HLA associations

- HLA DR3 is associated with diabetes mellitus, autoimmune hepatitis, dermatitis herpetiformis, Graves' disease, membranous glomerulonephritis, myasthenia gravis, Addison's disease, Sjogren syndrome and systemic lupus
erythematosus (SLE).
-HLA B47 is associated with congenital adrenal hyperplasia.
-HLA B27 is associated with seronegative arthropathies such AS, RS.
-HLA A28 is associated with schizophrenia.
-HLA DR7 is associated with minimal-change disease (nephrotic syndrome).

#General

Remember:

Endocrine causes of HTN include:

-Acromegaly
-Cushing's syndrome
-Conn's syndrome
-Pheochromocytoma
-Hyperthyroidism
-Hypothyroidism
-P.Hyperparathyroidisim.

#Cardiology

It is recommended to withhold :
- ticagrelor for 3–5 days,
-clopidogrel for 5 days, and
- prasugrel for 7 days

prior to non-cardiac surgery.

#Cardiology

Remember

Iron deficiency anemia (IDA) + = ?

-IDA + 🍞->diarrhea = Celiac disease

-IDA + dysphagia + esophageal webs = Plummer Vinson

-IDA + leg pain at night = Restless leg

-IDA + craving ice = Pagophagia

-IDA + hemolysis + hemoglobinuria = PNH.

#Blood

Antiphospholipid syndrome.

-Primary prevention 👉🏼Aspirin

-Secondary prevention 👉🏼 Warfarin for life INR 2-3 , if recurrence of DVT or arterial thrombosis while on warfarin , add aspirin and target INR above 3 (3-4).

-Secondary prevention in pregnancy 👉🏼 aspirin + LMWH .Can change to warfarin postpartum ( wait 5 days minimum ) .

#USMLE
#Rheumatology

Remember:

-The main cause of death in Systemic sclerosis is PAH, Pulmonary fibrosis, GIT involvement and Cardiac disease.

#Rheumatology

Remember:

-The main cause of death in Sarcoidosis is respiratory failure.

#Respiratory

Remember:

-Beta blockers are contraindicated in patients with Variant angina while they're the first line in Stable angina.

#Cardiology

Causes of anemia in Systemic sclerosis :

1-Chronic inflammation: anemia of chronic disease.

2-Medications: Certain medications used to manage systemic sclerosis, such as (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), or immunosuppressants, can cause or contribute to anemia as a side effect.

3-Malabsorption: Systemic sclerosis can result in gastrointestinal complications, including malabsorption of nutrients like iron, folate, and vitamin B12. Deficiencies in these nutrients can lead to anemia.

4-Kidney involvement: In some cases, systemic sclerosis can affect the kidneys, leading to decreased production of erythropoietin—a hormone necessary for red blood cell production. This can result in anemia.

5-Bleeding complications: If systemic sclerosis affects blood vessels or involves gastrointestinal complications such as ulcers, abnormal bleeding can occur, leading to anemia.

6-Autoimmune anemia.

#Rheumatology

-Behçet’s is associated with the HLA- B51 allele.

#Rheumatology

In GBS

-Albuminocytologic dissociation, characterized by elevated protein levels and normal cell counts in cerebrospinal fluid (CSF), is a hallmark finding of GBS.

#Neurology

What drugs should be avoided in MG?

-Aminoglycoside, penicillamine, ciprofloxacin, quinine, antiarrhythmic drugs.

#Neurology

Remember:

Campylobacter jejuni: campylobacter enteritis is the most common disease associated with GBS.

Cytomegalovirus: most common virus associated with GBS.

#Neurology

Remember:

Pseudo-gout is the most common cause of acute mono-arthritis in elderly.

#Rheumatology

What is Felty’s syndrome?

-Rheumatoid arthritis with splenomegaly and neutropenia is called Felty’s syndrome.

-There may be hypersplenism (anemia, leukopenia and thrombocytopenia).

#Rheumatology

Remember:

-EMG shows progressive incremental response in LEMS (reverse of myasthenia gravis, where there is decremental response).

#Neurology

Remember:

-Abnormality of reflex, muscle power and autonomic disturbance are absent in myasthenia gravis.

#Neurology

In LEMS:

-There is defect in acetylcholine release at the neuromuscular junction that is thought to be due to an auto-antibody against prejunctional voltage gated calcium channel on the motor nerve terminal.

-Small cell carcinoma of the lung may trigger the auto-antibody reaction.

#Neurology