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INSTRUCTIONThis patient developed shortness of breath and orthopnoea during pregnancy, please examine.This 55-year-old patient has atrial fibrillation, please do the relevant clinical examination.SALIENT FEATURESHistory Symptoms of left-sided heart failure: exertional dyspnoea, orthopnoea,paroxysmal dyspnoea. Less frequent symptoms: haemoptysis, hoarseness of voice, symptomsof right-sided failure (these symptoms are somewhat more specific formitral stenosis). Obtain a history of … Read more

Colorectal CancerA. General characteristics Risk factors • Polyps plus osteomas, dental abnormalities, benign soft tissue tumors, des moid tumors, sebaceous cysts.• Risk of CRC is 100% by approximately age 40.c. Turcot syndrome• Can be inherited as autosomal dominant or recessive.• Polyps plus cerebellar medulloblastoma or glioblastoma multiforme.d. Peutz–Jeghers• Autosomal dominant.• Single or multiple hamartomas that … Read more

Pulmonary Hypertension A. General characteristics Treatment b. Rales (51%)c. Tachycardia (30%)d. S4 (24%)e. Increased P2 (23%)f. Shock with rapid circulatory collapse in massive PEg. Other signs: low-grade fever, decreased breath sounds, dullness on percussionC. Diagnosis pulmonary angiography. If the duplex is positive, treatment for DVT is thesame as for PE. If the duplex is negative/uncertain, … Read more

Acute Respiratory Distress SyndromeA. General characteristics b. Decreased pulmonary compliance—leads to increased work of breathing.c. Increased dead space—secondary to obstruction and destruction of pulmonarycapillary bed.d. Low vital capacity, low FRC.B. Causes A: Chest radiograph showing typical findings in ARDS. B: Another example of ARDS. Alsonote presence of an ET and Swan–Ganz central venous catheter.(A from … Read more

Hypertensive Emergency A. General characteristics

Premature Complexes A. Premature atrial complexes 7. Usually asymptomatic and do not require treatment. Monitor for increased fre quency. If symptomatic (e.g., palpitations),β-blockers may be helpful. Premature ventricular complexes • If left ventricular systolic dysfunction is present, consider digoxin or amiodarone (useful for rhythm control).b. Cardioversion to sinus rhythm (after rate control is achieved)• Candidates … Read more

A. General characteristics • If patient responds to medical therapy, perform a stress ECG to assess needfor catheterization/revascularization. Many patients with USA that is controlled with medical therapy eventually require revascularization.• If medical therapy fails to improve symptoms and/or ECG changes indicativeof ischemia persist after 48 hours, then proceed directly to catheterization/revascularization. Additional indications for … Read more

Category: Education / Student Life / Productivity Estimated Reading Time: 8 Minutes Raise your hand if you’ve ever done this. You spend hours reading your textbook, meticulously highlighting key passages. You reread your notes until your eyes glaze over. You feel so prepared. Then, you sit down for the exam, stare at the first question, and your mind … Read more

A. General characteristics B. Clinical features C. Diagnosis (of CAD) b. Contrast is injected into coronary vessels to visualize any stenotic lesions. Thisdefines the location and extent of coronary disease.c. Angiography is the most accurate test for detecting CAD.d. If CAD is severe (e.g., left main or three-vessel disease), refer patient for surgicalrevascularization (CABG).D. Treatment … Read more

Category: Personal Finance / Lifestyle Estimated Reading Time: 7 Minutes Let’s play a game. It’s three days before payday. You check your bank account. There’s money in there… but payday is right there. You think to yourself, “I got paid a decent amount… where did it all go?” If this sounds familiar, you aren’t bad with money. You … Read more