Kardiologie Vaka Sorulari

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Doktor-1975
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Kardiologie Vaka Sorulari

Mesaj gönderen Doktor-1975 » Çrş Eyl 25, 2019 7:11 pm

18 yaşında bir erkek hasta yorgunluk ve nefes darlığından şikayetçi. Sol parasternal kenarında sert bir pan-sistolik üfürümle parasternal alanda sistolik thril i mevcut, En olası tanıniz nedir?

  a. TOF

  b. ASD

  c. VSD

  d. PDA

  e. TGA



HekimBaba
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Mesaj gönderen HekimBaba » Prş Eyl 26, 2019 12:56 am

Doktor-1975 yazdı:
Çrş Eyl 25, 2019 7:11 pm
18 yaşında bir erkek hasta yorgunluk ve nefes darlığından şikayetçi. Sol parasternal kenarında sert bir pan-sistolik üfürümle parasternal alanda sistolik thril i mevcut, En olası tanıniz nedir?

  a. TOF

  b. ASD

  c. VSD

  d. PDA

  e. TGA
C

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Doktor-1975
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Mesaj gönderen Doktor-1975 » Cum Kas 15, 2019 12:47 am

#Loperamide_Toxicity
*Loperamide, a common over-the-counter antidiarrheal drug and opioid derivative, is formulated to act upon intestinal opioid receptors. However, at high doses, loperamide crosses the blood-brain barrier and reaches central opioid receptors in the brain, leading to central opiate effects including euphoria and respiratory depression.
*Pt take loperamide to avheive euophoric effect &to attenuate opid withdrwal symptoms
#Mechanisim
Loperamide has been shown to inhibit sodium channels and delayed-rectifier potassium currents in vitro, which may prolong QTc duration. It’s also known to inhibit calcium channels, which may contribute to potential cardiac toxicity.
#Ecg_changes
*wide qrs complexes
*wide qtc interval
*ventricular arrythmias(torsade depoints,VT&VF)
*cardiac arrest &death
#Management
is typically supportive and may include naloxone for the reversal of opioid receptor antagonism and advanced cardiac life support therapy for patients with cardiac arrest
Ref:Ahajournals.org


https://www.bilder-upload.eu/bild-8ef41 ... .jpeg.html

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Mesaj gönderen Doktor-1975 » Pzt Kas 18, 2019 9:48 pm

New Cardiology Question

A 58-year-old man with a history of medically managed coronary artery Notes disease, end-stage renal disease, hypertension, and diabetes presented with 2 weeks of intermittent shortness of breath with exertion. On the day of admission, he developed substernal chest discomfort described as, “Someone stepping on me.” In the emergency department, he was found to have a new left bundle branch block and went urgently to the catheterization lab where he was found to have a completely occluded proximal left anterior descending artery that was opened successfully with a bare-metal stent. Thirty minutes after his intervention, the patient has this ECG done in the coronary care unit. What is the most reasonable next step?

A. Continue observation

B. Start intravenous (IV) amiodarone

C. Prepare the patient urgently for cardioversion

D. Call the interventional cardiologist to transport emergently back to the catheterization lab for repeat angioplasty

E. Have transcutaneous pacing pads placed on the patient, and the pacemaker on stand-by

Patient’s ECG

https://ibb.co/9cLTz9D

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