Emergency notes🫀

Hematuria + proteinuria + hypertension + periorbital edema 👉 Glomerulonephritis Hematuria+ hemoptysis + Rapid deterioration of renal function 👉 Goodpasture syndrome Or Granulomatosis with polyangiitis depend on age Hematuria +Chronic sinusitis or nasal ulcer + Epistaxis 👉 Granulomatosis with polyangiitis Hematuria + cramping abdominal pain + painful palpable purpura+ arthralgia 👉 Henoch Schonlein purpura Hematuria+ resistant asthma + eosinophilia(>1,000)+neuropathy 👉 Churg Strauss

🤡Beta blockers, calcium channel blockers, and nitrates can cause false negative results on exercise and pharmacologic stress testing and should be held for 48 hours prior to testing.  However, aspirin, statins, and lisinopril are not known to affect stress testing results.

A 64-year-old man is admitted to the hospital due to intermittent palpitations and lightheadedness for the past several days.  The patient has had no chest pain or shortness of breath.  He has a history of coronary artery disease with prior myocardial infarction and percutaneous coronary intervention.  Medications include metoprolol, lisinopril, aspirin, clopidogrel, and rosuvastatin.  Echocardiogram reveals mild left ventricular dilation, a left ventricular ejection fraction of 30%, and no major valvular abnormality.  Serum potassium is 4.2 mEq/L, and magnesium is 1.9 mg/dL.  On day 2 of hospitalization, the patient develops sudden-onset and sustained palpitations.  Blood pressure is 122/60 mm Hg and pulse is 120/min.  He is alert and does not appear to be in acute distress.  The lungs are clear bilaterally.  ECG rhythm strip is shown in the exhibit.  Which of the following is the best next step in management of this patient

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Treatment of sustained monomorphic VT depends on the patient's clinical status.  Patients with pulseless VT are treated with immediate defibrillation.  Patients with a pulse but evidence of hemodynamic instability (eg, hypotension, angina, confusion) are treated with immediate synchronized electrical cardioversion ().  In hemodynamically stable patients such as this one, pharmacologic cardioversion to sinus rhythm should be attempted.  Intravenous amiodarone is usually the preferred agent; other agents (eg, procainamide, sotalol, lidocaine) are also sometimes used

Tetrology of Fallot "Don't DROP the baby": Defect (VSD) Right ventricular hypertrophy Overriding aorta Pulmonary stenosis

Respiratory depression inducing drugs "STOP breathing":⭐️ Sedatives and hypnotics Trimethoprim Opiates Polymyxins

Lithium: side effects LITHIUM:⭐️ Leukocytes Increased (leukocytosis) Tremors Hypothyroidism Increased Urine Moms beware (teratogenic)

Antiarrhythmics: class III members BIAS:⭐️ Bretylium Ibutilide Amiodarone Sotalol

Beta blockers: members "The NEPAL Prime Minister":💡 Timolol Nadolol Esmolol Pindolol Atenolol Labetalol Propranolol Metoprolol

The mnemonic “ELEVATION”, can help you remember STEMI mimics - Electrolytes (Hyperkalemia) - Left Bundle Branch Block - Early Repolarization - Ventricular Hypertrophy (Left) - Aneurysm (Ventricular) - Thailand (Brugada Syndrome) - Inflammation (Pericarditis) - Osborne (J) Waves (hypothermia) - Non-Ischemic Vasospasm

اليوم المحاظرة الثالثة في شرح الECG الساعة ب٨

مساء الخير.. شوية النوب من ٨ لل 9 عدنا محاظرة online عن ECG interpretation ..