Category: Internal Medicine

Mnemonic: A, E, I, O, U Acidosis (persistent metabolic acidosis with pH <7.1) Electrolyte imbalance (refractory hyperkalaemia) Intoxication: toxins that can be dialysed – “I STUMBLED“ Overload (fluid overload refractory to diuretic treatment) Uraemia (symptomatic uraemia, including uraemic encephalopathy, uraemic pericarditis)

Criteria by Barrter and Schwartz Causes Related Posts Further Reading / Reference

Introduction A subtype of the 2009 pandemic High risk groups: Immunocompromised / chronic illness Pregnant women Children >5 years old Clinical Features Symptoms Fever Diarrhoea Vomiting Cough Sore throat Rhinitis Headache, myalgia, lethargy Investigation Influenza PCR Treatment Oseltamivir (Tamiflu®)

Introduction Also called microvascular angina Key features: positive findings on exercise stress test, but normal coronary artery angiography Clinical Features Symptoms Angina on exertion Investigations ECG at rest: normal Exercise stress test: ST depression Coronary arteries angiography: normal Treatment Nitrates

Causes Valvular causes • Infective endocarditis• Rheumatic fever• Aortic root dilatation • Marfan’s syndrome• Ehler-Danlos syndrome• • Hypertension• Aortic dissection • Ankylosing spondylitis• Syphilis Clinical Features Symptoms • Shortness of breath• Signs • Wide pulse pressure• Collapsing pulse• Murmurs: Early diastolic murmur, Austin-Flint murmur (in severe AR) Investigations • Echocardiography Management Medical • Treatment of […]

Introduction • A myeloproliferative disorder caused by malignant proliferation of a clone derived from one pluripotent stem cell leading to an excess proliferation of red blood cell, leucocytes and platelets → hyperviscosity of blood & thrombosis• JAK2 mutation is present in >95% cases • Age group: commoner >60s, peak in 60s Presentation (i) Asymptomatic• Detected […]

• Used to assess bleeding risk in a patient with atrial fibrillation started with anticoagulant Components Haemoglobin <13 g/dL (male) or <12 g/dL (female) OR Haematocrit <40% (male) or <36% (female) — 2 points Abnormal renal function (eGFR < 60 mL/min/1.73m2)) — 1 point Age >74 years — 1 point Bleeding history (GI bleeding / […]

• Used to assess bleeding risk in a patient with atrial fibrillation started with anticoagulant Components Hypertension (SBP >160 mmHg) — 1 point Abnormal renal and or liver function — 1 or 2 points (1 point for each abnormality) Renal: ESRF, requiring dialysis /renal transplant Liver: cirrhosis / serum bilirubin 2×normal / AST or ALT […]

Introduction • A multi-system disease• Female to male ratio 3:1• Peak incidence: 30 – 50 years old • 2 types: (i) , (ii) diffuse cutaneous systemic sclerosis Pathogenesis • Widespread vascular damage involving small arteries, arterioles, and capillaries, leading to arterial lesions & chronic ischaemia • Vasoconstriction / vasospasm occurs • Fibroblasts stimulated to cause […]