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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Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
๐ŸŸจWhat is the characteristic finding in renal biopsy of pt with Post streptococcal gleumerulonephritis ?


โžก๏ธlumby bumby appeance
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Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
๐ŸŸจGood pasture disease and Role of G
โžก๏ธ
Ig G
anti Glomerular memberane antibodies
๐Ÿ”ฅ8โค1
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#pearls_in_nephrology

โš ๏ธ #association_of
๐Ÿ‘‰โ€œflashโ€ pulmonary oedema
๐Ÿ‘sudden onset breathlessness
๐Ÿ‘cough frothy pink sputum
๐Ÿ‘‰hypertension in young patient (ห‚ 50 y)
๐Ÿ‘‰no obvious cardiovascular risk factors
#Think #RAS fibromuscular dysplasia

#Do MR Angiograghy
#TTT: Angioplasty.
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#Pearls_in_Nephrology

#IgA_nephropathy
๐Ÿ‘‰commonest cause of glomerulonephritis
๐Ÿ‘‰common during the 2nd; 3rd decade of life.
๐Ÿ‘‰commonly occurs #within 2 days of an onset of an URTI (sore throat, pharyngitis).
๐Ÿ‘‰#normal_C3
๐Ÿ‘‰diagnosed by a renal biopsy
(mesangial IgA deposition).
๐Ÿ‘‰There is considerable #overlap with #HSP
(arthritis, rash, abdominal pain,
nephritis)

#Presentations:
โžก๏ธYoung male ;more common in males
โžก๏ธRecurrent episodes of
painless macroscopic haematuria
โžก๏ธwithin 24-48 hours after URTI
(sore throat, pharyngitis).
โžก๏ธmay present with proteinuria, renal failure
or hypertension.
โžก๏ธ #Good_prognosis
with normal BP, renal function and absence
of proteinuria at presentation.

#Management:
๐Ÿงtreatment is conservative.
๐Ÿง #If the proteinuria is < 3 g/day
โžก๏ธACEIs used to reduce progression of
proteinuria.
๐Ÿง #If nephrotic range proteinuria (>3 g/day)
โžก๏ธ8-12 week course of prednisolone.
๐Ÿง #If crescenteric nephritis on biopsy
โžก๏ธIV pulse steroid + cyclophosphamide.
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#Pearls_in_Nephrology

#Post_streptococcal_glomerulonephritis
๐Ÿ‘‰associated with low complement (C3).
๐Ÿ‘‰Main symptom in is proteinuria
(haematuria can occur).
๐Ÿ‘‰typical interval 1_3 weeks
between URTI (sore throat)
and the onset of renal problems
๐Ÿ‘‰#Renal_biopsy Not required.
โžก๏ธLM: wire-loop lesion
โžก๏ธEM: Humps in the subepitheilal space.
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#Clinical_Pearls๐Ÿ“

๐ŸŽฏHigh calcium + low PTH + normal ALP
= ๐Ÿง #Malignancy

๐ŸŽฏHigh calcium +high phosphate + normal ALP
=๐Ÿง #Multiple Myeloma

๐ŸŽฏHigh Calcium + high Phosphate + high ALP
= ๐Ÿง #Bone_metastasis

๐ŸŽฏHigh calcium + low phosphate + high ALP
= ๐Ÿง #Primary_Hyperparathyroidism

๐ŸŽฏLow calcium + low phosphate + high ALP
=๐Ÿง #Osteomalacia/#vitamin_D_defienancy

๐ŸŽฏLow calcium + high phosphate + Normal ALP
= ๐Ÿง #Hypoparathyroidism

๐ŸŽฏNormal calcium +Normal Phosphate + normal ALP
= ๐Ÿง #Osteoporosis

๐ŸŽฏNormal calcium + normal Phosphate + high ALP
=๐Ÿง #Paget_disease_of_bone
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@NaplexStudyGuide
Clinical Indications of Desmopressin๐Ÿ“

โ—พ๏ธ diabetes insipidus
โ—พ๏ธ nocturnal enuresis
โ—พ๏ธ hemophilia A
โ—พ๏ธ von Willebrand disease
โ—พ๏ธ high blood urea
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Test For ใ€ŠRhabdomyolysisใ€‹๐Ÿ”ป

๐Ÿ”ตCreatine kinaseโžก+Ve
๐Ÿ”ตUrine myoglobin
๐Ÿ”ตโฌ†Lactate dehydrogenase
๐Ÿ”ตโฌ†Serum K
๐Ÿ”ตโฌ†Prothrombin time
๐Ÿ”ตUrine โžก+Ve blood
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#Indications_of_Steroids_in_TB:

๐Ÿ“Pericarditis +/- Myocarditis
๐Ÿ“Meningitis
๐Ÿ“Adrenalitis
๐Ÿ“Uveitis
๐Ÿ“Paradoxical response
๐Ÿ“Endobronchial LN compression/impending rupture
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#B12 deficiency anemia

๐Ÿ“Causes
Vegetarian
Pernicious anemia
Ileal disease/ Chrons
Short Bowel syndrome

๐Ÿ“Dx
CBCโžก๏ธMacrocytic anemia
Peripheral blood filmโžก๏ธHyperpigmented neutrophils (MCQ ู…ู‡ู…ุฉ ู‡ู„ุจุง)
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#AML (M3)๐Ÿ“

Good prognosis
Characterised by DIC and Gum bleeding
Treated by / ATRA
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#Thalassemia and SCA and Hb electrophoresis ๐Ÿ“

๐ŸŸจThalassemiaโžก๏ธHb F + Hb A2
๐ŸŸจSCA โžก๏ธ Hb S + Hb F
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#Meylofibrosis๐Ÿ“

๐Ÿฉบpresentation/ pancytopenia , old age

๐ŸฉบDX
๐ŸŸจPBFโžก๏ธ tear drop poikilocytes
๐ŸŸจBM aspiration โžก๏ธDry tap
๐ŸŸจBM biopsy โžก๏ธ excessive proliferation of megakaryocytes
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Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
๐ŸŸจSeverity of COPD categorised by using

โžก๏ธFEV 1
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Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
๐ŸŸจFactors which improve survival in COPD

Smoking cessation
LTOT
Lung volume reduction surgery
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Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
๐ŸŸจCXR in patient with PE is usually

โžก๏ธNormal
๐Ÿ”ฅ6โค3
Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
ู…ู‡ู…ุงุงุงุงุงุงุช ุฌุฏุงู‹๐Ÿ“
โค14๐Ÿค—1
๐ŸŸจMost common ECG findings in patient with PE is
โžก๏ธSinus Tachycardia ๐Ÿ“

โžก๏ธOther signs
RBBB
Rt ventricular strain
S1Q3T3
(A large S wave in lead I, A Q wave in lead III and an inverted T wave in lead III)๐Ÿฉบ
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๐ŸŸจCURB-65 score

Patients are stratified for risk of death as follows:

0: low risk (less than 1% mortality risk)

1 or 2: intermediate risk (1-10% mortality risk)

3 or 4: high risk (more than 10% mortality risk). https://t.co/pZQ5BjtoIW
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