#Bedside_Notes
⚀Rheumatology
(د.بسمة الهباش)

Q1_ What are the most common causes of hip pain in pt with RA?
👇
1_ Avascular necrosis due to long term use of steroids
2_ Avascular necrosis due to vaculitis

Q2_ What is the DD of DIP joints involvement?
👇
1_ Psoriatic arthritis
2_ OA

Q3_ What is the DD of Monoarthritis ?
👇
1_ Gouty arthritis
2_ Septic arthritis
3_ Tuberculus arthritis

Q4_ What is the most common Rheumatological disease which leads to Shoulder and hip Stiffness ?
👇
PMR (Polymyalgia Rheumatica )

Q5_ What is the DD of Generalized hyperpigmentation ?
👇
1_ Adisson disease
2_ Systemic seclerosis
3_ Hemochromatosis

https://t.me/internal_medicine_Dr_Doha

Fusiform swelling (Spindle shaped fingers ) / Due to synovitis of PIP joints .
#Rhematoid_arthritis
#Rheumatology

🟨First sign in PBF in pt with vit B12 deficiency is

➡️Hypersegmented neutrophils

🟪key points 📝
#Hematology

Symptoms of anemia + neurological symptoms = Vit B 12 deficiency

Symptoms of anemia + neurological symptoms + H/O autoimmune diseases = Pernicious anemia

Pruritus after hot bath = PRV

Lower backpack + symptoms of hypercalcemia + high ESR = Multiple myeloma

Thrombocytopenia + hemolytic anemia + renal dysfunction + neurological symptoms = TTP

باش ما تتخلبطوش بين ال
HMWH and LMWH💡


📝نجوا لل LMWH
لان Low بيكون Fractionated
لان low بيأتر على factor واحد بس اللي هو factor
10
(تفكروا ال 10 بال O متع ال low😂)
و هذا علاش حتى لما بنديره monitoring نقيس مستوى
Factor 10
و لان low يصيرله elimination by kidney فقط


...........
توا نجوا لل HMWH
لان high ف اكيد هو اللي بيكون unfractionated
😏
ولأن high حيأتر على أكثر من factor و اللي هما، 9 ،10 ،11
و هذا علاش يندارله monitoring بال APTT
و لان high ف بيصيرله
Eilemenatin by liver and kidney 😇

ملاحظة:-اسمه un fractionated مش HMWH غير طبعا للتبسيط و تسهيل الحفظ

📝drugs that cause sidroplastic anaemia
( ALI)

A- Alcohol
L- Lead
I- Isoniazide

📝poor prognosis HL
( HALW SAM )

H- HB <10
A- Albumin <40
L- leukopenia
W- WBC >15×10^3
S- Stage 4
A- Age >45
M- Male gender