Internal Medicine By Doha Rawag
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MBBCh ,Tripoli University๐Ÿ‘ฉโ€๐ŸŽ“
GP at TUH๐Ÿ‘ฉโ€โš•๏ธ
Studies arab and Libyan board of internal medicine specialists ๐Ÿฉบ
Medical educator at https://t.me/New_Minds_Edu๐Ÿ’ป
ุงู„ู‚ู†ุงุฉ ุฎุงุตุฉ ุจูƒู„ ุดูŠ ูŠุชุนู„ู‚ ุจู…ุงุฏุฉ ุงู„ุจุงุทู†ุฉ .๐Ÿ’Š๐Ÿ’‰
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#Cardiology_Notes๐Ÿ’ญ

โš€DD of persistent ST segment elevations๐Ÿ“
๐Ÿ‘‡
1_Lt ventricular aneurysm
2_LBBB
3_Post MI Pericarditis

ู†ุณุฃู„ุช ุงู„ุณุคุงู„ ู‡ุฐุง ููŠ ุฅู…ุชุญุงู† ุงู„ุงูˆุฑุงู„ ูˆ ู‚ุนุฏ ุงู„ุฏูƒุชูˆุฑ ูŠู‚ูˆู„ูŠ what else ุŸ๐Ÿค”

ูƒุงู† ูŠุจูŠ ู…ุนุงู‡ู…
Failed thromolysis
Subarachnoid haemorrhage as a complication of thrombolytic use .
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#Cardiology_Notes ๐Ÿ’ญ

๐Ÿ”ดPoor prognostic criteria of heart failure ๐Ÿ“๐Ÿ’ญ

โ—ฝ4 ู…ู† ุงู„ู‡ุณุชูˆุฑูŠ ๐Ÿ‘‡
1_Old age
2_Male
3_Sever symptoms
4_PMH of IHDs

โ—ฝ4 ู…ู† ุงู„ุงู‚ุฒุงู…ู†ูŠุดู†๐Ÿ‘‡
1_Gallop rythym
2_Raised JVP
3_ Bilateral basal lung fine crepitations
4_Unstable Vital signs/ Hypotension, Bradycardia or pulses alternals , Cheyen stock breathing

โ—ฝ4 ู…ู† ุงู„ investigation ๐Ÿ‘‡
1_ Electrolyte / hyponatremia , hypokalemia
2_ RFT / โฌ†๏ธ bun
3_โฌ†๏ธ BNP
4_Echo / โฌ‡๏ธEF , lt ventricular hypertrophy .
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#Bedside_Notes
โ—ปRespiratory (ุฏ.ุฎู„ูŠูุฉ ุฏุนูŠุจ)

Q1_ What is the DD of large amount of sputum?
๐Ÿ‘‡
1_ Bronchiactesis
2_ Alveolar cell carcinoma

Q2_ ู„ูˆ ุงู„ู…ุฑูŠุถ ู‚ุงู„ูƒ ุงู„ุจู„ุบู… ู…ุชุนูŠ ุชุบูŠูŠุฑ ูุฌุงุกุฉ ู…ู† Small amout ุงู„ูŠ large amount ุŒ ุดู† ู…ู…ูƒู† ูŠูƒูˆู† ุตุงูŠุฑู„ู‡ ุŸ
๐Ÿ‘‡
1_ Ruptured abscess
2_ Empyema

Q3_ Why an ECG is recommended in pt with respiratory diseases?
๐Ÿ‘‡
1_ Drugs S/E..(Sulbutamol / Sinus Tachycardia )
2_ Chest infections exacerbates arrhythmia
( ุฎุงุตุฉ ุงู„ุจูŠุดู†ุช ุงู„ู„ูŠ ุนู†ุฏู‡ AF ุชู†ูˆุถ ุนู„ูŠู‡ ู„ู…ุง ูŠุตูŠุฑู„ู‡ pneumonia )
3_ pts with chronic respiratory diseases are risky for Core pulmonale .

https://t.me/internal_medicine_Dr_Doha๐ŸŒธ
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#Bedside_Notes
โ—ปRespiratory ( ุฏ.ู†ุนูŠู…ุฉ ุงู„ุชุฑูƒูŠ)

Q1_ What are the drugs which exacerbates the br.asthma ?
๐Ÿ‘‡
1_ B,Blockers
2_ NSAID / Aspirin, Voltarin , Ipopruphen
3_ ACEIs

Q2_ ุงู…ุชู‰ ู†ุณู…ุน Course crepitation
ููŠ ู…ุฑูŠุถ ุงู„ Br. Asthma ?
๐Ÿ‘‡
1_ If associated with Superimposed Infection
2_ If associated with Bronchiactasis

https://t.me/internal_medicine_Dr_Doha๐ŸŒน
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Blue Bloater vs Pink Puffer
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#Bedside_notes ๐Ÿ“
#Respiratory ๐Ÿซ(ุฏ.ุนุจุฏ ุงู„ูุชุงุญ ุงู„ุฑูŠุงู†ูŠ)

๐Ÿ”ด~ Drugs which can cause lung fibrosis~
( BBC every MANS go )๐Ÿ’ญ
B- Bleomycin
B- Busalfan
C- Cyclophosphamide / Cephalosporin
M- Methotrexate
A- Amiodarone
N- Nitrofuranton
S- Sulfasalazine

ุจุงู„ุฅุถุงูุฉ ุฅู„ูŠ GP๐Ÿ˜ ุงู„ู„ูŠ ู‡ู…ุง ุงู„ Gold ูˆุงู„ pencillamine D ูˆ ู‡ุงุฏูˆ ุฃุฏูˆูŠุฉ ู‚ุฏูŠู…ุฉ ูƒุงู†ุช ุฒู…ุงู† ุชุณุชุฎุฏู… ู„ุนู„ุงุฌ ุงู„ Rheumatoid arthritis .
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#Bedside_Notes
CNS / ุฏ.ูุงุทู…ุฉ ุงู„ู†ุนู…ูŠ

Q1_ What is the Definition of normal speech ?
๐Ÿ‘‡
Pt should be understanding you and speak clear for you to understand
NO Aphysia
NO Dysartheria
NO Dysphonia

Q2_ What are the causes of dysphonia?
๐Ÿ‘‡
๐Ÿ”ธ๏ธNon neurological
1_ After prolonged speech
2_ URTI
3_ Mass compression from outside
4_ Hypothyroidism
5_ Post inhaler use
6_ Post intubation
๐Ÿ”ธ๏ธNeurological
Recurrent laryngeal N damage

Q3_ Why you cannot use irritating substance for testing the Olfactory N ?
๐Ÿ‘‡
Bc it will stimulate the 5th cranial N.
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CNS / ุฏ.ูุงุทู…ุฉ ุงู„ู†ุนู…ูŠ

#Glabbelar_reflex

ุชุจุน ุงู„ 5th cranial N examination
ูƒูŠู ูŠู†ุฏุงุฑ ุŸ
ุชุถุฑุจ ุถุฑุจุฉ ุฎููŠูุฉ ุนุงู„ุฌุจู‡ุฉ (ุจุงู„ู‡ุงู…ุฑ ุงูˆ ู…ู† ุบูŠุฑู‡) / ุงู„ response ุงู„ุทุจูŠุนูŠ ูŠุตูŠุฑ Eye Blinking ู…ุฑุฉ ูˆุญุฏุฉ ุงูˆ 2

ู„ูˆ ุงุณุชู…ุฑ ุงูƒุซุฑ ู…ู† ู‡ูƒูŠ ู…ุนู†ุงู‡ุง / Exaggerated.
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