Bacteriostatic 🆚 Bactericidal antibiotics 💊

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Brugada Syndrome?

💡 Overview
Brugada Syndrome is a genetic disorder affecting the heart's electrical system.
It increases the risk of sudden cardiac death due to arrhythmias.
It often presents without any structural abnormalities in the heart.

🧬 Genetic Basis
The syndrome is primarily linked to mutations in the SCN5A gene.
This gene is responsible for the sodium channels in heart cells.
Mutations impair the flow of sodium ions, leading to abnormal electrical signals.

⚡ Symptoms
Many individuals with Brugada Syndrome are asymptomatic.
Symptoms, if present, include fainting, seizures, or sudden cardiac arrest.
These episodes often occur during sleep or at rest.

🔍 Diagnosis
Diagnosis is made through an electrocardiogram (ECG) showing characteristic patterns.
These patterns may not always be present, requiring additional testing.
Genetic testing can also confirm the diagnosis.

💊 Management
The primary treatment is the implantation of a cardioverter-defibrillator (ICD).
Lifestyle modifications, such as avoiding fever and certain medications, are important.
Antiarrhythmic drugs may be used in some cases.

🏃 Prognosis
With proper management, many patients can lead normal lives.
However, there is a lifelong risk of cardiac events, especially without an ICD.

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Resistant Hypertension?

💡 Definition
Resistant hypertension is high blood pressure that remains uncontrolled despite the use of at least three antihypertensive medications at optimal doses.
One of these medications should be a diuretic.

🔍 Causes
Primary causes can include poor medication adherence, suboptimal treatment, or secondary causes like obstructive sleep apnea.
Lifestyle factors like excessive salt intake or obesity can also contribute.

📊 Diagnosis
To diagnose resistant hypertension, healthcare providers must rule out pseudoresistance.
This involves checking for white coat hypertension, incorrect blood pressure measurements, or poor medication adherence.

💊 Treatment
Treatment includes optimizing the current medication regimen.
Adding a mineralocorticoid receptor antagonist (like spironolactone) may help.
Lifestyle changes such as weight loss, reduced salt intake, and regular physical activity are essential.

⚠️ Secondary Hypertension
Common causes of secondary hypertension include chronic kidney disease, primary aldosteronism, and thyroid disorders.
Addressing the underlying cause is crucial in managing resistant hypertension.

📅 Monitoring
Frequent blood pressure monitoring is necessary to evaluate the effectiveness of treatment.
Ambulatory or home blood pressure monitoring can provide a more accurate assessment than clinic readings.

🧠 Complications
If left untreated, resistant hypertension can lead to serious complications such as stroke, heart attack, and kidney failure.
Early and effective management is vital to prevent these outcomes.

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CYP450 inducers and inhibitors m mnemonics 💊

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Antihypertension medications interactions 💊

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De-Prescribing of Proton Pump Inhibitors AGA guidelines
Dr ELSAYED ELMURR,MD

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Wilson's Disease

🧬 Genetic Basis
Wilson's disease is a rare autosomal recessive genetic disorder.
It is caused by mutations in the ATP7B gene.
This gene is responsible for copper transport in the liver.
Defective copper transport leads to toxic accumulation.

🥇 Primary Problem
Excess copper accumulates in the liver initially.
It eventually spreads to other organs, like the brain and kidneys.
This leads to both hepatic and neurological damage.

🩺 Symptoms
Patients may experience liver symptoms like jaundice and hepatomegaly.
Neurological symptoms include tremors, poor coordination, and dystonia.
Psychiatric symptoms, such as mood swings and cognitive decline, are also common.

👁️ Diagnostic Feature
The characteristic Kayser-Fleischer rings are often seen in the eyes.
These are brownish rings around the cornea due to copper deposition.
Diagnosis is confirmed with blood and urine copper tests and liver biopsy.

💊 Treatment
Treatment involves lifelong use of copper-chelating agents like penicillamine.
Zinc supplements may be given to prevent copper absorption in the intestines.
In severe cases, liver transplantation may be considered.

👩‍⚕️ Prognosis
Early diagnosis and treatment can lead to a good quality of life.
Without treatment, the disease is fatal due to liver or neurological complications.

🌐 Reference ➡️ Cleveland clinic

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RAAS system

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Goodpasture syndrome

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Gestational hypertension 🆚 pre-eclampsia 🆚 eclampsia

🌸 Gestational Hypertension

Occurs after 20 weeks of pregnancy.

Diagnosed when a pregnant woman’s blood pressure is elevated, but there is no protein in the urine or other signs of organ damage.

Usually resolves after delivery.

Carries a risk of progressing to preeclampsia if not managed properly.


⚡️ Preeclampsia

Develops after 20 weeks of pregnancy and is characterized by high blood pressure along with signs of organ damage, particularly the kidneys (proteinuria).

May also include symptoms like severe headaches, blurred vision, upper abdominal pain, and swelling (edema).

Requires close monitoring, as it can lead to severe complications for both mother and baby if untreated.

Delivery is often the best treatment, and timing depends on the severity and gestational age.


🔥 Eclampsia

A severe form of preeclampsia that includes seizures.

It is a life-threatening condition that can lead to serious health risks for both mother and child.

May occur before, during, or after delivery.

Immediate medical intervention is required, often leading to emergency delivery for the safety of the mother and baby.

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🔵 بعون اللّٰه ثم بجهودِ فريق MCTU-23

  تم تجهيز تفريغ جزئية الفارما شابتر ال
Gastrointestinal Tract (GIT)

للدكتور عبد المتعال فودة كأحد أعمال اللجنة و بعون اللّٰه كتكملة لما بدأنا بهِ في تجهيز كتاب لتفريغات د/عبد المتعال فودا شامِلًا لجميع الشباتر بعونِ اللهِ وتوفيقه..

🟢 مميزات النسخة:
1⃣ خط كمبيوتر + ملونة
2⃣ متضمنة رسومات وصور توضيحية
3⃣ محتوية على جزئيات كتاب المنصورة (الذي يشرح منه الدكتور) كل جزئية تلي الجزئية التي تم شرحها مباشرة

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Antifungal medications 💊

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Hypertension urgency 🆚 emergency?

🚨 Hypertensive Emergency

A hypertensive emergency occurs when blood pressure is severely elevated (usually >180/120 mmHg) with target organ damage.

Target organ damage includes conditions like encephalopathy, stroke, myocardial infarction, acute heart failure, or acute kidney injury.

Symptoms may include severe headache, chest pain, breathlessness, visual disturbances, or confusion.

It is a life-threatening condition that requires immediate IV antihypertensive therapy to lower BP gradually.


🛑 Hypertensive Urgency

A hypertensive urgency also involves severely elevated blood pressure (typically >180/120 mmHg) without target organ damage.

Patients may be asymptomatic or have symptoms like headache, dizziness, or mild chest discomfort.

While urgent, it is not immediately life-threatening, and oral antihypertensive therapy can be used to reduce BP over 24–48 hours.

Close outpatient follow-up is crucial to avoid progression to a hypertensive emergency.


⚡ Key Differences

Organ damage presence differentiates emergency from urgency.

Treatment for emergency is immediate with IV therapy, while urgency allows for gradual control using oral medications.

Emergency symptoms are severe and life-threatening; urgency symptoms are milder or absent.

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