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Ankle-brachial index (ABI)

…or a non healing distal ulcer. Before compression treatment of a leg ulcer — compression in arterial insufficiency can cause necrosis. Screening in diabetes of 10…

Otoscopy and ear syringing

…and the examination is needed for the diagnosis. Before audiometry or the fitting of a hearing aid. Recurrent otitis externa in which the wax retains…

Dix–Hallpike test and Epley manoeuvre

…A symptom free interval between attacks, with possible residual unsteadiness. No hearing loss, tinnitus or neurological deficits. In horizontal positional vertigo (lateral semicircular canal) the…

Spirometry

…investigated Relative obstacles also include dementia, marked hearing loss and an inability to understand the instructions — spirometry requires active cooperation. Preparation and equipment Equipment: a…

Acute vertigo: quick reference for HINTS and differential diagnosis

…arrhythmia, panic attack, hypoglycaemia History, neurological examination, hearing, cardiac examination, ECG, selective vascular imaging Traumatic or toxic syndrome Onset after trauma, a change in medication…

Nail procedures — paronychia, ingrown toenail and subungual haematoma

…absolute contraindications, but be cautious and consider referral in: Diabetes with neuropathy or peripheral arterial disease — a risk of osteomyelitis and poor healing. Check the…

Urinary catheterisation

…studies of the urinary tract. Wound healing with a sacral pressure sore or extensive perineal wounds where urinary leakage prevents healing. Voiding problems in neurogenic…

Wound suturing

…contaminated wounds where a long time has passed since the injury (see below). Be particularly cautious with impaired healing: peripheral vascular disease, diabetes with neuropathy…

P-wave, PR interval, PR segment: physiology, criteria & ECG findings

…V2. lead V5 only notes vectors heading towards the exploring electrode (albeit with somewhat varying angles) and therefore displays a positive P wave throughout. Figure…

Leg ulcers — wound debridement and compression therapy

…ruler in the image. A reduction in size of 40% within four weeks predicts healing — failure to shrink should prompt reconsideration of the diagnosis. 3…

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