Internal Medicine By Doha Rawag
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MBBCh ,Tripoli University👩‍🎓
GP at TUH👩‍⚕️
Studies arab and Libyan board of internal medicine specialists 🩺
Medical educator at https://t.me/New_Minds_Edu💻
القناة خاصة بكل شي يتعلق بمادة الباطنة .💊💉
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Test For 《Rhabdomyolysis》🔻

🔵Creatine kinase+Ve
🔵Urine myoglobin
🔵Lactate dehydrogenase
🔵Serum K
🔵Prothrombin time
🔵Urine +Ve blood
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#Indications_of_Steroids_in_TB:

📝Pericarditis +/- Myocarditis
📝Meningitis
📝Adrenalitis
📝Uveitis
📝Paradoxical response
📝Endobronchial LN compression/impending rupture
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#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)
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#AML (M3)📝

Good prognosis
Characterised by DIC and Gum bleeding
Treated by / ATRA
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#Thalassemia and SCA and Hb electrophoresis 📝

🟨Thalassemia➡️Hb F + Hb A2
🟨SCA ➡️ Hb S + Hb F
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#Meylofibrosis📝

🩺presentation/ pancytopenia , old age

🩺DX
🟨PBF➡️ tear drop poikilocytes
🟨BM aspiration ➡️Dry tap
🟨BM biopsy ➡️ excessive proliferation of megakaryocytes
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Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
🟨Severity of COPD categorised by using

➡️FEV 1
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Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
🟨Factors 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)
🟨CXR in patient with PE is usually

➡️Normal
🔥63
Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
مهماااااات جداً📝
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🟨Most common ECG findings in patient with PE is
➡️Sinus Tachycardia 📝

➡️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)🩺
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🟨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
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🟨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🩺
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🟨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).
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#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.🩺
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✳️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
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#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🙏💪
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#Bronchiectasis+HRCT Findings📝

➡️Honeycombing
➡️signet ring sign
➡️Tram track sign
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❇️The mainstay of ttt in bronchiectasis is ➡️

📝Antibiotics + Chest physiotherapy .
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