•What are the commonest causes of PUO?

-Tuberculosis, collagen disease (e.g. SLE), malignancy (e.g. lymphoma, renal cell carcinoma).

#Medicine
#Infection

•Types of PUO:

1-Calssic
2-Nosocomial
3-Neutropenic "immune deficient"
4-HIV-associated.

#Medicine
#Infection

•What are the causes of good appetite
but loss of weight?

1-Diabetes mellitus.
2-Thyrotoxicosis.
3-Kala-azar.
4-Sometimes in malabsorption syndrome.

#Medicine
#Metabolic

•Endoscopic grading of GERD :

G1: Hyperaemic mucosa.
G2: superficial ulceration of mucosa only.
G3:deep ulceration.
G4: stricture or Barrett's esophagus.

#Medicine
#Esophagus

▫️The most common cause of bleeding in females before puberty is a foreign body.

▫️The most common cause of bleeding in females during adolescence is pregnancy complications.

▫️The most common cause of bleeding in females after menopause is atrophic vaginitis.

#Obs_Gyne

•Rifaximin:

-It is a broad-spectrum, nonabsorbable oral antibiotic.
-Reduces the number of ammonia-producing intestinal bacteria.
-May be added to lactulose if a second episode occurs to prevent recurrent episodes of hepatic encephalopathy.

زمان كانوا يستخدموا Neomycin.

#Medicine

Pericardium:

-The normal pericardial sac contains about 50 mL of fluid, similar to lymph, which lubricates the surface of the heart.

-The pericardium limits distention of the heart, contributes to the haemodynamic interdependence of the ventricles, and acts as a barrier to infection.

-Nevertheless, congenital absence of the pericardium does not result in significant clinical or functional limitations.

#Medicine

Causes of Microcytic anemia

TAILS

T- Thalassemia
A- Anemia of chronic disease
I -Iron deficiency anemia
L- Lead poisoning
S- Sideroblastic anemia.

#Medicine

•Acute management of asthma attack

O SHIT 😱
O= oxygen
S= salbutamol
H= hydrocortisone
I= ipratropium
T= theophylline" rare ".

#Medicine

🔘 Common tumor markers :

▪️Breast cancer CA 15-3
▪️Ovarian cancer CA 125
▪️Pancreatic cancer CA 19-9
▪️Colorectal cancer CEA
▪️Prostatic cancer PSA
▪️Hepatocellular carcinoma AFP
▪️Teratoma AFP
▪️Testicular seminoma LDH

•Achalasia

-Achalasia is caused by degeneration of the myenteric plexus with loss of the normal inhibitory neural structure of the lower esophageal sphincter (LES).

-There is failure of the LES to relax and decreased peristalsis.
-The LES is usually contracted to prevent the acidic gastric contents from refluxing backward into the esophagus.

-The vast majority of cases are of unknown etiology. A very small number can be from Chagas disease, gastric carcinoma, or a disease that can infiltrate into the area such as lymphoma.

#Medicine

-Barium esophagography is very accurate and shows dilation of the esophagus, which narrows into a “bird’s beak” at the distal end.

-The most accurate test overall (gold standard) is esophageal manometry, which shows increased lower esophageal (LES) resting pressure and absence of peristalsis.

-Diagnostic evaluation should be done in the following order:

1. Barium swallow
2. Esophageal manometry (must be done to confirm diagnosis)
3. Upper endoscopy (to rule out adenocarcinoma [pseudoachalasia]).

#Medicine

•Achalasia treatment :

-The BEST initial therapy is pneumatic dilation or laparoscopic surgical myotomy.

-Pneumatic dilation effective in 80–85% of patients, with 3–5% risk of perforation.

-Botulinum toxin injections into the LES is second-line treatment, to relieve symptoms for 6 months; also used for patients who are poor surgical candidates, e.g., the elderly with multiple comorbid conditions.

-Calcium channel blockers and nitrates are third-line treatment.

#Medicine

•Causes of CARPAL tunnel syndrome

Colles fracture
Amyloidosis
Rheumatoid arthritis
Pregnancy
Acromegaly
Low thyroid hormone (hypothyroidism).

#Surgery
#Medicine

Amiodarone's side effects:
P's
Prolonged QT
Photosensitivity
Pigmentation
Peripheral neuropathy
Pulmonary fibrosis
Peripheral conversion of T4 to T3 is inhibited.

#Medicine

Treatment of SVT:
ABCDE
-Adenosine
-Beta Blockers
-Calcium channel blockers
-Digoxin
-Excitation (vagal stimulation).

#Medicine

These drugs Do Block AV:
-Digoxin
-Beta blockers
-Adenosine
-Verapamil.

#Medicine

Beck's triad for cardiac tamponade:

3 D's
Distant heart sounds
Distended jugular veins
Deceased arterial pressure.


#Medicine

ACE-I side effects (CAPTOPRIL):

Cough
Angioedema
Potassium elevation
Taste abnormality
Oligohydramnios
Positive ketone
Renal Insufficiency"rash"
Leukopenia.

#Medicine

Remember:

NSAIDs contraindications:

Nursing and pregnancy
Serious bleeding
Allergy/ Asthma/ Angioedema
Impaired renal function
Drug (anticoagulant).

#Medicine

•Treatment of Neuroleptic Malignant Syndrome:

ABCDE

Amantadine
Bromocriptine, Benzodiazepines
Carbidopa/levodopa
Dantrolene
Electroconvulsive Therapy.

#Medicine