@chenxzhe on GrepMed

Status Epilepticus Continuous seizure activity > 5-10 min OR >= 2 seizures without full recovery First line • Lorazepam 2-4 mg IV • Diazepam 5-10 mg IV • Midazolam 2-4 mg IV (10 mg IM if no IV access) Second line • Phenytoin or fosphenytoin 20 mg/kg IV (Phenytoin max infusion 50 mg/min) (Fosphenytoin max infusion 150 mg/min) • Valproic acid 20 mg/kg IV • Phenobarbital 20 mg/kg IV at 50 mg/minute • Levetiracetam 2,000-4,000 mg over 15 min Third line • Pentobarbital (5-15 mg/kg bolus then 0.5-10 mg/kg/hr infusion) • Propofol (3-5 mg/kg bolus then 1-15 mg/kg/hr infusion #Status #Epilepticus #Management #Neurology #Epilepsy

Warfarin Adjustment Guidelines #Warfarin #Adjustment #Guidelines #Pharmacology #Management #INR #Dosing #Table

Giant Cell (Temporal) Arteritis: Clinical findings and Complications Signs/Symptoms: - Headache (usually constant, superimposed by waves of pain corresponding to pulsations of blood) - Scalp painful to palpation - Temporal artery tender, nodular, may be pulsatile - Masseter muscle pain when chewing claudication) - Vision loss (mono- or binocular) - Can lead to blindness! - Diplopia (seeing double) - Stroke or TIA-like symptoms (weakness, aphasia, dysarthria, etc) - Papillary Edema, Flame Hemorrhages #GiantCell #Temporal #Arteritis #Complications #Signs #Symptoms #diagnosis #Vasculitis

Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke: a clinical practice guideline https://www.bmj.com/content/363/bmj.k5108 Dual antiplatelet therapy with clopidogrel and aspirin given within 24 hours after high risk TIA or minor ischaemic stroke reduces subsequent stroke by about 20 in 1000 population, with a possible increase in moderate to severe bleeding of 2 per 1000 population. Discontinuation of dual antiplatelet therapy within 21 days, and possibly as early as 10 days, of initiation is likely to maximise benefit and minimise harms. #DAPT #Antiplatelet #Therapy #CVA #TIA #Stroke #Neurology #Management #Aspirin #Clopidogrel #BMJ

Restarting Anticoagulation after TIA or Acute Ischemic Stroke • TIA → Consider (re-) starting a NOAC ≥ 1 day after stroke onset • Persisting mild neurological deficit → No clinical worsening or clinical improvement → Consider (re-) starting a NOAC ≥ 3 days after stroke onset • Persisting moderate neurological deficit → Exclude hemorrhagic transformation by brain CT or MRI within 24 hours before (re-)starting a NOAC → Consider (re-) starting a NOAC ≥ 6-8 days after stroke onset • Persisting severe neurological deficit → Exclude hemorrhagic transformation by brain CT or MRI within 24 hours before (re-)starting a NOAC → Consider (re-)starting a NOAC ≥ 12-14 days after stroke onset #Restarting #Anticoagulation #TIA #Stroke #CVA #neurology #management

Hypomagnesemia (Serum level < 1.7 mg/dL) Neuromuscular manifestations • Tremor, tetany, seizures • Weakness • Apathy • Delirium • Coma Cardiovascular manifestations • Prolonged QTc • Widening of QRS • Atrial and ventricular dysrhythmias Hypokalemia • Renal potassium wasting Abnormalities of calcium metabolism • Hypocalcemia • Hypoparathyroidism • Parathyroid hormone resistance • Decreased synthesis of calcitriol #Hypomagnesemia #Signs #Symptoms #Diagnosis

Differential Diagnosis of Hypo and Hypermagnesemia #Diagnosis #EM #IM #Differential #Hypormagnesemia #Hypermagnesemia #Ddxof

Acid-Base Disorders - Differential Diagnosis Algorithm Acidemia (pH < 7.35) • Metabolic Acidosis (HCO3 < 24mmol/L) CO2 : HCO3 12:10 • Respiratory Acidosis (pCO2 > 40 mmHg) Alkalemia (pH > 7.45) • Metabolic Alkalosis (HCO3 > 28mmol/L) CO2: HCO3 7:10 • Respiratory Alkalosis (pCO2 < 35 mmHg) #AcidBase #Disorders #Differential #Diagnosis #Algorithm #Causes #Compensation

PLACO Mnemonic - Approach to Acid-Base Disorders P - Determine the pH L - Labs: PCO2 & HCO3 A - Calculate Anion Gap C - Compensation O - Other Processes Paresh Jadav, MD @jadav_md #PLACO #AcidBase #Acid #Base #diagnosis #nephrology #Mnemonic

Algorithm for the differentiation between simple and complex febrile seizures. Guidelines for evaluation of each. #Diagnosis #Management #EM #Neuro #Peds #Febrile #FebrileSeizure #Fever #Seizure #Algorithm #Workup #Simple #Complex