Melanoma: the invasion depth of the tumour is the single most important prognostic factor Malignant melanoma: prognostic factors The invasion depth of a tumour (Breslow depth) is the single most important factor in determining prognosis of patients with malignant melanoma …
Infective endocarditis: prognosis and management Poor prognostic factors Staph aureus infection (see below) prosthetic valve (especially ‘early’, acquired during surgery) culture negative endocarditis low complement levels Mortality according to organism staphylococci – 30% bowel organisms – 15% streptococci – 5% …
Mechanical valves – target INR: aortic: 2.0-3.0 mitral: 2.5-3.5 Prosthetic heart valves The most common valves which need replacing are the aortic and mitral valve. There are two main options for replacement: biological (bioprosthetic) or mechanical. Biological (bioprosthetic) valves Mechanical …
NICE now only recommend diagnosing people over the age of 80 years as hypertensive if they have stage 2 hypertension (ABPM daytime average or HBPM average BP >= 150/95 mmHg). Remember that the diagnostic criteria are different from the blood …
Long QT syndrome Long QT syndrome (LQTS) is an inherited condition associated with delayed repolarization of the ventricles. It is important to recognise as it may lead to ventricular tachycardia and can therefore cause collapse/sudden death. The most common variants …
Acute coronary syndrome: management NICE produced guidelines in 2010 on the management of unstable angina and non-ST elevation myocardial infarction (NSTEMI). They advocate managing patients based on the early risk assessment using a recognized scoring system such as GRACE (Global …
Atrial fibrillation: rate control and maintenance of sinus rhythm The Royal College of Physicians and NICE published guidelines on the management of atrial fibrillation (AF) in 2006. The following is also based on the joint American Heart Association (AHA), American …
Blood pressure target (based on clinic readings) for patients < 80 years – 140/90 mmHg Hypertension: diagnosis and management NICE published updated guidelines for the management of hypertension in 2011. Some of the key changes include: classifying hypertension into stages …
NICE do not recommend any further investigation for patients with an estimated coronary artery disease risk of greater than 90%. This includes all men over the age of 70 years who have typical symptoms. Chest pain: assessment of patients with …
ACE inhibitors have reduced efficacy in black patients and are therefore not used first-line Hypertension: diagnosis and management NICE published updated guidelines for the management of hypertension in 2011. Some of the key changes include: classifying hypertension into stages recommending …