If patient has atrial fibrillation, this CHA2DS2VASc Score should be done to assess the 1-year risk of thromboembolic event in non-anticoagulated patient with non-valvular atrial fibrillation Components • Congestive heart failure history – 1 point• Hypertension – 1 point• Age >75 years old – 2 points• Diabetes mellitus – 1 point• Stroke / TIA previously […]
Clinical Features Symptom • Calf pain & swelling, usually unilateral Physical examination • Calf tenderness, oedema, or redness Investigations Blood • D-dimer Venous Ultrasonography • 2-point compression testing Related Posts Pulmonary embolism
Definition / Introduction 📌 Sepsis = life-threatening organ dysfunction caused by dysregulated host response to infection 📌 Septic shock= sepsis that has circulatory, cellular and metabolic abnormalities that are associated with a greater risk of mortality than sepsis alone 📌 Hypoperfusion= ≥1 of the following after administration of ≥30 mL/kg IV fluid OR serum lactate […]
Introduction • Cardiac tamponade = pericardial effusion that causes increased intrapericardial pressure, leading to reduced ventricular filling & reduced cardiac output Causes • • Viral infection • Tuberculosis • Malignancy• to the chest area Presentation Individual with underlying risk factors of cardiac tamponade, presented with acute onset of SOB + hypotension (shock) Symptoms • • […]
Steps of Examination a. Head / Face • Look for =====OTHERS:• : ask patient to say ‘British Constitution’ b. Upper limbs • Shake hand to test • Ask patient to lift arms (forward), look for • : Ask the patient to touch his or her nose with the index finger and then turn the finger […]
Classification / Types Haemodynamically stable AFHaemodynamically unstable AF =====Fast AFRate controlled AF =====First detected AFParoxysmal AFPersistent AFPermanent AF Causes Presentation Symptomatic• Palpitations, SOB on exertion Asymptomatic• Identified from features in cardiac monitor / ECG Investigations ECG • Rate: can be >150 bpm• Rhythm: Irregularly irregular • P wave: absent• QRS complex: narrow Echocardiogram • TRO […]
Introduction • Pneumothorax = presence of air in pleural space Classification • Closed pneumothorax• Open pneumothorax• Tension pneumothorax Presentation • • May have SOB Clinical Features Physical examination (i) Lungs• Reduced chest movement on the affected side• Hyper-resonance of affected side • Decreased breath sounds of affected side (ii) • • Subcutaneous emphysema of the […]
“Dengue is a bread and butter. Every doctor must know dengue from front till the end” Introduction • Dengue must be identified and risk-stratified early • Dengue is a notifiable disease Pathogen • Dengue virus (single-stranded RNA virus, from Flavivirus genus)• Intrinsic incubation: 4 – 7 days, up to 14 days (viraemic period, may be […]
Patient Presentation “My father suddenly became aggressive and talking bad words since this morning”“Since discharge from Hospital X yesterday, my wife became more quite and answered incoherently” History Taking Relevant History • Any history of fall? • Any ?• Any weakness / slurred speech / facial asymmetry• Any Investigations Laboratory investigations • Full blood count […]
Scoring Notes • How to document GCS during daily review?3 separate components documented separately, then total upExample: E4 V 3 M4 (11/15) • SeverityGCS 13 – 15:: mild brain injuryGCS 9 – 12: moderate brain injuryGCS 3 – 8: severe brain injury (impending coma) • GCS <8, especially in trauma, is an indication for intubation […]