1- approach to Dysphagia ..

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🔸DDx.

🔸Focused Hx ( important Q. ) :
-show me with your finger at which level does the food get stuck?
-due to solid or liquid or both?
-painful or painless?
-transient, intermittent or progressive?
-associated Symptoms?
-Did you notice bulging of the neck while eating or drinking?
-ASK about - PMH , drug , exposure to radiation

⭕️Alarm Symptoms .

📌 Keep in your Mind :

↪️ Dysphagia should always be taken seriously and should prompt further evaluation .

↪️ Distinguish between oropharyngeal and esophageal dysphagia at the beginning of the interview.

↪️ The duration and frequency of a patient’s dysphagia provide useful clues and can help make the
diagnosis.

↪️ Dysphagia to solid food is most often due to a mechanical obstruction, whereas dysphagia to solid and liquid food is often due to a motor (motility) disorder.

2- approach to Hematuria ..

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🔸DDx.

🔸Focused Hx ( important Q. ) :

- at the beginning of micturition or at the end or throughout?
-feel pain or burning during micturition?
- associated with frequency, urgency or hesitancy?

- have loin pain? radiate to the groin? have pain in lower abdomen or generalized abdominal pain?
❗️ (If the patient complains of any pain, take detailed history ..)

- noticed bleeding from any other part of the body?
- have fever?
❗️ (If yes, take detailed history of fever).

- associated with nausea or vomiting?

- noticed any rash? Is it associated with joint pain and swelling?

- Did you ever pass stones previously?
- Did you suffer from any kind of trauma?
- Did you suffer from skin infection or sore throat recently?
- have hypertension, exertional breathlessness and swelling of the body?

- In female, enquire whether she is menstruating.

- ask about Drug hx / PMH / hx of renal diseases in his family / Exposure to radiation / travel

in general ..

↪️Glomerular hematuria
⁃ Dysmorphic RBC
⁃ RBC cast
⁃ Proteinuria > 500 mg/ day
⁃ No clots

Non-glomerular hematuria
⁃ Clots
⁃ No Dysmorphic RBC
⁃ No RBC cast
⁃ No Proteinuria

⭕️Alarm Symptoms .

📌 Keep in your Mind :

↪️ The first priority is to determine whether the discoloration is due to blood in the urine or another cause.

↪️ All patients with even a single episode of gross hematuria should receive a thorough history and physical examination
followed by urologic or nephrologic evaluation .

*Both microscopic and gross hematuria can be manifestations of serious disease, including malignancy.


↪️Even in patients with transient causes, if there are significant risk factors for malignancy, further evaluation should be considered.

↪️ older men with microscopic or gross hematuria are more likely to have a genitourinary malignancy, diagnostic evaluation should be pursued even in the presence of nocturia, polyuria, and decreased force of urinary stream ( suggestive of BPH ).

▫️ مساء الخير 🤍.

🔺 لتوضيح صار ابديت ع البوست ، شفت هيج طريقة كـ systems ارتب ومنظمة اكثر و اي ابديت راح ينضاف ع البوست وايضا ع بلي ليست اليوتيوب .

- مصدر الـ approach ، والـ playlist يلي مسويته بقناة اليوتيوب بيه فيديوات لقنوات مرتبة اطلعوا عليها ، وثنينهم موجودين بأول البوستات داخل القناة تكدرون تستعملوهم وية الصورة النزلتها لأهم مواضيع وتقرون حسب وقتكم .

https://t.me/ApproachSOMS

3- approach to Cough ..

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