…no local anaesthetic — but it leaves no specimen . That makes the choice of lesion the critical point: never freeze anything whose diagnosis you have not…

…sex as an independent risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly…

…uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to attend for sampling and follow up — relative, but in…

…thresholds: a DOAC is given at an eGFR 30 mL/min. At an eGFR of 15–30 mL/min the documentation is inadequate and closer…

…Guiding catheter trauma is an additional mechanism of dissection and impaired distal flow. These alternative causes must be distinguished from isolated no reflow because their…

…deeply sedated and not rousable. Sedation precedes respiratory depression and is the early warning sign. Choice of agent Situation Choice Reason : : : An opioid naive adult…

…Which of the following ECG findings is generally considered a normal variant in asymptomatic athletes and typically does not require further evaluation, assuming no significant…

…population measure that performs poorly at the level of the individual: it does not distinguish muscle from fat and takes no account of fat distribution…

…examination is not the technique but the handling of the specimen — an aspirate that clots before the smears are made is unusable, no matter how…

…the lung. No tube may be used before its position has been verified by an approved method, and auscultation is not such a method. Indications…

…hypoxaemia is not an indication for oxygen — look for the cause instead. Conditions in which the highest possible oxygen concentration is given irrespective of the…

…is considered when 4–6 weeks of adequate conservative treatment — modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect…

…likely. If there is AV dissociation, ventricular tachycardia is very likely. If there are no signs of ventricular tachycardia, antidromic AVRT should be strongly considered.

…or no effect on myocardial contractility or conduction. Clevidipine reduces mean arterial blood pressure (MAP) by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce…

…Section DICT Concern Cardiac side effects Severity of cardiotoxicity Hyaluronic Acid HYALURONIC ACID HYALURONIC ACID NA no no ZYPREXA Relprevv OLANZAPINE PAMOATE Olanzapine pamoate Arrhythmia…

…® Mechanism of action • Induces arteriolar vasodilation. No effect on venous circulation. • May cause reflex sympathetic stimulation (can be counteracted with simultaneous administration of beta…

…2015): Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging…

…55 mg/dL): No change to the therapy. • If LDL C ≥ 1.4 mmol/L (55 mg/dL): • Add ezetimibe (if not already added earlier)…

…pressure control. Mechanism of action Nitroglycerin provides nitric oxide (NO) that induces vasodilatation (of both arterioles and veins) via generation of cyclic GMP, which then…

…of intracranial pressure (ICP) and reduction in cerebral blood flow. Caution • Used cautiously in patients with high intracranial pressure or azotemia. • Should not be given…

…severe hypertension without clinical evidence of acute, ongoing target organ damage. Although BP reduction is required, these patients generally do not need hospital admission or…

…of myocardial ischaemia. Objective evidence of myocardial ischaemia. Absence of obstructive coronary artery disease, defined as no stenosis exceeding 50% diameter reduction and/or an…

…despite the absence of an angiographically obstructive lesion Coronary embolism or thrombus Epicardial coronary vasospasm Coronary microvascular dysfunction Spontaneous coronary artery dissection (SCAD) Standard angiography…

…An excerpt from the article follows: [...] Of every 10 such victims, the heart in 6 or 7 showed no recent disease in coronary arteries or…

…movements of limbs, neck and trunk, which may cause disturbances and thus reduce the quality of the ECG recording. Moreover, the reason for recording an…

…no cerebral perfusion, with an equal degree of hypoxia in all neurons. There is one fundamental difference between neurons and myocardium in the setting of…

…node does not possess automaticity, but cells surrounding it do. These cells are capable of generating an escape rhythm with a rate of 40 beats…

…in an ectopic focus (located distal to the block). Third degree AV block is a very serious condition because escape rhythms may (1) not occur…

…is not immediately required. 8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation…

…lowered at each measurement, and not to talk. Otherwise ordinary activities, including work. No showering or bathing. A diary of going to bed, getting up…

…not only in claudication, but before every compression treatment of a leg ulcer and as a risk marker in diabetes and known atherosclerotic disease. An…

Referensvärden A diagnosis of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by…

…wrong blood being given to the wrong patient — a mislabelled tube, or an identity check performed at the nurses' station instead of at the bedside…

…a 20 minute no touch period, for example after poisoning, since this is not compatible with a DCD process. The assessment of medical suitability is…

…All concentrations are given in mmol/L and the result in mosm/kg. Urea is included in the total osmolality but not in the effective…

…investigation , and a normal CT of the brain does not exclude an infarction in the posterior fossa. Preparation and equipment No special equipment is needed…

…three weeks of adequate anticoagulation before cardioversion — an INR ≥ 2.0 checked weekly on warfarin, or documented well managed DOAC therapy with no missed doses…

…and the intubator not being an anaesthetist (1 point). A score of 3 or more indicates a difficult intubation — call for help and get out…

…do not delay treatment when there are ECG changes, circulatory compromise or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of…

…local protocol before prescribing. Basic principles of treatment The patient should be managed in an emergency department, an intensive care unit, a coronary care unit…

…of the symptoms when the glucose is normalised [3]. A healthy person without diabetes therefore does not normally need investigation on the basis of an…

…A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance…

Procedurer Three of the commonest minor procedures in general practice concern the nails, and all three rest on the same foundation: an effective digital block…

…and an as required opioid at the same time. Opioids in abdominal pain of unclear cause do not delay the diagnosis and should be given…

…Confirm at least 2–3 cm of free fluid depth with no bowel in the path of the needle and measure the skin to peritoneum…

…basis of the haemodynamics, not the volume of fluid. A litre that has accumulated slowly can be asymptomatic, while 150 mL collected over an hour…

…is reached. Indications Diagnostic aspiration: a new pleural effusion of unclear cause. An effusion not confidently explained by heart failure must be aspirated. Suspected empyema…

…reduced contractility of hypothermia are not tolerated. A decision to withhold further life sustaining treatment. Preparation and equipment Continuous core temperature measurement. An oesophageal probe…

…hydrogen ions instead of potassium, and the urine stays acidic however much bicarbonate is given. Potassium replacement is not the management of a side effect…

…is initiated. High No treatment High 2 Oral anticoagulation (warfarin or NOAC) is recommended for all male patients with scores of 2 or more. Very…

…or no effect on myocardial contractility or conduction. Clevidipine reduces mean arterial blood pressure (MAP) by decreasing systemic vascular resistance (SVR). Clevidipine does not reduce…

…an antiandrogen used in the treatment of prostate cancer. PubMed search Abiraterone ) DrugBank search Abiraterone Aceprometazine None Classified as QT prolonging drug in DrugBank. No…

…yet no reliable model currently exists for the long term prediction of sudden cardiac arrest. The constraint does not lie in therapy: implantable cardioverter defibrillators…

…and therefore requires an emergency management pathway. Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity…

…or combinations of these mechanisms. Drug selection can therefore be tailored to the suspected mechanism. No antianginal class has demonstrated consistent superiority for symptom relief…

…There was no significant increase in fatal bleeding in the cited analyses. Nevertheless, the clinical importance of non fatal gastrointestinal and intracranial haemorrhage is substantial…

…widening pulse pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target, particularly when a lower DBP…

…are at increased risk of decompensation if infected with COVID 19. Moreover, there may also be an increased risk of myocarditis, given the similarities between…

…assessment. A carotid bruit is an important marker of cardiovascular risk, although the source material does not provide diagnostic sensitivity or specificity for bruit detection…

…in an asymptomatic individual is not supported by the available evidence described here. Systematic screening of the general population for cardiovascular risk factors has not…