Important knowledge

⚡️مهم امسكيو Most commen cause of death in ▪︎RA = Cardiovascular ❤️ ▪︎SLE = renal ▪︎Secleroderma = pulmonary 🫁

#Romatology

Drug Of choice in neuro-pathic pain ( IN GENERAL ) هاي بالتسلسل 🔼 و نفس التسلسل يمشي على Post Herpetic Neuralgia المصدر جوه ⬇️ اما اذا الموضوع Peripheral Neuropathy due to DM ( 1st Line : Duloxetine )

⚡️ Initial treatment of choise (MCQs) ---------- ▪︎phaeochromocytoma should start alpha blocker before beta blocker اذا نطيتة بيتا بلوكر بالاول تبقه ال alpha receptors شغاله وتاخذ ال upper hand وتسوي severe vasoconstriction وتسوي hypertensive crisis ممكن تموته بيها ▪︎hypopituterisum should give cortisol replacement before thyriod hormone لانو اذا نطيته ثايروكسين بالاول راح يصعد عندة ال metabolism وهوه اصلا ماعندة steriod فهنا انت راح تدخلة ب adrenal crisis وممكن تقتله

⚡️Causes of spontaneous hypoglycemia 1:adesson diseas 2:insulinoma 3:late dumping synderm 4:insuline autoimmune syndrome 5:hypopituterisum ▪︎It is rare to occur without DM (mostly occur in diapetic pt.)

⚡️Diazoxide can reduce insulin secretion in insulinomas

⚡️Effect of steriod on CBC (يزود العالين وينزل الناصين ) 🔸️ Increase ⬆️ : ▪︎RBC ▪︎WBC ▪︎Neutrophils 🔸️decrease ⬇️ : ▪︎lymphocytes ▪︎Eosinophils

⚡️ imaging modality of choice ----------------- ▪︎Pituitary gland = MRI ▪︎Adrenal gland = CT

⚡️ وحدة من ال side effects مال ال antithyriod drugs هي انو ممكن تسوي Agranulocytosis لذلك اي مريض ياخذ antithyroid وجا عندة soar throat او اي انفكشن ثاني ندزة CBC ليكون ال WBC قليل !!

⚡️ serum T3 measurement ميفيدنا بتشخيص ال hypothyriodism لانه ميكدر يميز بين ال hypo & euthyroidism وعليه نعتمد على TSH & T4 ( اهم واحد ال TSH )

⚡️The nerves most likely to be affected in diabetic Mononeuropathy are the 6th and 3rd cranial nerves (resulting in diplopia)

Target of blood suger indices in DM pt.

⚡️Relatively small amounts of insulin are required to suppress lipolysis لذلك جماعة ال DM type 2 ▪︎نادرا مايصير عدهم DKA ( لانه يصير بسبب ال Lipolysis و FFA ) الا اذا صار insulin depletion بال advanced stages وهذا نادرا جدا بينما يصير بال DM type 1 لانه ماعدهم انسولين ▪︎نادرا مايصير عدهم wiegh loss لانه ال lipolysis is prevented by insulin ( عكس DM type 1 يصير عدهم wiegh loss لانه ماعدهم انسولين )

#endocrine ⬇️

#hematology ⬆️

⚡️ leukemia ▪︎AML = Auer rods ▪︎CLL = Smudge cells

⚡️B cell type is most common type of :- ▪︎acute lymphiod leukemia (ALL) ▪︎non hodgkin lymphoma ( except in pt. with celiac become most common T type )

⚡️Philadelphia chromosome (Ph1) & leukemia -------------------------- ▪︎CML = about all pt. (95%) = good prognostic sign ▪︎ALL = found in some pt. = bad prognostic sign

⚡️Splenomegaly is common in Polycythemia Vera while rare in Essential Thrombocythemia

Other inherited aplastic anemia (rare)