DocArsh

physcian, cardiologist🫀. In Love with Medicine 💊 🩺👨‍⚕️

[DocArsh @postgradDoctor]

comment on Anatomy of Aortic valve-Bicuspid or unicuspid?

#bicuspidAorticValvr
#ECHOChallenge
#Cardiology

[DocArsh @postgradDoctor]

#Sinus_tachycardia is the delirium of cardiology.

#Delirium --> it's (basically) never the brain's fault.

#Sinus_tach --> it's (basically) never the heart's fault.

Don't be distracted by the wrong organ in search of the right answer!

#Cardiology

[DocArsh @postgradDoctor]

Cardiogenic pulmonary edema with raised BP= Start Nitrates before Diuretics
Cardiogenic pulmonary edeme with normal BP= give Diuretics ist and if no response then vasodilators like Nitrates
#Heartfailure #Pulmonaryedema
#Diuretics #Nitrates

[DocArsh @postgradDoctor]

In ACS do lipid profile within 24hrs, after there is a possibility of false low levels due to enhanced sympathetic activity and lipolysis
If serum triglycerides below 400mg, you can calculate the LDL level from Friedewald formula: (LDL=Total cholesterol - (HDL +Triglycerides/5)

[DocArsh @postgradDoctor]

TPM via Rt femoral under Fluoroscopy
#pacemaker
#CardioEd

[DocArsh @postgradDoctor]

Patients with HIV are at increased risk of lactic acidosis and hence prudent to check lactate levels before starting metformin..Lactic acidaemia with no or mild symptoms was detected in 8% to 21% of patients receiving at least 1 nucleoside reverse transcriptase inhibitor
#HIVAIDS

[DocArsh @postgradDoctor]

Donislecel(Lantidra) is an allogeneic (donor) pancreatic islet cellular therapy made from deceased donor pancreatic cells. Donislecel is administered as a single infusion into the hepatic (liver) portal vein.

[DocArsh @postgradDoctor]

The FDA has approved Lantidra (donislecel), a revolutionary treatment for people living with type 1 diabetes. Lantidra works by restoring the body's beta cells, potentially eliminating the need for external insulin.
#Type1DM #celullarTherapy

[DocArsh @postgradDoctor]

Bioavailability of Rivaroxaban decreases as the dose consumed increase (10mg>80%, 20mg>60%). In case of overdose patients are at risk of both bleeding and thrombosis/Embolism. Factor Xa levels or less accurately PT is used to quantity bleeding risk.
#DOACS

[DocArsh @postgradDoctor]

Patinet on carbamizole develop sore throat.. Normal WBC> continue carbamizole. Low WBC> stop carbamizole, switch to propylthiouracil temporarily and refer for radioiodine treatment
#Antithyroids
#Agranulocytosis
#RadioIodine
#Hyperthyroidism

[DocArsh @postgradDoctor]

Avoid paracetamol+NSAIDS as anti pyretic in heat stroke as they alter hypothalamic set point which has nothing to do with high temperature of heat stroke, focus on prompt cooling shift the patient away from direct sun light,oral and iv fluids.Avoid alcohol swabs also
#Heatstroke

[DocArsh @postgradDoctor]

If the pleural fluid appears bloody, a hematocrit can be obtained if there is doubt as to whether it is haemothorax. If the hematocrit of the fluid is more than half of patients’s peripheral blood hematocrit, Haemothorax is confirmed.
#Hemothorax #PleuralEffusion

[DocArsh @postgradDoctor]

NCS in GBS often provide normal results in acute settings, the classic demyelination may not be detectable for at least a week. Therefore the ist line investigation is Lumbar puncture showing raised protein( Albumino-cytological dissociation)
#GBS
#NCS
#CSF

[DocArsh @postgradDoctor]

Ordansetron use in pregnancy during ist trimester is associated with a small increased risk of Cleft lip/palate and should not be used ist line. If it has to be used then these risks should be discussed with pregnant women.
#NauseaVomitingofPregnancy #HyperemisesGravidarum
#onset

[DocArsh @postgradDoctor]

@syedmatiy Yes.. u deserve the credit!

[DocArsh @postgradDoctor]

15 years old male with 1 month history of high grade fever, presented with sudden onset right sided weakness, MR Brain ischemic insult. In work up of stroke in young patient, ECHO showed Aortic valve vegetation.

[DocArsh @postgradDoctor]

GIT with neuropsychiatric symptoms have 3 common differentials 1.Acute intermittent porphyria 2.Lead poisoning 3.Wilson disease!

[DocArsh @postgradDoctor]

MRI brain showed abnormal signals in basal ganglia(T1W, T2W and DW1) and a Low serum CERULOPLASMIN levels. Diagnosed as #Wilson_Disease.

[DocArsh @postgradDoctor]

22 years old with 6 months history of left sided weakness and abnormal movements of left hand. O/E 4/5 power on left side, involuntary writihing movement of the hand, stepping gate , rigidity and hepatomegaly 2 finger breadths below the costal margin.

[DocArsh @postgradDoctor]

Aspirin should not be stopped in patients with upper GI bleed in whom homeostasis has been achieved and using Aspirin for secondary prevention of vascular events.
#UpperGIbleed #Aspirin #MyocardialInfarction

[Conrad Fischer @SeeFisch]

GAME CHANGER
Finerenone
*Prevents progression of diabetic kidney disease
*Add to ACE (or ARB) and SGLT2 inhibitor