Escolar Documentos
Profissional Documentos
Cultura Documentos
Heart attacks
Lung diseases
Viral infections
Sleep apnea
Acute complications of IE
ECG interpretation - VT, SVT, AF, Atrial flutter, LBBB, heart block
ECG interpretation - STEMI, treatment, contraindications for treatment
CONTRAINDICATIONS ABSOLUTE
Active bleeding/aortic dissection
Brain hemorrhage/AV malformation/neoplasm
Stroke
RELATIVE
Risk of bleeding Elevated BP Last 3/12 surgery
Active peptic ulcer/ASA
Traumatic CPR
Internal bleeding (UGIB/UTI) / INR >2
Vascular puncture (non compressible)
Exposure to streptokinase >5days within 12mo)
Condition
Screening Test
Drug-induced/drug-related hypertension*
Drug screening
Pheochromocytoma
Renovascular hypertension
Sleep apnea
Thyroid/parathyroid disease
Definition of shock
Shock is defined as a state of cellular and tissue hypoxia due to reduced oxygen delivery and/or increased oxygen
consumption or inadequate oxygen utilization.
Heavy internal or external bleeding, such as from a serious injury or rupture of a blood
vessel
Burns
Raised PaCO2 and/or requiring mechanical ventilation with raised inflation pressures
Life-threatening asthma
Bradycardia
Dysrrhythmia
Hypotension
Exhaustion
Confusion
Coma
Acute severe asthma
Lung disorders in which the deep lung tissues become swollen and then scarred (interstitial
lung disease)
Lights criteria
Fluid is exudate if one of the following Lights criteria is present: [1, 2, 3, 4]
ABG interpretation
X-ray interpretation pneumothorax, pleural effusion, lobar pneumonia
X-ray (pleural effusion)
Describe findings from CXR
Diagnosis left side pleural effusion
5 possible cause
Altered permeability of the pleural membranes (eg, inflammation, malignancy, pulmonary embolus)
Reduction in intravascular oncotic pressure (eg, hypoalbuminemia due to nephrotic syndrome or cirrhosis)
Increased capillary permeability or vascular disruption (eg, trauma, malignancy, inflammation, infection, pulmonary
infarction, drug hypersensitivity, uremia, pancreatitis)
Increased capillary hydrostatic pressure in the systemic and/or pulmonary circulation (eg, congestive heart failure,
superior vena cava syndrome)
Reduction of pressure in the pleural space, preventing full lung expansion or "trapped lung" (eg, extensive
atelectasis, mesothelioma)
Decreased lymphatic drainage or complete blockage, including thoracic duct obstruction or rupture (eg, malignancy,
trauma)
Increased peritoneal fluid, with migration across the diaphragm via the lymphatics or structural defect (eg, cirrhosis,
peritoneal dialysis)
Movement of fluid from pulmonary edema across the visceral pleura
Persistent increase in pleural fluid oncotic pressure from an existing pleural effusion, causing further fluid
accumulation
Treatment
OHA types (4) with examples each
3 Microvascular complications of DM, how to screen / investigate for each
diabetic nephropathy, neuropathy, and retinopathy
The diagnosis of nephropathy is initially based on development of microalbuminuria. Microalbuminuria is defined as an albumin
excretion rate of 20 to 200 g/min. Because the average daily albumin excretion rate can vary by 40%, it is recommended that
three urine collections be made over several weeks before making this diagnosis. Overt nephropathy is defined as an albumin
excretion rate greater than 300 mg in 24 hours. This is associated with a linear decline in glomerular filtration rate (GFR) ranging
from 0.1 to 2.4 mL/min/month.
Diagnosis of retinopathy is based on finding the diagnostic signs of retinopathy on eye examinations as discussed earlier.
The diagnosis of neuropathy is based on presence of weakness or diminished sensation as described earlier. These findings can
be confirmed with nerve conduction studies.
Subcutaneous Nodules
Minor Diagnostic Criteria
Fever
Arthralgia
Previous rheumatic fever or rheumatic heart disease
Acute phase reactions: ESR / CRP / Leukocytosis
Prolonged PR interval
Dengue Phases
The proteobacteria are a major group of gram-negative bacteria, including Escherichia coli (E.
coli), Salmonella, Shigella, and
other Enterobacteriaceae,Pseudomonas, Moraxella, Helicobacter, Stenotrophomonas, Bdellovibrio, acetic acid
bacteria, Legionella etc. Other notable groups of gram-negative bacteria include
the cyanobacteria, spirochaetes, green sulfur, and green non-sulfur bacteria.
Give the name of infection / disease caused by each bacteria mentioned above
Give one example of antibiotics for gram +ve bacteria
Aminoglycosides vancomycin
Give one examples of antibiotic for gram ve bacteria
Physical sign of liver cirrhosis
3 causes of liver cirrhosis
3 Complication of liver cirrhosis
Hypokalaemia Causes & management
Hypokalaemia ECG changes
Hyperkalaemia Causes & management
Hyperkalaemia ECG changes
Hypercalcaemia causes
One Emergency & important management for hyperCa2+
2 causes of pathological fracture
5 most Common primary tumour that cause bone mets
Fundoscopy interpretation: Hypertensive retinopathy & Diabetic retinopathy
http://www.optometry.co.uk/uploads/exams/articles/cet_02_09_2011_otoole.pdf
What is glasgow coma scale and write down each components
CASE SCENARIO
67 years old, kco DM, HPT, c/o epigastric pain, vomiting etc. no diarrhoea and etc.
Three urgent investigations that you will ask for.
A man came to ED with profuse sweating and ., symptoms started 1 hr ago,
a) What is the findings of ECG ( ST elevation, LBBB, Tall tented T wave)
b) What is your diagnosis ( anterior MI, STEMI )
c) What is your urgent management for this pt.
60yo, malay with underlying DM for 20years, poorly controlled, latest HbA1c is 9%, on 2 types OHA
and just added s/c insulatard 16U ON.
Hpt diagnosed 6 years ago, on 2 types of antiHPT. Patient also diagnosed rheumatoid arthritis for
20years and on using painkiller frequently whenever she had pain, with history of taking traditional
medication.
Patient developed SOB and bilateral lower limb swelling for 2 weeks, associated with lethargy, feeling
unwell,
(ABG given)
a) Interpret the ABG
b) What are the causes for the above ABG result, please state two.
c) What is the condition he has?
d) What is the cause for the condition he had in (c).
e) List 3 important investigations u want to do
f) State 3 other examination / complication you want to look for.
Patient 14yo, uncontrolled GM, urine ketone positive.., fever 40 degrees, tachycardia HR 130bpm,
Bp lowish 80/60mmHg, neck stiffness.
a) List down current issues
b) Interpret ABG
c) Outline management
d) Causes of low BP
e) Causes of neck stiffness
f) How to investigate neck stiffness.
HONK
a) How to calculate serum osmolarity
b) treatment
20 years old malay lady presented with joint pain + stiffness 2/52, worsen for 3/7, associated with fever
1/52
On examination, She had facial rash, oral ulcer
a) What is the most likely diagnosis
b) What are the other features that can be found for your answer in the above question, please
state 5.
c) What are the investigation u want to do, please state 5.
d) What are the complication that may occur for this disease, state 5.
16yo, GCS 5/15, list down 10 causes for coma
Addisonian crisis
To take Consent
Indication(s)
Risk and benefit
How is the procedure carry out (roughly)
How to take a consent for OGDS
How to take a consent for Lumbar Puncture
How to take a consent for BMAT