…cardiovascular risk factors Concomitant nonsteroidal anti inflammatory drugs Corticosteroid therapy Other antiplatelet or antithrombotic drugs Selective serotonin reuptake inhibitors Patient selection Aspirin should not be…

…antigens and initiate an inflammatory response. The presence of antibodies directed against cardiac tissue, the latent interval of several weeks, improvement with anti inflammatory treatment…

…through intimal thickening. DES release antiproliferative and anti inflammatory agents from the stent surface and have substantially reduced this process compared with BMS. Neoatherosclerosis Neoatherosclerosis…

…In the critically ill patient, AF may be pre existing, newly detected for the first time, or newly developed during management of an acute illness…

…heterogeneous, and some patients may benefit from a more individualized selection strategy. When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care…

…extremely low and the potentially catastrophic consequences of wrongfully withholding an attempt, CPR is often initiated in individuals who are biologically dead or in w

…pressure and ECG should be observed for an additional 15 minutes after the completion of the infusion. The initiated infusion should always be completed (regardless…

…or heaviness [7]. Classically, it is initiated by exertion or stress and is relieved by rest or nitroglycerin [4], [6]. Presentation Nuances: While typical angina…

…may reduce rehospitalization for recurrent ischaemia and infarction. Clinical Presentation and Symptoms Cardiac rehabilitation is initiated in patients recovering from myocardial infarction, particularly after STEMI…

…Patients with persistent or recurrent chest pain require repeat blood sampling even when an accelerated algorithm has already been initiated. Evaluation and Physical Examination Patients…

…elevation, or an equivalent electrocardiographic pattern, suggesting acute coronary occlusion. Most patients with this working diagnosis subsequently develop myocardial necrosis and cardiac troponin elevation, although…

…support (ALS) can be initiated. In regards to cardiac arrest, BLS includes delivering high quality chest compressions, ventilations and use of an automatic external defibrillator …

…should maintain a high index of suspicion for drug induced arrhythmias in patients receiving agents known to alter the electrical properties of the heart (inducing…

…Number Needed to Treat (NNT) is the number of patients you need to treat to save one. If an intervention has an NNT of 10…

…In patients who experience a recurrent atherothrombotic or cardiovascular event within 2 years while receiving maximally tolerated statin based treatment, an LDL C goal below…

…rate . Hypoxia can precipitate cardiac arrest in septic patients; timely oxygenation can potentially prevent circulatory collapse. Initiate an intravenous bolus of 500 ml crystalloid solution …

…pharma" sham? These are actually questions that patients tend to ask nowadays and therefore I will make an effort to clarify the issues. Is high…

…inhibitors and inducers. Clinical indications Heart failure with reduced ejection fraction Ivabradine is an adjunctive option for selected patients with symptomatic HFrEF. The guideline defined…

…the isoelectric line. Most patients display QTc 500 ms during sinus rhythm. TdP is typically initiated by a long short coupling sequence. Common scenarios leading…

…This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained atherogenic particles accumulates over time, the probability of an acute…

…coronary calcification. CAC therefore functions primarily as an imaging biomarker of coronary atherosclerotic burden rather than as a direct measure of luminal obstruction. Calcified plaque…

…airways may cause complications in patients with skull fractures (risk of intracranial malposition of the tube) or coagulopathy (risk of bleeding). An advanced airway (tracheal…

…the isoelectric line. Most patients display QTc 500 ms during sinus rhythm. TdP is typically initiated by a long short coupling sequence. Common scenarios leading…

…can potentially be reversed if interventions are promptly instituted. In scenarios where an antidote is not available, it is essential to provide supportive care and…

…PAU is strongly associated with extensive atherosclerosis and frequently occurs in older patients with multiple vascular comorbidities. An isolated PAU is one without associated IMH…

…alone in patients with diabetes. Insulin resistance is accompanied by compensatory hyperinsulinaemia and, with progression, hyperglycaemia and pancreatic β cell dysfunction. These abnormalities initiate self…

…trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather than an isolated disorder of the lower limbs. Patients frequently have concomitant coronary, cerebrovascular…

…of CHADS VASc is to identify patients at high risk of stroke, TIA or systemic thromboembolism and initiate treatment with anticoagulants (rarely with antiplatelet agents)…

…atrial fibrillation. Consequently, alcohol should not be initiated as a cardiovascular preventive strategy. A drink equivalent contains approximately 12–14 g of ethanol. Representative quantities…

…recurrent infarction and limb threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of…

…85%). Many patients appreciate the exercise test because it offers them an opportunity to evaluate their performance and symptoms under the supervision of their clinician…

…Basic principle Manage the patient, not the list of poisons. Stabilisation according to ABCDE, the plasma glucose, a blood gas and an ECG all come…

…treatment in high risk embolism, unless there is an absolute contraindication. The agent and dose are according to the local protocol. Alternatives when there is…

…the management: is the patient unstable, how long has the fibrillation lasted, and does the patient need an anticoagulant? The unstable patient Immediate electrical cardioversion…

Hematologi & onkologi Infektionssjukdomar Lathundar Key message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation…

…commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often lacks abdominal…

…to the patient — the device senses the rhythm through the cable, not through the pads. A pulse oximeter, a blood pressure cuff, and an arterial…

…drugs, and how many doses, has the patient taken? Is the patient on an inhaled corticosteroid or other anti inflammatory treatment? Previous intensive care, intubati

…main clinical rule Two questions determine the initial management: 1. Does the patient have severe neurological symptoms that may be due to the hyponatraemia? 2…

…peripheral cannulae. Consider an arterial line if the patient is unstable or frequent blood gases are needed 3 Blood grouping and cross matching. Order red…

…the validity before ordering blood ; an expired type and screen discovered when the patient is already bleeding costs precious time. Exact validity periods and the…

…which casting harms the patient are that it is too tight — the swelling comes after the injury, not before — and that an edge or a…

…the investigation, not the end. In a frail older patient an apparently small insult — sleep deprivation, urinary retention or a new sedative drug, for example…

…well the patient was preoxygenated, whether the difficulties were anticipated, whether the position and the equipment are in order, and whether there is an explicit…

ECG Exercise stress test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually…

…concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute coronary syndrome (ACS)…

…presentation fits an exacerbation A COPD exacerbation is an acute or subacute worsening of dyspnoea, cough and sputum in particular that exceeds the patient's…

…and then selecting a targeted examination. The patient's description of the quality of the dizziness — rotatory vertigo, unsteadiness or faintness — discriminates poorly between dangerous…

…arms, an arm circumference too large for the available cuffs, and in a patient who does not tolerate repeated compression (for example marked thrombocytopenia). Set…

…consider an alternative treatment In aminoglycoside treatment of obese patients, an adjusted body weight is used: adjusted weight = ideal weight + 0.4 x (actual…

…haemodynamic instability — stabilise the patient first. Marked septal deviation towards the bleeding side (relative). Preparation and equipment Personal protective equipment (gloves, a visor, an apron)…

…is usually a false positive. Indications Evaluation of chest pain with an intermediate pre test probability of coronary artery disease. Assessment of exercise capacity and…

…substance that binds to charcoal, when it can be given early and the patient has an intact or a protected airway. The benefit is greatest…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…done wrongly. The two commonest errors are that an intramuscular injection in fact ends up subcutaneously in a patient with a high BMI, and that…

…needle itself. It is the decision whether to perform it now or after imaging, how the patient is positioned, which needle is chosen, and that…

…the tube is safe. A misplaced tube in the airway produces no reliable symptoms in a patient with an impaired cough reflex, and the first…

…The nasal cannula, the simple mask and the reservoir mask deliver an FiO2 that varies with the patient's minute ventilation: a markedly hyperventilating pati

…miss a posterior dislocation. The exceptions are an obvious recurrent dislocation in a patient with known instability and a low energy mechanism, and a neurovascularly…

…adrenaline, an antihistamine, oxygen. Drugs that must be dealt with before the test Agent Action before the test : : Hydrocortisone Omit the evening and morning doses…