…lungs, abdomen, urinary tract and neurology 7 Give an intravenous antipseudomonal beta lactam as soon as possible, aiming for within 60 minutes 8 Give oxygen…

…airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always assess the severity clinically, whatever the DS CRB65 score. Urinary tract Diagnosis…

…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…

…the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked obstructive airways…

…shock, hypoxia and any other underlying cause immediately. 9. Request ultrasound of the kidneys and urinary tract when a postrenal cause cannot confidently be excluded…

…is disputed and practice differs between units. Poisoning with other weak acids where the poison control centre recommends it, for example certain phenoxy acid herbicides…

…heart failure, atrial fibrillation, and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The…

…organ damage. Isolated malignant retinopathy without other acute organ damage can often be treated more cautiously with oral drugs under careful observation [3,4]. A…

…acute HMOD, although other guidance emphasizes that no single BP threshold is diagnostically sufficient: the presence of ongoing acute organ injury is decisive. The pathophysiology…

…frail older patient an apparently small insult — sleep deprivation, urinary retention or a new sedative drug, for example — may be enough to precipitate the condition…

ECG Myocardial ischemia and infarction Pathological R wave progression Normal R wave progression implies that the R wave amplitude increases gradually from V1 to V5…

…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…

…administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary Indications Ticagrelor, in combination with acetylsalicylic acid (ASA), is indicated for…

…Familial and genetic screening in cardiovascular medicine is the systematic assessment of relatives and other individuals who may carry an inherited predisposition to cardiovascular disease…

…C) is the principal therapeutic target in lipid management because LDL and other apolipoprotein B containing lipoproteins play a causal role in atherosclerotic cardiovascular disease…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

…dangerous differential diagnoses [1,2]. STEMI and other ECG patterns suggesting acute coronary occlusion are time dependent conditions. The decision on immediate reperfusion is based…

…drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre…

Indications Acute myocardial infarction. Unstable coronary artery disease. Stable angina pectoris. Secondary prophylaxis to prevent recurrence of cerebrovascular diseases, such as: Transient ischemic attacks (TIA…

…interventions intended to reduce recurrent infarction, ischaemic stroke, cardiovascular death, and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease…

…containing lipoproteins, including: LDL Intermediate density lipoprotein (IDL) Lipoprotein(a) [Lp(a)] Very low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non…

…only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin, so biomarker interpretation…

…which demonstrated that high blood pressure and high cholesterol levels, among other risk factors, were strongly associated with coronary artery disease and myocardial infarction. However…

…acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography, percutaneous coronary intervention (PCI…

…myocardial infarction and stroke Likelihood of repeat revascularization Symptom burden and treatment goals Diabetes, left ventricular function and other comorbidities Surgical risk and contraindications to…

…or arteries supplying the limbs. In adults over 40 years of age, atherosclerosis is the predominant cause. Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia…

…electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect cessation or treatment…

…most cardiac conditions may be associated with atrial flutter. As compared with several other supraventricular tachyarrhythmias, atrial flutter does not occur among otherwise healthy individuals…

…case the ECG or other examinations suggest left ventricular hypertrophy (LVH), one should suspect concomitant right ventricular hypertrophy (RVH) if the following ECG criteria are…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave…

…radiotracers emit positrons. When a positron collides with an electron, they annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect…

ECG Myocardial ischemia and infarction ST segment elevation in acute myocardial ischemia ST segment elevations with straight (horizontal, upsloping, or downsloping) or convex ST segment…

…atrial impulses are conducted to the ventricles. The atria and the ventricles are electrically dissociated from each other. This condition is referred to as atrioventricular…

…and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist / hip Men 0.90, women 0.85 = abdominal…

…rivaroxaban and edoxaban. Check every 6 months 15 30 Dabigatran contraindicated. The other DOACs are possible according to FASS, but the documentation is insufficient; check…

…compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A…

…of infection. Indications Infusion of vesicant solutions: vasopressors, concentrated potassium, cytotoxic drugs, parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other…

…margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology is…

…alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the…

…1. Assess airway, breathing and circulation. 2. Assess the neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke…

…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…

…pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the conditions in which the procedure is the wrong treatment …

…a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over the injection site. Bacteraemia or suspected septic bursitis or arthritis. A joint…

…a pulse that can be felt. The other predictable error is forgetting that pacing hurts a great deal in a conscious patient. Indications Immediate (transcutaneous)…

…Definition of aortic aneurysm Sinus of Valsalva 45 mm. Any other segment 40 mm in diameter. Thresholds for surgery Threshold for surgery Relevant patient category…

…8% Interpretation of ATRIA risk score. Comparison with other bleeding risk models Several bleeding risk assessment tools exist for patients with AF, including HAS BLED…

…AF patients. Evidence suggests that the increased stroke risk in women is more closely associated with other comorbidities and age rather than sex alone. Consequently…

…of the type of oral anticoagulant used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES…

…Components of the HEMORR₂HAGES Score The acronym HEMORR₂HAGES represents the following parameters: H epatic or renal disease (1 point) E thanol abuse (1 point) M…

…and other tachykinins, such as substance P. When ACE is inhibited, the resulting accumulation of these peptides irritates afferent neural pathways in the respiratory tract…

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Acute coronary syndrome (ACS) comprises a spectrum of clinical presentations caused by suspected acute myocardial ischaemia…

…and death. The clinical consequences are particularly important when pulmonary vascular obstruction is accompanied by limited cardiopulmonary reserve or other adverse comorbidity. The classification of…

…more recent analyses question whether this reflects true biological protection. Potentially favourable associations with myocardial infarction may coexist with adverse effects on stroke, heart failure…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…elevated cardiac troponin concentration and new ST segment depression in new onset AF should not automatically be labelled type 2 myocardial infarction without further assessment…

…or worsen with illness, treatment, or other interventions. Frailty commonly overlaps with multimorbidity and is frequent in patients with cardiovascular disease, including heart failure and…

…disease, with symptoms similar to seasonal flu (influenza) and other viral respiratory infections. However, in some individuals the infection may be severe and deadly. Importantly…