Remember:

-Patients with an acute myocardial infarction or unstable angina pectoris and severe hypertension should be treated with intravenous esmolol.

-Intravenous nitroglycerin may also be administered if needed.

-The target blood pressure is less than 140/90 mmHg in patients with acute myocardial infarction or unstable angina pectoris who are hemodynamically stable .

-A blood pressure of less than 130/80 mmHg at hospital discharge should be considered .

-Caution should be used in lowering the blood pressure in these patients to avoid lowering the diastolic blood pressure to less than 60 mmHg as this may decrease coronary perfusion and aggravate myocardial ischemia.

#Cardiology

Remember:

-The drugs of choice in treating patients with a hypertensive emergency and acute renal failure are clevidipine, fenoldopam, and nicardipine.

#Cardiology

-Drugs of choice for treating a hypertensive emergency caused by a pheochromocytoma or by an hyperadrenergic state caused by use of cocaine, amphetamines, phencyclidine, or monoamine oxidase inhibitors or by abrupt cessation of clonidine or other sympatholytic drugs are intravenous clevidipine, nicardipine, or phentolamin.

#Cardiology

Remember:

-Dysuria+increased WBCs in the urine + flank pain 👉🏼 acute pyelonephritis

-Dysuria+ increased WBCs in the urine without flank pain 👉🏼UTI

Dysuria + increased WBSs in the urine + suprapubic pain 👉🏼 acute cystitis.

#Renal

Features of myxedema coma:

I+5H
* impaired conciousnesss
* Hypoglycemia
* Hypothermia
* Hyponatremia
* Hypotension
* Hypothyroidism.

#Endocrine

-Percutaneous liver biopsy is contraindicated because of the severe coagulopathy, but biopsy can be undertaken using the transjugular route if appropriate in case of AHF.

#Liver

-The PT rapidly becomes prolonged as coagulation factor synthesis fails; this is the laboratory test of greatest prognostic value and should be carried out at least twice daily.

#Liver

Hepatitis B core IgM antibody is the best screening test for acute hepatitis B infection.

#Liver

Common Cardiac Signs in Radiology

#Cardiology

Behçet's disease.

#Rheumatology

Signs of lung disease.

#Respiratory

Complications of OSA:

1-Systemic hypertension
2-Arrhythmia (e.g., (atrial fibrillation, atrial flutter)
3-Pulmonary hypertension and cor pulmonale
4-Cardiac infarction, stroke, and sudden cardiac death (the risk of sudden death is high in infants and the elderly)
5-Polycythemia
6-Risk of accidents
7-Poor sleep leads to increased appetite and obesity.

#Respiratory

Remember:

Causes of mononeuritis multiplex include - Vasculitis - Diabetes - Sarcoidosis - paraneosplastic syndrome - amyloidosis.

#Neurology

-Cardiac rhabdomyomas are by far the most common primary cardiac tumor in childhood.

#Cardiology

Clinical Clues:

🔴Erythema nodosum -group A streptococcus
🔴Erythema marginatum - acute rheumatic fever.
🔴Erythema migrans (bull eye) - lyme disease
🔴Erythema toxicum - newborn pustules.
🔴Erythema multiforme -viral infections & drugs..
🔴Erythema infectiosum - fifth disease
🔴Erythema ab igne - long term exposure to heat
🔴Erythema induratum -cutaneous tuberculosis.

#General

Remember:

HbA1c is unreliable in CKD for glycemic control.
Why?
- falsely low
Because shortened RBC life span in CKD- more immature red cells- less time for glycation

So Glycated albumin/ fructosamine unaffected by anemia, each 3 weeks.

#Renal

-Third-degree (complete) AV block will have cannon A waves.
-They are the best way to distinguish third-degree AV block from sinus bradycardia before you obtain an EKG.

#Cardiology

-Sinus bradycardia is very common in association with MI because of vascular insufficiency of the sinoatrial (SA) node.

-USMLE
#Cardiology

-A systolic blood pressure goal of 140 mm Hg is probably appropriate for acute hemorrhagic stroke.

#Neurology

What are the discharge criteria of COPD patient?

-The patient should be clinically stable and no parenteral therapy for 24 hours
-Inhaled bronchodilators are required less than 4 hourly
-Oxygen delivery has ceased for 24 hours
-The patient is able to eat and sleep without significant episodes of dyspnea
-The patient or caretaker understands and is able to administer medications
-Follow up and home care arrangements (As for example home oxygen, home care, Meals on Wheels, community nurse, allied health, GP, specialist) have been completed
-The patient is ambulating safely and independently, and performing activities of daily living.

#Respiratory