#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🙏💪

❇️The mainstay of ttt in bronchiectasis is ➡️

📝Antibiotics + Chest physiotherapy .

❇️The best way to manage DM in patient with Cystic fibrosis is➡️

Insulin + high calorie diet. 📝

❇️Most common colonising organisim in patient with cystic fibrosis after age of 10 yrs is➡️

Pseudomonas aruginosa.📝

✳️Most common type of lung cancer worldwide is
➡️ lung adenocarcinoma 📝

🟨fibrosis predominantly effecting the lower zones of lung 🫁

📝Asbestosis
📝Idiopathic pulmonary fibrosis
📝Connective tissue diseases (Except Ankylosing spondylitis)
📝Drug induced ➡️ e.g Amiodarone, Nitrofuranton, Bleomycin , Methotrexate

و اي حاجة تانية غيرهم بتاتر على ال upper zones.

مهمة و لازم يجي منها سؤال سواء Case او MCQ📝

#light's_criteria

❇️Indication of steroids in sarcoidosis 📝

❇️Hypercalcemia and respiratory diseases

Sarcoidosis ➡️presence of 1α-hydroxylase enzyme in macrophages and giant cells that form part of the granuloma.

Squamous cell carcinoma of lung ➡️
parathyroid hormone-related peptide (PTHrP), a protein that has similar action to parathyroid hormone (PTH) .

ركزوا عليهم مهمات في ال MCQ📝

🩺Most common causes of pancreatitis in UK are

📝Gallstones
📝Alcohol

❇️CRP is now widely used marker of severity in acute pancreatitis.

مهمة هلبا في ال MCQ📝

ديما ال exception يجيبوا Lipase او Amylase و هما ما ليهم علاقة بالكرايتيريا.

🩺Dx of acute pancreatitis

❇️To confirm the DX
➡️pancreatic enzymes
Lipase more specific than Amylase ركزوووا 💢

❇️To assess the severity
➡️HCT
➡️WBC
➡️BUN
➡️CRP

❇️Imaging
➡️Abd US
📝Initial test ركزووووا💢
تشوفوا بيها edematous pancrease و منه ينشاف بيها لو فيه gallstones او dilatation of biliary tract و هكي نكونوا عرفنا السبب و نزيدوا ناكدوا نطلبوا عالبيشنت MRCP

➡️CT with contrast
Not routinly indicated, only if Dx is in doubt ركزوووا 💢.

💠Barrett’s esophagus.
✅Dx:
1️⃣The appearance of the esophageal lining (salmon pink color compared to normal white color).
2️⃣The salmon-pink area has specialized intestinal metaplasia.
3️⃣The white area is squamous epithelium.

Barium swallow showed corkscrew appearance of the distal esophagus denoting #sever_esophagal_spasm📝

🟪Key points 📝
#Gastroenterology

Jundice + newly diagnosed DM = Hemochromatosis

Jundice + abnormal movement = Wilsone disease

Jundice + itching = PBC

Jundice + H/O UC = PSC

Jundice + fever + RUQ pain = Ascending cholngitis

H/O DM + HTN + smoking + H/O post prandial abdominal pain = Mesenteric ischemia

Multiple ulcers + diarrhea = Zolinger syndrome