Antedates

Ice antidotes

||Ecstasy poisoning #

@Ecstasy is a semi-synthetic, hallucinogenic substance =(MDMA, 3,4-methylenedioxymethamphetamine). @Its effects range from= nausea, muscle pain, blurred vision, amnesia, fever, confusion, and ataxia to tachyarrhythmias, hyperthermia, hyper/hypotension, water intoxication, DIC, K+↑, acute renal failure, hepatocellular and muscle necrosis, cardiovascular collapse, and ARDS. @There is no antidote and treatment is supportive. Management depends on clinical and lab findings, but may include:=

 Administration of activated charcoal and monitoring of BP, ECG, and temperature for at least 12h (rapid cooling may be needed).  Monitor urine output and U&E (renal failure p293), LFT, CK, FBC, and coagulation (DIC p336). Metabolic acidosis may benefit from treatment with bicarbonate.  Anxiety: diazepam 0.1-0.3mg/kg PO. Max IV does over 2min.  Narrow complex tachycardias in adults: consider metoprolol 5-10mg IV.  Hypertension can be treated with nifedipine 5-10mg PO or phentolamine 2-5mg IV. Treat hypotension conventionally (p778).

JVP

Jugular venous pressure (pulse)
Causes of an elevated central venous pressure
Right ventricular failure
Tricuspid stenosis or regurgitation
Pericardial effusion or constrictive pericarditis
Superior vena caval obstruction
Fluid overload
Hyperdynamic circulation
Wave form
Causes of a dominant a wave
Tricuspid stenosis (also causing a slow y descent)
Pulmonary stenosis
Pulmonary hypertension
Causes of cannon a waves
Complete heart block
Paroxysmal nodal tachycardia with retrograde atrial conduction
Ventricular tachycardia with retrograde atrial conduction or atrioventricular dissociation
Cause of a dominant v wave
Tricuspid regurgitation
x descent
Absent: atrial fibrillation
Exaggerated: acute cardiac tamponade, constrictive pericarditis
y descent
Sharp: severe tricuspid regurgitation, constrictive pericarditis
Slow: tricuspid stenosis, right atrial myxoma

Causes of postural hypotension

Causes of postural hypotension


Hypovolaemia (e.g. dehydration, bleeding)
Drugs (e.g. vasodilators and other anti-hypertensives, tricyclic antidepressants, diuretics, antipsychotics)
Addison's* diseaseHypopituitarismAutonomic neuropathy (e.g. diabetes mellitus), amyloidosis, Shy-Drager syndrome)Idiopathic orthostatic hypotension (rare progressive degeneration of the autonomic nervous system, usually inelderly men)

During is a synonym for as

As the novel pandemic influenza A (H1N1) virus spread around the world
in late spring 2009 with a well-matched pandemic vaccine not immediately
available, the question of partial protection afforded by seasonal influenza
vaccine arose.

answer is b. During spring 2009 not c. after spring 2009

Mix or swith idea make false statement

which statement is false:
a. Participating in how one's own country is run should be left to the alert and educated.
c. People being required to vote, to participate in the decision making process, is a good idea

Of those who do take the time to register and vote, few are sufficiently alert and/or educated to vote with intelligence, thought, and compassion. Requiring participation in the governance of one's own country is not a bad idea.

a -> false. both statement are talking about governing.

Vaccination edu

When a healthy person becomes infected with a virus, eg. measles, the body recognises the virus as an invader, produces antibodies which eventually destroy the virus and recovery occurs. If contact with the measles virus occurs again in the future, the body’s immune system ‘remembers’ the measles virus and produces an increase in antibodies to destroy the virus.

Vaccination is the process that is used to stimulate the body’s immune system in the same way as the real disease would, but without causing the symptoms of the disease. Most vaccines provide the body with ‘memory’ so that an individual doesn’t get the disease if exposed to it.

Vaccination conveys immunity to diseases by a process called active immunity, which can be achieved by administration of either inactivated (ie. not live) or live attenuated organisms or their products. Live vaccines are attenuated, or weakened, by growing the organism through serial culturing (or passaging) steps in various tissue culture media. Inactivation is usually done using heat or formalin (sometimes both). Inactivated vaccines may include the whole organism (such as oral cholera vaccine), the toxin produced by the organism (such as tetanus and diphtheria vaccines), or specific antigens (such as Hib and pneumococcal vaccines). In some cases, the antigen is conjugated (ie. chemically linked) with proteins to facilitate the immune response. Inactivated viral vaccines may include whole viruses (such as IPV and hepatitis A vaccines) or specific antigens (such as influenza and hepatitis B vaccines). Live attenuated viral vaccines include MMR, rubella, varicella and yellow fever vaccines.

Immunity can also be acquired passively by the administration of immunoglobulins. Such immunity is immediate and is dose-related and transient. For example, measles or hepatitis B immunoglobulin can be used promptly after exposure in an unimmunised person to help reduce the chance of catching measles or hepatitis B from the exposure.