•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

•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

•Mention some causes of elevated troponin not the result of acute coronary syndrome:

-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

-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

•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

•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

•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

•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

•Which condition has the most common association with hypertrophic cardiomyopathy?

-Friedreich’s ataxia.

#Medicine

•What is the most characteristic pathophysiological abnormality in hypertrophic cardiomyopathy?

-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

•What is Fallot’s triology?

-ASD, pulmonary stenosis and right ventricular enlargement.

#Medicine

•What is Lutembacher syndrome?

-ASD with an acquired rheumatic mitral stenosis.

#Medicine

•How would you treat a patient suspected to have endocarditis?


-Until the bacteriology results are available, with intravenous benzylpenicillin and gentamicin.

#Medicine

•Mnemonic to remember Duke’s criteria for bacterial endocarditis,

BE FEVER:

Major:
B, blood culture positive at least twice, 12 h part
E, endocardial involvement from echocardiogram.
Minor:
F, fever
E, evidence from microbiology
V, vascular findings
E, evidence from immunology
R, risk factors/predisposing factors, e.g.drug abuse, valvular diseases.

#Medicine

•Compartment syndrome :

-When an injured muscle swells within a closed compartment bounded by inelastic fascia .
-Venous flow blocked 1st further increasing the edema and the pressure within the affected compartment eventually compromising the arterial supply as well .
-If this pressure is not urgently relieved, the muscles will die and is then replaced by fibrous tissue producing Volkmann's ischemic contracture as this patient in the photo due to too tight plaster .

#Surgery

•Dinner fork deformity in Colle's fracture:

-It usually occurs in old female with osteoporosis falling on outstretched hands and hyper extended wrist .

#Surgery

Autoimmune diseases that may cause Cancer:

1-Celiac disease →Gastric carcinoma or lymphoma.
2-Hashimoto's thyroiditis →Lymphoma.
3-Sjogren syndrome →NHL.
4-Pernicious anemia →MALT.

#Medicine

Physiological gastric secretions:


1•Parietal cells:

-Secrete hydrochloric acid (HCl) and intrinsic factor.
-Stimulated by acetylcholine, histamine, and gastrin.
-Inhibited by prostaglandins and somatostatin.

2•Mucosal cells:

-Secrete protective mucus
-Stimulated by acetylcholine, prostaglandins(whic inhibit HCl secretion), and secretin.

3•Chief cells:
-Secrete pepsinogen
-Stimulated by acetylcholine, gastrin, secretin, and vasoactive intestinal polypeptide (VIP).

#Medicine

•Erosions are more superficial than ulcers.

•Ulcers involve damage to the gastric mucosa extending beyond the muscularis mucosa layer into the submucosa.

#Medicine