…e.g., CYP2C9 variants) (1 point) E xcessive fall risk (1 point) S troke (1 point) HEMORR₂HAGES Score Risk category Incidence of major bleeding (per…

…to explain why neuronal cell death begins within 5–6 minutes (Lipton et al). Survival in cardiac arrest is highly dependent on the initial rhythm…

…cellular functions, such as contraction and relaxation. Increasing cardiac workload by increasing heart rate and contractility (i.e contractile force), results in increased metabolism. Cardiac…

…compromises the endothelial barrier, upregulating the expression of vascular cell adhesion molecule 1 (VCAM 1) and intercellular adhesion molecule 1 (ICAM 1), and increasing the…

…a small chin, tumour, an irradiated neck E valuate 3 3 2 3 fingerbreadths of mouth opening, 3 fingerbreadths from chin to hyoid, 2 fingerbreadths…

…S, Smith JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of hemorrhage induced traumatic cardiac arrest. Resuscitation 2019;140…

…the evidence is often conflicting. Many recommendations are therefore based on observational data, expert opinion, or extrapolation from other fields (e.g. sepsis research) or…

…an atherosclerotic plaque may also release atherosclerotic debris downstream, causing microvascular embolization (i.e occluding smaller vessels downstream). The thrombosis causes occlusion of the artery…

…To coordinate these two tasks, the heart has an intrinsic pacemaker–i.e. the sinus node–and an electrical conduction system composed of specialized myocardial…

…in a reduction of coronary blood flow and this causes subendocardial ischemia (i.e ischemia that only affects the subendocardium). STEMI, on the other hand…

…flow is patent. The rapid ST segment return is explained by rapid normalization of myocardial cell membrane potentials in the ischemic area. Myocardial cells are…

…the diagnosis can often be established by examining fewer leads. On the other hand, for the purpose of diagnosing morphological changes (e.g. myocardial ischemia…

…with sickle cell anemia. Method of Administration Route : Oral. Prasugrel can be taken with or without food. Administering a 60 mg loading dose on an…

…well as far field currents (i.e currents generated by tissues that the electrode is not connected to). Also, external signals from electronics (cell phones…

…myocardium like a wavefront in water. Specific ion channels located on the cell membranes open and close during de and repolarization, such that ions (Na…

…per minute) is on a par with the rate in sinus rhythm and there is atrioventricular conduction, these rhythms typically compete which is seen on…

…Components of the ATRIA Score The ATRIA score assigns points based on five clinical factors: Anemia: Hemoglobin <13 g/dL in men or <12 g…

Njurmedicin Lathundar Acute management on call Acute kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine…

Farmakologi & dosering Kardiologi Lathundar Three questions come up again and again on call: which dose, how long to interrupt treatment before a procedure, and how…

Infektionssjukdomar Akutsjukvård Lathundar Purpose and scope A quick reference for the doctor on call faced with suspected sepsis in adults: rapid recognition, microbiological sampling, empirical…

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…

…resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of circulating cells, inflammatory cell entry into the intima, and thrombus formation. Atherosclerosis is therefore not simply a…

…channel blocker (CCB). Nicardipine inhibits the influx of extracellular calcium in the myocardial and peripheral vascular smooth muscle cell membranes, thus inhibiting the contraction of…

…arterioles and veins via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane. Time to onset of action : 1…

…PCSK9 synthesis decreases circulating PCSK9, increases the availability of hepatic low density lipoprotein cholesterol (LDL C) receptors at the cell surface, and thereby enhances removal…

…disease, caused by infections (viral, bacterial, protozoal, fungal, parasitic), autoimmune processes (giant cell myocarditis, sarcoidosis, rheumatic heart disease, connective tissue disease, eosinophilic myocarditis), toxins (alcohol…

…pathological examination. Pathologically, infarction represents myocardial cell death caused by prolonged ischaemia. The first cellular abnormalities of ischaemia include depletion of glycogen, relaxation of myofibrils…

…depending on cell type. During de and repolarization ions (Na + [sodium], K + [potassium] and Ca 2+ [calcium]) flow back and forth across the cell membrane…

…the subendothelial accumulation of apolipoprotein B containing lipoproteins, macrophage infiltration, smooth muscle cell proliferation, and extracellular matrix deposition, ultimately leading to the formation of atherosclerotic…

…dissection or active major bleeding is not suspected. 6. Call the PCI service immediately in STEMI, a STEMI equivalent or very high risk NSTEMI. 7…

…per minute Bradycardia or arrhythmia PEF Over 50 percent of personal best or predicted 33 to 50 percent Under 33 percent, or unmeasurable Saturation on…

…The local stroke protocol and immediate contact with the on call stroke consultant or the thrombectomy centre take precedence where there is a discrepancy or…

…made is unusable, no matter how well the puncture went. Indications Unexplained cytopenia in one or more cell lines. Suspected acute leukaemia, myelodysplastic syndrome or…

…anything whose diagnosis you have not established. Indications Lesion Freeze time per cycle Number of cycles Margin : : : : Actinic keratosis, thin 5–10 s 1 1…

…by elevation Severe, worse on elevation, better when dependent Often painless (neuropathy) Surrounding skin Hyperpigmentation, oedema, lipodermatosclerosis, eczema Pale, hairless, atrophic, cold Dry, hyperkeratotic Pulses…

…effect on 24 hour mortality is uncertain and the evidence for non traumatic bleeding is weaker [2,3,4]. Do the following immediately: 1. Call…

…antibiotics within 60 minutes of triage or arrival. This is supported by international guidelines on neutropenic fever [2]. The direct evidence for exactly one hour…

…in the left lower quadrant lateral to the rectus sheath, and a cell count plus albumin on the sample. Indications Diagnostic paracentesis: Newly detected ascites —…

Procedurer Pericardiocentesis is performed on the basis of the haemodynamics, not the volume of fluid. A litre that has accumulated slowly can be asymptomatic, while…

…10 mg/mL with adrenaline 5 µg/mL (adrenaline gives a bloodless field and a longer duration; it is safe even on the fingers, toes…

…and veins) via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane. Nitroglycerin is similar in action and pharmacokinetics…

…dependent. Similarly, angioedema occurring in the setting of ACE inhibitor therapy is bradykinin mediated rather than mast cell mediated, distinguishing it from classic allergic reactions…

…associated vasculitis, Takayasu arteritis, giant cell arteritis and APS may also be associated with premature atherosclerotic disease. In a large UK clinical database, autoimmune disease…

…hyperinsulinaemia and, with progression, hyperglycaemia and pancreatic β cell dysfunction. These abnormalities initiate self perpetuating metabolic and inflammatory pathways that injure the vasculature, heart and…

…involve coronary or non coronary factors, and ischaemic thresholds vary substantially between individuals depending on the magnitude of the stressor, the presence of non cardiac…

…and thrombosis. Typical features include a lipid rich core, a thin fibrous cap, macrophage and foam cell accumulation, expansive or positive remodelling, neovascularization, plaque haemorrhage…

…associated with the Brugada syndrome. These mutations are located in genes encoding potassium and calcium channels of the outer cell membrane. Clinical presentation of Brugada…

…not be performed in the presence of absolute contraindications. Relative contraindications call for an individualized assessment of the risks; if the benefit outweighs the risk…

…than mild. 6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7…

…cuff compression should be avoided in the acute phase. A leg that has recently been operated on, is in a cast or has extensive wounds…

…Requires two samples drawn on two separate occasions with a separate identity check each time Always, once per patient if no valid result exists Type…

…by the clinical response and by repeated laboratory measurements, not by the values on admission alone. Diagnosis Current diagnostic criteria According to the international consensus…

…is normalised [3]. A healthy person without diabetes therefore does not normally need investigation on the basis of an isolated, asymptomatic low sensor reading alone…

…lidocaine 10 mg/mL. Sample tubes: an EDTA tube for the cell count and crystals, a sterile tube and blood culture bottles (aerobic and anaerobic…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…A1 pulley A good effect, often curative Plantar fasciitis The origin of the fascia on the calcaneus A risk of rupture; use sparingly Prepatellar and…

…often enough: undressing the patient, lowering the room temperature, a fan, paracetamol, cold infusions. A ventilator, an arterial line, a central venous catheter, ECG monitoring…

…to their indication. Do not routinely stop aspirin given as secondary prevention 8 Contact the endoscopist and the consultant on call early. In cirrhosis or…

…partial rupture into a complete one. Contact the urologist or the surgeon on call for urethrography and suprapubic drainage. Preparation and equipment A sterile catheterisation…

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…