•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
-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
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
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
-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
-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
-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
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
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
#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
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
Hyperthyroidism treatment in pregnancy:
-Propylthiouracil in 1st trimester,
methimazole in 2nd &3rd trimesters.
#Thyroid
-Propylthiouracil in 1st trimester,
methimazole in 2nd &3rd trimesters.
#Thyroid
Remember:
-The most common ECG abnormality in patient of pulmonary embolism is
ST-segement, T wave changes 49%, Sinus tachycardia 44%.
#Cardiology
-The most common ECG abnormality in patient of pulmonary embolism is
ST-segement, T wave changes 49%, Sinus tachycardia 44%.
#Cardiology
-A pleural fluid N-terminal pro-brain natriuretic peptide (NT-proBNP) >1500 pg/mL is highly suggestive of an effusion related to congestive heart failure.
#Respiratory
#Respiratory
Schematic representation of normal sinus rhythm showing standard wave, segments, and intervals
Normal sinus rhythm (NSR) is defined as the rhythm of a healthy heart. It means the electrical pulse from the sinus node is being properly transmitted throughout the heart muscle.
#Cardiology
Normal sinus rhythm (NSR) is defined as the rhythm of a healthy heart. It means the electrical pulse from the sinus node is being properly transmitted throughout the heart muscle.
#Cardiology