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ismailalmokyad's version from 2017-11-16 14:00

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Question Answer
What is acquired long QT syndrome (LQTS) ?It developed as result of interaction between medications as Sotalol and azithromycin.
How does Torsades de pointes usually present ?it commonly precipitated by premature bentricular beats followed by compnesated pause(short-long RR intervals). It can also provoked in pt with bradyarrhythmias(sinus or pauses) referred to as pause-dependent LQTS
How to treat patient who had a brief Torsade that terminates spontaneously?recurrence is high and IV magnesium sulfate should be given to avoid vfib and death.
How to deal with selective estrogen receptor modulator (raloxifene and tamoxifen) before surgery?It increase VTE and should be discontinued 4 weeks prior to surgery.
How does tricyclic antidepressant overdose present ?CNS (AMS, delirium, coma, seizures. Resp depression. Anticholinergic effect (dry mouth, blurred vision, dilated pupils, flushing, hyperthermia and urine retention), cardiotoxic effect(sinus tachy, hypotension, and arrhythmias)
What is the most common cause of death in TCA overdose?cardiotoxic effect as arrhythmias(as result of inhibition of fast sodium channels in his-purkinje tissue which prolong QT)
How to treat TCA overdose ?Sodium bicarbonate, it increase serum PH and increase serum sodium. which affect the TCA binding to fast channel and in turn prevent arrhythmias .
When does pt with hx of CAD or ACS can start sexual activities ?if low risk can start immediatly, if high risk will need detailed assessmant and indeterminated/intermediate risk pt will need stress test.
How to manage blunt thoracic trauma?FAST (focused assessment with sonography in trauma)
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