Dr Akbar MD: Cardiology / Internal Medicine

Area of Interest:
Run Heart Failure Clinic
Cardio Diabetics: Run Lipid Clinic
Cardio Obstetrics: Run ANC cardiac Clinic

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

Answer:All of the above

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

Absolute contra indications to exercise stress test : please choose the best answer

1. Ongoing unstable angina
2. Severe symptomatic aortic stenosis
3.Decompensated heart failure
4.Acute aortic dissection
5. All of the above

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@n_soumil24010 @Doctors_GUILD The author made a caption for this video and asks causes of sudden cardiac death
We don’t know what further happened to this young boy
If he recovered on his own, it may be a syncope ( transient loss of consciousness) or NON sustained VT lasting few seconds

F/U report needed

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@Rheumat_Aravind Hemochromatosis with hand arthritis ( calcium pyrophosphate deposition)
Neck skin shows acanthosis nigrans due to insulin resistance

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@drabdulhameed07 @Doctors__squad Looks like Ehler danlos syndrome
Hyper mobile joints

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@IhabFathiSulima Lymph node aspiration: pus is draining rule out TB

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@hemo_shk GCA/temporal arteritis involving large and medium arteries
Sudden blindness is a dreaded complication

Imaging guided temporal artery biopsy ( due to skip lesions, may be missed)

High dose corticosteroids followed by
Tocilizumab
Vitamin D calcium

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@IhabFathiSulima Vanishing tumour: accumulation of fluid (due to heart failure ) in the inter lobar fissure

Which clears up with anti failure treatment and diuretics

Repeat imaging shows no fluid opacity , so gets the name of vanishing tumour

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

Insulin secreting tumour: insulinoma
Where pro insulin, insulin and c peptide all elevated
While exogenous administration of insulin will cause high insulin but low c peptide levels

Beta cells in pancreas secrete pro insulin which is cleaved into active insulin and c peptide and that’s why all three raised in insulinoma

Exogenous insulin causes high insulin levels only as it doesn’t contain c peptide

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@TrackYourHeart Massive pericardial effusion with early diastolic collapse of RA due to cardiac tamponade

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@TrackYourHeart Thrombus : spontaneous echo contrast with hypo kinetic LV apex favours it

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

Verapamil
Any AV nodal blocking drugs (like beta blockers, digoxin, adenosine,non dihydro pyridine CCB like verapamil,diltiazem) block normal SA>>AV>> Purkinje>> ventricular pathway

Due to above blockade impulses find their way through accessory bypass pathways associated with WPW ( bundle of Kent,Mahaim fibres) are rapidly conducted through them

As there is no inherent delay (as happens at AV node normally) all conducted through by pass tracts bombard the ventricles directly and rapidly leading to rapid VT/VF with circulatory collapse

Drug of choice is procainamide( does not block AVNode)

Procainamide is a class 1 anti arrhythmic prolongs action potential in atrial and ventricular myocardium thus slowing down ventricular response rates

If circulatory collapse urgent sunchronized cardio version

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@DrAkhilX Xanthalasma, xerosis cutis, xerophthalmia, X chromosome

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@DrNikhilMD Renal cell carcinoma with cannon ball secondaries in both lungs

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@TrackYourHeart PCR for TB,interferon Y , ANA,

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@TrackYourHeart Cardiac tamponade
Echo shows early diastolic collapse of RA
Management: emergency pericardio centesis and drainage: send fluid for ADA,LDH, gram’s stain, culture for TB, fungus, bacterial,cytology

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@elonmuskADO 👍👍

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@DrAkhilX Osborne wave indicating hypothermia

[Dr Akbar MD: Cardiology / Internal Medicine @DrAkbarMD]

@hyderabaddoctor Sychosis barbae