-REMEMBER:

•Causes of HTN with hypokalemia include:

1-Conn's syndrome
2-Cushing syndrome
3-liddel's syndrome
4-11 beta hydroxylaze enz. defeciency
5-Renal artery stenosis.

#Cardiology

Remember:

-Drug of choice for pt suffering of gout and hypertension is Losartan.

Because it increase the excretion of uric acid by kidney.

-Drug of choice for pt suffering of gout and hyperlipidemia is fenofibrate.

Uricosuric action increase renal excretion uric acid.

#Cardiology

Remember:

-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.

-mrcp1
#GIT

Vitamin deficiency symptoms & treatment.

#Metabolic

Pulmonary function tests (PFTs) in asthma show:

• Decrease in FEVl of more than 20% with the use of methacholine or histamine.
• Increase in the diffusion capacity of the lung for carbon monoxide (DLCO).

#Respiratory

Asthma

Additional testing options include:
• CBC may show an increased eosinophil count.
• Skin testing is used to identify specific allergens that provoke bronchoconstriction.

#Respiratory

Asthma

Acetylcholine and histamine provoke bronchoconstriction and an increase in bronchial secretions.

Note:
Methacholine is an artificial form of acetylcholine used in diagnostic testing.

#Respiratory

Asthma

-Increased IgE levels suggest an allergic etiology.

-IgE levels may also helpguide therapy such as the use of the anti-IgE medication omalizumab.

#Respiratory

Pathophysiology in MS:

•Mitral valve stenosis → obstruction of blood flow into the left ventricle (LV) → limited diastolic filling of the LV (↓ end-diastolic LV volume) → decreased stroke volume → decreased cardiac output (forward heart failure)

•Mitral valve stenosis → increase in left atrial pressure → backup of blood into lungs → increased pulmonary capillary pressure → cardiogenic pulmonary edema.

#Cardiology

Remember:

-In presence of ECG changes with hyperkalaemia, 1st step should be infusion of 10 mL 10% calcium gluconate slowly.

-In presence of magnesium depletion, replacement of Mg may also be required for hypokalaemia to be corrected. "since low cell magnesium can enhance the mechanism for tubular potassium secretion, causing ongoing urinary losses".

-If low magnesium is associated with low Ca, 50mmol Mg chloride IV over 24hours.

-Hypercalcemia should initially be treated with intravenous 0.9% saline " to improve renal function and increase urinary calcium excretion".

#Metabolic

-Viral Infections Causes Aplastic Anemia:

●Acute viral hepatitis 👉🏼 Hepatitis A+B
●Parvovirus B19
●Epstein-Barr
●Cytomegalovirus
●HIV

-USMLE
#Blood

In case of ACAS:

-Half the deaths occur within 24 hours of the onset of symptoms and about 40% of all affected patients die within the first month.

-The prognosis of those who survive to reach hospital is much better, with a 28-day survival of more than 85%.

#Cardiology

Acute Coronary Artery Syndrome:

-Unfavourable features include

1-Poor left ventricular function
2-AV block
3-Persistent ventricular arrhythmias.
4-The prognosis is worse for anterior than for inferior infarcts.
5-Bundle branch block
6-High cardiac marker levels both indicate extensive myocardial damage. 7-Old age
8-Depression and social isolation are also associated with a higher mortality.

-Of those who survive an acute attack, more than 80% live for a further year, about 75% for 5 years, 50% for 10 years and 25% for 20 years.

#Cardiology

Electrical alternans:

-Consecutive, normally-conducted QRS complexes that alternate in height

-Occurs when the heart swings backwards and forwards within a large fluid-filled pericardium "acute pericarditis".

#Cardiology

Remember:

-The most sensative investigation for diagnosis of hypertrophic pulmonary osteoarthropathy is th isotope bone scan.

#Rheumatology

Remember:

-FVC is used to monitor respiratory function in Guillain-Barre syndrome.

#Neurology

Remember:

-Hepatitis D virus has the highest mortality in all peoples exept in pregnant women hepatitis E is the most lethal.

#Liver

Remember

Amiodarone is considered dangerous for :
- Pregnancy
- Long QT
- Hyperkalemia
- Accelerated idioventricular rhythm
- NA channel blockers poisoning
And
- AF in patients with WPW ..the IV form and not the oral one for those patients.

#Cardiology

BETA BLOCKERS;

1-All betablockers can cause reduction in HDL level except CARVEDILOL

2-All betablockers can cause hypertriglyceridaemia except CARVEDILOL

3-The betablocker of the choice in renal patients on dialysis+HF is CARVEDILOL

4-Target dose of CARVEDILOL in patients with HFrEF is 25mg twice (50mg twice if body weight 85Kg or more )

5-The best antihypertensive effect among betablockers is observed with CARVEDILOL and nebivilol

6-The best rate controlling effect among betablockers is observed with bisoprolol and metoprolol

7-The most selective beta1 blocker is nebivilol, so it the most suitable for patients with asthma or COPD

8-The lowest incidence of erectile dysfunction among betablockers is observed with Nebivilol

9-Betablocker can control HR in AF during rest and exercise(while digoxin control HR at rest only)

10-Betablockers are considered the fifth antihypertensive drug (after ACEI, ARBs, CCB, thiazide diuretics) except in pregnancy, Arrhythmias(AF), angina or HF ; in these cases, Betablocker can be used as first line for hypertension.

#Cardiology

Remember:

First line therapy in HTN in ESRD Patient on Dialysis are ACEI &ARBS.

#Cardiology

Hypertensive Encephalopathy

-In hypertensive encephalopathy, the treatment guidelines are to reduce the MAP 25% over 8 hours. Labetalol, nicardipine, esmolol are the preferred medications; nitroprusside and hydralazine should be avoided.

#Cardiology