By Steven S. Agabegi, Elizabeth D. Agabegi
Step-Up to medication is your lifeline for the medical years of clinical university. This ebook was once initially written via third-year clinical scholars looking for the precise overview book—not discovering it out there, they wrote it themselves! Now in its 3rd variation, Step-Up to Medicine boils down the total scope of established pathology in one creative software. each one point is customized for instant content material absorption, and an all-new, full-color inside differentiate parts for even swifter, extra effective overview. And, Step-Up to Medicine, third edition provides two different types of self-assessment—the sorts of questions you are going to wonder as a clinician plus USMLE-style perform questions. This assessment ebook provides simply the Step-Up to the drugs clerkship, accompanying shelf checks, and USMLE Step 2 that you just need! NEW positive factors for this blockbuster edition:<ul type="disc"> • Full-color, up to date inside layout brings the content material to you in a rousing, memorable style.
• Full-color, up to date artwork application illustrates concepts while an image says it best—plenty of medical pictures additionally complement topics.
• New content material on evidence-based drugs retains you present and proficient to steer your scientific selection making.
• improved content material on drug dosing is extra the place relevant.
CLASSIC beneficial properties scholars swear by:<ul type="disc"> • whole insurance of high-yield clinical themes guarantees you're attempt ready
• scientific Pearls containers assist you “file away” scientific medication connections for convenient retrieval at try out time
• quickly Hits glimmering within the margins spotlight hugely testable material—just see how the sparks fly at try out time
BONUS fabric and examine resources:<ul type="disc"> • publication with the absolutely searchable textual content is out there through thePoint .
• NEW three hundred USMLE-style questions supply one other technique of self-assessment and perform for these exams
• NEW Audio clips of breath and middle sounds additionally to be had on thePoint
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Extra info for Step-Up to Medicine (Step-Up Series)
Diagnosis 1. Treatment (see Clinical Pearl 1-12) 1. Acute AFib in a hemodynamically unstable patient: Immediate electrical cardioversion to sinus rhythm 6/11/12 4:23 PM D ise a ses o f t h e C a r dio v a scu l a r S y stem l 25 CLINICAL PEARL 1-12 Diseases of the Cardiovascular System Cardioversion Versus Defibrillation Cardioversion • Delivery of a shock that is in synchrony with the QRS complex: Purpose is to terminate certain dysrhythmias such as PSVT or VT; an electric shock during T wave can cause Vfib, so the shock is timed not to hit the T wave.
Long-term amiodarone therapy is an alternative. Bradyarrhythmias Sinus Bradycardia • Sinus rate <60 bpm: Clinically significant when rate is persistently <45 bpm • Causes include ischemia, increased vagal tone, antiarrhythmic drugs; may be a normal finding in trained athletes • Can be asymptomatic; patients may complain of fatigue, inability to exercise, angina, or syncope • Atropine can elevate the sinus rate by blocking vagal stimulation to the sinoatrial node. A cardiac pacemaker may be required if bradycardia persists.
3. Chronic AFib a. , AFib in the absence of underlying heart disease or other cardiovascular risk factors) under age 60 do not require anticoagulation because they are at low risk for embolization (aspirin may be appropriate). • Treat all other patients with chronic anticoagulation (warfarin). Quick Hit The AFFIRM trial showed that rate control is superior to rhythm control in treatment of AFib. Quick Hit Risk of CVA in patients with AFib • Patients with “lone AFib”: 1%/yr • Patients with heart disease: 4%/yr Atrial Flutter A.