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

•What is Kussmaul’s sign?


-Normally there is an inspiratory decrease in JVP.
-In constrictive pericarditis, there is an inspiratory increase in JVP.
-Kussmaul’s sign is also seen in
severe right heart failure regardless of aetiology.
-It is caused by the inability of the heart to accept the increase in right ventricular volume without a marked increase in the filling pressure.

#Medicine

•What is the relation between thrombolysis and onset of symptoms in MI?

-Thrombolytic therapy reduces mortality and limits infarct size.
-The shorter the interval between the onset of symptoms and the initiation of thrombolysis, the greater is the survival.
-The greatest benefit occurs if the treatment is initiated within the first 3 h, when a 50% or greater reduction in mortality rate can be achieved.
-The magnitude of benefit declines rapidly thereafter, but a 10% mortality reduction can be achieved up to 12 h after the onset of pain.

#Medicine