Acute Paracetamol Toxicity: following overdose glucuronidation and sulphation pathways are rapidly saturated -> increased metabolism to NAPQI (N-acetyl-P-benzoquineimine); glutathione is required to inactivate NAPQI and when levels depleted -> hepatocellular death takes place
Liver Failure in Toxicology common agents: paracetamol; iron; idiosyncratic; illicit and herbal; alcohol
MRI Head: T2 (transverse relaxation time constant) = water/CSF is white. T1 (longitudinal relaxation time constant) = water/CSF is black
Chest X-ray interpretation
CK-MB: creatine kinase dimer of M and B chains; found mainly in myocardial cytosol (also in skeletal muscle); one of three isoenzymes of creatine kinase (CK)
CRP = C-reactive protein OVERVIEW discovered in 1930 by studying Streptococcus pneumoniae infection -> named for its ability to bind to the somatic C-polysaccharide of such bacterial belongs to the family of pentraxins (calcium dependent ligand-binding plasma proteins) Normal range…
Cerebrospinal fluid (CSF) is a clear, colorless body fluid found in the brain and spinal cord.
CT Chest: contrast used to highlight mediastinal structures; entire thorax imaged with no skip areas; slices are 5-10mm thick
CT Head scan interpretation and differential diagnosis
Erythrocyte Sedimentation Rate (ESR): non-specific marker of inflammation; slower to respond than CRP
Somatosensory evoked potentials (SSEPs) consist of a series of waves that reflect sequential activation of neural structures along the somatosensory pathways. SSEP of particular interest in critical care, due to their role in neuroprognostication
MRI and the Critically Ill: Restricted access to patients; Remote monitoring; MR compatible equipment; Safety of patients and staff; Getting the highest quality scan possible