•Acute management of asthma attack
O SHIT 😱
O= oxygen
S= salbutamol
H= hydrocortisone
I= ipratropium
T= theophylline" rare ".
#Medicine
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
▪️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
-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
-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
-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
Amiodarone's side effects:
P's
Prolonged QT
Photosensitivity
Pigmentation
Peripheral neuropathy
Pulmonary fibrosis
Peripheral conversion of T4 to T3 is inhibited.
#Medicine
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
ABCDE
-Adenosine
-Beta Blockers
-Calcium channel blockers
-Digoxin
-Excitation (vagal stimulation).
#Medicine
Beck's triad for cardiac tamponade:
3 D's
Distant heart sounds
Distended jugular veins
Deceased arterial pressure.
#Medicine
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
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
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
ABCDE
Amantadine
Bromocriptine, Benzodiazepines
Carbidopa/levodopa
Dantrolene
Electroconvulsive Therapy.
#Medicine
•Henoch-Schonlein purpura Features:
"PAAN"
Purpura
Abdominal pain
Arthritis
Nephritis
#Medicine
#Pediatrics
"PAAN"
Purpura
Abdominal pain
Arthritis
Nephritis
#Medicine
#Pediatrics
•Frequent causes of haemolytic neonatal jaundice at 24 hours of age:
RAGS
-Rhesus incompatibility
-ABO incompatibility
-G6PD deficiency
-Spherocytosis.
#Pediatrics
RAGS
-Rhesus incompatibility
-ABO incompatibility
-G6PD deficiency
-Spherocytosis.
#Pediatrics
Most Important Tests of Synovial Fluid:
(3 C's)
-Culture and gram stain
-Cell count and differential
-Crystal examination (protein, LDH, glucose less helpful)
#Medicine
(3 C's)
-Culture and gram stain
-Cell count and differential
-Crystal examination (protein, LDH, glucose less helpful)
#Medicine
Day of appearance of rash in a febrile patient:
“Very Sick Person Must Take Double Tablets”
Very – Varicella (day 1
Sick – Scarlet fever (day 2
Person –Small pox (day 3
Must – Measles (day 4
Take – Typhus (day 5
Double – Dengue (day 6
Tablets – Typhoid (day 7.
#Medicine
“Very Sick Person Must Take Double Tablets”
Very – Varicella (day 1
Sick – Scarlet fever (day 2
Person –Small pox (day 3
Must – Measles (day 4
Take – Typhus (day 5
Double – Dengue (day 6
Tablets – Typhoid (day 7.
#Medicine
Respiratory depression inducing drugs
"STOP"
-Sedatives and hypnotics
-Trimethoprim
-Opiates
-Polymyxins.
#Medicine
"STOP"
-Sedatives and hypnotics
-Trimethoprim
-Opiates
-Polymyxins.
#Medicine