Do the following things, in this order of priority.
- Dehydration – rehydrate with IV fluids
- Insulin – to combat hyperglycaemia
- Electrolytes – potassium shifts are a concern
A simple acronym solves everything. The point is not to let the patient DIE.
Do the following things, in this order of priority.
A simple acronym solves everything. The point is not to let the patient DIE.
Lipase is more specific for pancreatic disorders than amylase.
Lipase has a p in it. So does pancreas.
Amylase has nothing.
It’s magic!
There are three major ones, plus more!
The way to remember this is that, in line with the subpar nature of hypokalaemia, everything is weak and low!
ST depression is a depression, so it is low.
The T waves have low amplitude, so they too are low.
The dip of the letter U, as in U waves, looks like the minimum point of a parabola, so it’s also low.
Conveniently, it all follows an alphabetical pattern: ST, T, U.
“Cushing response?!” you cry. “Why is Cushing’s name everywhere and why should I care?! BAH!”
How astute! In fact, that disgruntled sound you make is quite appropriate.
If hyperkalaemia is indeed real and not caused by haemolysis or a bad sample, treatment can be appropriate. It’s urgent if there are ECG changes.
Of course, the underlying cause should be treated; if it’s hypoaldosteronism, such as from adrenal insufficiency, corticosteroids should be given. If it’s volume depletion, that should be corrected. If the hyperkalaemia is caused by a medication, that medication should be ceased.
A lumbar puncture is a procedure that involving drawing out cerebrospinal fluid, fondly known as CSF. For example, it can be used to check CSF for immune cells and glucose levels in suspected meningitis.
Lumbar puncture is considered an invasive procedure. But even with that aside, it’s not appropriate for everyone. That is, it does not suit all patients.
Contraindications to lumbar puncture are:
Colles and Smith fractures are both fractures of the distal radius.
And that’s how an American CD is made.
Medications don’t cure people. Acronyms do.
Well, maybe medications do a little bit.
Maybe.
Anyway, here’s how to remember how to treat acute heart failure in an examination setting.
Paradoxical salad dressing is terrible.
What is it? Well, it occurs when you pour too much salad dressing on your salad.
Why is that bad?
Because then your salad becomes worse than it initially was without the salad dressing.
And then you don’t win friends with your salad, because your salad tastes bad.
Calamity.
This is tragic, because salad dressing is designed to make salad better. Paradoxically, it’s made it worse.
Paradoxical undressing, on the other hand, is also an undesirable occurrence.
Is it when you take your clothes off and that ironically repulses people from wanting to sleep with you?
No, it’s not.
Rather, it’s a phenomenon that occurs in the final stages of hypothermia.
Hypothermia
Hypothermia is when body temperature becomes abnormally low. <35°C is a good guide.
This can be precipitated by events such as swimming in icy water or being exposed to harsh weather conditions.
Paradoxical undressing
You would expect a hypothermic person to feel extremely cold. You would expect, then, a desire to put more clothes on.
Paradoxically, in very severe hypothermia, this is not the case. As a stark precursor to death, victims in the final stages of hypothermia are seized by the urge to remove clothing.
A postulated mechanism is as follows:
References