🔹Symptoms & signs of leukaemia .

Infantile spasms infant seizures - #pediatric

د. أحمد الشهاري
#Pediatrics

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أهلاً يا أصحاب 🙈....

د. عادل:
إقرأوا كويّس، و ركزّوا على المواضيع اللّي أخذت معي و مع د. توفيق و المواضيع اللّي كنت أركز عليها و أعمل عليها مداخلات أثناء ال Presentations

طريقة الإمتحان Cases، و أسئلة عليها

الدكتور يشتينا Educated علشان يكون ال Evalution تمام ....و كل شيء مرتب (ترتيب سريع و حالي) و جاهز كالتالي:
إذا مافيش جراحه نظري نبدأ على طول، و أذا فيه جراحه نبدأ نترتب سريييييييع بعد الجراحه النظري

الدفعه تتقسم مجموعتين
1- المجموعة الأولى :أول 4 راوندز(اللّي قد أخذوا الجلديه) يخرجوا من القاعه.
2- المجموعه الثانيه : ال 4 راوندز الباقيه (اللّي ما قد أخذوا الجلديه) يظلّوا في القاعة يبدأ فيهم

يعني الدكتور شيمتحننا على مجموعتين، تخلّص المجموعه الأولى و بعدين الثانيه بكل ترتيب و نظام

و بس 🐵🐵

إختبار الجلدية عملي- المجموعة الثالثة(B)

د.عادل النجار

كان عبارة عن أسئلة oral يسأل كل طالب، وكذا spot diagnosis لـصور حالات في تلفونه يمرر على الطلاب.

الأسئلة الـ oral:
-What are Milia?
-What is Acne Conglobata?
-What is isotretinoin?
-What are precautions for patients using isotretinoin?
-What is the effect of isotretinoin in a patient drinking alcohol?
-What is Leishmaniasis?
-What is "Volcano sign"?
-What is " Von Zumbusch"?
-What is the drug of choice for treating "Von Zumbusch"?
-What is Acitretin?
-What is Methotrexate?
-What is the nodule?
-What is the" Herald patch"?
-What are the skin signs of "Tuberous Sclerosis"?
-Mention the Bullous Diseases?
-What is Stevens-Johnson Syndrome?
-What is" Toxic Epidermal Necrolysis (TEN)"?
-Types of tinea capitis?
-What is leprosy?
-What are the sexually transmitted diseases related to dermatology?
-Methods of transmission of "Gonorrhea" other than sex?
-What is Syphilis and its cause? Characters in skin?
-What is "Condylomata lata"?
-What is the Herpes zoster?
-Differences between HZ and Herpes simplex.
-What are the characters of Lichen planus?
-What is pityriasis rosea and versicolor?
-Characters of herpes simplex?
-What are the end results of treatment of nodulocystic form of acne?
-What is the Fixed drug eruption? Most common causative drug? Most common site?
-Why is "black dot" type of tinea capitis called so?
-What is vitiligo?
-What is Behçet Disease?
-What are the causes of Ecchymoses?
-Differences between impetigo and herpes simplex diseases?
-Characters of Tinea Corporis?
-What is Scabies and its characters?
-What is Burrow?
-Adverse effects of systemic Glucocorticoids.What is their effect in eyes? Causes of Glaucoma?
-What is the " Dapsone"? Its other name? "Sulfones"
-What is Granuloma annulare?
-A child comes to you complaining of a hyperkeratotic ulcer in mouth, what is your spot diagnosis?
-What are the most important features of herpes zoster?
-What's the paget's disease?
-Does psoriasis improve with pregnancy or worsen? It improves.

الــصــــور:

1-Acne vulgaris
2-Thermal burn
3-Squamous cell carcinoma
4-Tinea capitis "Gray patch"type"
5-Fixed drug eruption" 2 pics"
6-Ecchymoses
7-Lichen planus
8-Tinea versicolor
9-Tinea corporis
10-Post inflammatory hypopigmentation
11-Hypopigmentation and scars after nodulocystic acne treatment
12-Scabetic nodules in penis & scrotum
13-Pityriasis rosea
14-Tinea capitis "kerion"
15-Herpes zoster.

بإختصار راوند الجلدية حلو، ومش بهذيك الصعوبة اللي كانوا يتكلموا، والدكتور جنتل و يشتي commitment و تعرف الـ principles في الـ Dermatology، وكل شيء بـ pass smoothly.

Best wishes.✨

✒️-Mohammad Aldailami

Methods of transmission of "Gonorrhea" other than sex? ايش هن ياديلمي

1-A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum. 

2-It may be able to spread through the objects contaminated with body fluid from an infected person. The bacteria typically does not survive long outside the body, typically dying within minutes to hours.

3-Also much less commonly, as a result of poor hygiene or the complementary/alternative “medical” use of urine.

🔹lesions of skin

The best is "Erythroderma", of chronic type.

Dermatitis herpetiformis is considered an Autoimmune disease.

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د. عادل النجار :
أي مجموعة تدخل راوند الجلدية و تكون مجهّزة الواجبات المكلّفة (المعروفة)على الطلاب....
و من دون لف و دوران عليّ(يعني على الدكتور 🙊)...و من دون أخذ التكاليف من دفع سابقة
و كل واحد يتحمل مسئولية نفسه

Treatment of Psoriasis

According to age, site, pattern and exposure sites:
-Steroids are not used in face or intertriginous areas due to atrophy , but we use pimecrolimus
-Suppurative care and emollients are important.

LOCALIZED PSORIASIS
Topical agents are first line of treatment.

1-Trunk and Extremities
a) Topical fluorinated glucocorticoids, e.g.betamethasone valerate. Glucocorticoid-impregnated tape useful for small plaques.
b) For small plaques (≤4 cm), triamcinolone, there will be hypopigmentation.
c)Topical anthralin preparations, but very irritant.
d) Vitamin D analogues, e. g. calcipotriene.
e) Topical pimecrolimus is effective in inverse psoriasis and seborrheic dermatitis–like psoriasis of the face and ear canals.

2-Scalp
-Mild:
Ketoconazole shampoos followed by betamethasone valerate.

-Severe:
Removal of scales from plaques before active treatment by 10%salicylic acid in mineral oil.
Then use clobetasol propionate, lotion.
But it is better to use systemic treatment for recurrence or ineffective.

3-Palms and Soles,Nails
a) Topical glucocorticoids
b) PUVA
c) Retinoids (acitretin >isotretinoin) orally
d) Combination of a and b.

GENERALIZED PSORIASIS
1-Acute, Guttate Psoriasis
a) First treat streptococcus infection with antibiotics.
b) Narrow band UVB irradiation most effective.
c) PUVA.

2-Generalized Plaque-Type Psoriasis
a) Narrow-Band UVB Phototherapy:
Effective only in psoriasis with very thin plaques
b) Oral PUVA Photochemotherapy
oral (8-MOP or 5-MOP) then exposure to UV radiation.
-Side effects: keratosis, Squamous cell carcinoma.
c)In patients with recalcitrant plaque-type psoriasis, acitretin (in males) or isotretinoin (in females) may be combined with other antipsoriatic therapy.
4-Methotrexate أهم واحد
Is the drug of choice and the most convenient treatment for generalized plaque type psoriasis.
Warning: Before starting ttt, check CBC, LFT and RFT because it is contraindicated in anemia or liver and renal diseases also in pregnancy.
After treatment do liver biopsy.
5-Cyclosporine
6-Monoclonal Antibodies and Fusion Proteins:
a) Alefacept
b) Efalizumab
7-Tumor necrosis factor (TNF) α antagonists, e.g.Infliximab.

GENERALIZED PUSTULAR PSORIASIS
(von Zumbusch)
-Patients Should be treated in specialized unit like that of burn cases,do isolation, fluid replacement, and repeated blood cultures which are necessary.
DOC is (acitretin, 50 mg/d).

بإختصار:
Isolated localized chronic stable psoriasis 👉🏻T.glucocorticoids.
Generalized plaque type psoriasis 👉🏻Methotrexate.
Inverse psoriasis 👉🏻T.pimecrolimus.
GENERALIZED PUSTULAR PSORIASIS👉🏻Acitretin.

BCC👉🏻 Mohs surgery
SCC👉🏻 Surgery
M.melanoma👉🏻 Surgical excision

Quick notes:
Asboe Hansen's sign
Pressure over the surface of a bulla by the finger leads to peripheral bilster spreading.
Pemphigus vulgaris.

Fixed drug eruption:
Fixed to the drug and fixed to the same site.
-Characteristic early lesion is a sharply demarcated macule hours after
ingestion of the offending drug. Initially erythema, then dusky red to violaceous.
-Most common causative drug is Tetracyclines.
-Most common site involved is Genital skin.
-After healing leads to hyperpigmentation.

Treatment of Urticaria and Angioedema:
Chronic urticaria👉🏻Antihistamines
Acute urticaria with angioedema👉🏻Prednisone
Hereditary angioedema👉🏻Danazol
Severe angioedema 👉🏻Adrenaline life saving
Chronic idiopathic or autoimmune urticaria👉🏻 Cyclosporine "When systemic Glucocorticoids contraindicated or side effects.