💠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

📝Hands in GIT

✅️*1.Clubbing*
(Liver cirrhosis , IBD)

✅️ *2.leuconychia*
(whitening of the nails due to hypoalbuminaemia)

✅️*3.koilonychia*
(‘spooning’ of the nails due to iron, B12, or folate deficiency)

✅️*4.Muehrcke’s lines*
(transverse white lines due to hypoalbuminaemia)

✅️*5.blue lunulae*
(bluish discolouration seen in Wilson’s disease)

✅️ *6.Palmar erythema*
(chronic liver disease, pregnancy)

✅️ *7.Dupuytren’s contracture* (thickening and fibrous contraction of palmar fascia ( most likely alcoholic liver disease)

✅️ *8.Hepatic flap/asterixis*
(hepatic encephalopathy, uraemia from renal disease)

✅️Pseudomembranous colitis ttt

🟨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