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In Breast imaging

Mammography :

-It's a soft tissue radiograph taken by placing the breast in direct contact with ultra ultrasensitive film and exposing it to Low-voltage High amperage X-ray.

-The dose of radiation is Low so it's considered very safe Investigation.

The sensitivity of mammography Increases with increased age ( less dense breast tissue ) .

-5% of breast cancer's are missed on mammographic screening programs even retrospectively.

#Breast


-The use of isotope scanning is routinely Indicated when nodularity is associated with toxicity.

#Thyroid
The risk of a discrete of isolated thyroid malignancy in a Male is 4 folds that of a female.

That's why it's forbidden for a male to have isolated thyroid swelling.

#Thyroid
-All patients with GBS should be given subcutaneous fractionated or unfractionated heparin and support stockings until they are able to walk independently to prevent deep vein thrombosis.

#Neurology
-Botulinum toxin is so potent that you need only a taste of contaminated food to kill you .. as little as 0.05 micrograms would kill you.

-But How it does that ?
Well , it does so by irreversibly binding and sticking to your cholinergic nerve terminals , no Acetylcholine would be released , you will be paralysed from Up downwards " descending paralysis " eventually reaching the muscles responsible for your respiration leading to death from respiratory failure all that and the toxin only acts peripherally as it Doesn't cross the Blood Brain Barrier.

#Infections
Remember:

-Most lethal bacterial toxin in the world is Botulinum toxin.

-The second most lethal bacterial toxin in the world is Tetanoplasmin toxin.

#Infections
In case of Aortic stenosis:

-Milder degrees of stenosis may be difficult to distinguish from aortic sclerosis, in which the valve is thickened or calcified but not obstructed.

-Patients with impaired left ventricular function, velocities across the aortic valve may be diminished because of a reduced stroke volume; this is called low-flow aortic stenosis.

#Cardiology
Remember:

-Most common cause of painless hematuria in male above 50 yrs is transitional cell carcinoma of bladder.
Intrauterine Infections: Causes《Cataract》In Newborns:
-Rubella
-Herpes simplex
-Varicella
-Toxoplasmosis
-Syphilis

#USMLE
#Pediatrics
Hypothyroidisim causes diastolic HTN secondary to hyperchlostrolaemia&
Mps deposition with vesseles stifness
Hyperthyroidisim causes systolic HTN due to sympathetic over activity
Why do patients with Rheumatoid arthritis develop exudative pleural effusions with low glucose?

-Due to Glucose consumption by inflammatory cells: Inflammatory cells that accumulate in the pleural space often consume glucose as a source of energy. This increased glucose consumption by the inflammatory cells can lead to a decrease in glucose levels within the pleural fluid.

#Rheumatology
A lower left sternal border systolic murmur:

VSD vs TR vs HOCM

-TR 👉🏼intensity increases with inspiration ( Carvallo sign ) and there would be systolic neck vein expansion .

-HOCM 👉🏼 Intensity increases with standing or Valsalva and associated with double apical beat and bified carotid pulse .

-VSD 👉🏼Harsh pan systolic murmur with possible hyperdynamic apex , accentuated S2 ,and right ventricular heave.

#Cardiology
Neurological findings in B12 deficiency

1-Peripheral nerves:
• Glove and stocking paraesthesiae
• Loss of ankle reflexes

2-Spinal cord:
Subacute combined degeneration of the cord:
Posterior columns –diminished vibration sensation and proprioception
Corticospinal tracts – upper motor neuron signs

3-Cerebrum:
• Dementia
• Optic atrophy

4-Autonomic neuropathy.

#Hematology
#Anemia
Note:

-Increased ferritin does not rule out iron deficiencyanemia. It can be increased in response to simultaneous inflammation.

#Hematology
#Anemia
Remember:

-In combination with an elevated TIBC, low ferritinand iron levels are diagnostic of iron deficiency anemia.

#Hematology
#Anemia