A 65 year old man with a history of ischaemic heart disease is found unresponsive. He has no central pulse and is making no respiratory effort. This is his ECG. What is the diagnosis and what will you do?

◽Presentation
👇
Rate➡️150
Rhythm➡️Regular
Axis➡️Left axis deviation
PR/P wave➡️Not visible
QRS➡️Wide
ST/T wave➡️Unable to assess
QTc/other➡️Unable to assess

◽Diagnosis
This is ventricular tachycardia (VT)

A 58 year old man who attends the emergency department with chest pain loses consciousness whilst he is having his initial ECG. He has no central pulse and is taking occasional deep breaths. What is going on?

◽Presentation
👇
Rate➡️Initially 100, then 300
Rhythm➡️Initially regular, then irregular
PR/P wave➡️Initially present, then unable to visualise
QRS➡️Initially narrow, then wide
ST/T wave➡️Initially massive ST elevation in II III and aVF with reciprocal depression in I and aVL. Then unable to visualise
QTc/other➡️Unable to assess

◽Diagnosis
👇
This is ECG initially shows an inferior STEMI, which then deteriorates into ventricular fibrillation (VF).

A 60 year old man presents with tight central chest pain radiating to his left shoulder. This is his initial ECG. Present your findings and give a diagnosis.

◽Presentation
👇
Rate➡️90
Rhythm➡️Regular
Axis➡️Normal
PR/P wave➡️Normal
QRS➡️Narrow
ST/T wave➡️Grossly elevated in V2, V3, V4, V5 and V6. Reciprocal depression in II, III and aVF.
QTc/other➡️Normal

◽Diagnosis
👇
This patient has ST elevation in the anterior and lateral leads. This is therefore an anterolateral ST elevation MI (STEMI).

A 29 year old  presents with central chest pain. She has a history of recent flu-like illness but no significant past medical history. This is her ECG. What is the diagnosis?

Presentation
👇
Rate➡️60
Rhythm➡️Regular
Axis➡️Normal
PR/P wave➡️PR segment depression
QRS➡️Narrow
ST/T wave➡️Widespread ST elevation (saddle shaped)
QTc/other➡️Normal

Diagnosis
👇
The diagnosis is pericarditis. Pericarditis often presents in young people after a history of viral illness. He you can see the characteristic widespread saddle-shaped ST elevation and PR depression.

A 55 year old renal dialysis patient presents to the emergency department having missed his last session of dialysis due to feeling dizzy and unwell. This is his ECG. Present your findings and give a diagnosis.

◽Presentation
👇
Rate➡️100 – 150
Rhythm➡️Irregular
Axis➡️Unable to establish
PR/P wave➡️Not visible
QRS➡️Widened
ST/T ➡️waveMerged with QRS
QTc/other➡️Unable to assess

◽Diagnosis
👇
This is the classic sine wave ECG pattern of severe hyperkalaemia. It can quickly deteriorate into ventricular fibrillation (VF).

A 45 year old man is found collapsed at home. There is no history available. This is his ECG. What is the diagnosis?

◽Presentation
👇
Rate➡️Highly variable – up to 300 bpm
Rhythm➡️Irregular
Axis➡️Unable to assess
PR/P wave➡️Absent during episodes of extreme tachycardia
QRS➡️Wide
ST/T wave➡️Unable to assess
QTc/other➡️Unable to assess

◽Diagnosis
👇
This is a difficult case and shows runs of polymorphic VT or Torsades de pointes.

◽Presentation
👇
Rate➡️64 beat/min
Rhythm➡️Regular
Axis➡️Normal
PR/P wave➡️Constant prolongation of PR interval in lead 2
QRS➡️Normal
ST/T wave➡️Normal
QTc/other➡️Normal

◽Diagnosis
👇
This is a First degree heat block.

◽Presentation
👇
Rate➡️ 75 beat/min
Rhythm➡️irregular
Axis➡️Normal
PR/P wave➡️progressive prolongation of PR interval in lead 2 , followed by a Missed beat
QRS➡️Normal (Narrow)
ST/T wave➡️ ST segment elevations in lead 2 , 3 , AVF , Otherwise are Normal.
QTc/other➡️Normal

◽Diagnosis
👇
This is a Second degree heat block (Mobitz type I ) with Acute inferior STEMI.

◽Presentation
👇
Rate➡️ 100 beat/min
Rhythm➡️irregular
Axis➡️Lt axis deviations
PR/P wave➡️Normal and constant PR intervval , followed by Missed beat in lead 2
QRS➡️M shaped in V1 , V 2
ST/T wave➡️Normal
QTc/other➡️Normal

◽Diagnosis
👇
This is a Second degree heat block (Mobitz type II) with RBBB.

◽Presentation
👇
Rate➡️ 55 beat/min
Rhythm➡️Regular PR , Regular RR intervals
Axis➡️Normal axis
PR/P wave➡️Normal
QRS➡️Wide
ST/T wave➡️Normal
QTc/other➡️Normal

◽Diagnosis
👇
This is a Third (Complete)degree heart block.

ال pdf هذا عبارة عن كيسات محلولة و فيه أغلب ال ECG cases اللي تجي في الإمتحان ، ان شاء الله يفيدكم🌸

أهم مواضيع ال ECG في إمتحان الاورال✋📝✏

STEMI (بأنواعها )
AF
Atrial flutter
SVT(مش شرط تحدد النوع المهم تزبطها )
VT
VF (ما تجيش هلبا)
Torsade de pointes (ما يجيش هلبا)
Heart block (بأنواعه التلاتة)

طبعاً بعد ما تقروا ال ECG و تقولوا ال presentation يسألك بعدها على DX و ال Causes لازم اتبتوهم مهماااات هلباا💡💡

بالنسبة لل TTT ما يسألوش عليها و لو سألوا يبوا إجابة سطحية .

ربي يوفقكم جميعاً.🧡💛

السلام عليكم ورحمة الله وبركاته 🌸🌸

هذا شيت ملخص للهستوري ، كاتباته من ايامات كنت سنة خامسة، بنفس طريقة د. محمد شلوف و زايدة عليه شوية إضافات

كنت نبي نعدله اكثر ، لكن ما لقيتش وقت☹

ان شاء الله يفيدكم و لا تنسوني من صالح الدُعاء🤲

#OSCE
◽General
🔹️Hand examination

Q1_ What are the stages of clubbing?
1_ Stage 1/ +ve flactuation test
2_ Stage 2/ loss of normal angel b/w nail and nail fold
3_ Stage 3/ loss of window ( Sham Roths sing )
4_ Stage 4 / Drum stick
5_ Stage 5/ Hyperthrophic pulmonary osteoathropathy


Q2_What are the bedside tests for Clubbing ?
1_flactuation test
2_nail angels
3_widow sign

Q3_What are the hand features of Marfan syndrome?
1_ Wrist sign
2_ Thumb sign
3_ Arachnodactaly
4_ Joint flexity

Q4_What're the hand features of IE ?
1_ Splinter haemorrhage
2_ Osler nodules
3_ Janeway lesion
4_ Clubbing

Q5_What is the DD of yellow nail ?
1_Onychomycosis
2_ Chronic paronychia
3_ Pseudonymous infection
4_ Yellow nail syndrome ( Yellow nail + Branchiactasis + lymphedema)
5_Drugs ( Topical 5`flurouracil , tetracycline)

Q6_What're the hand deformities of RA ?
1_Swan neck defomity
2_ Boutonniere deformity
3_ Z deformity
4_ Radial deviations at wrist joint
5_ Alnar deviations at wrist joint

Q7_ What're the special tests of wrist examination?
1_Phalen test
2_ Tinel test