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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
Iron deficiency:
-Ferritin is the parameter of choice in diagnosing iron deficiency.

#Hematology
#Anemia
Leukemoid reaction

Definition

-Reactive leukocytosis: cell hyperplasia withproliferation of myeloid or lymphoid elements.

-Characterized by an increased leukocyte alkaline phosphatase (LAP) score

Causes:

-Infections (predominantly bacterial, e.g.,pertussis)

-Severe purulent conditions (e.g., perforated appendicitis)

Drugs:

-Associated with certain solid tumors (e.g., lung cancer, renal cancer)

#Hematology
Leukoerythroblastic reaction

Definition:
-The presence of immature and/or abnormal cells : e.g. nucleated red blood cells; in the peripheral blood

Causes:
Bone marrow infiltration or fibrosis (e.g.,myelofibrosis, bone marrow metastasis)

#Hematology
-Beta-blockers are effective in preventing cardiac events in approximately 70% of patients with long QT syndrome .

#Cardiology
Upper sternal border murmur:

AS vs PS murmur

-AS 👉🏼 decrease with standing and radiates to carotid artery . May be maximum at apex ( Gallaverdin sign).

-PS 👉🏼 maximum on pulmonary area and spread to left infraclavicular area .

#Cardiology
Secondary causes of Nephrotic Syndrome:

-SLE
-Rheumatoid arthritis
-Henoch-Schönlein purpura
-SCA
-Lymphoma
-Drugs
-NSAID
-Gold

#USMLE
#Renal