He is the first son of a G2P2A0 mother a product of emergent CS due fetal bradycardia, his mother has no chronic illnesses, and he had born as a term without NICU admission. His vaccination status is negative except for the BCG vaccine. He has normal developmental milestone in all four domains
His past medical history was unremarkable until the age of 7 months, when he developed frequent watery bowel motions, vomiting, fever, and dehydration, labeled as gastroenteritis, hospitalized for 17 days. Following discharge, he remained well for a few days before developing cracked lips, a napkin rash, fever, and another episode of gastroenteritis, necessitating a second hospitalization for 10 days. During this admission, he was started on zinc sulfate syrup 30 mg twice daily, to which he responded well, with improvement in his lesions.
One month later, he developed the same symptoms again, and multiple clinicians and dermatologists continued to label him with zinc deficiency. At the age of 1 year and 4 months, he began to develop edema, ulcerations with bleeding, and nail changes affecting his fingers and toes, and he started to have gradual hair loss. On November 8, 2024, he was admitted to our hospital with fever, multiple skin abscesses, epistaxis, and sloughing of the napkin area, which had turned black, treated as overwhelming sepsis, He was managed accordingly and discharged home with no fever, normal hematological indices and same acrodermatitis, at December 16, 2024.
He has no admission for chest, bone, CNS infection, nor he developed a gastroenteritis other than that previous two before age of 1 year, all of his admission was regarding skin infections, fever, sepsis. There is no significant past surgical history. He comes from a consanguineous family, as his father and mother are first cousins. He has a 1-month-old healthy sister. The father has seven siblings (two brothers, five sisters), and the mother has seven siblings (four sisters, three brothers), all of whom have healthy both sex children. However, within the extended family, the mother’s paternal uncle’s daughter had a son who died at age 3 yrs, labeled with immunodeficiency and presenting with the same rash pattern. There is no family history of recent travel or pet exposure. (autosomal recessive or X-linked inheritance)
His past medical history was unremarkable until the age of 7 months, when he developed frequent watery bowel motions, vomiting, fever, and dehydration, labeled as gastroenteritis, hospitalized for 17 days. Following discharge, he remained well for a few days before developing cracked lips, a napkin rash, fever, and another episode of gastroenteritis, necessitating a second hospitalization for 10 days. During this admission, he was started on zinc sulfate syrup 30 mg twice daily, to which he responded well, with improvement in his lesions.
One month later, he developed the same symptoms again, and multiple clinicians and dermatologists continued to label him with zinc deficiency. At the age of 1 year and 4 months, he began to develop edema, ulcerations with bleeding, and nail changes affecting his fingers and toes, and he started to have gradual hair loss. On November 8, 2024, he was admitted to our hospital with fever, multiple skin abscesses, epistaxis, and sloughing of the napkin area, which had turned black, treated as overwhelming sepsis, He was managed accordingly and discharged home with no fever, normal hematological indices and same acrodermatitis, at December 16, 2024.
He has no admission for chest, bone, CNS infection, nor he developed a gastroenteritis other than that previous two before age of 1 year, all of his admission was regarding skin infections, fever, sepsis. There is no significant past surgical history. He comes from a consanguineous family, as his father and mother are first cousins. He has a 1-month-old healthy sister. The father has seven siblings (two brothers, five sisters), and the mother has seven siblings (four sisters, three brothers), all of whom have healthy both sex children. However, within the extended family, the mother’s paternal uncle’s daughter had a son who died at age 3 yrs, labeled with immunodeficiency and presenting with the same rash pattern. There is no family history of recent travel or pet exposure. (autosomal recessive or X-linked inheritance)
❤4
General examinations
A toddler male patient, conscious, alert, and appearing ill, with pallor and fever at the time of examination. He has no jaundice, no cyanosis, but appears to be in distress. There is no lymphadenopathy, and meningeal signs are negative. He has multiple tender, red, swollen lumps at different sites on the body, mostly appear to be subcutaneous abscesses.
A toddler male patient, conscious, alert, and appearing ill, with pallor and fever at the time of examination. He has no jaundice, no cyanosis, but appears to be in distress. There is no lymphadenopathy, and meningeal signs are negative. He has multiple tender, red, swollen lumps at different sites on the body, mostly appear to be subcutaneous abscesses.
❤5👏1
He has sparse hair, with hair loss, leg edema tender, without dysmorphic features, he is not hypotonic, and is lying in bed receiving his intravenous medication.
BP : 110/ 70 mmHg
RR : 20 BPM
HR : 140 BPM
Temp : 39 cْ
SPO2 : 98% with RA
HT : 79 cm below 2nd centile (0.20%)
WT : 10 kg below 2nd centile (1.24%)
OFC : 46 between 2nd and 5th centile (4.91%)
Chest examination: Good air entry, normal vesicular breath sounds, no added sounds, normal S1 and S2 heart sounds, and no murmurs.
Abdominal examination: Abdomen distended with everted umbilicus, soft, tender with no superficial masses. Huge hepatomegaly.
What are the diferential diagnosis you think about ? and what are the investigation you may ask for ?
BP : 110/ 70 mmHg
RR : 20 BPM
HR : 140 BPM
Temp : 39 cْ
SPO2 : 98% with RA
HT : 79 cm below 2nd centile (0.20%)
WT : 10 kg below 2nd centile (1.24%)
OFC : 46 between 2nd and 5th centile (4.91%)
Chest examination: Good air entry, normal vesicular breath sounds, no added sounds, normal S1 and S2 heart sounds, and no murmurs.
Abdominal examination: Abdomen distended with everted umbilicus, soft, tender with no superficial masses. Huge hepatomegaly.
What are the diferential diagnosis you think about ? and what are the investigation you may ask for ?
❤7
There are alot of differential diagnosis for such case
1- Hereditary Acrodermatitis Enteropathica with Underlying Disease
✅ Goes With: Classic periorificial (perioral, perinasal, periorbital) and acral dermatitis. Poor wound healing, recurrent infections. Growth retardation. Initial response to zinc but relapsed as patient labeled at age of 8 month , and his picture at age of 1,4 year he looks like having good response to zinc. Inherited as autosomal recessive
Underlying Possible Diseases Affecting Zinc Absorption more that the already malabsorption gene defect in patients of Acrodermatitis enteropathica:
Celiac disease :- Abdominal distention, foul-smelling stool (suggestive of malabsorption).
Cystic fibrosis :- Difficult-to-wash stool (steatorrhea); could be the first presenting sign, but no recurrent lung infections noted.
❌ Against:
Already on high-dose zinc yet still flaring :- having good compliance
Side note : Zinc dose in acrodermatitis enteropathica is 3 mg/kg/day , pt wt is 10 kg, and receiving 30 mg * 2
Toxicity from zinϲ supplementation is rare, although long-term administration of high doses (>50 mg zinс/day) may lead to copper deficiency, reduced immune function, and lower high-density lipoprotein cholesterol levels. High intakes are also associated with nausea, gastric distress, vomiting, and loss of appetite
this side note might raise a suspecion to copper deficiency as well as contributing factor for the immune deficiency
2- Wiskott-Aldrich Syndrome
Goes With: Eczema-like rash, Recurrent infections (skin abscesses, potential immunodeficiency), Bleeding tendency (epistaxis, gum bleeding). Male child. X-linked inheritance, Against: ?
3- Chronic Granulomatous Disease (CGD)
Goes With: Recurrent deep skin abscesses. Susceptibility to bacterial & fungal infections, Persistent infections despite standard treatment. Goes Against: no catalase-positive organisms. No lung, liver, or bone involvement
4- Hyper-IgE Syndrome (Job’s Syndrome)
Goes With: Severe, recurrent skin abscesses (often cold, Staphylococcal). Eczematous rash (AE-like). Possibly recurrent infections.
5- Biotin Deficiency
Goes With: Periorificial dermatitis (mimics AE), Alopecia, seizures? Goes Against: No hypotonia
6- Pellagra (Niacin Deficiency)
Goes With: Severe rash could mimic photosensitive pellagra lesions.
Goes Against: No diarrhea or neurologic signs (dementia/confusion).
For the Inx, his CBC show different images at different times, ranging from Normal CBC with normal plt count and volume, to low plt count, and another one shows pancytopenia, explained as Sepsis affecting these finding, patient CBC indices improves with proper antibiotics coverage , while blood film is normal
CRP range from -ve to +ve according to infection status
Ph stool 9 , occult blood +ve
RFT is normal, LFT showing normal to slightly elevated transminitis , his ALP is ranging from normal to not properly elevated for age ( Depressed serum alkaline phosphatase activity for age has been proposed to provide supportive evidence for zinc deficiency)
he has two zinc level, one is 60 and the other is 85, both are normal according to uptodate , but zinc level is not specific not a sensitive test due to being affected by gloves, tubes, skin, if contamination with zine or contain zinc, and it's decreased by infection, low alb, increased by acute catabolic state
his s electoryles is normal , his Ig Assay done three times
each has different values, IgE is normal that makes hyperIgE unlikely
but the IgM is normal in one, borderline in 2nd, Low in third one, IgG also, so it was unhelpful may be due to lab errors ?
DHR is 70 , according to lab reference, it's borderline
for PT PTT INR it's normal, for BMA,BMB it was normal
for Skin biopsy it was unhelpful
normal Echo study , US of abdomin showing thickened terminal ilium suggesting IBD thought the radiological picture is not
1- Hereditary Acrodermatitis Enteropathica with Underlying Disease
✅ Goes With: Classic periorificial (perioral, perinasal, periorbital) and acral dermatitis. Poor wound healing, recurrent infections. Growth retardation. Initial response to zinc but relapsed as patient labeled at age of 8 month , and his picture at age of 1,4 year he looks like having good response to zinc. Inherited as autosomal recessive
Underlying Possible Diseases Affecting Zinc Absorption more that the already malabsorption gene defect in patients of Acrodermatitis enteropathica:
Celiac disease :- Abdominal distention, foul-smelling stool (suggestive of malabsorption).
Cystic fibrosis :- Difficult-to-wash stool (steatorrhea); could be the first presenting sign, but no recurrent lung infections noted.
❌ Against:
Already on high-dose zinc yet still flaring :- having good compliance
Side note : Zinc dose in acrodermatitis enteropathica is 3 mg/kg/day , pt wt is 10 kg, and receiving 30 mg * 2
Toxicity from zinϲ supplementation is rare, although long-term administration of high doses (>50 mg zinс/day) may lead to copper deficiency, reduced immune function, and lower high-density lipoprotein cholesterol levels. High intakes are also associated with nausea, gastric distress, vomiting, and loss of appetite
this side note might raise a suspecion to copper deficiency as well as contributing factor for the immune deficiency
2- Wiskott-Aldrich Syndrome
Goes With: Eczema-like rash, Recurrent infections (skin abscesses, potential immunodeficiency), Bleeding tendency (epistaxis, gum bleeding). Male child. X-linked inheritance, Against: ?
3- Chronic Granulomatous Disease (CGD)
Goes With: Recurrent deep skin abscesses. Susceptibility to bacterial & fungal infections, Persistent infections despite standard treatment. Goes Against: no catalase-positive organisms. No lung, liver, or bone involvement
4- Hyper-IgE Syndrome (Job’s Syndrome)
Goes With: Severe, recurrent skin abscesses (often cold, Staphylococcal). Eczematous rash (AE-like). Possibly recurrent infections.
5- Biotin Deficiency
Goes With: Periorificial dermatitis (mimics AE), Alopecia, seizures? Goes Against: No hypotonia
6- Pellagra (Niacin Deficiency)
Goes With: Severe rash could mimic photosensitive pellagra lesions.
Goes Against: No diarrhea or neurologic signs (dementia/confusion).
For the Inx, his CBC show different images at different times, ranging from Normal CBC with normal plt count and volume, to low plt count, and another one shows pancytopenia, explained as Sepsis affecting these finding, patient CBC indices improves with proper antibiotics coverage , while blood film is normal
CRP range from -ve to +ve according to infection status
Ph stool 9 , occult blood +ve
RFT is normal, LFT showing normal to slightly elevated transminitis , his ALP is ranging from normal to not properly elevated for age ( Depressed serum alkaline phosphatase activity for age has been proposed to provide supportive evidence for zinc deficiency)
he has two zinc level, one is 60 and the other is 85, both are normal according to uptodate , but zinc level is not specific not a sensitive test due to being affected by gloves, tubes, skin, if contamination with zine or contain zinc, and it's decreased by infection, low alb, increased by acute catabolic state
his s electoryles is normal , his Ig Assay done three times
each has different values, IgE is normal that makes hyperIgE unlikely
but the IgM is normal in one, borderline in 2nd, Low in third one, IgG also, so it was unhelpful may be due to lab errors ?
DHR is 70 , according to lab reference, it's borderline
for PT PTT INR it's normal, for BMA,BMB it was normal
for Skin biopsy it was unhelpful
normal Echo study , US of abdomin showing thickened terminal ilium suggesting IBD thought the radiological picture is not
👍5❤3
the patient is already on zinc and antibiotics coverage , the new onset rash with high grade fever and cough developed 6 days ago considered as measles as it was typical , though we were giving him a niacin tab to cover the suspicion of pellagra, we stopped it since we didn't get a response and there is a risk of rash as a side effect of niacin
Next steps few days ago was as
1- Waiting WES result.
2- Celiac screen ( Total IgA, tTG IgA, IgG ) -- we got it today as normal
3- S Copper ( Normal )
4- Start Biotin supplement. on 20 mg per day.
5- Consider using IV Zinc if available ( not availble in iraq)
6- Vit A for suspected measles.
Flow cytometry also sent for better immune assessment
Clinically regarding the rash , there is some response( for the periorifical rash) not the one we considered it as measles (it's already start to fade out)
We are focusing on three ddx, WAS, Biotin, Acrodermatitis enteropathica (require life long zinc)
We hope to reach the final Dx and we hope it's a treatable condition.
Next steps few days ago was as
1- Waiting WES result.
2- Celiac screen ( Total IgA, tTG IgA, IgG ) -- we got it today as normal
3- S Copper ( Normal )
4- Start Biotin supplement. on 20 mg per day.
5- Consider using IV Zinc if available ( not availble in iraq)
6- Vit A for suspected measles.
Flow cytometry also sent for better immune assessment
Clinically regarding the rash , there is some response( for the periorifical rash) not the one we considered it as measles (it's already start to fade out)
We are focusing on three ddx, WAS, Biotin, Acrodermatitis enteropathica (require life long zinc)
We hope to reach the final Dx and we hope it's a treatable condition.
👍10❤5👏1
Pediatrics Mastering
Photo
Discharged home well few days ago, presented for follow up , investigation today revealed normal CBC , RFT, LFT , on zinc and biotin, pending a WES study, as his last investigation revealed SCID , next step is to exclude other ddx , before BMT .
❤20👏5👍3🔥2
Normal references value for rarely used investigations will be added to Lab test
مع تحديث لطريقة عرض التحاليل وتسهيل اكبر للوصول الى استخدام عملي سريع مفيد بالحياة اليومية
هاي التحاليل مشكلة، لانه تجي النتيجة ومنكدر حتى نفسرها لان منعرف شكد النسب الطبيعية ولا نعرف وين نلكاها
مع تحديث لطريقة عرض التحاليل وتسهيل اكبر للوصول الى استخدام عملي سريع مفيد بالحياة اليومية
هاي التحاليل مشكلة، لانه تجي النتيجة ومنكدر حتى نفسرها لان منعرف شكد النسب الطبيعية ولا نعرف وين نلكاها
❤7👍4👌1
الذكاء الاصطناعي .. لازم كل طبيب يتعلم يستخدمه
اولاً .. الموضوع حالياً بسباق، بين الدول المتقدمة
بين امريكا والصين .. و باقي الدول
كانت الشركات تعمل سراً على مشاريع الذكاء الاصطناعي قبل اطلاقه للعوام الى ان جاء سام، مؤسس شركة open ai المسؤولة عن جات جي بي تي المدعوم من قبل امريكا واطلقه للناس
نزل بالبداية بإصدار ٣، ثم ٣.٥ ثم ٤
كوكل اطلقت bard الي سمته لاحقاً gemini
هذا الذكاء .. يحتاج رقاقات الكترونية حتى يشتغل.. والرقاقات سعرها كلش مكلف تصنعها شركات مثل نيفيديا المعروفة بصنعها للرقاقات الالكترونية و الي عنده كومبيوتر اكيد سامع بكارد شاشة نفيديا
امريكا استثمرت ٥٠٠ مليون او بليون ما اتذكر الرقم بالذكاء الاصطناعي
وكالوا لشركة نيفيديا ما نقبل تصدرين الرقاقات الي تشتغل بجودة عالية للصين
صدريلهم بس الرقاقات القديمة..
اجت الصين وكالت لجماعتها، بالرقاقات القديمة اريد نصنع ذكاء اصطناعي
وهنا انطلق ال deepseek بتكلفة ٢٧ مليون او بليون ..
امريكا .. كالت راح نسوي مثلكم بس بتكلفة ٥٠٠ بدل ٢٧
اجى ايلون ماسك واطلق النموذج الخاص بيه GROK
والسباق مستمر ..
شنو الفرق بين الذكاء الاصطناعي المجاني والمدفوع ؟
الفرق بالقدرة .. يعني مثلاً نموذج مجاني، يجاوب سؤال ويصرف طاقة معينة .
بينما المدفوع راح يجاوب السؤال بعد تحليل اكثر واعمق و دراسة اكبر ويصرف طاقة اكبر.. فسووه بفلوس لأنه يكلفهم طاقة
هذا الشرح بتعابير بسيطة
ف الي يستخدم جات جي بي المجاني .. معناها يستخدم الاصدار ٤ .. المدفوع هو 4o ، واكو اعلى منه ال o1 محدود الاستخدام و الاعلى بعد ال o3 الي بعده ما منشور بشكل مفتوح تماما .. و هسة اصدروا 4.5 يعني التطور مستمر
الفرق بين هاي الاصدارات هو بالدقة والذكاء
يعني اكو اصدارات تكون اذكى واجوبتها اصح من الاصدار السابق او المجاني
وكل نموذج يختلف عن الاخر
مثلاً كوكل جيميناي، مدرب على الاوراق البحثية للجامعات وكل محتوى كوكل، رغم ميعجبني حيل بالاسئلة الي تحتاج تحليل منطقي
مثلاً كروك نموذج ايلون ماسك كلش ذكي بالبرمجة وبيه ميزات حلوة
ديب سيك تم تدريبه من خلال التواصل مع جيميناي و جات جي بي تي .. يعني بقى يتواصل وياهن وياخذ معلومات لأنه محد ينطيه مصدر معلومات
حالياً .. الانسب والي اشوفه زين للمعلومات الطبية هو جات جي بي تي
سويت بيه حساب مشترك، بسعر تكلفة شهرية ٥ الاف دينار ارخص مما لو تشترك لوحدك
بداخله نماذج مدربة للاجابة على معلومات طبية من الكتب الطبية
يعني مثلاً
NelsonGPT
مدرب للاجابة على الاسئلة من كتاب نلسون وينطيك المصدر ايضاً
والخ من المصادر الاخرى المتاحة لمختلف الاختصاصات.. الي يريد يشترك يتواصل وياي
@n92sa
اولاً .. الموضوع حالياً بسباق، بين الدول المتقدمة
بين امريكا والصين .. و باقي الدول
كانت الشركات تعمل سراً على مشاريع الذكاء الاصطناعي قبل اطلاقه للعوام الى ان جاء سام، مؤسس شركة open ai المسؤولة عن جات جي بي تي المدعوم من قبل امريكا واطلقه للناس
نزل بالبداية بإصدار ٣، ثم ٣.٥ ثم ٤
كوكل اطلقت bard الي سمته لاحقاً gemini
هذا الذكاء .. يحتاج رقاقات الكترونية حتى يشتغل.. والرقاقات سعرها كلش مكلف تصنعها شركات مثل نيفيديا المعروفة بصنعها للرقاقات الالكترونية و الي عنده كومبيوتر اكيد سامع بكارد شاشة نفيديا
امريكا استثمرت ٥٠٠ مليون او بليون ما اتذكر الرقم بالذكاء الاصطناعي
وكالوا لشركة نيفيديا ما نقبل تصدرين الرقاقات الي تشتغل بجودة عالية للصين
صدريلهم بس الرقاقات القديمة..
اجت الصين وكالت لجماعتها، بالرقاقات القديمة اريد نصنع ذكاء اصطناعي
وهنا انطلق ال deepseek بتكلفة ٢٧ مليون او بليون ..
امريكا .. كالت راح نسوي مثلكم بس بتكلفة ٥٠٠ بدل ٢٧
اجى ايلون ماسك واطلق النموذج الخاص بيه GROK
والسباق مستمر ..
شنو الفرق بين الذكاء الاصطناعي المجاني والمدفوع ؟
الفرق بالقدرة .. يعني مثلاً نموذج مجاني، يجاوب سؤال ويصرف طاقة معينة .
بينما المدفوع راح يجاوب السؤال بعد تحليل اكثر واعمق و دراسة اكبر ويصرف طاقة اكبر.. فسووه بفلوس لأنه يكلفهم طاقة
هذا الشرح بتعابير بسيطة
ف الي يستخدم جات جي بي المجاني .. معناها يستخدم الاصدار ٤ .. المدفوع هو 4o ، واكو اعلى منه ال o1 محدود الاستخدام و الاعلى بعد ال o3 الي بعده ما منشور بشكل مفتوح تماما .. و هسة اصدروا 4.5 يعني التطور مستمر
الفرق بين هاي الاصدارات هو بالدقة والذكاء
يعني اكو اصدارات تكون اذكى واجوبتها اصح من الاصدار السابق او المجاني
وكل نموذج يختلف عن الاخر
مثلاً كوكل جيميناي، مدرب على الاوراق البحثية للجامعات وكل محتوى كوكل، رغم ميعجبني حيل بالاسئلة الي تحتاج تحليل منطقي
مثلاً كروك نموذج ايلون ماسك كلش ذكي بالبرمجة وبيه ميزات حلوة
ديب سيك تم تدريبه من خلال التواصل مع جيميناي و جات جي بي تي .. يعني بقى يتواصل وياهن وياخذ معلومات لأنه محد ينطيه مصدر معلومات
حالياً .. الانسب والي اشوفه زين للمعلومات الطبية هو جات جي بي تي
سويت بيه حساب مشترك، بسعر تكلفة شهرية ٥ الاف دينار ارخص مما لو تشترك لوحدك
بداخله نماذج مدربة للاجابة على معلومات طبية من الكتب الطبية
يعني مثلاً
NelsonGPT
مدرب للاجابة على الاسئلة من كتاب نلسون وينطيك المصدر ايضاً
والخ من المصادر الاخرى المتاحة لمختلف الاختصاصات.. الي يريد يشترك يتواصل وياي
@n92sa
❤17🕊2
كطبيب حاليا او صيدلاني بشنو يفيدك الذكاء الاصطناعي ؟
يغنيك عن البحث في كوكل تماما، اي معلومة يجيبها الك بثواني وبالمصدر والمختصر
يفتهم الي تريده ويجاوبك على سؤالك
يساعدك ب اقتراح
Ddx
للكيس الي متعرف شنو تسويلها ومحتار بيها
بس لازم تحكم عقلك تجنبا للخطأ
ماعندك وقت تكتب لانك بالتور؟ دزله مسج صوتي هو يحول المسج الصوتي الى نص و يقراه ويجاوبك
عندك وقت، اتصل بيه اتصال وتناقش وياه
مبدئيا
احنا صرنا نستشيره بالكيسات بشكل مستمر وينطينا نقاط تذكير مهمة ويساعدنا
يعني تكدر تعتبره مساعدك الشخصي الي يذكرك لمن تنسى
يساعدك لمن تحتاج دفعة
يشرحلك لمن ما تفهم موضوع معين
خصوصاً الاسئلة الي متعرف منين تجيب جوابها
ابني ميحب ياكل .. شنو اسويله؟
اسئله وشوف شون يغرد
يغنيك عن البحث في كوكل تماما، اي معلومة يجيبها الك بثواني وبالمصدر والمختصر
يفتهم الي تريده ويجاوبك على سؤالك
يساعدك ب اقتراح
Ddx
للكيس الي متعرف شنو تسويلها ومحتار بيها
بس لازم تحكم عقلك تجنبا للخطأ
ماعندك وقت تكتب لانك بالتور؟ دزله مسج صوتي هو يحول المسج الصوتي الى نص و يقراه ويجاوبك
عندك وقت، اتصل بيه اتصال وتناقش وياه
مبدئيا
احنا صرنا نستشيره بالكيسات بشكل مستمر وينطينا نقاط تذكير مهمة ويساعدنا
يعني تكدر تعتبره مساعدك الشخصي الي يذكرك لمن تنسى
يساعدك لمن تحتاج دفعة
يشرحلك لمن ما تفهم موضوع معين
خصوصاً الاسئلة الي متعرف منين تجيب جوابها
ابني ميحب ياكل .. شنو اسويله؟
اسئله وشوف شون يغرد
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تم انشاء الاكاونت المشترك.. وتم اضافة نموذج لكل برانج ، واعطاء النموذج توجيهات للاجابة بأفضل شكل مناسب
هاي البرانجات الحالية.. والكتب الي انضافت إلها
Emergency Ai
• Textbook of Paediatric Emergency Medicine 4th ed 2023.pdf
• Tintinalli's Emergency Medicine Manual 8th Edition 2018
• Nelson Textbook chapter -Emergency Medicine, Critical Care, and Anesthesia.pdf
• Oxford Handook of Emergency Medicine 4th Ed.pdf
• Oxford Emergencies in Trauma
• Tintinalli's Emergency Medicine Manual 9th
• Rosen's Emergency Medicine Concepts and Clinical Practice 2 Volume
Pediatrics Ai
• Nelson Textbook of Pediatrics (22nd Edition and 2023 Essentials),
• Avery’s Diseases of the Newborn
• Fanaroff and Martin’s Neonatal-Perinatal Medicine
• Gomella’s Neonatology
• Kendig’s Disorders of the Respiratory Tract in Children
• BNF for Children
• Red Book (32nd Edition)
• AAP Reference Ranges
• Lanzkowsky’s Manual of Pediatric Hematology and Oncology 7ed.
• Textbook of Pediatric Emergency Medicine.
• Neonatal Resuscitation Program (NRP)
• Current Procedures in Pediatric and Neonatal Care."
General Surgery Ai
• Abrahams' and McMinn's Clinical Atlas of Human Anatomy
• Bailey & Love's Short Practice of Surgery, 26th Edition
• Rush University Medical Center Review of Surgery, 6th Edition,
• Schwartz's Principles of Surgery 10th ed.
• Case Files Surgery, Fourth Edition (LANGE Case Files)
• Case Files Surgery, Fifth Edition (LANGE Case Files)
Internal Medicine Ai
• Harrison's Principles of Internal Medicine, Twenty-First Edition (Vol.1 & Vol.2)
• Davidson's Principles and Practice of Medicine, 24th Edition
• Macleod's Clinical Examination - 13th Edition
• Lanzkowsky’s Manual of Pediatric Hematology and Oncology 7 ed
Gyne & Obs Ai
• Obstetrics and Gynecology 6th Edition by Charles R. B. Beckmann
• Callen's Ultrasonography in Obstetrics and Gynecology 6ed
• Essential Obstetrics and Gynaecology International Edition, 6th Edition
• Obstetric Guidelines 2017-19 The Bedside Clinical Guidelines Partnership in association with the Staffordshire, Shropshire & Black Country Newborn and Maternity Network and Southern West Midlands Maternity and Newborn Network Obstetric
• The second edition of Emergencies in Obstetrics and Gynaecology
• Textbook for MRCOG-1: Basic Sciences in Obstetrics and Gynaeocology
• Obstetrics by Ten Teachers - 21st Edition - Louise C Kenny
• STEP 2 CK - Lecture Notes 2016 USMLE® Obstetrics & Gynecology
• Gynaecology by Ten Teachers - 21st Edition - Louise C Kenny
Pharmacist Ai
• BNF 85
• BNF for children 2022-2023
• Lippincott® Illustrated Reviews Pharmacology 8E 2023
• Textbook of Clinical Pharmacology 2025
Oncology Ai
• DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology 12ed
• Hoffman and Abeloff's Hematology-Oncology Review 2018
• ASCO-SEP® Medical Oncology Self-Evaluation Program 2024
• Oxford Handbook of Oncology (4th ed.)
• Physicians' Cancer Chemotherapy Drug Manual 2024
• Harrison's Principles of Internal Medicine, Twenty-First Edition (Vol.1 & Vol.2)
• Lanzkowsky’s Manual of Pediatric Hematology and Oncology 7ed.
Family Medicine Ai
• Toronto Notes 2017
• CURRENT Medical Diagnosis & Treatment 64 ed.
• Case Files: Family Medicine (4th Edition)
• Swanson's Family Medicine Review: A Problem-Oriented Approach (8th Edition)
• Family Medicine: A Practical Approach (2nd Edition)
• The Family Medicine Board Review Book 2018
• Family Medicine A clinical and applied 2015
• Guide to the Canadian Family Medicine 2018
• First Aid for the Family Medicine Boards 3th edition.
• The Color Atlas and Synopsis of Family Medicine 2nd ed
• Graber and Wilbur's Family Medicine Examination and Board Review, Fourth Edition
Dermatology Ai
هاي البرانجات الحالية.. والكتب الي انضافت إلها
Emergency Ai
• Textbook of Paediatric Emergency Medicine 4th ed 2023.pdf
• Tintinalli's Emergency Medicine Manual 8th Edition 2018
• Nelson Textbook chapter -Emergency Medicine, Critical Care, and Anesthesia.pdf
• Oxford Handook of Emergency Medicine 4th Ed.pdf
• Oxford Emergencies in Trauma
• Tintinalli's Emergency Medicine Manual 9th
• Rosen's Emergency Medicine Concepts and Clinical Practice 2 Volume
Pediatrics Ai
• Nelson Textbook of Pediatrics (22nd Edition and 2023 Essentials),
• Avery’s Diseases of the Newborn
• Fanaroff and Martin’s Neonatal-Perinatal Medicine
• Gomella’s Neonatology
• Kendig’s Disorders of the Respiratory Tract in Children
• BNF for Children
• Red Book (32nd Edition)
• AAP Reference Ranges
• Lanzkowsky’s Manual of Pediatric Hematology and Oncology 7ed.
• Textbook of Pediatric Emergency Medicine.
• Neonatal Resuscitation Program (NRP)
• Current Procedures in Pediatric and Neonatal Care."
General Surgery Ai
• Abrahams' and McMinn's Clinical Atlas of Human Anatomy
• Bailey & Love's Short Practice of Surgery, 26th Edition
• Rush University Medical Center Review of Surgery, 6th Edition,
• Schwartz's Principles of Surgery 10th ed.
• Case Files Surgery, Fourth Edition (LANGE Case Files)
• Case Files Surgery, Fifth Edition (LANGE Case Files)
Internal Medicine Ai
• Harrison's Principles of Internal Medicine, Twenty-First Edition (Vol.1 & Vol.2)
• Davidson's Principles and Practice of Medicine, 24th Edition
• Macleod's Clinical Examination - 13th Edition
• Lanzkowsky’s Manual of Pediatric Hematology and Oncology 7 ed
Gyne & Obs Ai
• Obstetrics and Gynecology 6th Edition by Charles R. B. Beckmann
• Callen's Ultrasonography in Obstetrics and Gynecology 6ed
• Essential Obstetrics and Gynaecology International Edition, 6th Edition
• Obstetric Guidelines 2017-19 The Bedside Clinical Guidelines Partnership in association with the Staffordshire, Shropshire & Black Country Newborn and Maternity Network and Southern West Midlands Maternity and Newborn Network Obstetric
• The second edition of Emergencies in Obstetrics and Gynaecology
• Textbook for MRCOG-1: Basic Sciences in Obstetrics and Gynaeocology
• Obstetrics by Ten Teachers - 21st Edition - Louise C Kenny
• STEP 2 CK - Lecture Notes 2016 USMLE® Obstetrics & Gynecology
• Gynaecology by Ten Teachers - 21st Edition - Louise C Kenny
Pharmacist Ai
• BNF 85
• BNF for children 2022-2023
• Lippincott® Illustrated Reviews Pharmacology 8E 2023
• Textbook of Clinical Pharmacology 2025
Oncology Ai
• DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology 12ed
• Hoffman and Abeloff's Hematology-Oncology Review 2018
• ASCO-SEP® Medical Oncology Self-Evaluation Program 2024
• Oxford Handbook of Oncology (4th ed.)
• Physicians' Cancer Chemotherapy Drug Manual 2024
• Harrison's Principles of Internal Medicine, Twenty-First Edition (Vol.1 & Vol.2)
• Lanzkowsky’s Manual of Pediatric Hematology and Oncology 7ed.
Family Medicine Ai
• Toronto Notes 2017
• CURRENT Medical Diagnosis & Treatment 64 ed.
• Case Files: Family Medicine (4th Edition)
• Swanson's Family Medicine Review: A Problem-Oriented Approach (8th Edition)
• Family Medicine: A Practical Approach (2nd Edition)
• The Family Medicine Board Review Book 2018
• Family Medicine A clinical and applied 2015
• Guide to the Canadian Family Medicine 2018
• First Aid for the Family Medicine Boards 3th edition.
• The Color Atlas and Synopsis of Family Medicine 2nd ed
• Graber and Wilbur's Family Medicine Examination and Board Review, Fourth Edition
Dermatology Ai
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• Lever's Histopathology of the skin -11th ed - 2015
• Diagnostic Dermoscopy - The Illustrated Guide (2022)
• Dermoscopy in General Dermatology for Skin of Color Enzo Errichetti
• Dermoscopy The Essentials 3rd Edition
• Dermoscopy of the hair and nail-Tosti-2 ed-2016
• Dermoscopy and Trichoscopy in Diseases of The Brown Skin
• Bolognia 5th Edition 2024
• • Andrews' Diseases of the Skin - 13th Edition
• Diagnostic Dermoscopy - The Illustrated Guide (2022)
• Dermoscopy in General Dermatology for Skin of Color Enzo Errichetti
• Dermoscopy The Essentials 3rd Edition
• Dermoscopy of the hair and nail-Tosti-2 ed-2016
• Dermoscopy and Trichoscopy in Diseases of The Brown Skin
• Bolognia 5th Edition 2024
• • Andrews' Diseases of the Skin - 13th Edition
❤2
من الحالات النادرة الي تنشاف بالعمر مرة .. طفل عنده
Infantile hyalinosis
Multiple progressive joint contractures
Firm subcutaneous nodule
Chronic diarrhea
Recurrent infection
Infantile hyalinosis
Multiple progressive joint contractures
Firm subcutaneous nodule
Chronic diarrhea
Recurrent infection
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