or…