scholarly journals Provisional Cycle of Reviews

2002 ◽  
Vol 1 (3) ◽  
pp. 112-112
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Diabetic Ketoacidosis ◽  
Neuroleptic Malignant Syndrome ◽  
Serotonin Syndrome ◽  
Gi Bleeding ◽  
Medical Emergencies ◽  
In Pregnancy

2002 Volume 1: 2 Cellulitis Diabetic Ketoacidosis Ventilation of the Asthmatic Pulmonary Embolism Anaphylaxis Volume 1: 3 Medical Emergencies in Pregnancy Non-Variceal GI Bleeding Atrial Fibrillation Neuroleptic Malignant syndrome / serotonin syndrome Myaesthenia Gravis

scholarly journals Provisional Cycle of Reviews

2003 ◽  
Vol 2 (1) ◽  
pp. 33-33
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Diabetic Ketoacidosis ◽  
Neuroleptic Malignant Syndrome ◽  
Serotonin Syndrome ◽  
Gi Bleeding ◽  
Medical Emergencies ◽  
In Pregnancy

2002 Volume 1:2 Cellulitis Diabetic Ketoacidosis Ventilation of the Asthmatic Pulmonary Embolism Anaphylaxis Volume 1:3 Medical Emergencies in Pregnancy Non-Variceal GI Bleeding Atrial Fibrillation Neuroleptic Malignant syndrome / serotonin syndrome Myaesthenia Gravis

scholarly journals Provisional Cycle of Reviews

2002 ◽  
Vol 1 (2) ◽  
pp. 71-71
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
Gastrointestinal Bleeding ◽  
Diabetic Ketoacidosis ◽  
Airway Disease ◽  
Obstructive Airway Disease ◽  
Chronic Obstructive ◽  
Chronic Obstructive Airway Disease ◽  
Medical Emergencies ◽  
In Pregnancy

2002 Volume 1: 2 Cellulitis Diabetic Ketoacidosis Ventilation of the Asthmatic Pulmonary Embolism Anaphylaxis Volume 1: 3 Medical Emergencies in Pregnancy Non-Variceal Gastrointestinal Bleeding Atrial Fibrillation Chronic Obstructive Airway Disease Myaesthenia Gravis

Self-Assessment MCQ Questions Vol.1 No.2

2002 ◽  
Vol 1 (2) ◽  
Author(s):  
Martin Taylor ◽  
◽  
B Edmunds ◽  
Alison Evans ◽  
P J Francis ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Optic Disc ◽  
Insulin Regimen ◽  
Altered Level ◽  
Sliding Scale ◽  
Venous Pulsation ◽  
Spontaneous Venous Pulsation ◽  
In Pregnancy

(A Evans & M Taylor) · Diabetic Ketoacidosis 1. Only occurs in patients with a history of Insulin-treated Diabetes 2. Can be precipitated by Acute Pancreatitis 3. The diagnosis is excluded by a blood glucose less than 14 mmol/l 4. Has a higher mortality than Hyper-Osmolar Non-Ketotic coma 5. Patients with newly diagnosed Diabetes Mellitus rarely present with Diabetic Ketoacidosis · The Sliding Scale Insulin Regimen 6. 50 units of isophane insulin should be mixed in 50 mls of N/Saline and commenced at 6 units/hour 7. If there is a delay in commencing the intravenous sliding scale 10 units of soluble insulin should be given sub-cutaneously 8. Blood glucose falls of greater than 5 mmol/hour should be avoided 9. When the blood glucose falls to less than 5 mmol/l then the insulin infusion should be stopped 10. If the blood glucose remains above 20mmol/l additional bolus injections of insulin should be administered · Cerebral oedema in DKA 11. Is more common in children than adults 12. Typically occurs 4-12 hours after the start of treatment 13. If suspected clinically a CT scan should be performed prior to treatment with mannitol 14. Should be treated with mannitol 0.5g/kg 15. Intubation and hyperventilation may be required (AP Williams, T Krishna & AJ Frew) · The following statements are true of Anaphylaxis 16. Anaphylaxis results from generation of specific IgG antibody directed against an allergen 17. Biphasic reactions affect fewer than 5% of patients 18. Intravenous adrenaline is the treatment of choice 19. Bronchodilators such as salbutamol may be useful 20. Intravenous hydrocortisone will provide rapid relief from symptoms (G R Jones) · Regarding the antibiotic treatment of cellulitis 21. Aspiration of the lesion yields a pathogen in over 80% of cases 22. Cellulitis resulting from a bite injury may be due to an unusual pathogen 23. Oral agents may be as effective as vancomycin in treating MRSA cellulitis 24. 80% of patients are suitable for outpatient intravenous antibiotic therapy 25. Combination of gentamicin with penicillin enhances streptococcal killing (S Fletcher) · Indicators of life threatening asthma requiring immediate ICU admission are 26. PEFR < 200 l/min 27. Cyanosis despite high inspired FiO2 28. Generalized audible inspiratory and expiratory wheeze 29. Hypertension and tachycardia 30. Altered level of consciousness or confusion · CPAP and Non Invasive Ventilation 31. Has no place in the management of the asthmatic patient 32. May reduce the inspiratory work of breathing 33. May reduce air trapping 34. CPAP > 10 cm/H2O is most beneficial 35. Can be usefully combined with a heliumoxygen mix · Mechanical ventilation of asthmatic patients is 36. A straightforward therapeutic manoeuvre 37. Intubation is associated with severe acute complications 38. Requires a careful balancing act between high inspiratory flow and prolonged expiratory time 39. May not aim for normocapnoea 40. Is well tolerated (C Borland) · Pulmonary embolism 41. Is associated with a mortality of less than 5% 42. Is the most frequent cause of maternal death 43. Nowadays is rarely an unsuspected post mortem finding 44. Is found in a minority of patients undergoing perfusion lung scanning 45. Is usually due to genetic factors · For pulmonary embolism in women 46. The pill is a major risk factor 47. Warfarin may be safely given in pregnancy provided control is optimum 48. Warfarin may be safely given during breast feeding 49. Thrombolysis is indicated for massive post partum pulmonary embolism 50. Spiral CT is the imaging method of choice in pregnancy · In treatment of pulmonary embolism 51. Low molecular weight heparin is no more effective than unfractionated heparin 52. Warfarin can be started at diagnosis 53. Thrombolysis has not been shown to reduce mortality in hypotensive patients 54. Alteplase is preferred to streptokinase or urokinase 55. Inferior vena caval filters double the risk of deep vein thrombosis (P J Francis & B Edmunds) · Regarding direct ophthalmoscopy 56. The macula is located temporal to the optic disc 57. Blurring of the temporal margin of the optic disc can be a normal finding 58. To examine the red reflex, the patient is instructed to fixate over the examiner’s shoulder 59. Myopic examiners should set the dial on the ophthalmoscope on a minus lens (unless wearing their glasses) 60. Viewing the fundus of a myopic patient is challenging because the image is magnified · Regarding papilloedema 61. Visual loss occurs early in the disease 62. Unilateral swelling of the ONH excludes the diagnosis 63. Spontaneous venous pulsation will be absent 64. The presence of spontaneous venous pulsation excludes the diagnosis 65. The optic nerve head (ONH) swells because axoplasmic flow is interrupted

scholarly journals PREDICTORS AND HOSPITAL OUTCOMES OF ATRIAL FIBRILLATION IN PATIENTS HOSPITALIZED WITH DIABETIC KETOACIDOSIS

2021 ◽  
Vol 77 (18) ◽  
pp. 323
Author(s):  
Kashyap Shah ◽  
Harshith Thyagaturu ◽  
Vivek Modi ◽  
Haresh Gandhi ◽  
Mohsin Mughal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Diabetic Ketoacidosis ◽  
Hospital Outcomes

scholarly journals Burden of major gastrointestinal bleeding among oral anticoagulant-treated non-valvular atrial fibrillation patients

2021 ◽  
Vol 14 ◽  
pp. 175628482199735
Author(s):  
Steven Deitelzweig ◽  
Allison Keshishian ◽  
Amiee Kang ◽  
Amol D. Dhamane ◽  
Xuemei Luo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Proportional Hazards ◽  
Bleeding Event ◽  
Cox Proportional Hazards ◽  
High Rate ◽  
Gi Bleeding ◽  
Increased Risk ◽  
Gi Bleed

Background: Gastrointestinal (GI) bleeding is the most common type of major bleeding associated with oral anticoagulant (OAC) treatment. Patients with major bleeding are at an increased risk of a stroke if an OAC is not reinitiated. Methods: Non-valvular atrial fibrillation (NVAF) patients initiating OACs were identified from the Centers for Medicare and Medicaid Services ( CMS) Medicare data and four US commercial claims databases. Patients who had a major GI bleeding event (hospitalization with primary diagnosis of GI bleeding) while on an OAC were selected. A control cohort of patients without a major GI bleed during OAC treatment was matched to major GI bleeding patients using propensity scores. Stroke/systemic embolism (SE), major bleeding, and mortality (in the CMS population) were examined using Cox proportional hazards models with robust sandwich estimates. Results: A total of 15,888 patients with major GI bleeding and 833,052 patients without major GI bleeding were included in the study. Within 90 days of the major GI bleed, 58% of patients discontinued the initial OAC treatment. Patients with a major GI bleed had a higher risk of stroke/SE [hazard ratio (HR): 1.57, 95% confidence interval (CI): 1.42–1.74], major bleeding (HR: 2.79, 95% CI: 2.64–2.95), and all-cause mortality (HR: 1.29, 95% CI: 1.23–1.36) than patients without a major GI bleed. Conclusion: Patients with a major GI bleed on OAC had a high rate of OAC discontinuation and significantly higher risk of stroke/SE, major bleeding, and mortality after hospital discharge than those without. Effective management strategies are needed for patients with risk factors for major GI bleeding.

Right Atrial Thrombosis and Pulmonary Embolism: A Narrative Review

2020 ◽  
Vol 46 (08) ◽  
pp. 895-907
Author(s):  
Nina D. Anfinogenova ◽  
Oksana Y. Vasiltseva ◽  
Alexander V. Vrublevsky ◽  
Irina N. Vorozhtsova ◽  
Sergey V. Popov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Embolism ◽  
High Risk ◽  
Transesophageal Echocardiography ◽  
Three Dimensional ◽  
Right Atrial ◽  
Treatment Protocols ◽  
High Risk Patients ◽  
Risk Patients ◽  
The Right

AbstractPrompt diagnosis of pulmonary embolism (PE) remains challenging, which often results in a delayed or inappropriate treatment of this life-threatening condition. Mobile thrombus in the right cardiac chambers is a neglected cause of PE. It poses an immediate risk to life and is associated with an unfavorable outcome and high mortality. Thrombus residing in the right atrial appendage (RAA) is an underestimated cause of PE, especially in patients with atrial fibrillation. This article reviews achievements and challenges of detection and management of the right atrial thrombus with emphasis on RAA thrombus. The capabilities of transthoracic and transesophageal echocardiography and advantages of three-dimensional and two-dimensional echocardiography are reviewed. Strengths of cardiac magnetic resonance imaging (CMR), computed tomography, and cardiac ventriculography are summarized. We suggest that a targeted search for RAA thrombus is necessary in high-risk patients with PE and atrial fibrillation using transesophageal echocardiography and/or CMR when available independently on the duration of the disease. High-risk patients may also benefit from transthoracic echocardiography with right parasternal approach. The examination of high-risk patients should involve compression ultrasonography of lower extremity veins along with the above-mentioned technologies. Algorithms for RAA thrombus risk assessment and protocols aimed at identification of patients with RAA thrombosis, who will potentially benefit from treatment, are warranted. The development of treatment protocols specific for the diverse populations of patients with right cardiac thrombosis is important.

Atrial Fibrillation in Pregnancy Associated With Oral Terbutaline

2002 ◽  
Vol 100 (5, Part 2) ◽  
pp. 1096-1097 ◽  
Author(s):  
Michael P. Carson ◽  
Allan J. Fisher ◽  
William E. Scorza
Keyword(s):  
Atrial Fibrillation ◽  
In Pregnancy

scholarly journals Neuroleptic malignant syndrome following catatonia: Vigilance is the price of antipsychotic prescription

2017 ◽  
Vol 5 ◽  
pp. 2050313X1769599 ◽  
Author(s):  
Thomas J Reilly ◽  
Sean Cross ◽  
David M Taylor ◽  
Richard Haslam ◽  
Sophie C Tomlin ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Adverse Drug Reaction ◽  
Pulmonary Embolism ◽  
Neuroleptic Malignant Syndrome ◽  
Kidney Injury ◽  
Clinical Suspicion ◽  
Antipsychotic Treatment ◽  
High Dose ◽  
Intravenous Fluids ◽  
Life Threatening

Objectives: To describe a case of neuroleptic malignant syndrome following antipsychotic treatment of catatonia, highlighting the potentially serious complications of this rare adverse drug reaction. Methods: We present a case report of a patient who developed this syndrome with various sequelae. Results: The patient developed neuroleptic after being treated with lorazepam and olanzapine for catatonia. He subsequently developed the complications of rhabdomyolysis, acute kidney injury, pulmonary embolism, urinary retention and ileus. He received high-dose lorazepam, anticoagulation and intravenous fluids. Antipsychotic medication in the form of haloperidol was reinstated with no adverse effect, and he went on to make a full recovery. Conclusions: This case illustrates the potential life-threatening complications of neuroleptic malignant syndrome and the need for a low index of clinical suspicion. It also highlights the lack of evidence for treatment of catatonia, including the use of antipsychotics.

scholarly journals Hyperthermia syndromes in psychiatry

2009 ◽  
Vol 15 (3) ◽  
pp. 181-191 ◽  
Author(s):  
Niraj Ahuja ◽  
Andrew J. Cole
Keyword(s):  
Drug Treatment ◽  
Neuroleptic Malignant Syndrome ◽  
Electroconvulsive Therapy ◽  
Serotonin Syndrome ◽  
Systematic Approach ◽  
Psychiatric Patients ◽  
Initial Diagnosis ◽  
Malignant Hyperpyrexia ◽  
Malignant Catatonia

SummaryPresence of fever in psychiatric patients may signify a number of potentially fatal conditions. Several of these are related to treatments (e.g. neuroleptic malignant syndrome with antipsychotics, serotonin syndrome with serotonergic antidepressants, and malignant hyperpyrexia with anaesthesia used for administration of electroconvulsive therapy) or exacerbated by them (e.g. malignant catatonia with antipsychotics). New classes of drug treatment may be changing the epidemiology of these disorders. We suggest that an initial diagnosis of hyperthermia syndrome is clinically useful as there are some important commonalities in treatment. We outline a systematic approach to identify a particular subtype of hyperthermia syndrome and the indications for more specific treatments where available.

Initial Treatment of Pulmonary Embolism

2007 ◽  
Vol 6 (3) ◽  
pp. 95-101
Author(s):  
Alastair Proudfoot ◽  
◽  
Helen Yarranton ◽  
Simon Gibbs ◽  
Derek Bell ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Initial Treatment ◽  
Acute Pulmonary Embolism ◽  
Inferior Vena ◽  
Previous Article ◽  
Diagnostic Approach ◽  
Inferior Vena Caval ◽  
Common Presentation ◽  
In Pregnancy

Acute pulmonary embolism (PE) is a common presentation on the acute medical take. In our previous article in Vol 6 issue 1 we discussed the diagnostic approach to this condition. This article concentrates on the treatment of PE, including guidance for treatment of PE in pregnancy and cancer. This article also discusses the role of alternative anticoagulants, thrombolysis, surgery and inferior vena caval filters.

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