Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

Procedurer Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the…

Procedurer Emptying the stomach has gone from routine to exception. Activated charcoal — in Sweden usually called medicinal charcoal — is the first line measure in decontamination…

…the abscess or at least half its diameter. Too small an incision is the commonest technical error. 4. Cut straight into the cavity with a…

Procedurer Edrophonium is a very short acting cholinesterase inhibitor: the effect appears within less than a minute and has gone after 5–10 minutes. That…

…disease and other manifestations of diffuse atherosclerosis. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are revascularization procedures. Both can improve coronary flow…

Procedurer A cast should hold the fracture still and do nothing else. The two ways in which casting harms the patient are that it is…

Procedurer The laryngeal mask is the single most important tool when intubation fails, since it restores oxygenation without requiring a view down into the larynx…

Procedurer What determines a lumbar puncture is rarely the needle itself. It is the decision whether to perform it now or after imaging, how the…

…Half of all opioid dosing errors arise at the dilution step, and an undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure Intravenous…

Procedurer Oxygen is a drug and must be prescribed as one: with an indication, a route of administration and a target range for the saturation…

…vomiting, generalized malaise, and visual disturbances such as altered color perception and halo vision. Cardiac toxicity presents as various arrhythmias, ranging from bradycardias related to…

Echocardiography Right ventricular strain When assessing the right half of the heart, it is important to familiarize yourself with the principles of hemodynamics and conditions…

…opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological half life : : : : Hydrocortisone (cortisol) 20 mg Marked Short, 8–12 hours Prednisolone…

…Treatment of postoperative hypertension. Mechanism of action Ultra short acting calcium channel blocker (CCB). Half life: 5 minutes. Rapidly inactivated by esterases. Effects • Clevidipine is…

…Relatively cardioselective (beta 1 receptor blocker) beta blocker with ultra short acting effect. • Half life: 9 minutes. Effects • Esmolol is a beta adrenergic receptor blocker…

…of cardiovascular disease. It has been the number one killer in Western and high income countries for more than half a century, causing approximately 20…

…most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination…

…< 3 mg/L Rises within 6–8 h, half life about 19 h ESR Women < 20, men < 15 mm/h Rises slowly…

…Treatment of postoperative hypertension. Mechanism of action Ultra short acting calcium channel blocker (CCB). Half life: 5 minutes. Rapidly inactivated by esterases. Effects • Clevidipine is…

…who cannot swallow the tablets whole, they can be crushed, mixed in half a glass of water, and consumed immediately. The mixture can also be…

…and the drug is highly protein bound (96%). The elimination half life is multiphasic. An initial 50% reduction in plasma concentration occurs 3 to 10…

…make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with symptomatic HF. The distinction is clinically useful but not…

…tissue enzymes, including neprilysin. Their respective half lives therefore differ substantially: approximately 20 minutes for BNP and 90 minutes for NT proBNP. Consequently, plasma concentrations…

…The drug possesses an active, acetylated metabolite with a half life exceeding 80 hours, allowing for sustained hemodynamic effects for days after the infusion is…

…threatening ischaemia (CLTI). Clinical presentation and symptoms Asymptomatic and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking…

…body mass index, and current smoking—account for more than half of the population attributable risk of cardiovascular mortality and approximately one fifth of the…

…mitigation of reperfusion injury are complementary objectives of initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias…

…should be smooth. The T wave is normally slightly asymmetric since its downslope (second half) is steeper than its upslope (first half). Women have a…

…3 mg/kg Body weight 50 kg: Adult dosage. Adverse effects Adverse effects typically persist <10 seconds due to the short half life of adenosine…

…2800 adults per 1 million individuals have congenital heart defects, and half of them have moderate or complicated defects; the remaining third have mild defects (…

…Treatment of postoperative hypertension. Mechanism of action Ultra short acting calcium channel blocker (CCB). Half life: 5 minutes. Rapidly inactivated by esterases. Effects • Clevidipine is…

…enlargement (hypertrophy, dilatation) Enlargement of the right atrium is commonly a consequence of increased resistance to empty blood into the right ventricle. This may be…

…SPECT Technetium 99m (Sestamibi or Tetrofosmin): With a six hour half life allowing high doses for better image quality. this tracer diffuses passively into cardiomyocytes…

…considered a normal finding. The regurgitation results in blood flowing back from the pulmonary artery into the right ventricle during diastole. The most common cause…

…Hemorrhages, either manifesting externally or concealed internally, account for approximately half of all traumatic cardiac arrests. In the absence of evident hemorrhage, potential etiologies to…

…stenosis: Maximum flow velocity exceeds 1 m/s. Pressure half time (PHT) exceeds 190 ms in pronounced stenosis. Mean pressure gradient 5.0 mmHg suggests…

…17 mm/m2 Aortic arch 22 36 mm Descending aorta 20 30 mm ​Indexing means that the value is adjusted for body surface area (BSA)…

…at longer intervals Age 75 years Start at half the adult dose and lengthen the interval Liver failure A reduced dose and a longer interval…

…36 mm 13 17 mm/m2 Aortic arch 22 36 mm Descending aorta 20 30 mm ​Adjustment refers to adjusting for body surface area (BSA)…

…1 cm² ZTime velocity integral of the tricuspid inflow (cm) 60 cm Pressure half time (T ½,ms) ≥ 190 ms Right atrium Severly enlarged Vena…

…ZTime velocity integral of the tricuspid inflow (cm) 60 cm Pressure half time (T ½,ms) ≥ 190 ms Right atrium Pressure half time (T ½…

…and reuptake into cells through a nucleoside transport system. Because of these highly efficient elimination pathways, adenosine has an extremely short elimination half life of…

…Cardiovascular events occur earlier, and approximately half of premature deaths in RA may be directly attributable to CVD. Excess mortality becomes apparent approximately 7–10…

…and clinical phenotype Heart failure with an LVEF greater than 40%—comprising HFmrEF and HFpEF—accounts for approximately half of patients with symptomatic heart failure…

…Figure 3 ). Enlargement of the right atrium is commonly a consequence of increased resistance to empty blood into the right ventricle. This may be due…

…on the presenting electrocardiogram (ECG) and the presence of troponin elevation, ACS are classified into unstable angina (UA), non ST segment elevation myocardial infarction (NSTEMI)…

…of activity, unlike typical exertional angina. A precipitating factor is identifiable in up to one half of cases. Reported precipitants include vigorous physical activity, emotional…

…and increased heart rate. However, when roughly half of the maximal cardiac output is achieved, the stroke volume cannot increase further, which means that a…

…pandemic. Indeed, a growing body of evidence suggests that heart failure is now the most frequent complication of diabetes ( Shah et al, McMurray et al )…

…pandemic. Indeed, a growing body of evidence suggests that heart failure is now the most frequent complication of diabetes ( Shah et al, McMurray et al )…

…relation to respiration). Approximately half of all newborns exhibit sinus pauses ( Southall et al ) and this is considered a normal finding. Sinus pause occurs in…

…Sudden unexpected cardiac arrest is the mechanism of death for about half of all individuals with heart failure ( Packer et al ) and 30% of people…

…of cardiac arrest have an ICD. Half of all victims of cardiac arrest have no previous history of cardiovascular disease. Sudden cardiac death accounts for…

…AHA), American College of Cardiology (ACC) and the European Society for Cardiology (ESC). A large body of evidence, based on randomized controlled clinical trials, supports…