…dose ends up subcutaneously, which gives a poorer immune response and more local reaction. Procedure Intramuscular — deltoid 1. Expose the whole shoulder; rolling up a…

…left ventricle is usually considerably larger than the right ventricle, the QRS complex is actually a reflection of the electrical potentials generated by the left…

…that should make them seek help immediately. Indications An undisplaced or reduced fracture to be treated conservatively. Immobilisation after reduction of a dislocation. Immobilisation of…

…phenotypes Initial assessment should distinguish congestion from hypoperfusion. This distinction provides a practical framework for selecting treatment: Clinical state Principal management approach Congestion without hypoperfusion…

…overt congestion is not apparent. Such a discrepancy should prompt consideration of an infiltrative cardiomyopathy within the appropriate clinical context. Several patient related factors influence…

…a normal finding. Abnormal (pathological) causes of sinus bradycardia In all other situations, sinus bradycardia should be regarded as a pathological finding. Numerous pathological conditions…

…with the right atrium being depolarized before the left atrium. The first half of the P wave is therefore a reflection of right atrial activation…

Echocardiography Generating the ultrasound image The ultrasound transducer generates short bursts (pulses) of ultrasound waves. Reflected ultrasound waves are analyzed by the machine during the…

…left ventricle is many times larger than the vector generated by the right ventricle, the QRS complex is actually a reflection of left ventricular depolarization…

Cardiology Introduction Since its initial description in 1992 as a syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death (SCD), Brugada…

…visual diameter reduction. Relevant determinants include: Lesion eccentricity Vessel tortuosity Calcification Plaque rupture or asymmetric filling defects Serial lesions Vessel size The relationship of the…

…with the right atrium being depolarized before the left atrium. The first half of the P wave is therefore a reflection of right atrial depolarization…

…blocker exposure. The incidence of cardiogenic shock complicating STEMI has fallen with prompt reperfusion and reduction of infarct size. Earlier estimates approached 20%, whereas contemporary…

…Pathophysiology of pulmonary embolism (PE). Hemodynamic effects Pulmonary embolism leads to increased resistance in the main pulmonary artery, and thereby increased afterload on the right…

…effect varies tenfold between individuals, and the only way to find the right level is to give a small dose, wait until it has worked…

…It generally results from accumulation of pericardial fluid, blood, or, less commonly, a mass. Tamponade occurs when intrapericardial pressure equals or exceeds right atrial pressure…

…4.0 cm 2 . Aortic stenosis is a progressive disease that leads to a gradual reduction in the orifice area. As the area is reduced…

…haemorrhage control) planned in advance. A history of a severe transfusion reaction: contact transfusion medicine before transfusing again. Preparation and equipment Compatibility testing Test What…

…vomiting, muscle cramps, apathy, confusion, impaired reflexes. Severe <115 mmol/L Seizures, coma, respiratory arrest, brainstem herniation and death. Table 2. Grading of hyponatremia. Hypernatremia…

…an orthopaedic surgeon before attempting reduction. Posterior shoulder dislocation, which is often associated with fracture and requires an orthopaedic surgeon. Dislocation of a native hip …

…rated as 6 or above (according to the 10 point scale) should prompt termination of the stress test (refer to Termination criteria during stress testing)…

…progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and, when prolonged or severe, myocardial necrosis. It most commonly reflects atherothrombosis: disruption of…

…on the size of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of coronary blood flow…

…important risk factors. Severe atherosclerosis of the axillary or subclavian arteries may increase the risk of embolization. Risk assessment should be individualized. There are no…

…radiotracers emit gamma photons directly. These gamma rays are detected by gamma cameras to create tomographic images of the left ventricle. In PET (Positron Emission…

…term to describe a reduction of blood flow to tissues and organs. A few decades later Cohnheim demonstrated that ligation of the left anterior descending…

…92 percent until the risk of hypercapnia has been assessed. 3. Take an arterial blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention…

…functional) capacity. Functional capacity is a strong predictor of both cardiovascular and overall mortality, offering incremental prognostic data beyond perfusion imaging and ECG reaction. Coronary…

…PCI of an occluded infarct related artery is not recommended in stable, asymptomatic patients without severe ischaemia. Evaluation and Physical Examination The initial evaluation should…

…LDL C reduction required is greater than can reasonably be obtained with a statin alone but does not necessarily require the larger effect of a…

…the muscle fibers themselves can only be shortened by about 13% of their length, but the sum of all contractions results in a reduction of…

…thrombolysis should result in 50% ST segment return (i.e reduction of the ST segment elevation by 50%) within 60 minutes after administration of thrombolysis…

…A1c (HbA1c) reduction, blood pressure, lipids and smoking cessation. Weight loss was considered extremely difficult across patient categories. However, the emergence of incretin based therapies…

…category of elevated blood pressure, defined as office SBP 120–139 mmHg or DBP 70–89 mmHg. This distinction supports a risk based approach because…

Psykiatri Akutsjukvård Lathundar Rapid summary Alcohol withdrawal occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite…

Akutsjukvård Lathundar Basic principle Anaphylaxis is a rapidly developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin…

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…

…The urgency varies: Object Urgency : : Button battery Immediately — leakage of fluid causes a chemical burn Two or more magnets (including in different nostrils) Immediately — pressure…

…crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction…

…and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to…

…ivabradine should be considered to reduce the risk of heart failure hospitalisation and cardiovascular death. The recommendation is class IIa, level B. Every effort should…

…this form of hypertension was a physiological reaction that was necessary to maintain normal hemodynamics, hence the term essential . However, a growing body of science…

…can be counteracted with simultaneous administration of beta blockers). Effects Induces arteriolar vasodilation without effects on venous circulation. The reduction in systemic vascular resistance (SVR…

…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…

…dioxide retention for the latter. The treatment is also time limited by its very nature: a patient who has not responded within a couple of…

…disease (ASCVD). Atherosclerosis develops through the progressive deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory…

…associated with increased ASCVD risk. Management in this range therefore focuses principally on ASCVD prevention and reduction of LDL C, non HDL C and apolipoprotein…

…stricture or a known diverticulum Relative Recent nasal or pharyngeal surgery Signs that should raise the suspicion of a base of skull fracture: periorbital bruising…

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…

…Clinical presentation and assessment Identifying tobacco exposure Every cardiovascular assessment should establish: Current smoking status. Cigarettes smoked per day. Duration of smoking and cumulative exposure…

…a drop in blood pressure, and finally a reduction in heart rate. This sequence is characteristic of neurally mediated hypotension. Clinical Presentation and Symptoms Vasovagal…

…Discharge Management The STRONG HF trial demonstrated the safety and efficacy of an approach based on starting and titrating oral medical therapy for heart failure…

…delayed intensification of lipid lowering therapy may leave patients exposed to avoidable risk. Contemporary guidance therefore supports an early, intensive approach: treatment should begin immediately…

…CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences of extensive myocardial ischaemia, including heart failure…

…A reduction of at least 50% from baseline . The treatment sequence is generally: High intensity statin therapy at the highest tolerated dose. Addition of ezetimibe…

…insufficiency and cardiovascular disease, irrespective of diabetes status The clearest and most consistent cardiovascular signal is reduction in hospitalization for heart failure. Benefits also include…

…manifest at rest because of the severe reduction of coronary flow caused by acute atherothrombosis. Table 1: Myocardial and ECG reaction in various settings with…

…risk of fluid retention and impaired kidney function). Patients with bronchial asthma, chronic obstructive pulmonary disease, hay fever, or nasal polyps (increased risk of hypersensitivity…

…should not be combined with statins because it alters statin absorption, hepatic uptake and disposition. Clinical presentation and symptoms Typical SAMS consists of: Symmetric muscle…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…