#Clinical_Pearls📝

🎯High calcium + low PTH + normal ALP
= 🧐 #Malignancy

🎯High calcium +high phosphate + normal ALP
=🧐 #Multiple Myeloma

🎯High Calcium + high Phosphate + high ALP
= 🧐 #Bone_metastasis

🎯High calcium + low phosphate + high ALP
= 🧐 #Primary_Hyperparathyroidism

🎯Low calcium + low phosphate + high ALP
=🧐 #Osteomalacia/#vitamin_D_defienancy

🎯Low calcium + high phosphate + Normal ALP
= 🧐 #Hypoparathyroidism

🎯Normal calcium +Normal Phosphate + normal ALP
= 🧐 #Osteoporosis

🎯Normal calcium + normal Phosphate + high ALP
=🧐 #Paget_disease_of_bone

@NaplexStudyGuide
Clinical Indications of Desmopressin📝

◾️ diabetes insipidus
◾️ nocturnal enuresis
◾️ hemophilia A
◾️ von Willebrand disease
◾️ high blood urea

Test For 《Rhabdomyolysis》🔻

🔵Creatine kinase➡+Ve
🔵Urine myoglobin
🔵⬆Lactate dehydrogenase
🔵⬆Serum K
🔵⬆Prothrombin time
🔵Urine ➡+Ve blood

#Indications_of_Steroids_in_TB:

📝Pericarditis +/- Myocarditis
📝Meningitis
📝Adrenalitis
📝Uveitis
📝Paradoxical response
📝Endobronchial LN compression/impending rupture

#B12 deficiency anemia

📝Causes
Vegetarian
Pernicious anemia
Ileal disease/ Chrons
Short Bowel syndrome

📝Dx
CBC➡️Macrocytic anemia
Peripheral blood film➡️Hyperpigmented neutrophils (MCQ مهمة هلبا)

#AML (M3)📝

Good prognosis
Characterised by DIC and Gum bleeding
Treated by / ATRA

#Thalassemia and SCA and Hb electrophoresis 📝

🟨Thalassemia➡️Hb F + Hb A2
🟨SCA ➡️ Hb S + Hb F

#Meylofibrosis📝

🩺presentation/ pancytopenia , old age

🩺DX
🟨PBF➡️ tear drop poikilocytes
🟨BM aspiration ➡️Dry tap
🟨BM biopsy ➡️ excessive proliferation of megakaryocytes

🟨Severity of COPD categorised by using

➡️FEV 1

🟨Factors which improve survival in COPD

Smoking cessation
LTOT
Lung volume reduction surgery

🟨CXR in patient with PE is usually

➡️Normal

مهماااااات جداً📝

🟨CURB-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

🟨The most common infective causes of COPD exacerbations are:

📝bacteria:
-Haemophilus influenzae (most common cause)
-Streptococcus pneumoniae
Moraxella catarrhalis

📝Respiratory viruses:
-account for around 30% of exacerbations
-human rhinovirus is the most important pathogen🩺

🟨Type 1 respiratory failure (T1RF): is characterised by
hypoxaemia (PaO2 < 8 kPa)
normal or low CO2.

🟨Type 2 respiratory failure (T2RF): is characterised by
hypoxaemia (PaO2 < 8 kPa) hypercapnia (PaCO2 > 6.5 kPa).

#Signs_of_Acute_severe_asthma📝
Any one of the followings:

*Peak flow 33% to 50% best
*Predicted Respiratory rate ≥25 per minute
*Heart rate ≥110 beats per minute
*Inability to complete sentences in one breath.🩺

✳️Respiratory Conditions: Choice of investigations📝
__________

✅Extrinsic upper airway obstruction assessment➝ Flow-volume loop

✅Expiratory obstruction (e.g. Asthma, COPD)➝ FEV1

✅Respiratory muscle strength assessment (e.g. GBS, Myasthenia gravis)➝ FVC

✅Assessment whether obstructive or restrictive lung disease➝ FEV1/FVC ratio
◾If ratio <0.7 indicates obstructive
◾If ratio is >0.7 indicates restrictive

✅Monitoring of Asthma➝ PEFR

#Keypoints_Pneumonia 🩺📝

Symptoms of pneumonia + Rust-colored sputum+H/O herps libials =
❇️Sterptococcus pneumonia

Symptoms of pneumonia + yellow to green Sputum + H/O common cold (flu) =
❇️Staph.aureus

Symptoms of pneumonia + red currant jelly Sputum + Alcoholic or Diabetes patients + cavitary lesion in upper lobe =
❇️Klebsiella pneumonia

Symptoms of pneumonia + SIADH (⬇️Na) + H/O of using hot water tanks =
❇️Legionella pneumonia

Symptoms of pneumonia + Hemolytic anemia (positive cold agglutinins test) + GBS + Erythema multiform =
❇️Mycoplasma pneumonia

مهماااااات هلبا تبتوهم🙏💪