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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ุงู‚ุฑูˆุง ูˆ ูƒุงูุญูˆุง ู…ู† ุฃุฌู„ ู‡ุฐู‡ ุงู„ู„ุญุธุฉ๐Ÿ’œ๐Ÿ’ช
โค9๐Ÿ”ฅ6๐Ÿ‘1๐Ÿ‘1
ุฑุณุงู„ุฉ ุชูุงุคู„๐Ÿ’Œ

ุซู‚ ุจุงู„ู„ู‡ ูŠุง ุตุฏูŠู‚ูŠ ๐Ÿ˜€

ุฃู† ุฑุฒู‚ูƒ ุงู„ู…ุชุฃุฎุฑ ุงู„ุฃู† ู‚ุฏ ูŠูƒูˆู†
ุฃูุถู„ ุจูƒุซูŠุฑ ู…ู† ุฃุฑุฒุงู‚ู‡ู… ุงู„ู…ุชู‚ุฏู…ุฉ โค

ูู…ุง ุงุจุทู‰ ุจุงู„ุณูŠู„ ุฅู„ุง ุจู…ุง
ูŠุญู…ู„ู‡ ู…ู† ุฌูˆุฏ ูˆูƒุฑู… ๐Ÿค—

ูู„ุง ุชูŠุฃุณ ูˆุงู†ุชุธุฑ ู…ู† ุงู„ู„ู‡ ูƒู„
ู…ุง ู‡ูˆ ุฌู…ูŠู„ ูˆุชูุงุฆู„ ๐Ÿ˜
โค5
#ุงุฎุชุตุงุฑุงุช_ุชุณุงุนุฏ_ููŠ_ุงู„ุญูุธ ๐Ÿ’ก

๐Ÿ”ด~ Drugs that cause lung fibrosis~
( BBC every MANS go )
B- Bleomycin
B- Busalphan
C- Cyclophosphamide / Cephalosporin
M- Methotrexate
A- Amiodarone
N- Nitrofuranton
S- Sulfasalazine
(ู‚ุงู„ู‡ ุฏูƒุชูˆุฑ ุงู„ุฑูŠู†ุงู„ูŠ ููŠ ูˆุงุญุฏ ู…ู† ุงู„ุจูŠุฏุณุงูŠุฏ )
ู„ูƒู† ู…ุง ุญุทุชุด ููŠ ุงู„ุงุฎุชุตุงุฑ ุงู„ GP๐Ÿค” ุงู„ู„ูŠ ู‡ู…ุง ุงู„ Gold ูˆุงู„ pencillamine ๐Ÿ˜...
๐Ÿ”ด~ Drugs that cause vit B9 deficiency ~
( MAP )
M- Methotrexate/ Metformin
A- Azathioprine
P- phenytoin/ pyrimethamine

๐Ÿ”ด~ Drugs that cause polyneuropathy ~
( SHIP GAME CC-TV )
S- Statin
H- Hydralazine
I- Izoniazide
P- Phyentoin
G- Gold
A- Amiodarone
M- Metronidazol
E- Etambutol
C- Cyclophosphamide
C- Cisplastin
T- Talidomide
V- Vincrestin

๐Ÿ”ด~ drugs that cause sidroplastic anaemia ~
( ALI)
A- Alcohol
L- Lead
I- Isoniazide

๐Ÿ”ด~ poor prognosis HL ~
( HALW SAM )
H- HB <10
A- Albumin <40
L- leukopenia
W- WBC >15ร—10^3
S- Stage 4
A- Age >45
M- Male gender

๐Ÿ”ด~ poor prognosis NHL ~
( BAD LM )
B- B2 microglobulin
A- Age >65
D- coexcit Disease
L- LDH
M- Metstisis

๐Ÿ”ด~ poor prognosis multiple myeloma ~
( ABCH )
A-albumin
B- B2microglobulin
C- creatinine
H- HB

๐Ÿ”ด~ Drugs which have no effect on mortality and morality ( Doesn't improve the prognosis ) in pt with IHD
(CMN)
C- CCB
M- Morphine
N- Nitrates

๐Ÿ”ด~ Drugs which have no effect on mortality and morality ( Doesn't improve the prognosis) in pt with HF
( DD )
D- Diuretics
D- Digoxin
โค2๐Ÿฅฐ2
ุงู„ุณู„ุงู… ุนู„ูŠูƒู… ูˆุฑุญู…ุฉ ุงู„ู„ู‡ ูˆุจุฑูƒุงุชู‡ ุฏููุนุฉ ุงู„ู…ู‚ู„ูˆุจุฉ

ุฃุนู„ู† ุนู† ูุชุญ ูƒูˆุฑุณ Clinical examination ุงู„ูƒูˆุฑุณ ุญูŠูƒูˆู† ุดุงู…ู„ ู„ู„ู…ูˆุงุถูŠุน ุงู„ุชุงู„ูŠุฉ๐Ÿ‘‡
1_ General examination
ุจุญูŠุช ู†ุบุทูˆุง ุงู‡ู… ุงู„ุญุงู„ุงุช ุงู„ู„ูŠ ุชุฌูŠ ููŠ ุงู„ุฅู…ุชุญุงู† ููŠ ู„ุฌู†ุฉ ุงู„ุฌูŠู†ูŠุฑุงู„ ูˆ ุงู„ู„ูŠ ู‡ู…ุง
Anemia / Jundice/ โฌ†๏ธ JVP / lymphadenopathy/ Bilateral llO / Thyroid examination/ Rheumatoid hand examination

2_ Cardiovascular examination
3_ Respiratory examination
4_ Abdominal examination
5_ CNS examination /
Motor examination, Sensory examination, Cranial nerves examination , How to examine the coordination, How to examine pt with parkinson , How to examine the mental status .


ุงู„ู…ูƒุงู† /ู…ุณุชุดูู‰ ุทุฑุงุจู„ุณ ุงู„ุฌุงู…ุนูŠ (ุงู„ุทุจูŠ)๐Ÿฅ

ู„ู„ุชุณุฌูŠู„ ูˆ ู„ู…ุนุฑูุฉ ุจุงู‚ูŠ ุงู„ุชูุงุตูŠู„ ุชูˆุงุตู„ูˆุง ู…ุนุงูŠ ุนุงู„ุฎุงุต @Doha_Rawaq .

ุงู† ุดุงุก ุงู„ู„ู‡ ุจุงู„ุชูˆููŠู‚ โœŒ

ุฏ.ุถุญู‰ ุนู„ู‰ ุฑูˆุงู‚.
https://t.me/internal_medicine_Dr_Doha.
๐Ÿ”ฅ3โค1
๐Ÿ”ด#Bedside_Notes
#Cardiovascular / ุฏ.ู…ุญู…ุฏู†ุนู…ุงู†
ู…ู…ูƒู† ุชุฌูŠูƒู… ุฃุณุฆู„ุฉ ููŠ ู„ุฌู†ุฉ ุงู„ OSCE

Q1_ What are the types of pacemaker ?
๐Ÿ‘‡
1_ Temporary (External)
2_ Permenant (Internal )

Q2_ What are the indication of pacemaker?
๐Ÿ‘‡
1_ Heart block
2_ very slow heart rate ( Sever Bradycardia)
โžก๏ธSinus sick syndrome
โžก๏ธDigoxin, BB toxicity ๐Ÿ‘‡
ุทุจุนุงู‹ ู‡ุงุฏูŠ ุชุตูŠุฑ ููŠ ุงู„ุจูŠุดู†ุช ุงู„ู„ูŠ ุนู†ุฏู‡ู… AF ู„ุงู†ู‡ู… ูŠุชุนุงู„ุฌูˆุง ุจุงู„ุฃุฏูˆูŠุฉ ู‡ุงุฏูŠ ู ูƒ S/E ู„ูŠู‡ุง ู…ู…ูƒู† ูŠุฎุดูˆุง ููŠ
Sever Bradycardia .

Q3_ What is the specific sign for lt ventricular failure?
๐Ÿ‘‡
โžก๏ธS3 gallop

Q4_What are the characteristic clinical sings found in pt with TR ?
๐Ÿ‘‡
1_ Epigastric pulsation
2_ โฌ†๏ธ JVP
๐Ÿ”ฅ2โค1
๐Ÿ”ด#Bedside_Notes
#Cardiovascular / ุฏ.ุฃุณุงู…ุฉ ุงู„ุจู‡ูŠู„ูŠู„

Q1_ What is the mechanism of PND and why it occurs at night ?
๐Ÿ‘‡
1_ โฌ†๏ธ venous return / Flat position
2_ โฌ‡๏ธ sympathetic/ Broncho-construction + โฌ‡๏ธ contractility of heart

Q2_ What are the uses of Slidinifine (Vigra)?
๐Ÿ‘‡
1_ Pulmonary HTN
2_ Erectile dysfunction

Q3_ What is the mechanism of action of Slidenifine ?
๐Ÿ‘‡
1_ Vasodilatation
2_ โฌ†๏ธ NO (Nitrous Oxide)

Q4_ What are the causes of Pulmonary HTN ?
๐Ÿ‘‡
1_ Lt side HG
2_ Chronic lung disease (Hypoxia)
3_ CTD / SLE
4_ Portal HTN ( porto_pulmonary HTN which occurs in sever advanced liver cirrhosis )
5_ Idiopathic
6_ Congenital

Q5_ What is the age of sudden death ?
๐Ÿ‘‡
Male / 45
Female / 50

Q6_What are the cardiopulmonary diseases which are absolutely C/I for pregnancy?
๐Ÿ‘‡
1_ Sever AS
2_ HOCM
3_ Pulmonary HTN

Q7_ ุนู„ุงุด ู†ุดูˆููˆุง ููŠ ุงู„
central cyanosis
ููŠ ุงู„ Tongue ุŸ
๐Ÿ‘‡
1_ High and rich in vasculature
2_ No sympathetic nerve supply
3_ internal organ / ู…ุง ูŠุชุนุฑุถุด ู„ู„ุตู‚ุน ุฒูŠ ุงู„ุตุจุน
๐Ÿ‘1๐Ÿฅฐ1
โค1
Central and peripheral cyanosis.
๐Ÿ”ฅ1
๐Ÿ”ด#Bedside_Notes
#Cardiovascular/ ุฏ.ุฑุถุง ุจู† ูุถู„

Q1_ What is the DD of visible pulsation at suprasternal notch ?
๐Ÿ‘‡
1_ Thoracic aortic aneurysm
2_ Hyperdynamic circulation
3_ Normal ( Thin person )

Q2_ What is the DD of visible pulsation at Epigastric area ?
๐Ÿ‘‡
1_ Abnormal aortic aneurysm
2_ Rt ventricular dilatation
3_ Pulsatile liver ( Due to TR )
4_ Normal (Thin person )

Q3_ What are the causes of displaced apex in pt with MS ?
๐Ÿ‘‡
ุทุจุนุงู‹ ููŠ ุงู„ุญุงู„ุฉ ู‡ุงุฏูŠ ู…ูุฑูˆุถ lt ventricule ูŠูƒูˆู† normal size
ูุงู„ุงุณุจุงุจ ุญุชูƒูˆู† ูŠุง ุงู…ุง
1_ Rt ventricular dilatation
ูˆ ู‡ุงุฏูŠ ุชุตูŠุฑ late ุจุณุจุจ ุงู„ Backwards symptoms on the lung then on the Rt side of the heart
2_ Presence of other pathology / Congenital heart disease

Q4_ What are the causes of Acute MR ?
๐Ÿ‘‡
1_ Acute MI
2_ Endocarditis
3_ Sever chest truma

Q5_ What are the DD of Kussmal sign ?
๐Ÿ‘‡
1_ Constictive pericardaitis
2_ Cardiac temponade
3_ Restrictive cardiomyopathy
๐Ÿ‘3โค2
ุงู† ุดุงุก ุงู„ู„ู‡ ุชุณุชููŠุฏูˆุง ู…ู†ู‡ ููŠ ุงู…ุชุญุงู† ุงู„ูƒู„ูŠู†ูƒ
#CNS๐Ÿง 
#bedside_notes๐Ÿ“
ุฏ.ุฌู…ุงู„ ุงู„ุจุงุฑูˆู†ูŠ

How to examine mental status of pt ?

ุดู†ูˆ ุฅุณู…ูƒุŸ
ุดู†ูˆ ุงู„ูˆู‚ุช ุชูˆุง ( ุตุจุญ ุŒ ุนุดูŠุฉ ูˆ ู„ุง ู„ูŠู„ ) ุŸ
ูˆูŠู† ุงู†ุช ุชูˆุง ุŸ
**ูุฑุถุงู‹ ุนุฑู ูˆ ู‚ุงู„ูƒ ุงู†ูŠ ููŠ ุงู„ู…ุณุชุดูู‰ ุŒ ุชุณุฃู„ู‡ ๐Ÿ‘‡
ุนู„ุงุด ุฌูŠุช ู„ู„ู…ุณุชุดูู‰ ุŸ
ู…ู† ุงู„ู„ูŠ ุฌุงุจูƒ ู„ู„ู…ุณุชุดูู‰ ุŸ
**ู„ูˆ ููŠู‡ ู…ุนุงู‡ Relative ุชุณุฃู„ู‡ ๐Ÿ‘‡
ู…ู† ู‡ุฐุง ู„ู„ูŠ ู…ุนุงูƒ ุŸ
**(ูุฑุถุงู‹ ู…ุนุงู‡ ูˆู„ุฏู‡ ) ุชุณุฃู„ู‡ ๐Ÿ‘‡
ูˆู„ุฏูƒ ู‚ุฏุงุด ุนู…ุฑู‡ ุŒ ู…ูˆุงู„ูŠุฏ ูƒู… ุŸ!
ุชูˆุฑูŠู‡ ุณุงุนุฉ ูˆ ู„ุง ุชู„ูŠููˆู† ูˆ ู„ุง ุจูŠุฑูˆ ูˆ ุชุณุฃู„ู‡ ู‡ุฐุง ุดู†ูˆ ุŸ
ุชู‚ูˆู„ู‡ ูŠุนุฏ ุจุงู„ุนูƒุณ (ุนุดุฑุฉ / ุชุณุนุฉ .....)
ุชุณุฃู„ู‡ ุนู„ู‰ ุชุงุฑูŠุฎ ุญุงุฌุฉ ู‚ุฏูŠู…ุฉ (ู…ุชู„ุงู‹ ุŒ ุนู…ูŠ ู…ู„ุญู‚ ุนู„ู‰ ุงู„ุบุงุฑุฉ ุŸ ููŠ ุงูŠ ุณู†ุฉ ูƒุงู†ุช )
NB:- 1st 3 Questions to assess the orientation for time , place and person .

ุจุงู„ุชูˆููŠู‚ .๐Ÿ’™๐Ÿ’œ
โค2๐Ÿ‘2
Forwarded from Doha Ali Rawaq
๐Ÿ‘1
Forwarded from Doha Ali Rawaq
Signs of Anemia ๐Ÿ‘‡
๐Ÿ‘1
Forwarded from Doha Ali Rawaq
Signs of Jundiceโ˜๏ธ
๐Ÿ‘1