Cardiovascular

• Immunocompromised Patients → at risk of developing oral candidiasis.
• Troponin → peaks 24-48hrs after MI, returns to normal 5-14 days after MI.
• Left Ventricular Outflow Obstruction (may cause collapse) → aortic stenosis and HOCM. Ix for outflow obstruction is echocardiogram.
• AVRT → accessory pathway is bundle of kent, slurred upstroke on QRS complex (delta wave), definitive treatment is radiofrequency ablation of accessory pathway.
• Adenosine (SVT) → contraindicated in asthmatics (use verapamil).
• AF → cardioversion if presenting within 48hrs of symptom onset. If >48hrs, must undergo anticoagulation for 3-4 weeks before cardioversion.
• Left Ventricular Hypertrophy → ECG shows deep S wave in V1/V2, tall R wave in V5/V6. Diagnosis via echocardiogram.
• Heart Sounds → fixed wide splitting of S2 (atrial septal defect), S3 (rapid ventricular filling - LVF), S4 (ventricular hypertrophy - hypertension, HOCM).
• Pleuritic Chest Pain → causes include subphrenic pathology (eg. hepatic abscess).

Abdomen

• Ciclosporin → immunosuppressant following renal transplant. Causes gum hypertrophy.
• Chronic Pancreatitis → normal amylase. Weight loss, steatorrhoea, diabetes mellitus. Low faecal elastase is diagnostic.
• Retrocaecal Appendix → may cause RUQ pain. Positive psoas sign (pain on extending hip).
• Hepatocellular jaundice causes dark urine (as conjugated bilirubin is water soluble). Post-hepatic jaundice causes pale stools (reduced stercobilinogen) and dark urine.
• Antibiotics for Acute Abdomen → cefuroxime (cephalosporin) + metronidazole (cover anaerobes).
• Complications of Abdominal Surgery
  • Wound infection → erythematous, discharge
  • Anastomotic leak → diffuse abdominal tenderness, guarding, rigidity, hypotensive/tachycardic (systemic illness). Usually occurs 5-7 days post-op.
  • Pelvic abscess (eg. post-appendectomy) → pain, fever, sweats, mucus diarrhoea

Neurology