By Catherine Parchment-Smith, Claire Ritchie Chalmers
Presents the main updated fabric, matching the MRCS syllabus, to help training for the MRCS A examinations. The publication covers each significant topic within the MRCS syllabus; works systematically via each normal surgical subject more likely to look within the examination; highlights very important rules of surgical procedure; comprises very important lists and important issues; is obviously laid out with illustrations to help knowing.
Read or Download MRCS Part A: Essential Revision Notes: Book 1 PDF
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Presents the main updated fabric, matching the MRCS syllabus, to help coaching for the MRCS A examinations. The ebook covers each significant topic within the MRCS syllabus; works systematically via each common surgical subject prone to look within the examination; highlights very important rules of surgical procedure; includes very important lists and very important issues; is obviously laid out with illustrations to assist knowing.
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Additional info for MRCS Part A: Essential Revision Notes: Book 1
The valve needs assessing with echocardiography (valve area <1 cm2 or gradient of >50 mmHg indicates critical AS). Clinically look for mitral facies, diastolic murmur and atrial fibrillation (AF) (increased pressure chronically enlarges the left atrium). Minimise fluid overload and changes in cardiac rate. Causes reduced efficiency of the atria to pumpprime the ventricles. Common causes of atrial fibrillation Acute causes Fluid overload Sepsis (especially chest) Ischaemic event Alcohol Pulmonary embolism (PE) Dehydration Thyrotoxicosis Chronic causes Ischaemic or valvular disease Questions to ask yourself about each case of AF Is it reversible?
You may not withhold information from a patient at the request of any other person including a relative. If a patient insists that he or she does not want to know the details of a condition or a treatment, you should explain the importance of knowing the options and should still provide basic information about the condition or treatment unless you think that this would cause the patient some harm. You must record in the medical records if you have withheld treatment and your reasons for doing so.
Patients should have the pacemaker evaluated by cardiology before and after surgery because they will be able to assess and advise on any changes required to the settings. Unipolar diathermy current may pass down pacing wires, causing cardiac burns so advice should be sought from the cardiologist if unipolar diathermy is thought to be necessary. Cardiac failure Due to acute or chronic ischaemic or valvular disease Exercise tolerance is a good indictor of cardiac reserve; ask: • How far can you walk?