Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
โณ๏ธCharcot's triad of Ascending cholangitis
1-RUQ pain
2-Fever
3-Jundice
โณ๏ธReynoid's pentad
ููุณูู +
๐Confusion
๐Hypotension
1-RUQ pain
2-Fever
3-Jundice
โณ๏ธReynoid's pentad
ููุณูู +
๐Confusion
๐Hypotension
โค5๐ฅ3
๐Most common congenital abnormalty of GIT is
โ ๏ธ Meckele's Diverticulam
โ ๏ธ Meckele's Diverticulam
โค8
๐Most common complication of ERCP is
โ ๏ธAcute PANCREATITIS.
โ ๏ธAcute PANCREATITIS.
โค6๐1
๐Some 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
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
โค3๐1
๐Hands in GIT
โ ๏ธ*1.Clubbing*
(Liver cirrhosis , IBD)
โ ๏ธ *2.leuconychia*
(whitening of the nails due to hypoalbuminaemia)
โ ๏ธ*3.koilonychia*
(โspooningโ of the nails due to iron, B12, or folate deficiency)
โ ๏ธ*4.Muehrckeโs lines*
(transverse white lines due to hypoalbuminaemia)
โ ๏ธ*5.blue lunulae*
(bluish discolouration seen in Wilsonโs disease)
โ ๏ธ *6.Palmar erythema*
(chronic liver disease, pregnancy)
โ ๏ธ *7.Dupuytrenโs contracture* (thickening and fibrous contraction of palmar fascia ( most likely alcoholic liver disease)
โ ๏ธ *8.Hepatic flap/asterixis*
(hepatic encephalopathy, uraemia from renal disease)
โ ๏ธ*1.Clubbing*
(Liver cirrhosis , IBD)
โ ๏ธ *2.leuconychia*
(whitening of the nails due to hypoalbuminaemia)
โ ๏ธ*3.koilonychia*
(โspooningโ of the nails due to iron, B12, or folate deficiency)
โ ๏ธ*4.Muehrckeโs lines*
(transverse white lines due to hypoalbuminaemia)
โ ๏ธ*5.blue lunulae*
(bluish discolouration seen in Wilsonโs disease)
โ ๏ธ *6.Palmar erythema*
(chronic liver disease, pregnancy)
โ ๏ธ *7.Dupuytrenโs contracture* (thickening and fibrous contraction of palmar fascia ( most likely alcoholic liver disease)
โ ๏ธ *8.Hepatic flap/asterixis*
(hepatic encephalopathy, uraemia from renal disease)
โค4
ุงูุณูุงู
ุนูููู
ูุฑุญู
ุฉ ุงููู ูุจุฑูุงุชู ๐ค
ุฏูุงุชุฑุฉ ุงููู ู ุดุชุฑููู ู ุนุงู ูู ููุฑุณ ุงููุณุชูุฑู ุญูุจุฏูุง ุชุฏุฑูุจ ุงููุณุชูุฑู ู ู ููู ุงูุฌู ุนุฉ ุงูุฌุงูุฉ ุงู ุดุงุก ุงููู ุงูู ูุงูู 8_11
ุฃูุงู ุงูุชุฏุฑูุจ/ ูู ุฌู ุนุฉ
ุฃูู main complaints ุญูุงุฎุฏููู
Dysnea
Chest pain
ูู ูู ู ุญุงุถุฑุฉ ุญูุฎุชุงุฑ 4 ุฏูุงุชุฑุฉ ูุงุฎุฏูุง ุงููุณุชูุฑู ู ุงูุจููุฉ ุงุณุชู ุงุน
ุจุญูุซ ูู main complaint ูุงุฎุฏูุง ุนููู ุฒูุฒ ุณููุงุฑูููุงุช ู ุฎุชููุฉ๐
ู ูุฎุชู ูุง ูู ุณููุงุฑูู ุจ Disscussion
DD + Investigations
ููุณ ู ุง ู ุทุงูุจูู ุจูู ูู ุงูุฅู ุชุญุงู
ุดูููุง ููุฏููุงุช ุงูู ูุตุฉ ููู ูุถูุนูู ุงููู ุจูุงุฎุฏููู ู ู ููููู ุงู ุดุงุก ุงููู ๐๐ชป
ุฑุฌุงุกุงู ุงููู ู ุณุฌููู ู ุนุงู ูู ุงูููุฑุณ ูุชูุงุตููุง ู ุนุงู ุจุงุด ูุถูููู ููุฑูุจ ุงูุชุฏุฑูุจ ู ุจุงููุณุจุฉ ู ุชูููุช ุงูุงูู ุญูุฒูู ูุงุญูุงู ูู ุงููุฑูุจ ุงูู ุฎุตุต ููุชุฏุฑูุจ.โ๏ธโฐ๏ธ
ุฏูุงุชุฑุฉ ุงููู ู ุดุชุฑููู ู ุนุงู ูู ููุฑุณ ุงููุณุชูุฑู ุญูุจุฏูุง ุชุฏุฑูุจ ุงููุณุชูุฑู ู ู ููู ุงูุฌู ุนุฉ ุงูุฌุงูุฉ ุงู ุดุงุก ุงููู ุงูู ูุงูู 8_11
ุฃูุงู ุงูุชุฏุฑูุจ/ ูู ุฌู ุนุฉ
ุฃูู main complaints ุญูุงุฎุฏููู
Dysnea
Chest pain
ูู ูู ู ุญุงุถุฑุฉ ุญูุฎุชุงุฑ 4 ุฏูุงุชุฑุฉ ูุงุฎุฏูุง ุงููุณุชูุฑู ู ุงูุจููุฉ ุงุณุชู ุงุน
ุจุญูุซ ูู main complaint ูุงุฎุฏูุง ุนููู ุฒูุฒ ุณููุงุฑูููุงุช ู ุฎุชููุฉ๐
ู ูุฎุชู ูุง ูู ุณููุงุฑูู ุจ Disscussion
DD + Investigations
ููุณ ู ุง ู ุทุงูุจูู ุจูู ูู ุงูุฅู ุชุญุงู
ุดูููุง ููุฏููุงุช ุงูู ูุตุฉ ููู ูุถูุนูู ุงููู ุจูุงุฎุฏููู ู ู ููููู ุงู ุดุงุก ุงููู ๐๐ชป
ุฑุฌุงุกุงู ุงููู ู ุณุฌููู ู ุนุงู ูู ุงูููุฑุณ ูุชูุงุตููุง ู ุนุงู ุจุงุด ูุถูููู ููุฑูุจ ุงูุชุฏุฑูุจ ู ุจุงููุณุจุฉ ู ุชูููุช ุงูุงูู ุญูุฒูู ูุงุญูุงู ูู ุงููุฑูุจ ุงูู ุฎุตุต ููุชุฏุฑูุจ.โ๏ธโฐ๏ธ
โค10๐1
ุงูุณูุงู
ุนูููู
ูุฑุญู
ุฉ ุงููู ูุจุฑูุงุชู ุฏูุงุชุฑุฉ๐ฉบ
ููู ู ู ูุชูุงุตู ู ุนุงู ุจุฎุตูุต ููุฑุณ ุงู Examination ูุงู ู (Manouver+ findings) ููุฃุณู ู ูููุฉ ุงูุชุณุฌูู ุญุงููุงู
ูุงู ุงุฎุฑ ูุฑูุจ ููู ูููู ูู ูุต 12 ู ูู ุงู ุชุญุงููู ูู 1 ุฃุนุชูุฏ ู ุด ุญูููู ู ูุงุณุจ ูุนุทู ุจุนุฏ ุงููุฑูุจ ูุฐุง
ู ุจุงููุณุจุฉ ููุชุฑุฉ ุงูุฅู ุชุญุงู ุจุนูู ุงููู ุญูุนุทู ููุฑุณ findings ุ ุญูููู ู ุฏุชู ููู ูู ุฒู ู ุง ุนุทูุช ููุฏูุนุงุช ุงููู ูุจููู ุ ููุชูุง ุญูุฒู ุฅุนูุงู ุจุงูุฎุตูุต
ู ููููู ู ุณุฏุฏูู ุจุนูู ุงููู ุชุนุงูู ๐คโจ๏ธ
ููู ู ู ูุชูุงุตู ู ุนุงู ุจุฎุตูุต ููุฑุณ ุงู Examination ูุงู ู (Manouver+ findings) ููุฃุณู ู ูููุฉ ุงูุชุณุฌูู ุญุงููุงู
ูุงู ุงุฎุฑ ูุฑูุจ ููู ูููู ูู ูุต 12 ู ูู ุงู ุชุญุงููู ูู 1 ุฃุนุชูุฏ ู ุด ุญูููู ู ูุงุณุจ ูุนุทู ุจุนุฏ ุงููุฑูุจ ูุฐุง
ู ุจุงููุณุจุฉ ููุชุฑุฉ ุงูุฅู ุชุญุงู ุจุนูู ุงููู ุญูุนุทู ููุฑุณ findings ุ ุญูููู ู ุฏุชู ููู ูู ุฒู ู ุง ุนุทูุช ููุฏูุนุงุช ุงููู ูุจููู ุ ููุชูุง ุญูุฒู ุฅุนูุงู ุจุงูุฎุตูุต
ู ููููู ู ุณุฏุฏูู ุจุนูู ุงููู ุชุนุงูู ๐คโจ๏ธ
โค10๐1
#Respiratory
๐จType 1 respiratory failure (T1RF): is characterised by
hypoxaemia (PaO2 < 8 kPa)
normal or low CO2.
๐จType 2 respiratory failure (T2RF): is characterised by
hypoxaemia (PaO2 < 8 kPa) hypercapnia (PaCO2 > 6.5 kPa).
๐จType 1 respiratory failure (T1RF): is characterised by
hypoxaemia (PaO2 < 8 kPa)
normal or low CO2.
๐จType 2 respiratory failure (T2RF): is characterised by
hypoxaemia (PaO2 < 8 kPa) hypercapnia (PaCO2 > 6.5 kPa).
โค3
#Respiratory
โณ๏ธRespiratory Conditions: Choice of investigations๐
__
โ Extrinsic upper airway obstruction assessmentโ Flow-volume loop
โ Expiratory obstruction (e.g. Asthma, COPD)โ FEV1
โ Respiratory muscle strength assessment (e.g. GBS, Myasthenia gravis)โ FVC
โ Assessment whether obstructive or restrictive lung diseaseโ FEV1/FVC ratio
โพIf ratio <0.7 indicates obstructive
โพIf ratio is >0.7 indicates restrictive
โ Monitoring of Asthmaโ PEFR
โณ๏ธRespiratory Conditions: Choice of investigations๐
__
โ Extrinsic upper airway obstruction assessmentโ Flow-volume loop
โ Expiratory obstruction (e.g. Asthma, COPD)โ FEV1
โ Respiratory muscle strength assessment (e.g. GBS, Myasthenia gravis)โ FVC
โ Assessment whether obstructive or restrictive lung diseaseโ FEV1/FVC ratio
โพIf ratio <0.7 indicates obstructive
โพIf ratio is >0.7 indicates restrictive
โ Monitoring of Asthmaโ PEFR
๐2โค1
#Respiratory
#Signs_of_Acute_severe_asthma๐
Any one of the followings:
*Peak flow 33% to 50% best
*Predicted Respiratory rate โฅ25 per minute
*Heart rate โฅ110 beats per minute
*Inability to complete sentences in one breath.๐ฉบ
#Signs_of_Acute_severe_asthma๐
Any one of the followings:
*Peak flow 33% to 50% best
*Predicted Respiratory rate โฅ25 per minute
*Heart rate โฅ110 beats per minute
*Inability to complete sentences in one breath.๐ฉบ
โค1
#Respiratory
๐จThe most common infective causes of COPD exacerbations are:
๐bacteria:
-Haemophilus influenzae (most common cause)
-Streptococcus pneumoniae
Moraxella catarrhalis
๐Respiratory viruses:
-account for around 30% of exacerbations
-human rhinovirus is the most important pathogen๐ฉบ
๐จThe most common infective causes of COPD exacerbations are:
๐bacteria:
-Haemophilus influenzae (most common cause)
-Streptococcus pneumoniae
Moraxella catarrhalis
๐Respiratory viruses:
-account for around 30% of exacerbations
-human rhinovirus is the most important pathogen๐ฉบ
โค2๐1
๐จSeverity of COPD categorised by using
โก๏ธFEV 1
โก๏ธFEV 1
๐2โค1
๐จFactors which improve survival in COPD
Smoking cessation
LTOT (Long Term Oxygen Therapy)
Lung volume reduction surgery
Smoking cessation
LTOT (Long Term Oxygen Therapy)
Lung volume reduction surgery
โค7๐1
Forwarded from Internal Medicine By Doha Rawag (Doha Ali Rawaq)
โ๏ธThe mainstay of ttt in bronchiectasis is โก๏ธ
๐Antibiotics + Chest physiotherapy .
๐Antibiotics + Chest physiotherapy .
๐2โค1