-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

-Depressed ankle reflex with extensor plantar response :

• Peripheral neuropathy + stroke
• Peripheral neuropathy + cervical myelopathy
• Cervical & lumbar spondylosis
• SCD of cord
• Motor neuron disease
• Syphilitic tabes dorsalis
• Friedrich ataxia
• Lesion of conus medullaris

#Neurology

-Anterior STEMI Vs RV infraction:

How to differentiate between Anterior STEMI and isolated RV infarction (as both can shows ST elevation from V1-V3)?
-In patients with anterior left ventricular infarction, ST segment elevation is the lowest in lead V1, increasing in amplitude toward lead V5.
On the other hand, patients with an occluded RCA and RV infarction display the greatest amplitude of ST segment elevation in lead V1, which progressively decreases toward lead V5.

#Cardiology