AAS Medical Notes

Dyspneic old man with signifact past hx for DM and HT. #ECG

for both diagnosis is phrenic nerve palsy

left upper lobe pancoast tumor,compressing the phrenic nerve and cause left hemidiaphragm paralysis(by x_ray hemidiaphragm elevation)

these are the radiological finding A:left lung lobectomy B:after three years,right compensatory emphysema & left hemidiaphragm elevation (paralysis)

أبو ال DM من يجيك للطوارئ و ضايج هم سويلة ECG.

Spot the Dx !

Spot the Dx?

Remember😊 Pathogenesis of type I diabetes ➡️An autoimmune disease—mediates the destruction of β- cells. ➡️It develops in genetically susceptible individuals who are exposed to an environmental factor that triggers the autoimmune response; β-cell destruction ensues. ➡️Overt Type 1 DM does not appear until about 90% of β-cells are destroyed. Pathgenesis of type II diabetes. ➡️Obesity (greatest factor) plays a major role. it associated with increased free fatty acids, which make muscles more insulin resistant,. Therefore, obesity exacerbates insulin resistance. ➡️Lack of Insulin compensation in type II: Normally pancreas secretes more insulin in response to free fatty acids, thus neutralizing the excess glucose. In type II, free fatty acids fail to stimulate pancreatic insulin secretion. 👉Obesity increases the risk of type 2 diabetes 80–100 fold, 👉Type 2 diabetes is associated with metabolic syndrome. Metabolic syndrome has proposed criteria based on increased waist circumference (or BMI >30) plus two of: ⛔Diabetes (or fasting glucose >6.0 mmol/L), ⛔hypertension ⛔Raised triglycerides or low HDL cholesterol. Remember DM can cause painless or silent MI. ☢️Other causes of painless MI ▶️Diabetes mellitus with autonomic neuropathy ▶️Elderly ▶️ CVD أبو ال DM من يجيك للطوارئ و ضايج هم سويلة ECG.

Oxford

اووك نجاوب بفويس مبسط أن شاء الله

By which mechanism the patient with epilepsy can get acute renal failure ?? Please, do not google it 😂😂. اجانه بيشنت عنده هستري مال epilepsy و داخل بحالة uremic encephalopathy بالرغم من أن علاجاته الي جاي يآخذهن هن non nephrotoxic ، فشنو الربط ؟ @AhmedAbdSambot

Super summarized ECG notes with super benefits

QUICK HINTS ➡️Legionella pneumonia is common in organ transplant recipients, patients with renal failure ➡️Fever: this can be as high as 39.5–40°C. If swinging fevers are present this often indicates empyema  The absence of fever does not exclude ➡️cough, at first is short, painful and dry, but later is accompanied by the expectoration of mucopurulent sputum. ➡️Rust-coloured sputum may be produced by patients with Strep. Pneumon ➡️Upper abdominal tenderness is sometimes apparent in patients with lower lobe pneumonia or those with associated hepatitis. ➡️Physical signs of consolidation develops in 2 days, disappears after 2 weeks  Radiological signs develop 12 to 18 hours after the onset and usually disappear within 4 week Acute interstitial pneumonia 👉develops rapidly over days to weeks and results in progressive hypoxemic respiratory failure; 👉mortality is still high at 50%. 👉 predominantly affects the lower lobes of the lung, tends to affect a younger patient population, 👉 strongly associated with connective tissue disease (most often systemic sclerosis).

3 rd day post op (herniotomy) 31 yo F, complained of a sudden onset dyspnea with no haemoptysis . O/E : no cyanosis, tachpneia, tachycardia, no distended JVP . Normal chest auscultation . Your dx ? @AhmedAbdSam

#ECG

مثل متعرفون Haemophilia A Factor VIII deficiency Hemophilia B Factor IX deficiency Von Willebrand diseaseis deficiency or defect of von willebrand factor وهذا VWF اله دور بل platelet aggregation وايضا يساهم بعمل F VIII وهذا جدول مقارنه بسيطه المهم والي لازم ننتبهله Hepatitis C virus infection is the major cause of morbidity and the second leading cause of death in hemophilia patients exposed to older clotting factor concentrates. the bleeding seen in vWD is much milder than that of hemophilia spontaneous hemarthroses do not occur in VWD in VWD excessive haemorrhage may be observed only after trauma or surgery So In many patients, diagnosis is not made until prolonged bleeding is noted after surgery or trauma. Blood group antigens (A and B) are expressed on vWF, reducing its susceptibility to proteolysis As a result people with blood group O have lower circulating vWF levels than individuals with non-O groups

+ fever for 2 days duration . Ddx . @AhmedAbdSam