DVT complete diagnostic approach resident survival guide

Revision as of 22:02, 8 March 2014 by Twinkle Singh (talk | contribs)
Jump to navigation Jump to search
Probability of infective endocaritis Characteristics
Definite diagnosis by pathological criteria❑ Microorganisms demonstrated by culture or histological examination
of a vegetation, OR
❑ Pathological lesions; vegetation or intracardiac abscess confirmed by histological
examination showing active endocarditis
Definite diagnosis by clinical criteria❑ 2 major criteria; OR

❑ 1 major criterion and 3 minor criteria; OR

❑ 5 minor criteria
Possible diagnosis❑ 1 major criterion and 1 minor criterion; OR
❑ 3 minor criteria
Rejected diagnosis❑ Firm alternative diagnosis explaining evidence of IE, OR

❑ Resolution of IE syndrome with antibiotic therapy for 4 days, OR
❑ No pathological evidence of IE at surgery or autopsy, with antibiotic therapy for 4 days, OR

❑ Does not meet criteria for possible IE as above



Criteria Definite Infective Endocarditis According to Modified Duke Criteria
Pathological Criteria
Microorganisms demonstrated by culture or histological examination of a vegetation
Pathological lesions; vegetation or intracardiac abscess confirmed by histological examination showing active endocarditis
Clinical Criteria
2 major criteria; or
1 major criterion and 3 minor criteria; or
5 minor criteria
Possible IE
1 major criterion and 1 minor criterion; or
3 minor criteria
Rejected
Firm alternative diagnosis explaining evidence of IE; or
Resolution of IE syndrome with antibiotic therapy for 4 days; or
No pathological evidence of IE at surgery or autopsy, with antibiotic therapy for 4 days; or
Does not meet criteria for possible IE as above
Management of focal atrial tachycardia
Acute treatment
Conversion
Hemodynamically unstable patient
DC cardioversion (Class I, level of evidence B)
Hemodynamically stable patient
Adenosine (Class IIa, level of evidence C)
OR
Verapamil (Class IIa, level of evidence C)
OR
Diltiazem (Class IIa, level of evidence C)
OR
Beta blocker (Class IIa, level of evidence C)
OR
Amiodarone (Class IIa, level of evidence C)
OR
Sotalol (Class IIa, level of evidence C)
OR
Procainamide (Class IIa, level of evidence C)
OR
Flecainide (Class IIa, level of evidence C)
OR
Propafenone (Class IIa, level of evidence C)
Rate control
Verapamil (Class I, level of evidence C)
OR
Diltiazem (Class I, level of evidence C)
OR
Beta blocker (Class I, level of evidence C)
OR
Digoxin (Class IIb, level of evidence C)