Heart Sound Abnormalities
S1 Loud MV or TV open long -> shuts forcefully MS increased HR short AV conduction Soft first degree HB LBBB MR Splitting RBBB S2 Loud HT AS PHT Soft AS AR Splitting increased normal splitting (wider on inspiration): RBBB,…
Necrotising fasciitis
Reviewed and revised 12 July 2015 OVERVIEW CLASSIFICATION From Misiakos et al, 2014: Classification of responsible pathogens according to type of infection. Fournier gangrene is typically polymicrobial infection with aerobes and anaerobes, such as coliforms, klebsiella, streptococci, staphylococci, clostridia, bacteroids, and corynbacteria CAUSTIVE…
Nocardia
OVERVIEW gram positive bacilli that form weakly acid-fast beaded branching filaments found worldwide in soil and some form part of healthy oral flora usually transmitted by inhalation or traumatic inoculation disease of the immunocompromised – esp T-cell mediated immunity (AIDS,…
Hyperthermia
OVERVIEW Definitions Hyperthermia is when core temperature exceeds that normally maintained by homeostatic mechanisms Fever or pyrexia is an elevation of body temperature above the normal range of 36.5–37.5 °C (97.7–99.5 °F) due to an increase in the temperature regulatory set point Uncontrolled hyperthermia differs…
Corticosteroids Overview
Corticosteroids: two types: glucocorticoids (cortisol) and mineralocorticoids (aldosterone)
both cholesterol based
Alcoholic Ketoacidosis
Alcoholic Ketoacidosis: rare; small proportion of chronic ethanol abusers; relatively benign if patients given IV dextrose and fluids; unclear aetiology
Adrenal insufficiency
Adrenal insufficiency: primary, secondary and tertiary + acute/chronic
Post parathyroidectomy care
Post parathyroidectomy care: the parathyroid glands produce parathyroid hormone and are involved in calcium metabolism
Patients and families that want “everything” done
Patients and families, when asked, may say they want "everything" done. The request for "everything" rarely really means "everything" - this needs to be explored
Hyperphosphataemia
Hyperphosphataemia: renal failure; increased renal resorption (hypoparathyroidism, thyrotoxicosis); cellular injury with release (tumour lysis syndrome, rhabdomyolysis, haemolysis, ischemic gut)
Transoesophageal Echocardiography
Transoesophageal Echocardiography: allow real time anatomical and physiological assessment of cardiac status; probes (single, bi, omiplane and epivascular)
Shunts and Echocardiography
OVERVIEW can use bubble testing to ID calculate gradients if L->R shunt reverses due to pulmonary hypertension it is Eisenmenger syndrome Echo may not detect extra-cardiac shunts ASD patent foramen ovale (30% incidence in general population) ostium secundum ostium primum…