AAS Medical Notes

ALL 3 will give you Microcytic Erythrocytosis (Low MCV + High RBC Count): 👉 Polycythemia Vera 👉 Hypoxia 👉 Thalassemia Note: Microcytosis is disproportionately with very low MCV for the near normal Hb level that characteristics of thalassemia. ( Low MCV + High RBC count + Normal Hb) in this case 👇 So thalassemia is more suggestive than hypoxia and polycythemia vera #hematology

📑 Fatigue plus Suggestive diagnosis 📝 Female + fatigue + photosensitivity+ active urine sediment 👉 SLE nephritis 📝 Female + fatigue + pruritis + Raised ALP > AST and AST 👉 Primary biliary cirrhosis 📝Female + Fatigue + dyspnea+ Syncope 👉 Pulmonery HTN 📝Obesity + fatigue + daytime sleepiness 👉 Obstructive sleep apnea 📝Fatigue + hyperCa + cough 👉 Sarcoidosis 📝Fatigue + hyperCa + tummy pain + positive family history 👉 MEN type 1 📝 Female + fatigue + double vission 👉 Myasthenia gravis or Graves disease 📝 Female + Fatigue + hypoNatrimia 👉 Acute intermittent porphyria with SIADH 📝 Fatigue + hypoNa + hyperK 👉 Addison's disease 📝 Fatigue + hyperNa+ borderlime low k 👉 Conn's disease 📝 Male+ Facial appeance change + fatigue + uncontrol HTN/DM 👉 Acromegaly 📝 Fatigue + deranged LFT + joint pain + bloody diarrhoea 👉 Primary sclerosing cholangitis 📝 Male + fatigue + proximal myopathy after exercise or heavy carbohydrate meal 👉 Periodic paralysis 📝 Male + fatigue + Frontal baldness+ Ptosis+ Delayed relaxation of Hand grip 👉 Myotonic dystrophy 📝 Female + fatigue + proximal weakness + Muscle pain + raised CPK 👉 Polymyositis 📝 Female + Fatigue+ Low mood + Hot weather preference+ constipation 👉 Hypothyroidism 📝 ELDERLY + fatigue + shoulder & Hip girdle pain 👉 Polymyalgia rheumatica 📝 Young + Unusual fatigue + loss motion+ Iron & B12deficiency 👉 Celiac disease 📝 Female + fatigue all the time + sleep problem 👉 Chronic fatigue syndrome 📝 Fatigue + Other autoimmune disease or Gastrectomy 👉 Anemia (pernicious) 📝 Fatigue+ weight loss + fever+ night sweat 👉 Case for D.D (Cancer, lymphoma, HIV, infective endocarditis) 📝 Young female + Fatigue + deranged LFTs + secondary amenorrhoea 👉 Autoimmune hepatitis

This pt presented with insidious shortness pf breath. He is hypeetensive and asthmatic. What are the ECG findings @AASmedicalbot #ECG

Please, don’t perform carotid sinus massage CSM for the following patients: 1. Older than 45 years 2. Hx of transient ischaemic attack TIA or stroke 3. Hx of heart attacks (MI or angina) 4. Hx of VT/VF لان هذول المرضى عدهم peripheral vascular disease PVD و ممكن عدها carotid atherma الي يصير بيها dislodgment و تسبب stroke. ملاحظة ثانية: اذا المريض ما أستجاب إلى 10 second course of CSM فهذا poor responder، و شوفلك غير طريقة بعد، لان مهما تحاول ما راح يستجيب بعد. بس اكو طريقة حلوة: يكلك اكو نسبة جيدة من الاشخاص عدهم unilateral non respinsive، فلازم تنتقل للجهة الثانية ملاحظة ثالثة: CSM = compression on the carotid sinus with or without rubbing #cardio

أجتكم كيسات الـ Acute exacerbation of asthma??? كم كيس اجاكم بعد هذا التراب ؟؟؟ شلون سويتولهم منجمنت؟؟؟ حته باجر ان شاء الله راح نشرح الـ Managment of asthma exacerbation حسب الـ recent guideline @AASmedicalbot

👉 Beta blocker (Propranolol) >> Use as a Prophylaxis for Migraine. 👉 CCB (Verapamil) >>Use as a prophylaxis for Cluster Headache. #pharma

يلا يشباب أطربونا هههخخهه DM, HT, presented with shorteness of the voice. @AASmedicalbot #ECG

يمته اكول على مريض الضغط انه صار shocked؟؟؟ Shock in Previously hypertensive pt = decrease systolic BP by > 40 mmHg. مو كل hypotension هو shock يا اخوان؟؟؟ Hypotension + hypoperfusion = shocked What is the hypoperfusion?? Hypoperfusion = end organ dysfunction due to hypotension like mental confusion, peripheral coldness, oliguria, and increase lactic acids فهسه هذا المريض هو shocked، لازم نسأل نفسنه يا نوع من الشوك ممكن يكون عندة؟؟ لأن مثل ما تعرفون عدنا انواع من الشوك Hypovolaemic Anaphylactic Neurogenic Obstructive (like pulm embolism, cardiac tampinade) Septic, and Cardiac This patient has shock + congested lung + peripheral edema 👉👉 so, he has cardiogenic shock. What is the Rx??? Since the SBP > 89 mmHg 👉👉 so the drug of choice is dobutamine + high flow Oxygen + sitting position + try to exclude mechanical causes like mitral regurgitation و بس اكتب بالبحث dobutamine راح يطلعك شلون ننطية و شلون يجي و كلشي يطلعلك عنه. #cardio

Masquarding bundle branch block VS bifascicular block شلونه الفيديو؟؟ صراحة ما ردت اطول بيه، ردت هيدلاين بس #ECG

This pt presented with insidious shortness of breath for the last 3 days. He is known case of asthma + heart failure + hypertension, but he is mot smoker. O/E: SPO2 93% at room air Warm extremities Good capillary refill BP 90/60 mmHg Bilbasilar crepitation What are the ECG finding #ECG @AASmedicalbot

شلون positive energy ❤️❤️❤️. شكرا لكل متابعينا. أسأل الله لكم و لي التوفيق الدائم. @AASmedicalbot

و هاي التكملة Bifascicular block BFB #ECG

Bifascicular block اقروها زين، عدنا كيس عليها ان شاء بعد شويه ننزله #ECG

60yo pt, heavy smocker, presented with progressive fatigue, SOB with orthopnea, dizziness and mental confusion. PMHx:HTN & DM On medications: aspirin, metformin & anti-HTN O/E: Vital signs: BP = 90/ 75 mm Hg PR = 110 bpm regular RR = 22 breath/min SpO2 = 90% Cardiac auscultation: systolic murmur at cardiac apex His extremities: cool with edema in both legs Chest auscultation: wheezes. Neurological examination: confused, no lateralization ABG shows: pH 7.25 pCO2 36 mm Hg pO2 90 mm Hg HCO3 19 mEq/L lactate 7 mEq/L What is the most likely Dx? What is the most initial test? What is the most important initial Mx? 👇 @AASmedicalbot #cardio #emergency

طبعا هجي كيسات اتمنى اشرحها ع الصبورة او ورقة وقلم 😭😭😭😭😭😭 و نفهم شنو كهربائية القلب و نفهم شنو الـ ecg بطريقة 100٪ حتى نعرف نحل كيسات ecg حتى لو احنه ما شايفين مثلها قبل.

اگول شي مهم و كلش مهم In DKA, we send urine exam for ketone bodies اليورن دبستك الي موجود يتفاعل فقط مع الـ acetoacetate الي هو احد انواع الكيتون بودي. ما يتفاعل مع الـ beta hydroxybutyrate. و مثل ما تعرفون DKA is state of beta hydroxybytarate acidosis في حالات الـ DKA اهم شي عدنا هو الهيدروكسي بيوتاريت الي يكون 3 اضعاف الاسيتواسيتيت. فلا تعتمد على الـ GUE كلش، و حاول تدز المريض blood gas. This is the home message in DKA. Reference: Marino’s guideline #emergency

Inhaled insulin فد شي عظيم ❤️❤️❤️ ان شاء الله تتخلص الاطفال من حقن الانسولين المزعجة