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

Pathologic Q waves in ECG.

#Cardiology

DD for pathological Q waves in ECG.

#Cardiology

Remember:

-The diagnosis of Miller Fisher syndrome can be confirmed by a positive anti-GQ1b iGg antibody testing.

#Genetic

Asthma

Step 1. Always start the treatment of asthma with an inhaled short-acting
beta agonist (SABA) as needed.

-Examples of SABA are:
• Albuterol
• Pirbuterol
• Levalbuterol

-USMLE
#Respiratory

Asthma

Step 2. Add a long-term control agent to a SABA. Low-dose inhaled corticosteroids.
-(ICS) are the best initial long-term control agent.

-Example of ICS are:
• Beclomethasone, budesonide, flunisolide, fluticasone, mometasone,
triamcinolone.

#Respiratory

Asthma

Step 3. Add a long-acting beta agonist (LABA) to a SABA and ICS, or increase
the dose of the ICS.

-LABA medications are salmeterol or formoterol.

#Respiratory

Asthma

Step 4. Increase the dose of the ICS to maximum in addition to the LABA
and SABA.

#Respiratory

Asthma

Step 5. Omalizumab may be added to the SABA, LABA, and ICS in those who
have an increased IgE level.

#Respiratory

•Anti hypertensives drug of choice:

-In CKD/DM/proteinuria-ACEi/ARB

-In Gout-Losartan-Uricosuri, lowers uric acid levels

-With CAD/myocardial dysfunction-Beta blocker

-In Post renal Tx-CCB

-Pregnancy-Methyldopa/Labetolol/CCB.

#Cardiology