■ مساء الخير يا شباب توضيح ليه بيحصل hyperglycemia with Chronic liver faliure
و ليه بيحصل hypoglycemia with acute liver faliure ؟

♤ أي سبب بيعمل CLF بغض عن النظر عمل injury or damage or inflammation موجود على liver cell surface ال insulin receptors لما يحصل damage لل liver يقل معها Number of insulin receptors on the surface of the liver فيحصل insulin resistence فيؤدي إلى elevation of gulcose ( hyperglycemia)

♤ بيحصل hypoglycemia with ALF بسبب sudden severe failure of glycogenolysis

■ Notes on GE :
https://t.me/med_Notes2/575

■ Notes on neonatal cholestasis :
https://t.me/med_Notes2/552

■ Notes on liver function tests :
https://t.me/med_Notes2/534
https://t.me/med_Notes2/579?single

■MCQ on liver function tests :
https://t.me/med_Notes2/517

■MCQ on neonatal cholestasis :
https://t.me/med_Notes2/560

■ Notes on HBV markers :

● HBsAg : it detects in the serum during Acute or chronic infection
♤ خلي بالك لو قعد أكثر من 6 شهور يعني دخل في chronic state or carrier state

● Anti-HBs :
يعني المريض حصله
   resloved infection ( recovery) or immunity ( natural or vaccine)

● HBcAg : only detected in the liver biopsy

● Anti-HBc  =
♤ its presence : بيدل على infection ممكن يكون acute or chronic
♤ بيدل برضو على أنه المريض حصله resolved infection ( recovery) أو
immunization ( natural only)

♤IgM = Acute infection
♤IgG =  chronic infection

● HBeAg = it detected in the serum during Acute or chronic infection

♤ its presence = highly infectivity ( high viral replication)

● Anti-HBe :
♤ its presence  = low infectivity ( low viral repilcation ) 
♤ بيدل على انه المريض حصله
Resloved infection ( recovery ) or immunity ( only natural )

● PCR ( HBV DNA ) = it is the most sensitive index of viral replication

■ compare between post-tonsillectomy hge جدول مهم

■ توقعات امتحان GIT :-

● الباطنة :
1- Types & common causes of gastritis
2- symptoms ( grades) of HE

● الأطفال :
1_ C/P & investigation of wilson disease or C/P & investigation of AIH

2_ complications of gastroenteritis ( Acute diarrhea ) or
enumerate causes of Acute diarrhea & pathogenesis of bacterial diarrhea

● الجراحة :
1- pathology & C/P & ttt of 1ry malignant liver tumors or C/P & ttt of Amebic liver abscess

2- pathology & C/P & ttt of pleomorphic adenoma

3- C/P & investigation of chronic cholecystitis

4- C/P & investigation of calcular OJ or compare between calcular & malignant OJ

● ENT :

1- Causes & ttt & C/P of velopharyngeal incompetence or snoring & sleep apnea
Or
2- C/P & ttt & investigation of nasopharyngeal fibroma
Or
3- C/P & investigation& ttt of quinzy ( peritonsillar abscess)
Or
4- compare between post tonsillectomy hge

يا شباب سؤال symptoms of HE هتكتب من grade 0 لحد grade 4
ممكن يقول السؤال بطريقة تانية يكون عاوز west haven criteria of HE هتكتب من covert HE لحد grade 4