-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

•Example of drugs cause peripheral neuropathy :

VIA

- Vincristine
- Isoniazid
- Amiodarone.

#Medicine

•Henoch-Schonlein purpura Features:

"PAAN"

Purpura
Abdominal pain
Arthritis
Nephritis

#Medicine
#Pediatrics

Monoarthritis: causes

"GHOST"

-Gout
-Hemarthroses
-Osteoarthritis
-Sepsis
-Trauma.

#Medicine

•Frequent causes of haemolytic neonatal jaundice at 24 hours of age:

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

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

Respiratory depression inducing drugs

"STOP"

-Sedatives and hypnotics
-Trimethoprim
-Opiates
-Polymyxins.

#Medicine

Antinuclear Antibody +ve:
4 S

-SLE
-Systemic sclerosis
-Sjorgen syndrome
-Sometimes normal

#Medicine

Difficult intubation:

L E M O N

-Look externally
-Evaluate 3-3-2 rule
-Mallampati score
-Obstruction
-Neck Mobility.


#Medicine

Varicose vein : symptoms

AEIOU

-Aching
-Eczema
-Itching
-Oedema
-Ulceration (LDS, hemosiderin, varicosities)

#Medicine

Causes of chronic constipation


🇺🇸👤JOE BIDEN 🏛


🗳Juvenile eating disorder(anorexia nervosa)
🗳Other(pregnancy, systemic sclerosis, myotonic dystrophy)
🗳Environmental and dietary(low fiber diet, immobility,...)

🗳Bowel obstructing lesions
🗳Irritable bowel syndrome, Idiopathic chronic constipation
🗳Drugs(Aluminum,Opiates,
...), Dyssynergic defecation
🗳Endocrine and metabolic (hypothyroidism,hypokalemia,hypercalcemia)
🗳Neurogenic disorders(Multiple sclerosis, Hirschsprung disease,...)


#Medicine