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MEN I is also known as Wermer syndrome .

MEN I is composed of : 3-Ps

-Pituitary adenoma .
-Parathyroid adenoma or hyperplasia .
-Pancreatic tumour .

#Surgery
Typical symptoms of Hypercalcaemia :

-Painful bones , abdominal groans , renal sones , and psychic moans .

#Medicine
APGAR score :

-Done at 1st minute after birth and then at 5 minutes intervals .

Consist of Newborn's ;

Heart rate ( None , less than a 100 or a 100 or more )

Respiratory EFFORT ( Absent , irregular or Gasping , regular and strong cry )

Muscle Tone / Activity ( flacid baby , some flexion of the limbs , Active and well flexed )

Reflex irritablity / Grimace ( response to nasal catheter ) : ( No response , Grimace, Cough or cry )

Baby's Color : ( blue or pale , pink body with acrocyanosis , pink allover )


8-10👉🏼 All good
7 or less 👉🏼 RESUSCITATE .


#Pediatrics
Cigarette Smoking is not always bad..!!

Smoking is protective or decrease incidence or severity of the following diseases ..

▪️Endometrial cancer.
▪️Endometrial hyperplasia.
▪️Endometriosis.
▪️Ovarian cancer.
▪️Ulcerative colitis.
▪️Pre-eclampsia and Eclampsia.
▪️Parkinson's disease.
▪️Sarcoidosis .
▪️Breast Cancer ( there's debate ).
▪️Uterine fibroids.
▪️Hashimoto's thyroiditis.

•However , the High risk of smoking outweighs the little benefit found only on statistical studies .

#Medicine
- Acute appendicitis in pregnancy is least common in the THIRD trimester .

#Surgery
-Nightstick fracture ( isolated ulnar shaft fracture ).

#Surgery
Montagia fracture dislocation:

-Fracture of the ulnar shaft with concomitant dislocation of the radial head .

#Surgery
•Remember that Philadelphia chromosome is 9:22 translocation .

•The presence of this chromosome indicate a good prognosis is CML ( chronic myeloid leukemia )

•However , if present in ALL .. it's a marker of poor prognosis ..


•Remember it as ( a CaMeL 🐪 is happy in Philadelphia's nice weather ).

#Medicine
-Huntington's disease is Movement , memory , and mood disease .

#Medicine
•Pituitary adenomas are the most common cause of panhypopituitarism; the mass compresses the gland, causing pressure, trauma, and necrosis.

#Medicine
-‘Klatskin tumour’

- It is cholangiocarcinoma at the confluence of the hepatic ducts and common hepatic duct above the level of the cystic duct (20% of cholangiocarcinomas).

-Klatskin tumour is classified as 4 types:

Type I 👉🏼Just at or below the confluence.

TypeII 👉🏼At the confluence.

TypeIII👉🏼 at the confluence extending along the RHD.

TypeIV👉🏼 at the confluence extending along the LHD.

-It causes obstructive jaundice with hydrohepatosis without enlargement of gallbladder.
-Management is like cholangiocarcinoma.


#Biliary
•Post renal failure ( uraemia ) is the most common cause of death in cervical cancer.

#Obs_Gyne
•Keep in mind that trivial mitral valve regurgitation is a normal finding in 70% of the population .

#Medicine
Apple core sign aka ( Eaten apple sign ) : cancer colon .

#Surgery
#Xray
Bird peak sign : Achalasia cardia .

#Surgery
#Xray
Triple bubble sign : Jejunal atresia.

#Surgery
#Xray
Double bubble sign : Duodenal atresia.

#Surgery
#Xray
Single bubble sign : Pyloric atresia.

#Surgery
#Xray
Abdominal X-ray signs :

1. Single bubble sign : pyloric atresia .

2. Double bubble sign : duodenal atresia .

3. Triple bubble sign : jejunal atresia .

4. Bird beak sign : esophageal achalasia .

5. Eaten apple sign ( apple core sign ) : cancer colon .


#Surgery
-Hypercalcemia is treated initially with hydration and loop diuretics and then with bisphosphonates , if all failed consider Dialysis .

#Medicine
What drugs should be avoided in heart failure?

1- Antiarrhythmic drugs
2- Non-dihydropyridine calcium antagonists, e.g. verapamil, diltiazem in patients with systolic chronic heart failure
3- Tricyclic antidepressants
4- Non-steroidal anti-inflammatory drugs (NSAIDs)
5- Cyclo-oxygenase 2 inhibitors
6- Corticosteroids
7- Doxorubicin and trastuzamab
8- Thiazolidinediones.

#Medicine