■ Notes on IBD :-
● UC :
♤ the disease starts distally in Rectum then spreads proximally

♤ Bleeding per rectum is the most important feature

♤ perforation is the most dangerous of the local complications

♤ Increase risk of cancer colon more than CD

♤ somking is a protective for UC

♤  decrease of Albumin is due to poor nutrition & PLE & -ve ARP

♤ fecal lactoferrin is a highly sensitive & specific marker for detecting intestinal inflammation

♤ colonoscopy is the most important investigation is used to assess disease extent & activity

♤ barium enema :
lead pipe appearance ( loss of haustration + narrowing the lumen)
PseudoPolyp

♤ 5-ASA Agents is the mainstay of ttt in mild to moderate UC

♤GCs is used in acute flares only not in remission manitenance ( moderate to severe UC)

♤ metronidazole & ciprofloxacin is the most commonly used

مقارنة بين UC & CD مهمة

■ Notes on CD :-

♤ terminal ileum & right colon ( ileocolonic) are most commonly involved

♤ cobblestone appearance is the characteristic of CD

♤ pain  & tenderness in right iliac fosaa = acute appendicitis is relieved by defecation

♤ Malabsorption syndrome is more common with CD ( decrease in Na & mg & ca & albumin& fat soluble vitamins )

♤ it lead to intestinal obsdruction & fisula formation

♤ Colonoscopy is the most important investigation

♤ barium enema : severe narrowing of the lumen ( string sign )

♤ AZA as maintenace therapy in UC & CD & treating active perineal disease & fistula in CD

♤ Ciprofloxacin & metronidazole are effective in peri anal CD

♤ Avoid antidiarrheal durgs in toxic megacolon lead to precipitate toxic megacolon with colonic inflammation 

■ Notes on pharynx ( Part 1)  :-

♤ the routine investigation to diagnose adenoids are plain x-ray on nasopharynx

♤ the commonest cause of death in diphtheria is airway obstruction d.t pseudomembrane

♤ pulse in diphethria :not conicides with temperature

♤ the most imporatnt item in ttt post tonsillectomy 2ry Hge is Antibiotics

♤ during tonsillectomy the neck must be extended

♤ the cause of 2ry hge after tonsillectomy is due to infection of tonsillar bed

♤ tonsillectomy is absolutely  CI  in case of hemophilia & purpura & heart & kidney diseases

♤ during adenoidectomy the neck must be flexed to avoid injury of prevertebral ms

♤ in plummer vinson s : dysphagia is more for solids then fluids

♤  quinsy is ch.ch by deviation of uvula to opposite side & trismus & drooling of saliva

♤ trismus in qunisy is due to spasm of medial pterygoid ms

♤ the most dangerous organism causing acute follicular tonsillitis is beta hemolytic streptoccus

♤  Trotter's triad is ch.ch by unilateral ( facial pain , conductive deafness , palatal immobility )

♤ Nasophayngeal carcinoma don't affect on the facial nerve

♤ the most common presentation for nasopharyngeal cancer is neck mass

♤ peritonsillar & parapharyngeal & retropharyngeal & submandibular spaces are the site of abscess formation in the head & neck

■  Notes of Pharynx (Part 2 ) :

♤ Acute retropharyngeal abscess is treated by internal drainage via longitudinal inscision

♤  the swelling in Acute retropharyngeal abscess in one side of the midline of the pharynx

♤ the commonest site of quinsy is superior to tonsils


♤  While chronic retropharyngeal abscess is ttt by External drainage posterior to sternomastoid ms

♤  Frog face appearnce is a clinical manifestation of nasopharyneal fibroma

♤ Ludwig angina is a cellulitis of floor of mouth



♤  Pain in the ear in cases of acute tonsillitis referred via 9th nerve


♤ Vincet's angina is ch.ch by very severe local symptoms & mild systemic symptoms

♤ low grade fever &  feeble  very rapid pulse & bull neck are known to occur in tonsillar diphtheria 

■ Notes on Phaynx :

● Part 1 :

https://t.me/med_Notes2/366

● Part 2 :

https://t.me/med_Notes2/368

■ Notes on GIT internal medicine :

● IBD :

○ MCQ on IBD :
https://t.me/med_Notes2/353

○ UC :
https://t.me/med_Notes2/348

○ CD :
https://t.me/med_Notes2/351

● PUD :
https://t.me/med_Notes2/335