Critical Care

NON ST ELEVATION ACUTE CORONARY SYNDROME

Cardiac Critical care / /

NON ST ELEVATION ACUTE CORONARY SYNDROME (NSTE-ACS)  Definition NSTE-ACS includes: NSTEMI (Non-ST Elevation Myocardial Infarction) → myocardial necrosis + ↑ troponin Unstable Angina (UA) → ischemia(ECG CHANGES) without necrosis (normal troponin)  PATHOPHYSIOLOGY  Plaque rupture/erosion → platelet activation → thrombus formation Partial or intermittent occlusion (NOT complete like STEMI) Leads to subendocardial ischemia Feature NSTE-ACS STEMI […]

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Amiodarone

Drugs In Critical Care / /

Amiodarone  1. CLASSIFICATION  Amiodarone = Class III antiarrhythmic (Vaughan-Williams classification)    2. MECHANISM OF ACTION  K⁺ channel blockade (Phase 3) ↑ repolarization time ↑ QT interval ↑ refractory period → prevents re-entry circuits Na⁺ channel blockade ↓ conduction velocity (especially in ischemic tissue) Ca²⁺ channel blockade ↓ AV node conduction Non-competitive β-blockade ↓ sympathetic drive

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Acute Kidney Injury

Nephro Critical care / /

Acute Kidney Injury (AKI)  KDIGO Definition of AKI AKI is diagnosed if any one of the following is present: Increase in Serum Creatinine-≥0.3 mg/dL (26.5 μmol/L) within 48 hours Relative Increase in Creatinine-≥1.5 times baseline within previous 7 days Reduced Urine Output—<0.5 mL/kg/hr for 6 hours KDIGO Staging of AKI Stage Serum Creatinine Criteria Urine

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Ventilator Associated Pneumonia

Pulmonology Critical care / /

Ventilator Associated Pneumonia (VAP)  Pneumonia occurring ≥48 hours after endotracheal intubation and initiation of invasive mechanical ventilation Infection not present or incubating at the time of intubation Related Terms (CDC Surveillance) Term Definition VAP Clinical diagnosis Ventilator-Associated Event (VAE) Surveillance definition VAC Ventilator-associated condition IVAC Infection-related VAC Possible VAP IVAC + microbiology  Exams focus: Clinical

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Fournier’s Gangrene

Infectious disease Critical care / /

Fournier’s Gangrene  Fournier’s gangrene (FG) is a rapidly progressive, life-threatening form of necrotizing fasciitis involving the perineum, genitalia, and perianal region. It is characterized by: Necrosis of superficial and deep fascial planes Microvascular thrombosis Extensive tissue destruction Polymicrobial infection Severe sepsis and septic shock Why Is It Dangerous? Mortality remains:20–40% ,Can exceed:70–80% when: Septic shock

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