What will decrease mortality in COPD patient? 🧐

1- Smoking cessation (if it is in choices it is always the best answer)
2- Vaccination (Pneumococcal and influanza vaccine)
3- Home oxygen therapy (only if indicated, don’t choose it unless indicated!)

Indications for long term home oxygen therapy in COPD patient:-
1- PaO2 in ABG (out of time of acute attack) less than 55
2- PaO2 55-59 + one of the following: dependent edema (Cor pulmonale), polycythemia (Hct > 56%), pulmonary hypertension, Nocturnal hypoxemia

Approach to Anemia

Clinical and radiographic clues to the etiology of pneumonia in children

Brucellosis treatment period:
Joint > 3ms
CNS > 6ms
Pregnancy > 4ws
Non local brucellosis > 6ws

LBBB and RBBB

Colonoscopy Surveillance

Paraneoplastic Syndromes

Light's criteria

SLE Antibodies

Approach to a Monoarthritic Joint

Vascular dementia: usually comes with hyperintensites in ct + hx of dementia follwing stroke or embolism.

Lewy body: Dementia + Parkinsonism + hallucinations.

Normal pressure hydrocephalus: dementia + unsteady gait + urinary incontinence + CT might show ventricular enlargement and hypo intensities.

Frontotemporal: dementia + personality changes

Severe asthma exacerbation management:

O2+ SABA+ ipratropium
No response? Systemic steroid
No response ? Mgso4 IV
No response? Intubate

Asthma
Mild intermittent >> SABA
Mild persistent >> SABA + ICS
Moderate persistent >> SABA +ICS + LABA

IE Prophylaxis

Approach to Cushing’s:
1- Confirm Cushing with 24h urine test
2- Measure ACTH if urine came +ve
3a- Low ACTH: CT abdomen
3b- high ACTH: High dexa suppression test
4a- +ve: MRI brain
4b- -ve: ACTH secreting tumor, perform CT chest

● PROPHYLAXIS IN SAUDI SOLDIERS GOING TO THE SOUTH: ATOVAQOUONE AND PROGUANIL

● PROPHYLAXIS IN SAUDI IN GENERAL : MEFLOQUINE

● PROPHYLAXIS FOR DEPRESSED PATIENT : ATOVAQUONE /PROGUANIL (mefloquine is contraindicated)

● PROPHYLAXIS IN SUDAN: MEFLOQUINE

● TX FOR MALARIA IN SAUDI : ARTESUNATE/pyrimethinamine/sulfadoxine

● TX for malaria in SOUTHEAST ASIA : ARTESUNATE AND MEFLOQUINE

Thiazolinediones : -zone
GLP-1 : -tide
DDP4 : -liptin
SGLT2 : -lozin

Smoking cessation approach:

Initial, Behavioral and motivational

Pregnant, behavioral (NRT if it fails)

Inpatient, NRT

Outpatient with cardiac problem, bupropion (Varenicline is debatable)

Outpatient without cardiac problem, Varenicline

Kidney problems, avoid Varenicline

Hx of seizures, anxiousness, or depression, avoid bupropion

Milestones