By Ragavendra R. Baliga MD MBA
A suite of brief instances prepared by way of medical sector, emphasising the foremost diagnostic good points of medical stipulations as typically provided within the brief case a part of the ultimate MB and MRCP examinations. additionally incorporated are most probably directions or instructions anticipated from the examiner for every , and the major issues which the candidate needs to inform the examiner. In June 2001 the MRCP brief situations examination is being changed with a brand new OSCE-style examination referred to as PACES (Practice evaluate of scientific exam abilities) and this publication will take complete account of this alteration.
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Additional info for 250 Short Cases in Clinical Medicine
They are also prone to accelerated coronary atherosclerosis. In 1967, Christiaan Barnard, a South African surgeon, was the first to perform cardiac transplantation in humans. Sir Magdi Yacoub, contemporary Professor of Cardiology at University of London and Royal Brompton Hospital and Harefield Hospital is an Egyptian-born surgeon who performed several pioneering cardiac operations. R. Sanders Williams, MD, Professor of Medicine and contemporary Dean, Duke University Medical School and Vice Chancellor, Duke University, has worked successively at Duke, Harvard, Oxford, and UT Southwestern in Dallas.
QUESTIONS What are the causes of bradycardia? · Physical fitness in athletes. · Idiopathic degeneration (ageing). · Acute myocardial infarction. · Drugs (beta-blockers, digitalis, calcium channel blockers). · Hypothyroidism. · Obstructive jaundice. · Increased intracranial pressure. · Hypothermia. · Hyperkalaemia. ADVANCED-LEVEL QUESTIONS How would you investigate this patient? · 12-lead ECG to confirm bradycardia. · 2448-hour ambulatory ECG recording is useful in patients with frequent or continuous symptoms.
It is a potentially dangerous condition and patients should be admitted to a coronary care unit and begun on antianginal therapy including beta-blockers, aspirin and intravenous nitrates. Intravenous heparin should be started in patients with rest angina of 48 hours duration and in those with chest pain and ischaemic ECG changes on admission. Most patients stabilize with this treatment, although some may require intra-aortic balloon counterpulsation before cardiac catheterization. A monoclonal antibody 7E3 against platelet glycoprotein llb/IIIa, which prevents platelet adhesion and degranulation, is undergoing evaluation in the treatment of unstable angina.