…when the FVC is low with a normal or high ratio. Reversibility: an increase in FEV₁ or FVC of 10 % of the predicted value after…

…pCO₂ Low Usually low Normal or raised Other Moderate work of breathing Accessory muscle use Cyanosis, exhaustion, hypotension or collapse The classification is based on…

…atrial fibrillation) if the block in the AV node is high grade. Causes of tachyarrhythmia with narrow QRS complexes (QRS duration < 0.12 s…

…classes. By acting on more than one pathophysiological pathway, combinations generally lower blood pressure more effectively than simply increasing the dose of a single drug…

…low grade systemic inflammation Insulin resistance Abnormal adipokine signalling Endothelial dysfunction Dyslipidaemia A prothrombotic state Albuminuria and declining estimated glomerular filtration rate Development of type…

…may therefore underestimate the ketosis early on and remain positive after the clinically relevant ketosis has resolved. Capillary measurement of beta hydroxybutyrate has high diagnostic…

…it provides a fairly good estimate of the actual workload. The perceived exertion may be graded from 0 (none) to 10 (maximal exertion) or according…

…Watts). Protocols for clinical exercise testing generally include an initial warm up period (at a low workload), followed by a successive (graded) increase in workload…

…low density lipoprotein and chylomicron remnants. It is calculated as: Non HDL C = total cholesterol − HDL C Apolipoprotein B (apoB) reflects the concentration of…

…A narrow pulse pressure suggests a low stroke volume Capillary refill < 3 s A simple and validated marker of perfusion Lactate < 1.6…

…a low risk patient (blue) and the corresponding high risk morph (red). Beyond the difference in R wave amplitude, note the slurred terminal portion of…

…rationale Bempedoic acid is an oral, small molecule lipid lowering agent used to reduce low density lipoprotein cholesterol (LDL C), particularly when statins cannot be…

…disorder characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic cardiovascular disease …

…Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a hepatic protein that regulates the availability of the low density lipoprotein receptor (LDL receptor) on hepatocytes…

…and dilatation Biventricular hypertrophy Simultaneous hypertrophy of the left and right ventricle is rather common. The ECG has low sensitivity with respect to detecting biventricular…

…Assessment of chronotropic function and pacemaker settings. Preoperative functional assessment before major surgery. At a low pre test probability most positive results are false positives…

…damage. Conversely, a rapid rise in blood pressure from a previously low level can cause organ damage at lower values, for example in pregnancy, acute…

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

…with a low muscle mass — the elderly, the undernourished, amputees, patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney…

…The quality of the test determines its entire value: a poorly performed manoeuvre gives a falsely low FVC and thus a falsely normal FEV₁/FVC…

…as it serves as a quick, low cost, and reliable screening tool for body composition, risk of type 2 diabetes, metabolic syndrome and specific cancers…

…Survey on Atrial Fibrillation. Chest . 2010;137(2):263 272. doi:10.1378/chest.09 1584. Friberg L, Rosenqvist M, Lip GY. Evaluation of risk…

…low density lipoprotein cholesterol (LDL C) and other apoB containing lipoproteins in atherosclerotic cardiovascular disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of…

…quantity of cholesterol delivered to the liver. The resulting hepatic response includes increased expression of low density lipoprotein receptors (LDLRs), which enhances removal of circulating…

…with more frequent injectable therapy, although the clinical importance of improved adherence remains dependent on sustained follow up and administration. Clinical indications and place in…

…and acute coronary syndromes (ACS). Its principal therapeutic objective is reduction of low density lipoprotein cholesterol (LDL C), the primary lipid target in contemporary secondary…

…Possible effects on erythropoietin activity and erythropoiesis SGLT2 inhibition may also activate adenosine 5′ monophosphate activated protein kinase and inhibit mammalian target of rapamycin complex…

…the intensity of reflected sound waves. Structures with high echogenicity will reflect more ultrasound and appear brighter on the image. Structures with low echogenicity reflect…

…treatment, with a very low number needed to treat (NNT), indicating high effectiveness. Although BLS is primarily developed for out of hospital cardiac arrest (OHCA)…

…of CAD, invasive coronary angiography is the first line option. Coronary computerized tomography angiography (CCTA) is currently the first line investigation for patients with low…

…is the leading cause of mitral regurgitation in low and middle income countries. Rheumatic heart disease typically results in thickening of the leaflets and may…

…fibrillation, fine (low amplitudes). ECG 6 . Ventricular fibrillation, coarse. ECG 7 . Ventricular fibrillation, coarse. ECG 8 . Ventricular fibrillation. ECG 9 . Delivery of shock (red arrow)…

…the cause of cardiac arrest, cardiopulmonary resuscitation (CPR) should be performed per standard guidelines. Cardiac arrests due to trauma are characterized by very low survival…

…8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is…

…is too low Normal Abnormal Abnormal A compensated simple disorder, or two opposing primary disorders It is therefore not enough to ask which of the…

…taken even at very low platelet counts, followed by compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side…

…evening. See the quick reference on inpatient insulin therapy Peptic ulcer A proton pump inhibitor with concomitant NSAID use or a history of ulcer, not…

…to adults in sinus rhythm, recorded at a paper speed of 50 mm/s with 1 mV = 10 mm. At 50 mm/s a…

…Timing The shock is delivered on the R wave The shock is delivered immediately Why Avoids the vulnerable phase of the T wave There is…

…possible on the spot, ENT must be contacted urgently rather than a routine referral being made. Two or more magnets constitute the same kind of…

…and 5 minutes of compression. Anticoagulant treatment is not in itself a bar to vaccination. Relative: Lymphoedema or previous axillary clearance on the same side…

…result. Overview of vasopressors and inotropes Vasoconstriction Vasodilatation Positive inotropy Phenylephrine Vasopressin Midodrine Noradrenaline Adrenaline, high dose Dopamine, high dose Adrenaline, low dose Dopamine, intermediate…

…with a daily wake up trial shortens the time on the ventilator. See the article on confusion for the management of delirium in intensive care…

…ventilating is not experienced in intubation. Planned anaesthesia for short procedures in a fasted patient at low risk of aspiration. A conduit for fibreoptically assisted…

… one of the most useful signs Low voltage on the ECG, electrical alternans Supportive; it does not exclude Diastolic collapse of the right atrium and…

…afterwards whether a nerve injury was caused by the injury or by the treatment. Indications A clinically or radiologically confirmed dislocation of the shoulder, elbow…

…root morphology. Age stratified formulas help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of aortic root dilation. Key…

…effect of acetylsalicylic acid. Use with caution in patients on low dose acetylsalicylic acid for cardioprotection. Pharmacokinetic interactions Methotrexate: NSAIDs inhibit tubular secretion of methotrexate…

…Lane DA, Lip GYH. Evaluation of the HAS BLED, ATRIA, and ORBIT bleeding risk scores in atrial fibrillation patients on warfarin. Am J Med . 2016…

… } Interpretation of CHADS VASc score and decisions on anticoagulation Men Women Points Recommendation Evidence Recommendation Evidence 0 No treatment Low No treatment High 1 Oral…

…the use of certain medications or alcohol. Interpretation of HAS BLED score A score of 0 1 indicates low risk A score of 2 suggests…

…atrial fibrillation (AF) on anticoagulation therapy. Its purpose is to guide clinicians in balancing estimating the risks of bleeding. Components of the HEMORR₂HAGES Score The…

…with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual…

…hospitalization (Class IIb recommendation). • On highest tolerated dose statin: • If LDL C < 1.4 mmol/L (55 mg/dL): No change. • If LDL C…

…addressing some of the SYNTAX Score's shortcomings, such as its inability to account for coronary dominance variability and its reliance on subjective lesion weighting…

…10% of cases. Intermediate high risk PE occurs in haemodynamically stable patients with both RV dysfunction on imaging and elevated cardiac biomarkers. Intermediate low risk…

…Interpatient variability mandates close clinical monitoring. The onset of action depends on the route of administration. Intravenous (IV) amiodarone generally acts within 1 to 2…

…of primary prevention trials involving individuals with an estimated 10 year cardiovascular risk of 10%. Approximately 12% reduction in non fatal myocardial infarction with low…

…and hyperkalemia. Clinical Presentation and Symptoms The clinical manifestation of bradycardia depends on the adequacy of cardiac output. Isolated sinus bradycardia that is unaccompanied by…

…10]. Physical examination may reveal a normal or low pulse pressure, an elevated jugular venous pressure with a paradoxical rise on inspiration (Kussmaul sign), and…