…older people with lost muscle mass (where a normal BMI may conceal sarcopenia), in oedema and ascites, and in people under 18 years of age…

…with a risk of transmission Until symptom free Haemoptysis of unclear cause Until investigated Relative obstacles also include dementia, marked hearing loss and an inability…

…blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of…

…wavelength and amplitude of sine curves. Figure 2. Sound waves can be described mathematically as sine curves. The peaks and lows of the sine curve…

…aiding in the diagnosis of aortic root dilation. Key Formulas BSA Calculation (Mosteller formula): [ \text{BSA (m²)} = \sqrt{\frac{\text{Height (cm)} \times \text…

…Underweight : Less than 18.5 Normal weight : 18.5 to 24.9 Overweight : 25 to 29.9 Obese : 30 and above Limitations of BMI Despite…

…the height difference (in millimeters) between the J point and the baseline (the PR segment). ST segment deviation occurs in a wide range of conditions…

…STEMI) the level of the J point is typically close to the level of the T wave apex (i.e the height difference between the…

…Sudden and unexpected cardiac arrest with loss of mechanical cardiac function. Results in loss of consciousness, cessation of breathing, and absence of a palpable pulse…

…Imaging evidence of new loss of viable myocardium or a new regional wall motion abnormality in an ischaemic pattern. Identification of a coronary thrombus by…

…is primarily attributed to specific genetic mutations: loss of function mutations in KCNQ1 (LQT1) and KCNH2 (LQT2), and gain of function mutations in SCN5A (LQT3)…

…both are predictable. Indications Inability to protect the airway: reduced level of consciousness, loss of pharyngeal reflexes, vomiting with a risk of aspiration. Inadequate oxygenation…

…The commonest cause of wound infection is retained contamination, not poor suture technique — and the commonest cause of permanent loss of function is a tendon…

…reversible causes of traumatic cardiac arrest ( Salomone et al ): Hypovolemia : Hypovolemic shock is common in both penetrating and blunt force trauma. Loss of blood volume…

…weight loss, hyperpigmentation, hyponatraemia, hyperkalaemia, postural symptoms. Suspected secondary adrenal insufficiency in pituitary disease, after pituitary surgery or radiotherapy, or with suspected suppression of the…

…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…

…the gene encoding the alpha subunit of the cardiac voltage gated sodium channel (Nav1.5) [6] . Loss of function (LOF) mutations in SCN5A lead to…

…tissues. 15 Recent evidence clarifies that while the benefits in conditions like osteoarthritis and obstructive sleep apnea primarily reflect the extent of weight loss, the…

Cardiology Clinical medicine Definition and Pathophysiology Dietary patterns are the overall combinations of foods habitually consumed rather than isolated nutrients considered independently. For cardiometabolic health…

…is primarily attributed to specific genetic mutations: loss of function mutations in KCNQ1 (LQT1) and KCNH2 (LQT2), and gain of function mutations in SCN5A (LQT3)…

…and venous Doppler signals Evidence of systemic disease or a potential embolic source Neurological assessment is central to triage. Sensory loss extending beyond the toes…

…disease. The relationship between triglyceride concentrations and aortic disease is less clearly defined, although triglycerides may contribute to the development and progression of aortic pathology…

…The magnitude of LDL C lowering depends partly on residual LDL receptor expression. PCSK9 monoclonal antibodies are less effective in homozygous FH when residual LDL…

…tamponade, and sudden: Loss of pulse. Loss of blood pressure. Loss of consciousness. Electromechanical dissociation or pulseless electrical activity despite ongoing sinus rhythm on the…

…right shunt, tamponade, or sudden loss of effective cardiac output. Their recognition is essential because treatment often requires urgent surgical or transcatheter intervention, with temporary…

…of painless or silent STEMIs is greater in patients with diabetes mellitus and increases with age. STEMI may present as sudden onset breathlessness. Other less…

…and Physical Examination The initial evaluation of a patient with suspected syncope aims to determine whether the transient loss of consciousness was due to syncope…

…low flow velocities during the loss of organized atrial systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi in non valvular AF…

…genetic cardiomyopathy that predominantly affects the right ventricle. ARVC is defined by the gradual loss of myocardial cells, which are replaced by fat and fibrous…

…from the sinoatrial node to the atrium and this delay increases gradually until one impulse is completely blocked and a loss of P wave occurs…

…requirement. Obstetric haemorrhage of around 1,500 mL or more with continuing bleeding, or a smaller measured blood loss if there is physiological compromise. Do…

…earache, hearing loss, ear discharge, dizziness, tinnitus, fever in a child without an obvious focus, and before every ear syringing. Removal of cerumen: Hearing loss…

…Pregnancy loss Polycystic ovary syndrome Functional hypothalamic amenorrhoea Fertility therapy and assisted reproductive technology The extent to which these conditions confer risk independently of conventional…

…and pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering in type 2 diabetes mellitus …

…nausea or vomiting. Persistent shortness of breath. Weakness, dizziness, light headedness, or loss of consciousness. No symptoms at the time of assessment. Ongoing chest discomfort…

…Reduced cellular uptake and clearance of LDL leads to increased circulating LDL C. The principal genetic mechanisms involve: Loss of function variants in the LDL…

…sedentary behaviour and loss of independence. Identification of PAD also provides an opportunity to recognise atherosclerosis in other arterial territories and to initiate secondary prevention…

…cause: Diminished heart sounds Disappearance of the friction rub Loss of the apical impulse Electrical alternans on the ECG Compression of the left lung base

…and chaotic ventricular depolarizations, rendering the left ventricle incapable of generating effective contractions. This results in circulatory collapse, loss of consciousness, and sudden cardiac arrest…

…loss. Massive haemorrhage meeting the criteria for activation of the massive transfusion protocol. Plasma and platelets: in ongoing bleeding with coagulopathy, or as part of…

…intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The…

…and tendon sheaths, loss of function Orthopaedic or hand surgeon, urgently Perianal and perirectal Often larger than it appears; risk of fistula Surgeon, often operative…

…The condition is associated with falls, aspiration, pressure sores, loss of function, longer length of stay, institutional care, readmission, cognitive decline and increased mortality [3…

…in advanced cases, loss of consciousness. Focal neurological findings are uncommon in hypertensive encephalopathy and should prompt consideration of stroke. Acute ischemic or intracerebral haemorrhage…

…required evidence of ischaemia: Symptoms compatible with myocardial ischaemia New ischaemic ECG changes Development of pathological Q waves Imaging evidence of new loss of viable…

…and At least one of the following: New ischemic ECG changes New pathological Q waves Imaging evidence of new loss of viable myocardium or a…

…the hallmark of NSTEMI and unstable angina is chest pain (chest discomfort). However, the chest pain caused by NSTEMI and unstable angina is less severe…

…related to high ventricular rates and the loss of the atrial kick. The rapid ventricular response can lead to a reversible depression of systolic function…

…anxiety Depression or psychological distress Loss of confidence in resuming normal activity Difficulty returning to work or recreational exercise Frailty or loss of muscle mass…

…with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness Confusion Profound weakness An arrhythmia Peripheral embolism An ot

…and stabilise the patient Immediate assessment 1. Assess airway, breathing, circulation and level of consciousness. 2. Attach ECG, pulse oximetry and repeated blood pressure measurement…

…with functional loss but preserved independence require a more detailed geriatric assessment. Where functional impairment is accompanied by inability to perform activities of daily living…

…Most cases of malfunction are associated with the electronics in the pulse generator or dislodgement or fracture of the leads. External causes are less common…

…the relaxation (i.e the stretching of myocardial fibers). The opposite is also true; the stiffer the myocardium, the slower and less pronounced the relaxation…

…a cryoprobe for contact technique. Cotton buds for small lesions (these give a more superficial and less controllable depth of freeze). A size 15 scalpel…

…less commonly, retrograde. Distal re entry tears may allow blood to return to the true lumen, whereas disruption of the adventitia can result in rupture…

…a high probability of unstable angina (UA), and patients whose initial findings are less definitive. The defining electrocardiographic feature is the absence of persistent ST…

…inhibition of pacing, inappropriate ICD therapy, or, less commonly, device damage. Oversensing is more likely with unipolar leads. Electrocautery is the most frequent source of…

…a result, pupils often dilate widely within 30–120 seconds of cardiac arrest and light reactivity is lost when cerebral blood flow ceases. In other…

…and less pronounced on the treadmill. Leg fatigue is, as compared with chest pain and dyspnea, a poor predictor of cardiovascular and all cause mortality…