Underground Clinical Vignettes-Pharmacology - Softcover

Bhushan, Vikas

Softcover

ISBN 10: 1890061352 ISBN 13: 9781890061357

Publisher: Wiley-Blackwell, 1999

Synopsis

S2S introduces the 2nd Edition of the only Step 1 review series dedicated to Clinical Vignettes. Each Underground Clinical Vignettes book presents 100+ frequently tested diseases with thousands of classic buzzwords in Hx, PE, lab, imaging and pathology.

About this title

From the Publisher:

Buy the UCV Step 1 Bundle (0-632-04559-0) and receive a new FULL COLOR picture atlas -- completely free!

- Hundreds of classic full-color photos of Histo, Path, Hem, Micro, and clinical images
- Page references to the UCV volumes for quick navigation
- Format designed for easy quizzing

Excerpt. © Reprinted by permission. All rights reserved.:

ID/CC-A 45-year-old female who works as a preschool teacher complains of fatigue, headache, dizziness, shortness of breath, and constipation.

HPI-She has been receiving amiodarone for 1 year for treatment for chronic palpitations that arose spontaneously, with tachycardia that reaches 220 beats per minute (SUPRAVENTRICULAR TACHYCARDIA) and increases when she drinks coffee, is under stress, or smokes.

PE-VS: bradycardia (HR 55); BP normal; no fever. PE: well hydrated, conscious, and oriented; no neck masses or bruit; diffuse crackling sounds and wheezes in both lung fields, predominantly in bases; abdominal and neurologic exams normal.

Labs-ECG: prolonged QT interval and QRS duration. AST and ALT moderately elevated.

Imaging-CXR: bilateral interstitial infiltrates (incipient pulmonary fibrosis).

Gross Pathology-N/A

Micro Pathology-N/A

Treatment-Continuously monitor ECG and vital signs. Sodium bicarbonate may reverse cardiac depressant effects if evident. Discontinue drug if evidence of pulmonary fibrosis.

Discussion-Amiodarone is a Class IA and III antiarrhythmic drug. Adverse reactions require careful monitoring and include thyroid dysfunction (both hypo- and hyperthyroidism), constipation, hepatocellular necrosis, and pulmonary fibrosis, which may be fatal. It may also produce bradycardia and heart block in susceptible individuals. Amiodarone has a long half-life, so if toxicity occurs, it persists long after the drug has been discontinued.

About this edition

• Publisher: Wiley-Blackwell
• Publication date: 1999
• ISBN 10: 1890061352
• ISBN 13: 9781890061357
• Binding: Paperback
• Edition number: 2
• Number of pages: 116