last MIN MRCP revision Part -D
MRCP Last min Revision
digoxin can be used to control the heart rate in AF when the patient is sedentary or there is coexisting heart failure
Rx
* Ankylosing S : TNF a / Adalimumab
* Abatacept is CTLA-4 IG interfere with T cell use in Rx of RA
* Tocilizumab is anti IL6 monoclonal AB used for RA
* Trastuzumab use in breast cancer S/E Cardiomyopathy so it's needs regular monitoring of EF
[11/06, 1:40 a.m.] ....: Sacubitril valsartan is dual action , combining ARB +Neprilysin inhibitor >>> It reduces both mortality & admission for heart failure by 20%
What's Fifth disease ??
Fifth disease is viral illness that most kids recover from quickly and without complications. Also called erythema infectiosum, it's caused by parvovirus B19. It's especially common in kids ages 5 to 15. Fifth disease causes a distinctive red rash on the face that makes a child appear to have a "slapped cheek."
* pt with resistant HTN with hypokalaemia 》》 》think in hyporeninaemic hyperaldosteronism
Street A& E in reducing LDL
Atorvastatin
Evolocumab inj
Ezetimibe
Empagliflozin
The only selective in elevation HDL is weight loss
Diarrhoea
# if D due to chronic laxative use >>>> in clonoscopy see Melanomas coli
# to Rx D related to bile acid Malabsoption >>>Colstryramine
# D due to carcinoid tumour >> RX octerotide
# D and weight loss >>> related to short bowel syndrome by Teduglutide ( is a glucagon like peptide 2 agonist which promote small bowel mucosal growth
In non-elderly men with osteoporosis and no clear pathology, measuring serum testosterone is very useful in elucidating a underlying cause
This is a patient with osteoporosis who needs investigations to determine the cause. In the absence of bone turner over disease the presence of erectile dysfunction suggests an underlying endocrine problem. The first line in investigating this would be to test morning serum testosterone. If this was found to be low, then LH and FSH should be tested. If testosterone is low and LH and FSH are not elevated then the underlying cause would be secondary hypogonadism. Secondary hypogonadism should be investigated with prolactin as prolactin can suppress LH and FSH, and potentially MRI of the pituitary to look for an adenoma. If the testosterone is low and LH and FSH are elevated then the underlying cause is primary hypogonadism and karyotyping should be done.
🔸IV adrenaline for cardiac arrest.
🔸Atropine is no longer used for any rhythms associated with arrest.
🔸IV fluid if arrest is due to hypovolaemia
🔸External pacing for P-wave systole
🔸amiodarone and defibrilater👉 for shockable rhythm algorithm
radiation induced constrictive pericarditis is known to demonstrate a worse long-term prognosis than other causes
Ivabradine tab :
MOA : inhibition of the cardiac pacemaker If current which controls spontaneous diastolic depolarisation in the sinus node and regulate heart rate
Indications : recommended by NICE for Rx of heart failure on top of B blocker or where BB contraindicated, where heart rate > 75 b/ m
Dose : 2.5 - 7.5 max mg bid per day
Dissecting thoraxic aora in CT scan 》》》 Tennis ball signs
Target SBP 100 mmHg
digoxin can be used to control the heart rate in AF when the patient is sedentary or there is coexisting heart failure
Rx
* Ankylosing S : TNF a / Adalimumab
* Abatacept is CTLA-4 IG interfere with T cell use in Rx of RA
* Tocilizumab is anti IL6 monoclonal AB used for RA
* Trastuzumab use in breast cancer S/E Cardiomyopathy so it's needs regular monitoring of EF
[11/06, 1:40 a.m.] ....: Sacubitril valsartan is dual action , combining ARB +Neprilysin inhibitor >>> It reduces both mortality & admission for heart failure by 20%
What's Fifth disease ??
Fifth disease is viral illness that most kids recover from quickly and without complications. Also called erythema infectiosum, it's caused by parvovirus B19. It's especially common in kids ages 5 to 15. Fifth disease causes a distinctive red rash on the face that makes a child appear to have a "slapped cheek."
* pt with resistant HTN with hypokalaemia 》》 》think in hyporeninaemic hyperaldosteronism
Street A& E in reducing LDL
Atorvastatin
Evolocumab inj
Ezetimibe
Empagliflozin
The only selective in elevation HDL is weight loss
Diarrhoea
# if D due to chronic laxative use >>>> in clonoscopy see Melanomas coli
# to Rx D related to bile acid Malabsoption >>>Colstryramine
# D due to carcinoid tumour >> RX octerotide
# D and weight loss >>> related to short bowel syndrome by Teduglutide ( is a glucagon like peptide 2 agonist which promote small bowel mucosal growth
In non-elderly men with osteoporosis and no clear pathology, measuring serum testosterone is very useful in elucidating a underlying cause
This is a patient with osteoporosis who needs investigations to determine the cause. In the absence of bone turner over disease the presence of erectile dysfunction suggests an underlying endocrine problem. The first line in investigating this would be to test morning serum testosterone. If this was found to be low, then LH and FSH should be tested. If testosterone is low and LH and FSH are not elevated then the underlying cause would be secondary hypogonadism. Secondary hypogonadism should be investigated with prolactin as prolactin can suppress LH and FSH, and potentially MRI of the pituitary to look for an adenoma. If the testosterone is low and LH and FSH are elevated then the underlying cause is primary hypogonadism and karyotyping should be done.
🔸IV adrenaline for cardiac arrest.
🔸Atropine is no longer used for any rhythms associated with arrest.
🔸IV fluid if arrest is due to hypovolaemia
🔸External pacing for P-wave systole
🔸amiodarone and defibrilater👉 for shockable rhythm algorithm
radiation induced constrictive pericarditis is known to demonstrate a worse long-term prognosis than other causes
Ivabradine tab :
MOA : inhibition of the cardiac pacemaker If current which controls spontaneous diastolic depolarisation in the sinus node and regulate heart rate
Indications : recommended by NICE for Rx of heart failure on top of B blocker or where BB contraindicated, where heart rate > 75 b/ m
Dose : 2.5 - 7.5 max mg bid per day
Dissecting thoraxic aora in CT scan 》》》 Tennis ball signs
Target SBP 100 mmHg
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