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Anesthesia Monitoring and Management
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
One hour into procedure. No eye movement, normal mucous membrane color and CRT.RR 5 breaths/minute.EtCO2 55 mmHg.SpO2 95%.Normal sinus rhythm, HR 32 beats/minutes.Blood pressure 120/55 (80) mmHg.This patient is currently hypoventilating, and this could be what has caused the saturation to be low.
The Cardiovascular System and its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Ventricular fibrillation displays similar chaotic spread of impulses and rapid rate of contraction, but the impulses spread throughout the ventricular myocardium rather than the atrium. The most frequent cause is ventricular myocardial infarction. Because the fibrillating ventricle is unable to effectively pump blood, the arrhythmia is fatal if not immediately terminated. The abnormal rhythm can be converted to normal sinus rhythm with application of a direct electrical current, a procedure called DC defibrillation, The primary therapy is prevention, using antiarrhythmic medications to suppress PVCs and prevent ventricular fibrillation.
Questions
Published in Neel Sharma, Tiago Villanueva, SBAs and EMQs in Psychiatry for Medical Students, 2019
A 26-year-old city worker presents to A&E complaining of central crushing chest pain. Chest examination reveals normal heart sounds with no tenderness on chest wall palpation. An ECG demonstrates normal sinus rhythm. A troponin taken 12 hours post-onset is 0.09 μg/L. What is the most likely aetiological cause? Cocaine misuseDiazepam overdoseAlcohol intoxicationCannabis misuseNone of the above
Veratrum parviflorum poisoning: identification of steroidal alkaloids in patient blood and breast milk
Published in Clinical Toxicology, 2022
Jared T. Seale, Joseph E. Carpenter, Matthew D. Eisenstat, Emily A. Kiernan, Brent W. Morgan, Daniel P. Nogee, Xinzhu Pu, Colin A. Therriault, Michael Yeh, Owen M. McDougal
Patient 7 is a 57-year-old female who picked V. parviflorum plants mistaken for ramps in Hiwassee, Cherokee County, North Carolina. She ate above-ground leafy material from two plants that were blanched in water and seasoned with a dressing. She developed nausea, vomiting, diarrhea, and cramping epigastric pain within 4 h of ingestion. She received oral promethazine and ondansetron from her primary care physician, but symptoms persisted. She presented to the ED 8 h after ingestion and was hypotensive, with blood pressure of 84/49, heart rate 91. Labs showed mild hypokalemia with potassium of 3.3 mEq/L, and undetectable digoxin. She continued to have intractable vomiting with persistent hypotension, with lowest blood pressure of 78/41, but no bradycardia. She was admitted and treated with IV fluids and metoclopramide, but did not require vasopressors. EKG showed normal sinus rhythm with rate of 96 and normal intervals. Her symptoms resolved with supportive care and she was discharged 42 h after ED presentation.
Acute Enophthalmos After Lumbar Puncture in a Patient with Type 1 Neurofibromatosis Related Sphenoid Wing Dysplasia
Published in Neuro-Ophthalmology, 2022
Deanna Ingrassia Miano, Gregory Byrd, Rani Kattoula, Aye Thet, Ryan Adkins, Ryan Cosgrove, Samantha S. Johnson
A 19-year-old African American woman with a medical history significant for NF-1 presented to hospital after collapsing while leisurely walking outside. She denied any previous syncopal events, blurred vision, diplopia, dizziness, headache, incontinence, weakness, sensory loss, nor history of drug or alcohol use prior to this incident. She denied taking any medications, including anti-epileptics. She had been diagnosed with NF-1 5 years earlier after a single epileptic event, which led to the discovery of a right-sided sphenoid wing dysplasia on imaging. In addition, her family history was positive for NF-1 in her mother. The evaluation was notable only for mild right ankle pain secondary to the fall. An electrocardiogram demonstrated normal sinus rhythm. Aside from the patient’s previously known NF-1 related sphenoid wing dysplasia, a non-contrast computed tomography (CT) scan of the head was negative for acute abnormality (Figure 1A). She was subsequently admitted to the hospital for a further work-up. An electroencephalogram revealed no epileptiform activity. No acute changes were appreciated on magnetic resonance imaging (MRI) at this time. CT angiography of the brain revealed a 2 mm infundibular dilatation at the origin of the left ophthalmic artery. No vasculitic findings were observed.
Aerococcus urinae tricuspid valve infective endocarditis
Published in Baylor University Medical Center Proceedings, 2022
Sanchari Banerjee, Sindhubarathi Murali, Atika Azhar, Anojan Pathmanathan, Debanik Chaudhuri
Her erythrocyte sedimentation rate was 113 mm/h, and the C-reactive protein level was 309.5 mg/dL. A complete blood count did not show leukocytosis, and troponin was negative. An electrocardiogram showed normal sinus rhythm. Blood cultures grew gram-positive cocci in clusters significant for A. urinae. Urine cultures were negative. Transthoracic echocardiography showed a markedly thickened tricuspid valve involving the posterior and septal leaflets with minimal regurgitation. Follow-up transesophageal echocardiography showed an ejection fraction of 60% with normal segmental wall motion, a dilated right atrium, and vegetations involving septal and posterior leaflets of the tricuspid valve with moderate tricuspid insufficiency. The larger vegetation on the septal leaflet measured approximately 1.2 × 0.9 cm (Figure 1). Pulmonary artery systolic pressure was elevated to 50 to 55 mm Hg. The mitral, aortic, and pulmonary valves were structurally normal.