Signs of lung disease.

#Respiratory

Complications of OSA:

1-Systemic hypertension
2-Arrhythmia (e.g., (atrial fibrillation, atrial flutter)
3-Pulmonary hypertension and cor pulmonale
4-Cardiac infarction, stroke, and sudden cardiac death (the risk of sudden death is high in infants and the elderly)
5-Polycythemia
6-Risk of accidents
7-Poor sleep leads to increased appetite and obesity.

#Respiratory

Remember:

Causes of mononeuritis multiplex include - Vasculitis - Diabetes - Sarcoidosis - paraneosplastic syndrome - amyloidosis.

#Neurology

-Cardiac rhabdomyomas are by far the most common primary cardiac tumor in childhood.

#Cardiology

Clinical Clues:

🔴Erythema nodosum -group A streptococcus
🔴Erythema marginatum - acute rheumatic fever.
🔴Erythema migrans (bull eye) - lyme disease
🔴Erythema toxicum - newborn pustules.
🔴Erythema multiforme -viral infections & drugs..
🔴Erythema infectiosum - fifth disease
🔴Erythema ab igne - long term exposure to heat
🔴Erythema induratum -cutaneous tuberculosis.

#General

Remember:

HbA1c is unreliable in CKD for glycemic control.
Why?
- falsely low
Because shortened RBC life span in CKD- more immature red cells- less time for glycation

So Glycated albumin/ fructosamine unaffected by anemia, each 3 weeks.

#Renal

-Third-degree (complete) AV block will have cannon A waves.
-They are the best way to distinguish third-degree AV block from sinus bradycardia before you obtain an EKG.

#Cardiology

-Sinus bradycardia is very common in association with MI because of vascular insufficiency of the sinoatrial (SA) node.

-USMLE
#Cardiology

-A systolic blood pressure goal of 140 mm Hg is probably appropriate for acute hemorrhagic stroke.

#Neurology

What are the discharge criteria of COPD patient?

-The patient should be clinically stable and no parenteral therapy for 24 hours
-Inhaled bronchodilators are required less than 4 hourly
-Oxygen delivery has ceased for 24 hours
-The patient is able to eat and sleep without significant episodes of dyspnea
-The patient or caretaker understands and is able to administer medications
-Follow up and home care arrangements (As for example home oxygen, home care, Meals on Wheels, community nurse, allied health, GP, specialist) have been completed
-The patient is ambulating safely and independently, and performing activities of daily living.

#Respiratory

-Pneumonia is the eighth leading cause of death, and the number 1 cause of death from infectious disease, in the United States. 

-Globally, pneumonia is the leading cause of death in children under 5 years old.

#Respiratory

-The classic etiologic agents of atypical pneumonia are Legionella species, Mycoplasma pneumoniae, and Chlamydia pneumoniae.

-Many other diseases, caused by various pathogens, should be considered in the differential diagnosis. Such etiologic agents include fungi, mycobacteria, parasites, and viruses (eg, influenza virus, adenovirus, respiratory syncytial virus, human parainfluenza virus, measles, varicella zoster, Hantavirus)

#Respiratory

Interpretation of thyroid function tests.

#Thyroid

Remember:

-Primaquine is contraindicated in pregnant women,
infants and known G6PD deficient patients.

-Primaquine can lead to hemolysis in G6PD deficiency.

#Infections

It is recommended to delay elective non-cardiac surgery until
- 6 months after elective PCI and
- 12 months after an ACS.

#Cardiology

Remember:

The three commonest causes of persistent dry cough with a normal chest X-ray are:
1-Asthma (50 ٪),
2-Sinusitis
3-Postnasal drip (25 ٪)
4-Reflux oesophagitis (20٪).

-Asthma may present as a cough (cough-variant asthma) with little or no airflow obstruction initially, although this develops later.

#Respiratory

Serum procalcitonin (PCT):

-Procalcitonin is an acute phase reactant that can help to diagnose bacterial lower respiratory tract infections. It is increased.

-Low PCT level after 2–3 days of antibiotic therapy can help facilitate the decision to discontinue antibiotics in treatment of Pneumonia.

#Respiratory

Asthma

-Chest x-ray is most often normal in asthma, but may show hyperinflation.


-The best initial test in an acute exacerbation is peak expiratory flow (PEF) or arterial blood gas (ABG).

Peak flow can be used by the patient to determine function.

#Respiratory

-REMEMBER:

•Causes of HTN with hypokalemia include:

1-Conn's syndrome
2-Cushing syndrome
3-liddel's syndrome
4-11 beta hydroxylaze enz. defeciency
5-Renal artery stenosis.

#Cardiology

Remember:

-Drug of choice for pt suffering of gout and hypertension is Losartan.

Because it increase the excretion of uric acid by kidney.

-Drug of choice for pt suffering of gout and hyperlipidemia is fenofibrate.

Uricosuric action increase renal excretion uric acid.

#Cardiology