CARDIOLOGY(C)

 A1.

 Evolution of symptomatology and event timeline - 
Past-
10yrs ago - Operation for Hernia
Since 2-3 yrs - Facial puffiness
1 yr ago - SOB grade II
1 yr ago - was diagnosed with Hypertension.
When the patient came to OPD - 
Since 2 days - SOB which progressed from Grade II to Grade IV.
Since 2 days - Decreased urine output.
Since 1 day - Anuria
After admission - 
CT scan - Showed dilated pulmonary vessels and thrombi in the atria.
2D Echo - Showed LV dysfunction.
Anatomical location - Atria (SA node)

A2.

  • Digoxin - It is a cardiac glycoside
             MOA - It increases intracellular sodium that will cause an influx of calcium in the heart and cause an                     increase in contractility. It is vagomimetic. 
             Indications - Heart failure and arrhythmias. 
  •          Carvediol - It is a beta-blocker.
             MOA - It blocks the beta receptors and lowers the heart rate, blood pressure and strain on the heart.
             Indications - Hypertension, heart failure, LV dysfunction with MI.
  •          Heparin - It is an anti-coagulant
             MOA - It produces its major anticoagulant effect by inactivating thrombin and activated factor X                                through an antithrombin dependent mechanism. By inactivating thrombin, heparin not only                                prevents fibrin formation but also inhibits thrombin induced activation of platelets and of factors V                      and VIII.
             Indications - Prophylaxis and treatment of venous thromboembolism and pulmonary embolism; Atrial                      fibrillation with embolization ; chronic consumptive coagulopathies.
  •           Acitrom - It is an Oral anti-coagulant
             MOA - It inhibits the reduction of Vitamin K by Vitamin K reductase. This prevents carboxylation of                           Vitamin K dependent clotting factors, II, VII, IX, X and interferes with coagulation.
             Indications - Thromboembolic diseases such as DVT, Coronary occlusion
  •           Cardivas - It is an adrenergic blocker
               MOA - Reversibly binds to beta adrenergic receptors on cardiac myocytes. Inhibition of these                                receptors prevent a response to the sympathetic nervous system, leading to decreased Heart                           rate and contractility
               Indications - Hypertension, Angina and heart failure.
  •           Dytor - It is a diuretic. Contains Torsemide + Spironolactone
               MOA - Through its action in antogonizing effect of Aldosterone, spironolactone inhibits the exchange of sodium for potassium in the distal renal tubule and helps to prevent potassium loss.
               Indications - Edema, Hypertension.
  •           Taxim - It is a cephalosporin antibiotic.
              MOA - It is bactericidal through inhibition of cell wall synthesis.
              Indications - Treatment of infections of throat, airway and urinary tract ; Typhoid fever.
  •          Thiamine - It is Vitamin B1.
              MOA -  Rapid restoration of Thiamine levels
              Indications - Wernicke's encephalopathy, infantile beriberi etc.
  •             Inj. HAI - It is a short acting insulin.

A3.

A4.
HTN, physical inactivity and obesity in this pt.

A5.
Anticoagulants being given to patient , therefore CVA and  for predicting future ischemic attacks we do the above  tests


Comments

Post a Comment

Popular posts from this blog

NEUROLOGY(D)

Image
  A1. Occurrence of seizure due to brain stroke: ·          Cells in the brain send electrical signals to one another ·          The electrical signals pass along your nerves to all parts of the body ·          A sudden abnormal burst of electrical activity in the brain can lead to the signals to the nerves being disrupted, causing a seizure ·          This electrical disturbance can happen because of stroke damage in the brain. ·          A seizure can affect vision, smell and taste, loss of consciousness and jerking movements. Mechanism of seizure activity: ·          You’re more likely to have a seizure if you had a haemorrhagic stroke (bleed on the brain). ·          Seizures can also be mor...
Read more

55yr old female with fever and headache

Image
Final exam Short case Name: M.Tejaswini Halltkt:1701006107 A 55yr old female came with chief complaints of: -fever since 4 days -headache since 4 days History of present illness Patient was apparently asymptomatic 4 days back then she developed fever which was insidious in onset, continous type relieved with medication and not associated with chills and rigors. Fever was associated with diffuse headache which was throbbing type present throughout the day and relieved with medication. There was 1 episode of vomiting which non projectile, non bilious, content was food. She also had neck stiffness. There's no history of photophobia, giddiness,seizures. Past history No similar complaints in past Not a known case of DM, HTN, TB, asthma, epilepsy Personal history Diet:mixed Appetite:normal Sleep:adequate Bowel and bladder: regular No addictions No known drug and food allergies Family history Not significant General examination Patient is conscious, coherent, coperative. Moderately built ...
Read more

INFECTIOUS DISEASE HEPATOLOGY(B)

 A1. Most likely cause is Amoebic liver abscess because of the following findings:             - Age of the patient             - Single abscess             - Right lobe involvement A2.  - right hypochondriac and epigastric pain , fever ➡ can be liver, biliary or right lower lobe pneumonia -Invesigations:          -CBP : Leucocytosis          -LFT : Elevated Alkaline phosphatase          -RFT           -Urine analysis           -USG : Single hyperechoic   oval shaped mass in right lobe                               ...
Read more