By Ragavendra R. Baliga MD MBA
A suite of brief circumstances prepared via scientific zone, emphasising the most important diagnostic gains of medical stipulations as in general provided within the brief case a part of the ultimate MB and MRCP examinations. additionally integrated are most probably directions or instructions anticipated from the examiner for every situation, and the foremost issues which the candidate needs to inform the examiner. In June 2001 the MRCP brief circumstances examination is being changed with a brand new OSCE-style examination referred to as PACES (Practice review of medical exam abilities) and this e-book will take complete account of this transformation.
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Additional info for 250 Short Cases in Clinical Medicine
If that too is negative he or she can remain on medical therapy and risk factor reduction. If the resting ejection fraction is <40% or if the stress is markedly abnormal (>2 nlm ST segment depression, hypotension at peak exercise or low working capacity) then coronary angiography should be carried out if there are no contraindications to revascularization. · In patients in whom the ECG is not intepretable because of resting ST-T wave abnormalities, digitalis therapy or left bundle branch block, rest and exercise radionuclide myocardial perfusion scintigraphy (with thallium or sestamibi) or rest and exercise echocardiography should be performed.
Beta-blocker and Blood pressure. Cigarette smoking and Cholesterol. Diet and Diabetes. Education and Exercise. Percutaneous transluminal coronary angioplasty (with or without coronary stent) · · · · Complementary to drug treatment and surgery: no improvement in survival. · Best results are achieved in discrete single-vessel coronary artery disease. The restenosis rate is -30% at 6 months; for balloon angioplasty with stenting. restenosis is lower, -20%. The ACME (Angioplasty Compared to Medicine) study showed that PTCA can offer better symptomatic relief than medical therapy in patients with single-vessel coronary artery disease, but is a much more expensive procedure and is associated with complications (including emergency and elective coronary by-pass and second PTCA).
Symptomatic congenital heart block. · Symptomatic sinus bradycardia. · Symptomatic second- or third-degree heart block. Which drug would you use to treat sinus bradycardia seen in the setting of an acute myocardial infarction? Intravenous atropine. What do you understand by the term chronotropic incompetence? Failure to reach a heart rate that is 85% of the age-predicted maximum (220 - age in years) at peak exercise, the failure to achieve a heart rate of 100 beats per minute, or a maximal heart rate more than 2 SD below that in a control population (N Engl J Med 2000; 342:703 9).
250 Short Cases in Clinical Medicine by Ragavendra R. Baliga MD MBA