OVERVIEW causes: degeneration, infective endocarditis, dilated aortic root, aortic dissection. SEVERITY ASSESSMENT large regurgitant jet on CFD— if takes up more than 65% of LVOT then severe flow reversal in aorta LV dilation— LV end-systolic diameter > 5.5cm large regurgitant…
TOE is better than but TTE, but TTE can be performed first; TTE cannot exclude aortic dissection; TOE is comparable to CT and MRI for diagnostic accuracy
Metabolic Alkalosis DDx
The relationship of urea and creatine is dependent on serum laboratory units used to determine the cause of acute kidney injury.
Creatinine = Non-protein end product of creatinine metabolism. Formed from skeletal muscle and excreted in constant amounts. Completely filtered by kidney (marker of GFR). Production proportional to muscle mass
Continuous renal replacement therapy (CRRT) is the modality most widely used in Australia and New Zealand ICUs. There is no evidence suggesting mortality benefit for one modality over another
Highlights and pearls on toxic alcohol ingestion from the EBMedicine article, "Toxic Alcohols: Not Always A Clear-Cut Diagnosis"
Tricyclic Antidepressants (TCA) are weak bases (pKa 8.5) that can cause life-threatening sodium channel toxicity
Citrate toxicity is primarily a result of hypocalcaemia and metabolic effects of excess citrate
Spider envenoming: In Australia the only two spiders of real importance = Funnel-web and the Red-Back; only these two can cause death or severe systemic illness
Severe toxicity from mushrooms is rare in humans; most symptomatic presentations are a self-limiting gastroenteritis requiring supportive care only; lethal hepatotoxicity from Amanita mushrooms must be excluded
Ciguatera Poisoning: A bizarre poisoning syndrome with acute and sometimes severe neurological and gastrointestinal symptoms caused by eating tropical reef fish that have accumulated ciguatoxin from the dinoflagellate Gambierdiscus toxicus; most common cause of fish poisoning worldwide.