Auscultatory changes in mitral stenosis after the onset of Atrial fibrillation ?
Auscultatory findings of mitral stenosis is the most common question asked in clinical cardiology right from first clinical year to higher specialty examinations . It should be answered in a systematic way.
What happens to the murmur and sounds in mitral stenosis after the onset of AF ? When I asked this question in my class , many struggled . Hence this post .
Reference
The Effect of Cycle Length on the Time of Occurrence of the First Heart Sound and the Opening Snap in Mitral Stenosis Addison L Messer Circulation. 1951;4:576-580,
Noninvasive study of early diastole in mitral stenosis.P Toutouzas, Circu...
Source: Dr.S.Venkatesan MD - December 31, 2013 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Clinical a2 os interval a2-os interval after atrial fibrillation atria fibrillation and pressytolic mumur cresendo accentuation criley concept cycle length and mdm s3 in mitral stenosis what happens to mdm after atrial fibrillatio Source Type: blogs
MKSAP: 74-year-old woman with fatigue, anorexia, and weight loss
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 74-year-old woman is evaluated for a 2-month history of fatigue, anorexia, and a 6-kg (13.2-lb) weight loss. She was treated with chemotherapy for ovarian cancer 6 months ago. She also has hypertension managed with hydrochlorothiazide.
On physical examination, temperature is 36.2 °C (97.2 °F), blood pressure is 132/75 mm Hg without postural changes, pulse rate is 86/min without postural changes, and respiration rate is 14/min. BMI is 23. There are no neurologic findings. Estimated central venous pressure is ...
Source: Kevin, M.D. - Medical Weblog - December 7, 2013 Category: Family Physicians Tags: Conditions Nephrology Source Type: blogs
Terbutaline and Albuterol for Lowering of Plasma Postassium
CONCLUSION: We conclude that in patients with terminal renal failure undergoing maintenance hemodialysis, intravenous bicarbonate is ineffective in lowering plasma potassium rapidly, and epinephrine is effective in only half the patients, whereas insulin in glucose is a fast and reliable form of therapy for hyperkalemic emergencies. Plasma aldosterone levels are appropriate in relationship to plasma potassium levels, and levels of other potassium-influencing hormones are generally normal. ADDepartment of Medicine, Kantonsspital, Aarau, Switzerland.PMID3052050 6 PubMed ...
Source: Dr. Smith's ECG Blog - December 6, 2013 Category: Cardiology Authors: Steve Smith Source Type: blogs
MKSAP: 38-year-old woman with increasing fatigue and weight gain
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 38-year-old woman reports a 3-month history of increasing fatigue and weight gain. She underwent transsphenoidal surgery 4 years ago to remove a nonfunctioning pituitary macroadenoma, followed 4 months later by radiation therapy because of residual tumor. She started taking hydrocortisone 14 months ago after adrenal insufficiency was diagnosed. The patient developed amenorrhea 1 year ago and began taking an oral contraceptive. Medications are hydrocortisone, norethindrone with ethinyl estradiol, and a multivita...
Source: Kevin, M.D. - Medical Weblog - November 2, 2013 Category: Family Physicians Tags: Conditions Endocrinology Source Type: blogs
Duopoly:Monopoly or Ferret:Rat?
As I read Julie Donnelly's Boston Business Journal report about Howard Grant's testimony at the recent health care cost trends hearings, I was reminded of a humorous piece written by Art Buchwald many years ago.It was about competition between the two airlines who ran shuttle services between New York and Washington, DC. It went something like this:Art calls US Airways to complain: "I see you just raised your fares to New York.""Yes, we did that to compete against Pan Am. They just raised their fares.""Wait, I thought the idea of competition was to lower prices.""Why would we do that? If we lowered our fares, and th...
Source: Running a hospital - October 9, 2013 Category: Health Managers Source Type: blogs
I've lost my one true constant in my life...
< div class= " separator " style= " clear: both; text-align: center; " > < a href= " http://1.bp.blogspot.com/-xTVbNgXN2Os/UfwjBNWnprI/AAAAAAAAAZk/iYuU48RPeBE/s1600/006.JPG " imageanchor= " 1 " style= " clear: left; float: left; margin-bottom: 1em; margin-right: 1em; " > < img border= " 0 " height= " 240 " src= " http://1.bp.blogspot.com/-xTVbNgXN2Os/UfwjBNWnprI/AAAAAAAAAZk/iYuU48RPeBE/s320/006.JPG " width= " 320 " / > < /a > < /div > < div class= " separator " style= " clear: both; text-align: center; " > < br / > < /div > < span style= " font-family: inherit; " > Friday, August 2, 2013 < /span > < br / > < span s...
Source: Sharing My Cancer Crapness - August 2, 2013 Category: Cancer & Oncology Source Type: blogs
Sunday Shots
Above: Waveland Avenue, Wrigleyville neighborhood, Chicago. Some rooftop seats can be seen, upper right. Addison and Sheffield. (Source: Dr. X's Free Associations)
Source: Dr. X's Free Associations - May 5, 2013 Category: Psychiatrists and Psychologists Authors: DrX Tags: Chicago Photos Front Page Source Type: blogs
21 Inspirational Quotes About Life
To live your life to the fullest, it’s always helpful to get a dose of inspiration. After all, it’s easy to deviate from the right path, so it’s nice to get a few reminders along the way.
In this post I’d like to share with you some inspirational quotes about life. Many of them are classic, but they become classic precisely because they contain a lot of truth.
I carefully selected each of the quotes below. My hope is that they can inspire you to move to the next level.
Without further ado, here they are:
Many of life’s failures are people who did not realize how close they were to success
when they gave up.
...
Source: Life Optimizer - April 11, 2013 Category: Consumer Health News Authors: Donald Latumahina Tags: Attitude Source Type: blogs
21 Inspirational Quotes About Life
To live your life to the fullest, it’s always helpful to get a dose of inspiration. After all, it’s easy to deviate from the right path, so it’s nice to get a few reminders along the way.
In this post I’d like to share with you some inspirational quotes about life. Many of them are classic, but they become classic precisely because they contain a lot of truth.
I carefully selected each of the quotes below. My hope is that they can inspire you to move to the next level.
Without further ado, here they are:
Many of life’s failures are people who did not realize how close they were to success
when they gave up.
...
Source: Life Optimizer - April 11, 2013 Category: Consumer Health News Authors: Donald Latumahina Tags: Attitude Source Type: blogs
Papilledema pearls
1. Cotton wool spots OFF disk may suggest hypertensive syndrome 2. Hemorrhages off disc suggest central retinal vein occlusion 3. New onset pulsatile tinnitus is significant finding indicating need to look for increased ICP, as well as transient obscurations, graying of vision for twenty seconds, with postural change and headache. Field before acuity is affected, disc edema usually affected. 4. MRI findings may include disc enhancement, occassionally, enhanced perioptic space (40 %), flattening of posterior globe (80 %), empty sella Get MRI/M...
Source: neurologyminutiae - April 8, 2013 Category: Neurologists Source Type: blogs
Time to Refill Your Prescription For Zxygjfb
The brand names of drugs are famously odd. But they seem to be getting odder. That's the conclusion of a longtime reader, who sent this along:
I was recently perusing through the recent drug approval list and was struck by how strange the trade names have become. Perhaps it is a request from the FDA so that there are fewer prescription errors, but some of these are really bizarre and don't quite roll off the tongue. USAN names I can understand, but trade names, to me anyway, used to be much more polished (Viagra, Lipitor etc). Could it have to do with the fact that most of these are for cancer? I have a list below compar...
Source: In the Pipeline - January 28, 2013 Category: Chemists Tags: Business and Markets Source Type: blogs
Dexamethasone To Reduce Hospital Stay
I have to say that the addition of a steroid, to a patient with an active infection often feels like an oxymoron. After all, just when the patient is battling a severe illness, why would we want to shut it down? Of course, I am not talking about those cases of relative adrenal insufficiency, where the steroid becomes a treatment for this, and is not functioning primarily as an immunomodulator. Anyway, in the recent study from the Lancet, the steroid used was dexamethasone which has minimal mineralocorticoid effect anyway.
Meijvis and colleagues randomized 304 patients with community acquired pneumonia (C...
Source: Doc To Doc - September 12, 2011 Category: Health Medicine and Bioethics Commentators Authors: digitaldoc Source Type: blogs
