Da heart

Question 1

Pericarditis ix, mx and cx

Answer 1

Ix- crucial are- ECG (saddle shaped), Echo (can be normal), Trop (can be raised if myopericarditis)
if trop raised- consider admitting
look for causes- viral serology, rheum arthritis, drugs, MI, other

mx- activity restrict, Colchicine and NSAIDS together
Cx- cardiac tamponade, heart failure
Acute pericarditis can cause a pericardial effusion, which in turn may cause cardiac tamponade

Question 2

Varicose veins mx

Answer 2

Investigation
venous duplex ultrasound: this will demonstrate retrograde venous flow

Management
the majority of patients with varicose veins do not require surgery. Conservative treatments include:
leg elevation
weight loss
regular exercise
graduated compression stockings

reasons for referral to secondary care include:
significant/troublesome lower limb symptoms e.g. pain, discomfort or swelling
previous bleeding from varicose veins
skin changes secondary to chronic venous insufficiency (e.g. pigmentation and eczema)
superficial thrombophlebitis
an active or healed venous leg ulcer

possible treatments:
endothermal ablation: using either radiofrequency ablation or endovenous laser treatment
foam sclerotherapy: irritant foam → inflammatory response → closure of the vein
surgery: either ligation or stripping