CARDIOVASCULAR SYSTEMppt.pptx

3 phenytoin beta blocker lidocaine lidocaine is

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3) PHENYTOIN /BETA BLOCKER / LIDOCAINE: - LIDOCAINE IS EFFECTIVE IN TREATMENT OF DIGITALIS INDUCED VENTRICULAR TACHYARRHYTHMIAS. 4) CARDIAC PACEMAKER: MAY BE REQUIRED IN DIGITALIS INDUCED AV BLOCK. 154
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5) ELECTRICAL CARDIOVERSION: MAY BE LIFE SAVING IN DIGITALIS-INDUCED VENTRICULAR FIBRILLATION. 6) FAB FRAGMENTS /DIGITALIS ANTIBODIES: - ARE POTENTIALLY LIFE SAVING IN SEVERE INTOXICATION. 155
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392 156 Ans. is 'd' i.e., Hemodialysis [Ref Harrison 16th1ep. 1375; KDT 61h/ep. 498, 499] Hemodialysis has no role in treatment of digoxin overdose. Hemodialysis is not useful in poisonings due to 1. Digoxin 2. Kerosene 3. Benzodiazepines 4. Organ ophosphates
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157
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RHEUMATIC FEVER ACUTE, RECURRENT, INFLAMMATORY DISEASE, MAINLY OF CHILDREN (AGED 5–15 YEARS), TYPICALLY OCCURRING 1–5 WEEKS AFTER GROUP A STREPTOCOCCAL INFECTION. PATHOPHYSIOLOGY:- 1. CROSS REACTIVITY OF HOST ANTISTREPTOCOCCAL ANTIBODIES TO CARDIAC ANTIGENS. 2. MICROBE INITIATED AUTOIMMUNE REACTIVITY. 158
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477 159 Ans. is 'a' i.e., Caused by group A streptococcus; 'd' Carriers have low risk of developing RF; 'e' M-5 protein cross reacts [Ref. Harrison 18t'1ep. 2752-2756; 17'1ep. 884, 2092, 2093; Robbin's 7/ep. 594]
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RHEUMATIC FEVER IS AN ACUTE IMMUNOLOGICALLY MEDIATED MULTISYSTEM INFLAMMATORY DISEASE THAT OCCURS FEW WEEKS AFTER AN EPISODE OF GROUP A STREPTOCOCCAL PHARYNGITIS'. STUDIES HAVE SHOWN THAT 3% INDIVIDUALS WITH UNTREATED GROUP. A STREPTOCOCCAL PHARYNGITIS DEVELOP RHEUMATIC FEVER. RHEUMATIC FEVER DOES NOT FOLLOW INFECTIONS BY STREPTOCOCCI AT OTHER SITES SUCH AS THE SKIN. 160
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479 161
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MAJOR MANIFESTATIONS: CARDITIS. POLYARTHRITIS. CHOREA. ERYTHEMA MARGINATUM. SUBCUTANEOUS NODULES. MINOR MANIFESTATIONS: CLINICAL : FEVER, POLYARTHRALGIA. LABORATORY : ELEVATED ERYTHROCYTE SEDIMENTATION RATE OR LEUKOCYTE COUNT. ELECTROCARDIOGRAM : PROLONGED P-R INTERVAL. 162
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163
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479 164 Ans. is 'a' i.e., Chorea; 'c' i.e., Arthritis; 'e' i.e., Carditis; [Ref Harrison 18th/ep. 2755 table (322.1)]
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165
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VALVE INVOLVEMENT IN RHEUMATIC HEART DISEASE MITRAL VALVE ALONE - 50%. AORTIC VALVE ALONE - 15–20%. MITRAL AND AORTIC VALVES TOGETHER - 35– 40%. MITRAL, AORTIC AND TRICUSPID VALVES - 2–3%. PULMONARY VALVE IS VIRTUALLY NEVER INVOLVED. 166
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485 167 Ans. is 'a' i.e., Mitral regurgitation [Ref Harrison 18th/ep. 2753, 1711ep. 2093,2094; O.P. Ghai 61h/ep. 376,] In Rheumatic fever valvular abnormalities usually are associated with chronic diseases but mitral regurgitation is seen in acute Rheumatic fever. Also know • Most commonly involved valve in case of Rheumatic fever is the mitral valve and the most common valvular deformity produced is mitral stenosis.
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486 168 Ans. is 'a' i.e., Pulmonary valve [Ref Harrison 18t"/ep. 2753; Robbins 7"/ep 594]
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489 169
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TREATMENT:- 1. TAB . ASPIRIN 75–100 MG/KG/DAY IN 4–5 DIVIDED DOSES , TILL THE ACTIVITY OF THE DISEASE SUBSIDES (ESR BECOMES NORMAL). 2. STEROIDS IN DOSE OF 1–2 MG/KG/DAY IF SYMPTOMS OF RF AND/OR CARDITIS PERSIST DESPITE ADEQUATE ASPIRIN THERAPY.
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  • Winter '16
  • jean grey
  • Cardiology, Ans., Constrictive pericarditis

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