•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
-About 90% of gallbladder cancers are accompanied with biliary stones , this is due to the fact that stones are very commonly associated rather than that they are a direct cause of the malignancy .
#Surgery
#Surgery
•What are the causes of absent radial pulse?
1-Aberrant radial artery or congenital anomaly (check the brachials and
BP)
2-Tied off at surgery or previous surgical cut-down
3-Catheterization of the brachial artery with poor technique
4-Following a radial artery line for monitoring of blood gases or arterial pressure
5-Subclavian artery stenosis
6-Blalock–Taussig shunt on that side (shunt from subclavian to pulmonary artery)
7-Embolism into the radial artery (usually caused by atrial fibrillation)
8-Takayasu’s arteritis (rare).
#Medicine
1-Aberrant radial artery or congenital anomaly (check the brachials and
BP)
2-Tied off at surgery or previous surgical cut-down
3-Catheterization of the brachial artery with poor technique
4-Following a radial artery line for monitoring of blood gases or arterial pressure
5-Subclavian artery stenosis
6-Blalock–Taussig shunt on that side (shunt from subclavian to pulmonary artery)
7-Embolism into the radial artery (usually caused by atrial fibrillation)
8-Takayasu’s arteritis (rare).
#Medicine
•What do you understand by a Blalock–Taussig shunt?
-It is the anastomosis of the left subclavian artery to the left pulmonary artery with the intention to increase pulmonary blood flow.
#Medicine
-It is the anastomosis of the left subclavian artery to the left pulmonary artery with the intention to increase pulmonary blood flow.
#Medicine
•What is the age of onset of Eisenmenger syndrome?
-In the case of PDA and VSD, about 80% occur in infancy, whereas in the case of ASD over 90% occur in adult life.
#Medicine
-In the case of PDA and VSD, about 80% occur in infancy, whereas in the case of ASD over 90% occur in adult life.
#Medicine
•At what age does COA case manifest?
-It is particularly likely to produce significant symptoms in early infancy (presenting as cardiac failure) or between the ages of 20 and 30 years.
#Medicine
-It is particularly likely to produce significant symptoms in early infancy (presenting as cardiac failure) or between the ages of 20 and 30 years.
#Medicine
•Which condition has the most common association with hypertrophic cardiomyopathy?
-Friedreich’s ataxia.
#Medicine
-Friedreich’s ataxia.
#Medicine
•What is the most characteristic pathophysiological abnormality in hypertrophic cardiomyopathy?
-Diastolic dysfunction.
#Medicine
-Diastolic dysfunction.
#Medicine
•Is the loudness of the murmur related to the size of the defect?
-No; in fact, very small defects cause loud murmurs.
#Medicine
-No; in fact, very small defects cause loud murmurs.
#Medicine