طب عام (سنة سادسة)⛧
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قناة تفتح ابوابها لجميع طلبة الطب في العالم تحت اشراف الدكتور المحترم الكبير الاستاذ محمد قاسم للتواصل مع صاحب القناة @Alive332002
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منشورات القناة
Repost from N/a
Q\ What is the name of sign ?
A\ Battel's sign
Q\ Regarding Battle sign give the site of fracture ?
A\ Basilar skull fracture (middle crainal fossa)
Q\ Associated with ?
A\ CSF Leakage (CSF otorrhea)
Q\ What nerves can be damaged ?
A\ Facial nerve and vestibulocochlear
nerve
| 2 | 🔴Cystic Fibrosis
▪︎Autosomal Recessive (AR) Chronic Progressive Disorder Caused By Mutation in CFTR Gene On Long Arm Of Chromosome 7 That Affects The Secretary & Absorptive Function Of Epithelial Cells in Multiple Body Organs
▪︎Results in Excessive Secretion Of Na & Cl in Sweat
▪︎Median Age Of Survival 45 Years
🔹Clinical Features
🔶A. Neonatal Symptoms
📍1. Start in Neonatal period As Delayed Passage Of Meconium (Meconium Ileus)
📍2. Neonatal Cholestatic Jaundice
📍3. Failure To Thrive
📍4. Heat Exhaustion (Heavy Sweating/Cold Pale Skin/Rapid Weak Pulse/Muscle Cramps)
📍5. Hypochloremic Metabolic Alkalosis & Hyponatremia
🔶B. Respiratory Symptoms
📍1. Then Start To Develop Chronic Respiratory Infections (Chronic Productive Cough & Wheeze)
📍2. Lung Hyperinflation & Progressive Bronchiectasis
📍3. Lung Atelectasis/Hemoptysis/Pneumothorax
📍4. Finger Clubbing
📍5. Chronic Sinusitis & Nasal Polyposis
📍6. Poorly Controlled Asthma
📍7. Allergic BronochoPulmonary Aspergillosis
📍8. Respiratory Failure & Death
🔶C. GIT & Endocrine Symptoms
📍1. Exocrine Pancreatic Insufficiency Results in Fat & Protein Malabsorption
▪︎Steatorrhea (Large Pasty Yellowish Offensive Stool That Floating)
▪︎Fat Soluble Vitamin Deficiency (ADEK)
▪︎Hypoalbuminaemia & Peripheral Edema
▪︎UnderNutrition
📍2. Relative Insulin Deficiency & Hyperglycemia
📍3. Mucous Inspissation in Pancreatic Ducts (Risk Of Recurrent Pancreatitis)
📍4. Secondary Amenorrhea in Women (But Can Give Birth) & Infertility in Men
📍5. Gallstones & Osteoporosis
📍6. Distal Bowel Obstruction (Thick Insspisated Mucous in Bowel Lumen)
📍7. Liver Cirrhosis & Portal Hypertension
🔹Dx Of Cystic Fibrosis
📍1. +Ve Neonatal Screening
📍2. +Ve Hx Of Cystic Fibrosis in Family (Siblings)
📍3. Clinical Features Present
📍4. Two +Ve Sweat Chloride Tests (≥60 mEq/L) ➡️ Dx Of Choice
📍5. DNA Analysis ➡️ Identify Two Mutations Responsible For Cystic Fibrosis
📍6. Nasal Potential Difference Test ➡️ Identify Abnormal Ion Transport Across Nasal Epithelium
🔹Mx (Symptomatic)
📍1. Antibiotics & Chest Physiotherapy
📍2. Pancreatic Enzymes Replacement
📍3. Laxatives Or Surgery For Meconium Ileus & Bowel Obstruction
📍4. Insulin For Hyperglycemia | 151 |
| 3 | اخر فرصة لاشتراك جات جي بي تي
جات بلص شهر كامل مع ضمان
@Alive332002 | 172 |
| 4 | 🔴Megaloblastic Anemia
▪︎Anemia Due To B12 Or Folate Deficiency That Interfere With Blood Cell's DNA Synthesis
🔹Causes Of B12 & Folate Deficiency
1. Breast Fed Infants Of Vegetarian Mother
2. Infants On Goat's Milk
3. Malabsorption Syndrome
4. Intrinsic Factor Deficiency (Pernicious Anaemia/Gastrectomy)
5. Ileal Diseases (IBD) Or Resection
6. Small Bowel Bacterial Overgrowth
7. Drugs (Methotrexate/Phenytoin/Valproate)
8. Increase Body Demands (Chronic Hemolytic Anemia/Prematurity/Pregnancy/Chemotherapy)
🔹Clinical Features
1. Anemia (Pallor/Anorexia/Fatigue)
2. Mild HepatoSplenoMegaly & Jaundice (Due To Mild Hemolysis)
3. Atrophic Glossitis (Beefy Red Tongue)
4. Atrophic Gastritis (Dyspepsia & Vomiting & Risk Of Cancer)
6. Intestinal Muocal Atrophy ➡️ Results in Chronic Diarrhea & Abdominal Pain
7. Neurological Changes (Only With Severe B12 Deficiency) ➡️ Peripheral Neuropathy/Deep Sensory Loss & Sensory Ataxia/Weakness & Paraplegia/Depression/Dementia/Coma
🔹Dx
📍1. CBC ➡️
▪︎Low HB
▪︎MCV High (>100)
▪︎Decrease Reticulocytes & WBCS & Platelets in Severe Cases
📍2. Blood Picture ➡️
▪︎Oval MacroCytic RBCs
▪︎HyperSegmented Neutrophils (4-5 Lobes)
📍3. BM Examination ➡️ Erythroid Hyperplasia & Megaloblastic Changes
📍4. Low Serum B12 Or Folate
📍5. +Ve Anti-Parietal Cells & Anti-IF AB ➡️ in Cases Of Pernicious Anaemia
🔹Mx
1. B12 Deficiency ➡️ Hydroxocobalamine IM 1000µg (1mg) Over 3w Then Every 3m For Life
2. Folate Deficiency ➡️ Folic Acid 5mg/Day For 4m | 214 |
| 5 | نصيحة لطلاب الطب لاتقرأ الملزمة مثل ماهي لان اغلب الملازم جافة وتمل بسرعة
خلي موضوع بالجات خاص بس للدراسة وخل هو يشرحلك الملازمة بشكل اجزاء هيج ماتنساها ابد حتى من يكمل شرح يدزلك ملخص بشكل صور او مخططات الها
استخدموا التكنلوجيا | 287 |
| 6 | 🔶C. Breast Cysts
▪︎Cysts Filled With Green-Yellow Fluid Present in The Breast During The Involution Phase (35-55 Years)
🔹Causes Of Breast Cysts
1. Regression (Involution) Of The Breast Stroma Results in Narrowing Of The Lobules Then Secretion Accumulation Then Ductules Obstruction
2. HyperEstrogenAemia
3. Hormonal Replacement Therapy (HRT)
🔹Clinical Features & Dx Of Breast Cysts
📍1. Seen More in PeriMenoPausal Period (35-55 Years Last Decade Of Reproductive Life)
📍2. Present As Sudden Breast Lump
▪︎Painless & Smooth (But Could Be Painful)
▪︎Multiple
▪︎Could Be Bilateral
▪︎May Mimic Carcinoma
📍3. US Features
▪︎AnEchoic Well Defined Halo
Oval Or Round Shape Mass
▪︎Thin Wall
▪︎Posterior Acoustic Enhancement
▪︎Horizontal Orientation بالعرض
🔹Mx Of Breast Cysts
📍1. Observation Only ➡️ If Asymptomatic & No Suspicious Features (Bi-Rads 2)
📍2. Aspiration Only ➡️ For Symptomatic Benign Cyst
📍3. Core Biopsy Or Excision ➡️ For Complex Cyst (Solid & Cystic Components) Or Blood Stained Aspiration (Risk Of CystAdenoCarcinoma)
📍4. Antibiotics ➡️ For Complicated Cysts With Infection
🔶D. GalactoCele
▪︎SubAreolar Breast Cysts Filled With Milk Present In Women During Or After Lactation
▪︎Usually Solitary (Single Cyst)
🔹Mx Of GalactoCele
📍1. Mostly Resolve Spontaneously After Stopping Of Breast Feeding
📍2. Aspiration ➡️ If Large & Not Resolved
📍3. If Recurrence ➡️ Do Nylon Strand To Open The Obstruced Duct Or Do ReAspiration
🔹Complications Of GalactoCele
1. No Resolution (Due To Inspissated Material)
2. Calcification
🔶E. Duct Ectasia
▪︎Abnormal Dilatation Of The Major Milk Ducts Results in Chronic Recurrent PeriDuctal Inflammation & Fibrosis
▪︎Due To Breast Tissue Involution (Shrinkage) During Ageing
🔹Clinical Features & Dx Of Duct Ectasia
1. Seen in Old Age Women (70 Years)
2. Present As Cheesy Or ToothPaste Nipple Discharge (Brown-Green-Mud Colour)
3. Slit-Like Nipple Retraction
4. Chronic Recurrent Mastitis ➡️ Results in SubAreolar Mass (Abscess) & Fistula
5. US Features ➡️ >3mm Major Milk Ducts Dilatation
🔹DDX Of Duct Ectasia
1. Breast Cancer
2. Mastitis
🔹Mx Of Duct Ectasia
1. Exclude Malignancy
2. Antibiotics For 2-3W ➡️ Co-Amoxiclav/Flucloxacillin/Ciprofloxacin/Cefixime/Metronidazole/Tinidazole
3. Major Mammary Duct Excision ➡️ For Profuse Nipple Discharge/SubAreolar Abscess | 317 |
| 7 |  Admission Criteria for Kidney Stones
#Emergency | 247 |
| 8 |  Gastrointestinal causes of chest Pain | 251 |
| 9 | السلام عليكم
يلي يريد يشترك بحساب جات بلس شهري خل يراسلني
@Alive332002 | 90 |
| 10 | أنصح الطلاب بالاشتراك بChat gpt اكثر من اي وقت اخر, النسخ الجديده دتسوي شغل حلو امانه.
كلود مفيد كلش كذلك بس بيها مشكله التوكينز ممكن ما تكون كافيه, فجات أصرف و يفي بالغرض | 184 |
| 11 | 🔴Bronchiectasis
▪︎Abnormal Permanent Dilatation Of Respiratory Bronchi As Result Of Chronic inflammatory Process Leading To Chronic Respiratory Infections (Chronic Productive Cough) & Lung Damage
▪︎Risk Of Progression into Respiratory Failure (Bad Prognosis)
🔹Causes Of Bronchiectasis
📍1. Congenital :
▪︎Cystic Fibrosis & Ciliary Dysfunction Syndrome
▪︎Primary Hypogammaglobulinaemia
▪︎Kartagener Syndrome/Young Syndrome/Yellow Nail Syndrome
📍2. Acquired :
▪︎TB Infection (Most Common)
▪︎Severe Infection in Childhood (Whooping Cough/Measles)
▪︎Foreign Body Ingestion
▪︎Suppurativa Pneumonia Infection
▪︎Allergic Aspergillosis
▪︎Bronchial Tumors
🔹Clinical Features Of Bronchiectasis
📍1. Chronic Daily Productive Cough
📍2. Pleuritic Chest Pain
📍3. Haemoptysis
📍4. Halitosis (Bad Mouth Odour)
📍5. Weight Loss & Anorexia
📍6. Exertional Dyspnea
📍7. Finger Clubbing (Not Always)
📍8. Auscultation :
▪︎Coarse Crackles & Wheeze
▪︎Local Diminished Breath Sounds (Lobe Collapse)
🔹Dx Of Bronchiectasis
📍1. Chest Xray (50% Sensitivity To See Signs Indicate Thickened Airways & Dilatation) :
▪︎Ring Shadow Sign
▪︎Tramlines Sign
▪︎Gloved Fingers Sign
▪︎Consolidation
📍2. CT (97% Sensitivity) :
▪︎1cm Airway Dilatation
▪︎Bronchial Wall Thickening
▪︎Airways Larger Than Accompanying Vessels (Signet Ring Sign)
🔹Mx Of Bronchiectasis
📍1. Regular Physiotherapy (To Assist Sputum Drainage)
📍2. Antibiotics :
▪︎Co-Amoxiclav/Macrolides (Clarithromycin)/Tetracyclines (Most Commonly Used)
▪︎Ciprofloxacin/Piperacillin-Tazobactam/Ceftazidime (For Psuedomonas Infection For 14 Days)
📍3. Bronchial Artery Embolization (For Severe Haemoptysis)
📍4. Surgical Excision Of Bronchiectatic Area
📍5. Lung Transplantation | 266 |
| 12 |  Babinski Sign | 276 |
| 13 |  Modified Allen Test | 322 |
| 14 | السلام عليكم
يلي يريد يشترك بحساب جات بلس شهري خل يراسلني
@Alive332002 | 685 |
| 15 |  البيان الرسمي لاطباء دفعة 2025. | 305 |
| 16 | 🔴Pneumothorax
▪︎Air Accumulation in Pleural Space (Between Visceral & Parietal Pleura)
🔹Causes Of Pneumothorax
📍1. Primary Sponetousnus :
▪︎Due To Apical Subpleural Blebs Rupture
▪︎No Hx Of Lung Disease
▪︎Mostly Occurs in Persons With :
🔻I. Cigarette & Cannabis Smokers
🔻II. Tall/Slim/Young Age Males (20-40 Years)
🔻III. Marfan Syndrome & Homocystinuria
📍2. Secondary Sponetousnus :
▪︎Hx Of Lung Disease Present
▪︎High Mortality Rate
▪︎Mostly Due To :
🔻I. COPD (Asthma Or Bullae Rupture in Emphysema)
🔻II. TB Infection & Lung Abscess
🔻III. Pulmonary Infarction
🔻IV. Lung Cancer
🔻V. Lung Fibrosis
🔻VI. Cystic Fibrosis
📍3. Traumatic ➡️ After Blunt Or Penetrating Or Iatrogenic Chest Trauma
📍4. Catamenial Pneumothorax ➡️ Pneumothorax Occurs At Time Of Menstruation In Women (Due To Endometriosis involving The Pleura)
🔹Types Of Sponetousnus Pneumothorax
📍1. Closed :
▪︎Air Accumulates Inside The Pleura Then The Leakage Stops
▪︎Spontaneous Air Absorption & Lung Re-Expansion in Days To Weeks
📍2. Open :
▪︎Air Moves Freely in & Out The Pleura
▪︎Seen in Emphysematous Bullae Rupture/TB Cavity/Lung Abscess
▪︎Risk Of Infection
📍3. Tension Pneumothorax (Most Dangerous) :
▪︎The Leakage Point Acts As One Way Valve Allow Air To Enter But Not Escape
▪︎Causing Large Amount Of Air Accumulation & Mediastinal Shift & Cardiovascular Compromise
🔹Clinical Features
📍1. Sudden Onset Unilateral Pleuritic Chest Pain & Dyspnea
📍2. Unilateral Decrease Or Absent Breath Sounds
📍3. Unilateral HyperResonant To Percussion
📍4. Unilateral Reduce Chest Expansion
📍5. Marked Tachycardia/Hypotension/Cyanosis/Tracheal Deviation Away (In Tension Pneumothorax)
🔹Dx Of Pneumothorax (By Chest Xray)
📍1. Visible Pleural Line
📍2. Absent Lung Markings At Periphery
📍3. Deep Sulcus Sign (Depression Of CostoPhrenic Angle)
*For Tiny Pneumothorax ➡️ Use Lateral Chest Xray
🔹Mx Of Pneumothorax
📍1. Give High flow Oxygen To All Patients
📍2. Mild Primary Sponetousnus (Lung Edge <2cm) ➡️ Resolve Spontaneously
📍3. Moderate To Large Primary Sponetousnus ➡️ Percutaneous Needle Aspiration Of Air
📍4. Secondary Sponetousnus (Chronic Lung Disease & Respiratory Distress Present) ➡️ InterCostal Tube Drainage & inpatient Observation
📍5. Tension Pneumothorax :
▪︎Immediate Insertion Of Blunt Cannula into The 2nd InterCostal Space Mid Clavicular Line
▪︎Then Chest Drain inserted into The 4th-5th-6th InterCostal Space Mid Axillary Line | 328 |
| 17 |  unilateral leg swelling:
DDx
▶ DVT(Deep vein thrombosis)
▶ Cellulitis
▶ Rupture Baker’s cyst
▶ Hematoma
▶ Trauma | 266 |
| 18 |  💢Collapsing pulse (water hammer pulse)
is a forceful pulse that rapidly increases and subsequently collapses.
🔹To assess for a collapsing pulse:
▪︎Palpate the radial pulse with your right hand wrapped around the patient’s wrist.
▪︎Palpate the brachial pulse (medial to the biceps brachii tendon) with your left hand.
▪︎Raise the patient’s arm above their head.
▪︎As blood rapidly empties from the arm in diastole, you should be able to feel a tapping impulse through the muscle bulk of the arm. This is caused by the sudden retraction of the column of blood within the arm during diastole.
🔹Causes of a collapsing pulse
▪︎Normal physiological states (e.g. fever, pregnancy)
▪︎Cardiac lesions (e.g. aortic regurgitation, patent ductus arteriosus)
▪︎High output states (e.g. anaemia, arteriovenous fistula, thyrotoxicosis) | 297 |
| 19 |  #Manegment of Pneumothorax 📝 | 275 |
| 20 | 🔴Pulmonary Hypertension
▪︎When The Mean Pulmonary Artery Pressure (BP Inside Pulmonary Arteries) At Least 25mmHg (Elevated)
🔹Causes
1. Mostly Due To Respiratory Failure By intrinsic Pulmonary Disease
2. As a Complication Of Connective Tissue Disease (Systemic Sclerosis)
3. From Chronic Thromboembolic Events (Recurrent DVT & PE)
4. Primary (Idiopathic) ➡️ Mostly Affects Women At Age Of 20-30 Years/Sporadic Or Familial/BMPR2 Gene Mutation
🔹Pathophysiology ➡️ Increase Pulmonary Vascular Resistance Or Increase Pulmonary Venous Pressure Or Increase Pulmonary Blood Flow ➡️ Causing RV Hypertrophy & Failure (Cor Pulmonale)
🔹Clinical Features (Mostly Due To RV Failure)
1. Dyspnea (SOB)/Chest Pain/Palpitation/Syncope On Exertion (By Fall in BP & No Increase in Cardiac Output)
2. Peripheral Odema/Ascites/Hepatomegaly (R Side HF)
3. RV Heave/S3 Heart Sound/Wide S2 Splitting/Loud P2/Raised JVP
🔹Ix & Dx
1. Right Heart Catheterization (Gold Standard) ▪︎Confirm Dx By Measuring Mean Pulmonary Artery Pressure (PAP 25 mmHg Elevated)
▪︎Or Measure Vasodilator Response Test (+Ve If Drop in PAP 10-40 mmHg)
2. Echo (Ix Of Choice) ➡️ Detect Right side Heart Enlargement
3. Chest Xray ➡️ Enlargement Of Pulmonary Arteries & Cardiac Silhouette/Loss Markings Of Peripheral Pulmonary Vessels (Pruning)
4. ECG ➡️ R Ventricular & Atrial Enlargement (Peaked P Wave in II & V1/Right Axis Deviation/Prominent R Wave in V1/Inverted T in V1-4)
🔹Mx
1. Diuretics For R Side HF Symptoms
2. Oxygen
3. Anticoagulants
4. Digoxin For Atrial Tachyarrythmia
5. Vaccination (Influenza & Pneumococcal)
6. Prostacyclin Analouge (Epoprostenol/Iloprost/Treprostinil)
7. Endothelin Blockers (Bosentan/Macitentan/Ambrisentan)
8. Phosphodiesterase Inhibitors (Sildenafil/Tadafill)
9. CCB in Vasoresponders (Patients Respond +Ve To Vasodilator Test)
10. Double Lung Transplant/Atrial Septostomy/Pulmonary ThromboEndArterectomy | 350 |
