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"You need just three things to be truly happy in this world: a person that you love, a job that you like, and a dream that you live for"…….from the book The Accidental Apprentice by Vikas Swarup

Aspirin may reduce coronary thrombosis at the expense of excess bleeding; clonidine may reduce hypertensive swings only to be countered by clinically important hypotension. As observed by Chinese philosophers, the whole is made up of the yin and yang — complementary, interdependent, and conceptually opposing entities that comprise a whole. (quoted from the Editorial:The Yin and Yang of Perioperative Medicine by Prashant Vaishnava, M.D., and Kim A. Eagle, M.D., NEJM: March 31, 2014)

MedTutor is an online tutoring site for medical students and young doctors in Internal Medicine. Write to MedTutor at: <moc.liamg|todikiwrotutdem#moc.liamg|todikiwrotutdem>.


April 2014

  1. Group Project - Semester 10 (Group A)
  2. Group Project - Submission by Group B
  3. Questions based on portfolios
  4. Summaries for analysis
  5. A rubric for assessment


ECG for analysis


Test your understanding about circulatory shock

1
Shock should only be diagnosed by the presence of arterial hypotension – a systolic blood pressure less than 90mm Hg systolic or a mean blood pressure less than 70mm Hg. True or False?

2
What does the presence of tachycardia with a cold and clammy skin tell us?
What does the presence of tachycardia with confusion and altered mental status tell us?
What does the presence of tachycardia with a urine output of less than 0.5ml per kg per hour tell us?

3
In what situation is pulse oximetry unreliable as a measure of adequate oxygen in the blood?

4
Can fluids be infused in patients with cardiogenic shock? Yes or No?

5
When should Norepinephrine be chosen as the inotropic agent of first choice?
When should Dobutamine be chosen as the inotropic agent of first choice?
What is the problem with using Dopamine as an inotropic agent?

Check your responses by reading this blog post

Dr Vela Menon, MD
Clinical Associate Professor of Medicine
International Medical University, Malaysia

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