•Montagia fracture dislocation:
-Fracture of the ulnar shaft with concomitant dislocation of the radial head .
#Surgery
-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
•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
•Pituitary adenomas are the most common cause of panhypopituitarism; the mass compresses the gland, causing pressure, trauma, and necrosis.
#Medicine
#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
- 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
•Keep in mind that trivial mitral valve regurgitation is a normal finding in 70% of the population .
#Medicine
#Medicine
•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
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
#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
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
-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
-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
•The Global Registry for Acute Coronary Events (GRACE) system:
-This is a risk score for prediction of death and myocardial infarction that incorporates renal dysfunction.
#Medicine
-This is a risk score for prediction of death and myocardial infarction that incorporates renal dysfunction.
#Medicine
•Killip (or Killip–Kimball) classification:
-The Killip classification is used to. characterize heart failure following MI:
Killip I: absent third heart sound and absence of crackles.
Killip II: third heart sound or crackles in <50% of lung fields.
Killip III: crackles in greater than 50% of lung fields.
Killip IV: cardiogenic shock.
#Medicine
-The Killip classification is used to. characterize heart failure following MI:
Killip I: absent third heart sound and absence of crackles.
Killip II: third heart sound or crackles in <50% of lung fields.
Killip III: crackles in greater than 50% of lung fields.
Killip IV: cardiogenic shock.
#Medicine
•Mention some causes of elevated troponin not the result of acute coronary syndrome:
-Myocarditis
-Heart failure
-Thromboembolism.
#Medicine
-Myocarditis
-Heart failure
-Thromboembolism.
#Medicine
•What is Levine’s sign?
-In acute myocardial infarction the patient often describes the pain by
illustrating a clenched fist.
#Medicine
-In acute myocardial infarction the patient often describes the pain by
illustrating a clenched fist.
#Medicine