Pulmonary_Embolism_.ppt
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This document discusses pulmonary embolism (PE), including risk factors, symptoms, diagnosis, and treatment. There are inherited and acquired risk factors for PE, such as genetic mutations or advanced age/smoking. Symptoms include dyspnea, tachycardia, and pleuritic pain. Diagnosis involves blood tests, imaging like CT scans, and potentially pulmonary angiography. Treatment involves anticoagulation with drugs like heparin or warfarin, or procedures like fibrinolysis, embolectomy, or IVC filter placement. Prevention focuses on anti-coagulation and mechanical methods like compression stockings.
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14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
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Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
All info about Diabetes and how to control it.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
The Nervous and Chemical Regulation of Respiration
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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- 2. Risk Factors Inherited conditions Acquired conditions
- 3. Inherited Factor • Factor V Leiden mutation • Prothrombin gene mutation • Deficiency of antithrombin III, protein C or protein S
- 4. Acquired Factor • Age • Smoking • Obesity • Atherosclerosis disease • Recent trauma or surgery • Long-haul air travel • Oral contraceptives • Pregnancy
- 5. Acquired Factor • Postmenopausal hormone replacement • Acute infection • Personal or family history of VTE • Cancer • Antiphospholipid antibody syndrome • Systemic hypertension • COPD • Pacemaker or ICD
- 6. Pathology
- 7. Symptoms and signs • Dyspnea • Tachycardia • Cyanosis • Syncope • Hypotension • Cardiogenic shock • Cardiac arrest
- 8. Symptoms and signs • Pleuritic pain • Hemoptysis • Distended neck veins • TR • Accentuated sound of pulmonic closure
- 9. Differential diagnosis • MI • Pneumonia • Bronchitis • Exacerbation of asthma • COPD • CHF • Pericarditis • Rib fracture • Pneumothorax • Primary pulmonary hypertension • anxiety
- 12. Lab work up • Blood work • ECG • CXR • CT • Echocardiogram • MRI • VQ scan • Pulmonary angiography
- 13. Diagnosis
- 14. Treatment • Fibrinolysis • Embolectomy • Catheter-based embolectomy • Anticoagulation • IVC filter
- 15. Fibrinolysis t-PA(alteplase) 100mg continuous infusion over 2hours
- 16. Anticoagulation Heparin Bolus 80units/kg Infusion 18units/kg/hr Keep aPTT 2-3倍(約60-80seconds)
- 17. Anticoagulation Low-molecular-weight heparin(LMWH)- Enoxaparin 1mg/kg BID or 1.5mg/kg QD
- 19. Anticoagulation Warfarin Heparin、LMWH、Fondaparinux overlap at least 5days Keep INR 2.0-3.0
- 20. IVC filter Anticoagulation contraindication Recurrent PE despite anticoagulation
- 24. Prevention Mechanical prophylaxis Graduated compression stockings(GCS) Intermittent pneumatic compression(IPC)
- 26. Regimens for VTE prophylaxis General surgery： Heparin 5000units sc TID or Enoxaparin 40mg sc QD or Dalteparin 2500 or 5000units sc QD
- 27. Regimens for VTE prophylaxis Orthopedic surgery： Warfarin(target INR 2-3)or Enoxaparin 30mg sc BID or Enoxaparin 40mg sc QD or Dalteparin 2500 or 5000units sc QD or Fondaparinux 2.5mg sc QD
- 28. Regimens for VTE prophylaxis Neurosurgery： Heparin 5000units sc BID or Enoxaparin 40mg sc QD and Graduated compression stocking/intermittent pneumatic compression Consider surveillance lower extremity ultrasonography
- 29. Regimens for VTE prophylaxis Oncologic surgery： Enoxaparin 40mg sc QD
- 30. Regimens for VTE prophylaxis Thoracic suregery： Heparin 5000units sc TID and Graduated compression stockings/intermittent Pneumatic compression
- 31. Regimens for VTE prophylaxis Medical patients： Heparin 5000units sc TID or Enoxaparin 40mg sc QD or Dalteparin 5000units sc QD or Fondaparinux 2.5mg sc QD or Graduated compression stockings/intermittent pneumatic compression for patients with contraindications to anticoagulation Consider combination pharmacological and mechanical prophylaxis for very high risk patients Consider surveillance lower extremity ultrasonography for ICU patients