Quick Notes
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-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
Behรงet'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:

๐Ÿ”ดErythema nodosum -group A streptococcus
๐Ÿ”ดErythema marginatum - acute rheumatic fever.
๐Ÿ”ดErythema migrans (bull eye) - lyme disease
๐Ÿ”ดErythema toxicum - newborn pustules.
๐Ÿ”ดErythema multiforme -viral infections & drugs..
๐Ÿ”ดErythema infectiosum - fifth disease
๐Ÿ”ดErythema ab igne - long term exposure to heat
๐Ÿ”ดErythema 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
Management algorithm of organophosphorus poisoning.

#Toxicology
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
-Pneumonia is the eighth leading cause of death, and the number 1 cause of death from infectious disease, in the United States. 

-Globally, pneumonia is the leading cause of death in children under 5 years old.

#Respiratory
-The classic etiologic agents of atypical pneumonia are Legionella species, Mycoplasma pneumoniae, and Chlamydia pneumoniae.

-Many other diseases, caused by various pathogens, should be considered in the differential diagnosis. Such etiologic agents include fungi, mycobacteria, parasites, and viruses (eg, influenza virus, adenovirus, respiratory syncytial virus, human parainfluenza virus, measles, varicella zoster, Hantavirus)

#Respiratory
Interpretation of thyroid function tests.

#Thyroid
Remember:

-Primaquine is contraindicated in pregnant women,
infants and known G6PD deficient patients.


-Primaquine can lead to hemolysis in G6PD deficiency
.

#Infections
It is recommended to delay elective non-cardiac surgery until
- 6 months after elective PCI and
- 12 months after an ACS.


#Cardiology