Internal Medicine By Doha Rawag
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MBBCh ,Tripoli University๐Ÿ‘ฉโ€๐ŸŽ“
GP at TUH๐Ÿ‘ฉโ€โš•๏ธ
Studies arab and Libyan board of internal medicine specialists ๐Ÿฉบ
Medical educator at https://t.me/New_Minds_Edu๐Ÿ’ป
ุงู„ู‚ู†ุงุฉ ุฎุงุตุฉ ุจูƒู„ ุดูŠ ูŠุชุนู„ู‚ ุจู…ุงุฏุฉ ุงู„ุจุงุทู†ุฉ .๐Ÿ’Š๐Ÿ’‰
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๐Ÿ“Ventricular ectopics
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๐Ÿ“A fib + LBBB
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๐Ÿ“VT
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๐Ÿ“Atrial Flutter
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ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ุฏูƒุงุชุฑุฉ โœจ๏ธ

ุงุณุชุนุฏุงุฏุงู‹ ู„ุฅู…ุชุญุงู† ุงู„ูƒู„ูŠู†ูƒ Clinical examination ุงู„ู„ูŠ ุญุงูŠุณ ูˆ ู…ุด ุนุงุฑูุฉ ุดู† ูŠู‚ุฑุง ู…ู† ู…ู†ู‡ุฌ ุงู„ู†ุธุฑูŠ ุจุงุด ูŠุบุทูŠ ุงู„ู…ูˆุงุถูŠุน ุงู„ู„ูŠ ุชุฌูŠ ููŠ ุฅู…ุชุญุงู† ุงู„ Examination ุงู„ู„ูŠ ุญูŠูƒูˆู† 3 ู…ุญุทุงุช ู„ุฌู†ุฉ general ูˆ ู„ุฌู†ุชูŠู† local๐Ÿฉบ

ุฌู‡ุฒุชู„ูƒู… ูƒูˆุฑุณ Examination discussion ูŠุดู…ู„ ุดุฑุญ ุงู„ุทุฑูŠู‚ุฉ ุงู„ุตุญูŠุญุฉ ู„ุตูŠุงุบุฉ presentation ู„ูƒู„ Finding ู…ู…ูƒู† ูŠุฌูŠูƒู… ู…ุน ุดุฑุญ ู„ู„ DD ูˆ ุงู„ Investigations ุงู„ุฎุงุตุฉ ุจูŠู‡

ุงู„ูƒูˆุฑุณ ุญูŠู†ุฒู„ ููŠ ู‚ู†ุงุฉ ุฎุงุตุฉ ุนุงู„ุชู„ูŠู‚ุฑุงู…๐Ÿ“ฒ๐Ÿ’ป

ุณุนุฑ ุงู„ูƒูˆุฑุณ 60 ุฏ ๐Ÿ’ญ

ุงู„ุฅุดุชุฑุงูƒ ุนุจุฑ ูƒุฑูˆุช ุงูŠ ูƒุงุด ู…ุชูˆูุฑุงุช ููŠ
ู…ุตูˆุฑุงุช ุงู„ูƒู„ูŠุฉ๐Ÿ”๐Ÿ“ 

ุงูˆ ุงู…ุงูƒู† ุชูˆุฒูŠุน ุงู„ICAHS :

https://newminds.app/ุฎุฑูŠุทุฉ-ู…ูˆุฒุนูŠู†-icash/๐Ÿ“ ๐Ÿ”

ู„ู„ุชุณุฌูŠู„ ููŠ ุงู„ูƒูˆุฑุณ ุงู„ุชูˆุงุตู„ ุนู„ู‰ ุงู„ุจูˆุช ุงู„ุชุงู„ูŠ:

@New_Minds_Robot๐Ÿ“ฒ๐Ÿคณ
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ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ูˆุฑุญู…ุฉ ุงู„ู„ู‡ ูˆุจุฑูƒุงุชู‡ ๐Ÿค

ูˆ ุงุฎูŠุฑุงู‹ ุงู„ู†ุณุฎุฉ ุงู„ุฌุฏูŠุฏุฉ ู…ู† ุดูŠุช The most common findings in clinical exam ุงู„ู„ูŠ ุจูุถู„ ุงู„ู„ู‡ ุงุณุชูุงุฏูˆุง ู…ู†ู‡ ุฃูƒุซุฑ ู…ู† ุฏููุนุฉ ูˆ ุณู‡ู„ ุนู„ูŠู‡ู… ุฅู…ุชุญุงู† ุงู„ูƒู„ูŠู†ูƒ Examination stations๐Ÿฉบ

ุงู„ุดูŠุช ู‡ุฐุง ุญุทูŠุช ููŠู‡ ูƒู„ ุฌู‡ุฏูŠ ูˆ ุฎุจุฑุชูŠ ุงู„ุจุณูŠุทุฉ ููŠ ู…ุฌุงู„ูŠ ุงู„ุจุงุทู†ุฉ ูˆ ุฑุชุจุชู‡ ุจุทุฑูŠู‚ุฉ ุชุณู‡ู„ ุนู„ูŠูƒู… ู‚ุฑุงูŠุชู‡ ูˆ ุฒูŠ ู…ุง ูŠุจูˆุง ุฏูƒุงุชุฑุฉ ุงู„ูƒู„ูŠุฉ
ููŠู‡ ุงุบู„ุจ ุงู„ findings ุงู„ู„ูŠ ู…ุทุงู„ุจูŠู† ุจูŠู‡ุง ูƒ fifith year ู…ุน ุงู„ discussion ุงู„ู„ูŠ ุญู†ุชุณุงู„ูˆุง ููŠู‡ุง ูˆ ุงู„ู„ูŠ ู‡ูŠุง ุงู„ DD ูˆ ุงู„ Investigations .๐Ÿ“

ู…ูˆูู‚ูŠู† ูˆ ู„ุง ุชู†ุณูˆู†ูŠ ู…ู† ุตุงู„ุญ ุงู„ุฏุนุงุก .๐Ÿค
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ุดูŠุช Examination Chicklist ๐Ÿ“๐Ÿฉบ
๐Ÿ“ุดูˆูŠุฉ ู†ุตุงุฆุญ ู„ุงู…ุชุญุงู† ุงู„ูƒู„ูŠู†ูƒ๐Ÿฉบ

ุฌู‡ุฒูˆุง ุงู„ุจุทุงู‚ุฉ ูˆ ุงู„ุจุงู„ุทูˆ ูˆ ุงู„ุณู…ุงุนุฉ ูˆ ุงู„ tape measure ูˆ ูƒู„ ุงู„ instruments ุงู„ู„ูŠ
ู…ุญุชุงุฌูŠู†ู‡ุง

ูˆ ุงู†ุชูˆ ุฏุงุฎู„ูŠู† ู„ู„ู„ุฌู†ุฉ ุฑูƒุฒูˆุง ุนุงู„ูˆุฑู‚ุฉ ุดู† ู…ุทู„ูˆุจ ู…ู†ูƒู… ุฃุฏูŠุฑูˆุง ุŒ ุชู„ู‚ูˆู‡ุง ู…ุนู„ู‚ุฉ ู†ู‡ุงูŠุฉ ุงู„ bed ู…ุชุน ุงู„ุจูŠุดู†ุช

ุทุจู‚ูˆุง ุงู„ุฎุทูˆุงุช ูƒุงู…ู„ุฉ ุจุฏุงูŠุฉ ุจ introduce yourself ู„ ุนู†ุฏ ู…ุง ุชุบุทูŠ ุงู„ุจูŠุดู†ุช ูˆ ุชุดูƒุฑู‡
ูˆ ุฏูŠู…ุง ุฎู„ูŠูƒู… ู…ุจุชุณู…ูŠู† ูˆ ุงุณุฃู„ูˆุง ุงู„ู…ุฑูŠุถ ู„ูˆ ุนู†ุฏู‡ ู…ูƒุงู† ูŠูˆุฌุน ููŠู‡ ุงูˆ ู„ุง ู…ู† ุงู„ุจุฏุงูŠุฉ

ุฎู„ูŠู‡ู… ุตุงุฏู‚ูŠู† ุณูˆุงุก ุนุฑูุชูˆุง findings ุงูˆ ู„ุง ุŒ ู‡ู…ุง ููŠ ุงู„ู†ู‡ุงูŠุฉ 3 ู„ุฌุงู† ุŒ ุญุชู‰ ู…ุง ุฒุจุทุชุด ููŠ ูˆุญุฏุฉ ุชุฒุจุท ููŠ ุงู„ุจุงู‚ูŠ ุŒ ูˆ ุจุนูˆู† ุงู„ู„ู‡ ุชุฌูŠุจูˆู‡ู… ุงู„ุชู„ุงุชุฉ

ุงุนุทูˆุง presentation ู…ุฑุชุจุฉ

ู„ู…ุง ุชู†ุณุงู„ูˆุง ููŠ ุงู„ DD ุญุทูˆุง ููŠ ุจุงู„ูƒู… ุนู…ุฑ ุงู„ุจูŠุดู†ุช ูˆ ุงุนุทูˆุง ุงู„ most likely DX ู‡ูŠุง ุงู„ุฃูˆู„ู‰
ู…ุชู„ุง ุจูŠุดู†ุช ุนู†ุฏู‡ signs of UMNL
ู„ู‚ูŠุชู‡ุง ุญูˆูŠุฌุฉ ูƒุจูŠุฑุฉ ู‡ุงุฏูŠ ุนุงู„ุงุบู„ุจ ischemic CVA ุŒ ูˆ ู„ูˆ ูƒุงู†ุช ุตุบูŠุฑุฉ ููŠ ุงู„ุนู…ุฑ ุนุดุฑูŠู†ุงุช ุชู„ุงุชูŠู†ุงุช ู‡ุงุฏูŠ ุนุงู„ุงุบู„ุจ MS
ูˆ ู‡ูƒุฐุง ู„ูƒู„ findings


ูˆ ุงู„ Investigations ุชุจุฏูˆุง ุจุชุญุงู„ูŠู„ ุงู„ most likely DX ูˆ ุชูƒู…ู„ูˆุง ุนู„ู‰ ุญุณุจ ุงู„ DD

ู…ูˆูู‚ูŠู† ู…ุณุฏุฏูŠู† ุจุนูˆู† ุงู„ู„ู‡ ุชุนุงู„ู‰ ๐Ÿค๐Ÿฉบ
โค23
‏"ุงู„ู„ู‡ู… ุฅู†ูŠ ุฃุณุนู‰ ุŒ ูˆููŠ ู…ุณุนุงูŠ ุฃุชุนุซู‘ุฑ ูˆุฃุชูˆู‡ ูˆุฃุชูˆู‚ู‘ู ูˆุฃุณู‚ุท
‏ุซู… ุฃุนูˆุฏ ุŒ ูŠุงุฑุจู‘ ุจุงุฑููƒ ุงู„ู…ุณุนู‰ ุจุงู„ู‚ุจูˆู„ ูˆุงู„ูˆุตูˆู„"..

ุจุงู„ุชูˆููŠู‚ ู‚ุฑูˆุจ ุงู„ุฃุญุฏ. ๐Ÿ’ช๐Ÿฉบ
โค30๐Ÿ‘2
Internal Medicine By Doha Rawag pinned ยซุงู„ุณู„ุงู… ุนู„ูŠูƒู… ุฏูƒุงุชุฑุฉ โœจ๏ธ ุงุณุชุนุฏุงุฏุงู‹ ู„ุฅู…ุชุญุงู† ุงู„ูƒู„ูŠู†ูƒ Clinical examination ุงู„ู„ูŠ ุญุงูŠุณ ูˆ ู…ุด ุนุงุฑูุฉ ุดู† ูŠู‚ุฑุง ู…ู† ู…ู†ู‡ุฌ ุงู„ู†ุธุฑูŠ ุจุงุด ูŠุบุทูŠ ุงู„ู…ูˆุงุถูŠุน ุงู„ู„ูŠ ุชุฌูŠ ููŠ ุฅู…ุชุญุงู† ุงู„ Examination ุงู„ู„ูŠ ุญูŠูƒูˆู† 3 ู…ุญุทุงุช ู„ุฌู†ุฉ general ูˆ ู„ุฌู†ุชูŠู† local๐Ÿฉบ ุฌู‡ุฒุชู„ูƒู… ูƒูˆุฑุณ Examination discussionโ€ฆยป
๐Ÿ“Sleroderma features (Another findings in General examination stations)

ุชุนู‚ู„ูˆุง ุนุงู„ููŠุณ ุฒูŠ ู…ุง ู…ูƒุชูˆุจ ููŠ ุงู„ุตูˆุฑุฉ ููˆู‚ ูˆ ุจุงู„ู†ุณุจุฉ ู„ู„ hands ุชุนู„ู‚ูˆุง ุนู„ู‰
Flexed deformity
Hyperpigmentation + hypopigmented patches
ุฏูŠู…ุง ุฑูƒุฒูˆุง ุนู„ู‰ salt on paper appearance ุงุบู„ุจ ุงู„ุญุงู„ุงุช ุนู†ุฏู‡ู…
Sclerodactaly

ู…ุฑุงุช ุชู„ู‚ูˆุง ุญุชู‰ ulcer ูˆ gangrene
ุจุณุจุจ ุฑูŠู†ูˆุฏ ุนู„ู‚ูˆุง ุนู„ูŠู‡ุง

๐Ÿ“DD
Scleroderma
Chronic Graft versus host diseses

๐Ÿ“Investigations
CBC , ESR , CRP, UEC, LFT ,ANA , Anti centromere antibodies, HRCT , CXR , ECG , Echo, Urine for Routine examination

๐Ÿ“Most common cause of death
Pulmonary hypertension
โค12๐Ÿ”ฅ1
โ—ผ๏ธููŠ ุจุนุถ ุงู„ุณู†ูˆุงุช ู„ู…ุง ุชูƒูˆู† ุงู„ findings ููŠ ู„ุฌู†ุฉ ุงู„ู†ูŠูˆุฑูˆ LMNL ) facial palsy) ุณุฃู„ูˆุง ุญุชู‰ ุนุงู„ treatment ุจุงู„ุฅุถุงูุฉ ุงู„ู„ูŠ DD ูˆ ุงู„ Investigations

๐Ÿ“Bellโ€™s Palsy โ€“ Treatment

Prednisone 50โ€“60 mg daily ร— 5 days โ†’ then taper over 5 days (should be started within 72 hrs).

ยฑ Antiviral (Acyclovir / Valacyclovir) if severe or Ramsay Hunt suspected.

Eye protection: artificial tears (day), ointment + eye patch (night).

Analgesics (paracetamol/NSAIDs) for pain.

Physiotherapy / facial exercises if prolonged weakness.


๐Ÿ‘‰ Most recover fully in 3โ€“6 months.
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๐Ÿ“ู‚ุงุนุฏุฉ ุงูŠ Nerve palsy ุงุญูุธูˆุง ุฃุณุจุงุจู‡ ุจุงู„ุงุฎุชุตุงุฑ ู‡ุฐุง

1-Vascular/ Stroke , Vasculitis, aneurysm , Cavernous Sinus Thrombosis
2-Infection/ meningitis, encephalitis, brain Abscess
3-Inflammation/ MS
4-Trauma
5-Tumeur / space occupying lesion (โฌ†๏ธ ICP)
6-Systemic diseases/ DM , sarcoidosis
โค11๐Ÿ”ฅ4
ุทู…ู†ูˆู†ุง ุนู„ูŠูƒู… ู‚ุฑูˆุจุงุช ุงู„ูŠูˆู…ุŒ ุฅู† ุดุงุก ุงู„ู„ู‡ ุฌุงูˆุจุชูˆุง ูƒูˆูŠุณุŸูˆ ุดู† ุฌูˆูƒู… ุงู„ stationsุŸ
๐Ÿ“Knee joint examination steps

1. Inspection โ€“ posture, deformity, swelling, scars, muscle wasting

2. Palpation โ€“ warmth, tenderness, effusion (bulge sign, patellar tap), crepitus, quadriceps wasting.

3. Movement โ€“ flexion/extension

4. Special tests ู‡ุงุฏูˆ ู…ุด ู„ูŠูƒู… ุชุจุน ุงู„ุฌุฑุงุญุฉ

5.assess the gait
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