#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

🩺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 in 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

🟨Dyphagia📝

Dysphagia to both fluids and solids = Achalasia
Dysphagia to solids only = Malignancy

🟨Alcoholic hepatitis
⬆️AST > ALT 2:1

🟨Non Alcoholic fatty liver
⬆️ALT > AST

عكس بعض ركزوا عليهم📝

🟨PBC and ( role of M)📝

Ig M
Anti Mitochondrial Abs
M2 subtype
Middle aged female

🟨Most common site of Carcinoid syndrome is

📝Ileum.

✳️Spontaneous bacterial peritonitis
SBP

📝Cause ➡️E.coli
📝Dx➡️Paracentesis➡️Neutrophils > 250 cells/ul
📝TTT➡️IV cefotaxime

✳️Charcot's triad of Ascending cholangitis

1-RUQ pain
2-Fever
3-Jundice

✳️Reynoid's pentad
نفسهم +
📝Confusion
📝Hypotension

Chrons disease VS Ulcerative colitis 📝

📝Most common congenital abnormalty of GIT is

✅️ Meckele's Diverticulam

📝Most common complication of ERCP is

✅️Acute PANCREATITIS.

📝Some GIT clenchers

Malabsorption symptoms + macrocytosis in young patient >>> coeliac disease

Malabsorption symptoms + improve with control of diary intake + negative endomyseal Abs>>> Lactose intolerance .

Malabsorption + joint pain + Bradycardia in middle age>>> Whipple's disease ( positive PAS biopsy).

Malabsorption + macrocytosis + negative endomyseal Abs and normal IgA>>> think in tropical sprue .

Malabsorption + recurrent epigastric pain to back + positive fecal elastase >>> chronic pancreatitis .

Malabsorption + symptoms of bronchiectasis >>> cystic fibrosis

Dr / Doha Ali Rawaq