…reported reductions of up to 50–55% in guideline summaries. It also lowers non HDL C by up to approximately 50% and apolipoprotein B by…

…subendothelial accumulation of apolipoprotein B containing lipoproteins, macrophage infiltration, smooth muscle cell proliferation, and extracellular matrix deposition, ultimately leading to the formation of atherosclerotic plaques…

…Danlos syndrome Inflammatory aortitis, including Takayasu arteritis and giant cell arteritis Bicuspid aortic valve Coarctation of the aorta Previous aortic trauma Pregnancy, particularly the third…

…from one contractile cell to another, starting in the endocardium and heading towards the epicardium. As evident from Figure 7 , the vector of the ventricular…

…A score of 3 or more indicates a difficult intubation — call for help and get out the videolaryngoscope and plan B before you give the…

…conduction system allows for rapid spread of the depolarization to the contractile cells. Figure 3 illustrates the components of the conduction system and its temporal…

…too small to be detected by skin electrodes; the ECG presents the electrical activity of the atrial and ventricular myocardium. Automaticity of pacemaker cells The…

…HDL cholesterol and increased small, dense LDL particles. Increased apoB containing particles and remnants may provide a more accurate assessment of atherogenic burden than LDL…

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

…more cell lines. Suspected acute leukaemia, myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma. Suspected bone marrow metastasis. Assessment of…

…the freeze–thaw–freeze cycle that causes cell death, not the cold alone. The temperature at the outer edge of the tissue is decisive: benign…

…cutaneous vasculitis, lymphoma or granulomatous disease. A treatment resistant rash without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma…

…injection. A needle of 0.8–1.2 × 50 mm for large joints (knee, shoulder), 0.5–0.6 × 25 mm for small joints (wrist…

…pressure Marked respiratory variation in mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute…

…sinus node–and an electrical conduction system composed of specialized myocardial cells. Conduction cells form bundles of fibers that spread the action potential rapidly and…

…A diagnosis of delirium is therefore the beginning of the investigation, not the end. In a frail older patient an apparently small insult — sleep deprivation…

…Use a balanced crystalloid in the first instance. Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse…

…depolarized by impulses generated by cells outside of the sinoatrial node (i.e by an ectopic focus), the morphology of the P wave may differ…

…symptoms, and ECG changes. Although the risk of cardiac arrest is very small, personnel must be well trained in resuscitation. Subject preparations The procedure must…

…This fluid is produced by the mesothelian cells and consists of 25 50 mL serous fluid. Function of the pericardium The pericardium is considered to…

…electrical impulses. Side effects of drugs (notably beta blockers, digitalis, verapamil, diltiazem, amiodarone, clonidine) – These drugs affect the pacemaker cells in the sinoatrial node. They…

…are small, round and have an irregular surface, the reflected sound waves are scattered in all directions (Figure 2). Although only a fraction of the…

Echocardiography Principles of echocardiographic examinations In small children, it is possible to perform the entire transthoracic echocardiography (TTE) with the child in the supine position…

…Inhibition of ACL reduces hepatic cholesterol synthesis and produces reductions in LDL C, non high density lipoprotein cholesterol, apolipoprotein B and high sensitivity C reactive…

…source.gif). ECG changes caused by pericardial effusion and cardiac tamponade Small amounts of pericardial effusion may not cause any ECG changes. Significant pericardial effusion…

…pulmonic) regurgitation Pulmonary regurgitation is also called pulmonic regurgitation . The majority of all adults exhibit a small pulmonary regurgitation, which is considered a normal finding…

…somewhere that makes incision in the emergency department the wrong move — in the hand, in the medial triangle of the face or perianally. Indications Fluctuant…

…recorded at a paper speed of 50 mm/s with 1 mV = 10 mm. At 50 mm/s a small square (1 mm) corresponds…

…titration. Half of all opioid dosing errors arise at the dilution step, and an undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure…

…Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment…

…weak, slow deceleration variable dense, steep deceleration, early termination of diastolic flow Jet width colour Doppler small,, < 10 mm length, narrow origin variable large…

…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…

…spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy: an otoscope with a charged battery and clean disposable specula…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…the full thickness of the dermis, particularly over joints and in cosmetically sensitive areas. Superficial wounds with well apposed edges, abrasions and small wounds under…

…produce tamponade depends principally on the rate of accumulation and the compliance of the pericardium. Rapid accumulation may cause tamponade with a relatively small volume…

…Source: Worldometer. Cardiovascular implications of COVID 19 Data on the natural history of COVID 19 relies on small samples of hospitalized patients. Most reports have…

…with: Small reference vessel diameter A small post procedural lumen Substantial residual stenosis Long lesions Diabetes mellitus Untreated edge dissection Components and mechanisms of DES…

…are elevated. The syndrome is therefore defined by symptoms and signs of congestion or impaired cardiac performance rather than by ejection fraction alone. Heart failure…

…beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, and…

…same extent by statins. Inclisiran Inclisiran is a liver targeted small interfering RNA. It promotes degradation of the messenger RNA encoding PCSK9, thereby suppressing hepatic…

…atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with AF. Stroke risk…

…former). Even small pressure elevations on the right side can compromise venous return to the right ventricle. Therefore, in the presence of a tamponade, chest…

…stroke constitutes 87% of all stroke cases and is further divided into the following categories: Lacunar stroke or lacunar infarct (occlusion of small penetrating arteries)…

…flat and on the same level as the baseline (recall that the baseline is the level of the PR segment). Refer to Figure 1 B …

…their size, encompassing: Small defects : <10% of the left ventricular myocardium. Medium defects : 10–20% of the myocardium. Large defects : 20% of the myocardium. Perfusion…

…Similar to vascular endothelium, the endocardium contains an underlying basement membrane and a small layer of loose connective tissue. The endocardium joins the endothelium that…

…the sinoatrial node are much too small to be detected on the surface ECG. Intracardiac electrodes – with the placement of electrodes against the sinoatrial node…

…BSA [body surface area]). Approximately 85% 90% of healthy individuals in the general population exhibit a small tricuspid regurgitation, which is considered a normal finding…

…but only a small increase in left ventricular pressure. This is explained by the fact that the left ventricle is capable of relaxing and expanding…

…of the artery with two fingertips and note the direction. Disinfect and allow to air dry. 2. Anaesthetise the skin with a small amount of…

…small change in T4 produces a large change in TSH. During acute illness the TSH can be falsely low or high in the absence of…

…shoulders as an alternative to a hanging head. Frenzel goggles or video Frenzel if available — small beats of nystagmus can otherwise be hard to see…

…indexed Aortic annulus 20 31 mm 12 14 mm/m2 Sinuses of Valsalva 29 45 mm 15 20 mm/m2 Sinotubular junction 22 36 mm…

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…

…and stabilise the patient Immediate assessment 1. Assess airway, breathing, circulation and level of consciousness. 2. Attach ECG, pulse oximetry and repeated blood pressure measurement…

…the larger , since a mask that is too small leaks and gives a poorer seal. Procedure Insertion of the laryngeal mask 1. Check the mask…

…or the cut off finger of a sterile glove rolled down. A nail splitter or strong pointed scissors, a Freer elevator or small artery forceps…

…medium for most adults, long for thick soft tissue and for the head of the humerus. A pressure bag or a 50 mL syringe with…

…ventilation with a high PEEP (an increased risk of pneumothorax; ultrasound guidance is mandatory) Relative A very small or loculated effusion — consider image guided puncture…