Cardiology Continous medical discussion: the ECG blog Infectious diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health…

…and possible infectious or other non cardiovascular adverse outcomes. Mechanisms of action Colchicine Colchicine appears to exert several anti inflammatory effects relevant to coronary disease:…

…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…

…system. The underlying pathophysiology varies widely and may involve intrinsic cardiac disease, extrinsic systemic conditions, or pharmacologic effects. Inflammatory heart disease, caused by infections (viral…

…aortic and mitral valve). Rheumatic heart disease is rare in high income countries, presumably because streptococcal infections are treated very liberally. Figure 1 shows the…

…pose a high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18% show significant valvular disease…

…haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome, autoimmune encephalitis…

Echocardiography Pericardial diseases: effusion and tamponade A long series of conditions can affect the pericardium (pericardium). The most common of these are acute pericarditis (perimyocarditis…

…and medications : A wide range of diseases and medications may cause sinus tachycardia; e.g congestive heart failure, lung disease (e.g COPD), fever, infections…

…Contact an infectious diseases physician early in a high risk course, in instability, with resistance problems, or with suspected fungal infection 10 Document the times…

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…joint disease. Contraindications Infection of the skin or soft tissues over the puncture site — use another approach or refrain. Bacteraemia without suspicion of joint infection…

…will heal badly however neatly the suture is placed. The commonest cause of wound infection is retained contamination, not poor suture technique — and the commonest…

…efficacy as compared with nicardipine. Labetalol is safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen…

…as carbohydrate administration. 3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness…

…management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb: marked peripheral arterial disease…

…low platelet counts, followed by compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow…

…make sure that never happens, and to make sure the catheter does not become the patient's next focus of infection. Indications Infusion of vesicant…

…insufficiency (Addison's disease), secondary adrenal insufficiency or long term corticosteroid treatment cannot increase their own cortisol production. Situation Action : : Fever, infection or gastroenteritis at…

…BCG Slow, local effect Contraindications Absolute: Infection, a wound, scar tissue, a tattoo or skin disease at the injection site. Known hypersensitivity to the preparation…

…determines its entire value: a poorly performed manoeuvre gives a falsely low FVC and thus a falsely normal FEV₁/FVC. Set aside time, coach actively…

…Delivery IV or IM. Dose Injections • IV: 10–40 mg every 4–6 hours • IM: 10–20 mg every 4–6 hours. Infusion • Afterload reduction…

…causally responsible. This distinction is important because AKI after a contrast study frequently occurs in patients with several simultaneous renal insults. Infection, hypovolaemia, cardiac dysfunction…

…inclisiran permits subcutaneous administration only twice yearly, an important practical distinction from therapies requiring monthly or biweekly injections. Inclisiran is used as an adjunct to…

…or associated with conditions such as systemic sclerosis, HIV infection, cirrhosis, and sickle cell disease. The classification also recognizes vasoreactivity subgroups among patients with idiopathic…

…cardiology include: Clinical setting or outcome Reported benefit of cessation Cardiovascular disease overall Substantial reduction in cardiovascular events and mortality Established coronary disease Approximately 36%…

Lungmedicin Akutsjukvård Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and…

…the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment : : : CRP < 3 mg/L Rises within 6–8 h, half life about 19…

…a biopsy for direct immunofluorescence). Suspected cutaneous vasculitis, lymphoma or granulomatous disease. A treatment resistant rash without a definite diagnosis. Choice of technique Diagnostic question…

…own laboratory uses before applying it. The D dimer is raised in pregnancy, malignancy, infection, surgery, trauma and old age. A positive value is not…

…body mass index Asian ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin…

…injuries, hemodynamic and respiratory instability, multiorgan failure, infections, seizures and temperature management. The ICU is the preferred level of care for the absolute majority. The…

…tamponade. Causes of pericardial effusion and cardiac tamponade The most common cause of pericardial effusion is infections, such as viral, bacterial, and tuberculous infections. Post…

…Blausen Gallery 2014. Causes of acute pericarditis/myocarditis The most frequent cause of pericarditis is infections, in particular viral infections. This explains why pericarditis may…

…P wave is positive in lead II. Sinus tachycardia is always considered pathological and the underlying cause must be investigated. Pain, infections, medications, fever, hypovolemia…

…work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis, deep neck infection, an expanding haematoma, facial trauma. An anticipated course requiring a…

…Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a self taken vaginal sample without a speculum…

…spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy: an otoscope with a charged battery and clean disposable specula…

…but some laboratories do not accept marrow blood in their analysers — check locally. Contraindications Peripheral venous cannula: Infection, burns or trauma at the puncture site…

…coagulopathy or thrombocytopenia Relative Ongoing anticoagulant treatment — plan the aspiration for the trough level or pause the drug according to local practice Relative Skin infection…

…wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds…

…antibiotics — suggests that an abscess has formed. Ultrasound settles the question when the clinical picture is unclear. Cellulitis without a pus cavity must not be…

…to a normoxic patient Temperature Treat fever and look for an underlying infection Swallowing Keep the patient nil by mouth until swallowing has been assessed…

…course (no more than 7 days) may be given to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection…

…individual assessment; certain tumour types are not a bar). Untreated generalised infection, or certain transmissible agents according to the current transmission risk assessment. In DCD…

…acute glaucoma is suspected (normal 10–21 mmHg). Tonometry is contraindicated with suspected perforation or infection. Removal Proceed from the least to the most invasive…

…failure The insulin requirement falls . Reduce the dose and measure more frequently Acute illness and infection The insulin requirement rises, often despite a reduced food…

…Septic phlebitis, ongoing soft tissue infection with systemic involvement. Relative: Condition Adaptation : : ABI 0.5–0.79 Reduced compression (20–30 mmHg) under vascular surgical…

…pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis in the target vein…