Acute Medicine: Clinical Cases Uncovered by Chris Roseveare

By Chris Roseveare

Acute drugs is the valuable a part of starting place and expert normal scientific education and is likely one of the such a lot swiftly increasing united kingdom health facility specialties.

Acute drugs: medical instances Uncovered combines sufferer circumstances and results, drawn from real-life studies, on the subject of the curriculum for education ordinarily (Acute) medication. It offers self-assessment MCQs, EMQs and SAQs to provide clinical scholars, junior medical professionals, nurses and allied healthcare pros the suitable practise for all times at the wards.

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The staff member was found and admitted to the coronary care unit, where a more detailed history was obtained. She reiterated that the pain was mild and usually occurred after eating; it was not in any way related to exertion and there were no risk factors for coronary artery disease. Her ECG was entirely normal. 2 ng/mL). Two further samples produced similar results. She was reviewed by a consultant cardiologist and underwent a series of further investigations including echocardiography, coronary angiography, cardiac MRI scan and myocardial biopsy, all of which were entirely normal.

All her medication was stopped and she has remained well ever since. Before taking any blood sample ask yourself the following questions. • What will I do if the test is abnormal? • What will I do if the test is normal? If the answer is the same for both questions, reconsider whether the test is necessary. Interpreting the results of blood tests When interpreting the results of blood tests it is important to remember the following. e. e. no test is 100% specific) Knowledge of the sensitivity and specificity of certain tests will help the clinician to determine the likelihood of a particular condition.

However, for any acutely unwell patient a generic ABCDE approach is the appropriate starting point, as described here. A Airway A patent airway is required to deliver oxygen to the lungs. Untreated, this will rapidly lead to cardiopulmonary arrest. 30 Airway obstruction requires immediate treatment; senior or anaesthetic assistance is likely to be required. Consider the questions below. Is the airway obstructed? • Listen (without a stethoscope) to the breath sounds: complete obstruction will result in the absence of breath sounds at the mouth or nose; partial obstruction results in harsh or gurgling inspiratory sounds • Look at the chest/abdominal wall – complete obstruction may result in paradoxical ‘see-saw’ movements of the chest and abdomen Why is the airway obstructed?

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