The Clasical traid of pheocromocytoma:

-Severe paroxysmal headaches,
-Diaphoresis (sweating), and
-Palpitations.

#Medicine
#Endocrine

-Glucagon is the main antidote in patients with beta blocker overdose with significant hypotension and bradycardia.

4-10 mg bolus then 2-5 mg / hour iv infusion.


#Medicine
#Cardiology

-Bicuspide aortic valve is the most common congenital cardiac anomaly in turner's syndrome 16%.


#Cardiology

-ACE-inhibitors and beta-blockers have NO effect on mortality in heart failure with preserved ejection fraction.

#Cardiology

Cough (acute): antimicrobial prescribing.

#Respiratory

-Avoid co-administering RAAS inhibitors and NSAIDs in patients with reduced renal perfusion (e.g., in congestive heart failure, renal artery stenosis) because doing so can significantly decrease their GFR.

#Nephrology

-AKI management is primarily supportive. Currently, there are no specific pharmacotherapies for AKI.

#Nephrology

Howship-Romberg Sign

◼️Pain radiating down the medial thigh to the knee due to
compression of obturator nerve (anterior division) by the hernial sac.

◼️Charactaristic of an incarcerated hernia.

◼️Present in 25-50% cases.

#Hernia

-On a native valve ,the most common organisms causing infective endocarditis is Streptococcus viridanse.

#Cardiology

Some findings give important clues to the chronicity of disease:

Examples:

♥️ LVH on ECG suggests HTN has been longstanding.

🫘 A thin, echogenic renal cortex on US suggests CKD rather than AKI.

🩸Anemia w/ low MCHC suggests longstanding Fe deficiency.

#Medicine

Main treatment of:

-Good pasture syndrome👉🏼Plasmapheresis.

-Churgstrauss or Wegner granulomatosis or PAN👉🏼 High dose steroids and cyclophosphamide .

-Minimal change disease👉🏼 Oral steroids.

-Scleroderma or diabetic associated nephropathy ( to slow progression )👉🏼ACEI .

#Medicine

-Presence of Anti-SSA/Ro in pregnant women with SLE is associated with an increased risk of [congenital heart block in the fetus].


#Rheumatology

Remember:

-In prosthetic valves Staphylococcus aureus & Staphylococcus Epidermidis are the most common causes of endocarditis. But MRS are rare causes.

#Cardiology

-Gastric linitis plastica is a diffuse type of cancer (3-19%of adenoca)in which the cells invade throughout the stomach, resulting in the thickening and rigidity of the stomach wall.

#Stomach
#GIT

•EBV associated malignancies :

-Burkitt ' lymphoma
-Hodgkin's lymphoma
-Nasopharyngeal carcinoma.

#Infections

-Primary hypoadrenalism is diagnosed by a short synacthen test and a failure to increase cortisol levels to above 500nmol/L.

#Endocrine

•Addison's disease:

-Investigations:

-Plasma cortisol is measured before and 30 minutes after giving Synacthen 250ug IM.

-Adrenal autoantibodies such as anti-21-hydroxylase may also be demonstrated.

#Endocrine

Remember these numbers:

•Possibility of Viral transmission by (needle stick/injury):

Hepatitis B = 0.3%
Hepatitis C = 0.03%
HIV = 0.003%

Common Questions in USMLE

#Liver

-Coxsackievirus is the most common identified cause of both pericarditis and myocarditis.

#Cardiology

•Uses of diuretics during CKD :

- Stages 1&2 = Thiazides.
- Stage 3 eGFR<60 = Thiazides or loop diuretics (Ex. furosemide)
- Stage 4 eGFR<30 = loop diuretics or combination therapy.
- Stage 5 eGFR <15 = loop diuretics or combination therapy.

#Nephrology

•Diabetic cardiomypathy:

-It is the structural, functional & metabolic changes that occur in cardiac muscles in noncontrolled diabetes patients in the absence of other comorbidities like CAD, hypertension leading to acute, acute, LV systolic dysfunction.

#Cardiology