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Indications for Digibind in Digoxin toxicity: - All symptomatic bardycardias or life-threatening arrhythmias (VT, VF, Mobitz type 2, complete heart block) - Hyperkalemia (>5 - 5.5 mEq/L) - Evidence of end-organ dysfunction Note: do not give calcium gluconate in patients with hyperkalemia due to digoxin toxicity as calcium increases the actions of digoxin. #Cardiology

The most specific EKG finding in digoxin toxicity is atrial tachycardia with AV block #Cardiology

The diagnosis is Retroperitoneal hematoma. Perform a CT of the abdomen.

A patient develops acute low back pain after coronary angiography. Exam reveals pain on hip flexion. What is the diagnosis? What test will you perform to confirm? #Cardiology

Atrial flutter ablation is usually more successful compared to atrial fibrillation. However, heart rate in atrial flutter is harder to control with medications than in atrial fibrillation. #Cardiology

In a patient with STEMI undergoing PCI, the preferred antiplatlet drug is ticagrelor. If the patient undergoes thrombolysis, the preferred drug is clopidogrel. #Cardiology

Indicators of successful thrombolysis in STEMI are: Resolution of chest pain, normalization of ST-segment, and development of transient benign accelerated idioventricular rhythm (reperfusion arrhythmia) #Cardiology

TIMI score is used to estimate mortality risk in patients with Unstable Angina or NSTEMI. Scores from 0-2 are low risk, 3-5 are intermediate risk, and scores 6-7 are high risk. Patients with intermediate to high-risk should undergo angiography within 24-48 hours. Low-risk patients should undergo cardiac stress testing before discharge. #Cardiology

Conditions in which EKG cannot be interperated on cardiac stress testing or during evaluation of ACS include: -LBBB - Use of certain cardiac drugs such as digoxin and procainamide (cause ST-T wave depression) - Wolff-Parkinson-White syndrome - Ventricular pacing - Left ventricular hypertrophy with significant ST-T wave abnormalities #Cardiology

High risk features on cardiac stress testing include: - Early onset chest pain or ST wave changes - large areas of ischemia - hemodynamic instability #Cardiology

If stable angina symptoms persist on optimal medical management or there are high-risk features on the cardiac stress test, perform coronary angiogram. #Cardiology

The target resting heart rate in stable angina is 55-60 bpm. Treatment is β-blocker and/or Non-dihydropyrodine CCB. If not angina controlled, use long-acting nitrates. If still not controlled, use ranolazine. #Cardiology

Prophylaxis for Rheumatic fever is with IM penicillin G (every 4 weeks), Penicillin V (daily), or Azithromycin (daily) Duration depends on severity of disease: ~ Uncomplicated RF: until 21 yrs old OR for 5 yrs ~ Carditis without valvular disease: 21 yrs old OR for 10 yrs ~ Carditis with valvular disease: 40 yrs old OR for 10 yrs Whichever is longer #Cardiology

Prophylaxis for Rheumatic fever is with IM penicillin G (every 4 weeks), Penicillin V (daily), or Azithromycin (daily) Duration depends on severity of disease: ~ Uncomplicated RF: until 21 yrs old OR for 5 yrs ~ Carditis without valvular disease: 21 yrs old OR for 10 yrs ~ Carditis with valvular disease: 40 yrs old OR for 10 yrs Whichever is longer

Indications to admit a patient with gross hematuria: - Hypotension - Anemia or thrombocytopenia - Anticoagulation intake - Very old - Failure of irrigation to yield clear urine #Renal #IM #Clinical

Causes of peripheral neuropathy #Neurology #DDx

When thinking of a differential diagnosis, keep yourself organized with the VITAMIN ABCDEK #mnemonic. Vascular Infectious/inflammatory Traumatic/toxic Autoimmune/Allergic Metabolic/malignant Iatrogenic/Idiopathic Neoplastic Alcohol Behavioral Congenital Degenerative/Drugs Endocrine Karyotype (Genetic) #Clinical

Causes of hematuria #DDx #Renal #IM

Kramer's scale can be used to estimate total bilirubin levels of an infant with jaundice if bilirubin measurement can't be obtained. #Pediatrics

Behcet disease is the only systemic vasculitis known to cause pulmonary artery aneurysms. Takayasu arteritis can cause aortic aneurysms. Kawasaki disease can cause coronary aneurysms. #Vascular