learn right now Flashcards
LBBB ddx
AMI Coronary artery disease HTN Myocarditis Cardiomyopathy
Left axis deviation
LAFB LBBB Inferior MI LVH Ventricular ectopy / paced beat WPW
Rightward axis DDx
LPFB Lateral MI RVH Acute or chronic lung disease Vetricualr ectopy Hyperkalaemia Na channel overdose Normal young / slender adults
Signs of RV infarction
With inferior MI ST elevation III > II ST elevation in V1, esp V1>V2 - ST elevation in V1 and depression V2 -isoelectric ST V1 and marked depression V2 Right sided chest leads
Sighs of posterior MI
With inferior or lateral MI
ST depression in V1-3 with upright T waves
Tall R waves in V1-3
Dominant R wave in V2 (R/S Ratio > 1)
Ring enhancing cerebral lesions
MAGIC DR
Metastasis Abscess (streptococcal, sterile) - immunocomp: toxo, candida, listeria, aspergillus Glioblastoma Infarct (subacute) Contusion Demyelination Radiation necrosis / resolving haematoma
Treatment of critical asthma
Continuous nebulised salbutamol Oxygen Nebulised ipratropium 500 mcg 20 min Methylprednisolone 1mg/kg to 60 mg Aminophylline 10mg/kg to 500 mg / 60 min. Mag sulfate 0.2 mmol/kg / 20 min Adrenaline 10mcg/kg IM Respiratory support - NIV/intubation
Potassium
Risk assessment salycilate poisoning
> 150 mg/kg symptomatic
300 mg/kg severe symptoms
500 mg/kg potentially lethal
Causes of HAGMA
Carbon monoxide, cyanide Alcohol Toulene Methanol Uraemia DKA Paracetamol, paraldehyde Isoniazid, iron Lactic acidosis Ethylene glycol Salicylate, starvation ketosis
Causes of NAGMA
Renal - RTA, addisons
Acetazolamide
Chloride Excess
Extra loss: diarrhoea, ureteric / small bowel fistulas
Causes Metabolic alkalosis
Contraction of volume Liquorice Endocrine - conns, cushings Vomiting / GIT loss Excess alkali - antacid, calcium, bicarb Renal - barters, gitlemann Post-hypercapnoea Diuretic
Causes of respiratory alkalosis
CNS hyperventilation: ICP, CVA, Psychogenic
Hypoxia: altitude, anaemia, VQ mismatch
Pulmonary: CCF, mechanical, pneumonia, PE
Toxin: nicotine, salicylate, xanthines
Cushings - primary abnormality, causes and electrolyte disturbances
High glucocorticoids
Iatrogenic, pituitary ACTH (co adenoma), ectopic ACTH (lung Ca), adrenal hyperplasia, adrenal tumour, CRH releasing tumour (pancreatic, thymic)
HTN, hypokalaemia, hyperglycaemia, metabolic alkalosis
Conns syndrome- primary abnormality, causes and electrolyte disturbances
Primary hyperaldosteronism
Idiopathic hyperplasia or adrenal adenoma
HTN, hypokalaemia, hypocalcaemia, hypernatraemia, metabolic alkalosis
Bartters syndrome- primary abnormality and electrolyte disturbances
Hyperaldosteronism
Normal BP, increased renal sodium loss
