AAS Medical Notes

Note : Bilateral tender gynecomastia 👉🏽👉🏽 think about spironolactone side effect . Other cause of bilateral gynecomastia are unlikely to be tender .

Which of the following comorbid conditions is more commonly associated with a higher incidence of gout? A Cushing syndrome B Hypertriglyceridemia C Pseudohypoglycemia D Osteoporosis

It is a case of staphylococcal scalded skin syndrome SSSS . Staphylococcal scalded skin syndrome (SSSS) is a serious skin infection caused by the bacterium Staphylococcus aureus. This bacterium produces an exfoliative toxin that causes the outer layers of skin to blister and peel, as if they’ve been doused with a hot liquid. SSSS — also called Ritter’s disease.

اذا الممرض گالك مو البيشنت 😑😑

المنجمنت مال ال tachy arrhythmia بطريقة بسيطة نوعاً ما . #ECG

Nice case to see . This patient received voltaren IM, he developed this lesion after a series of changeable lesions . It is very painful . Nicola syndrome : drug allergic reaction . Patients with NS experience extremely severe pain around the injection site of the drug immediately after injection, followed by rapid development of erythema, a livedoid reticular patch or a hemorrhagic patch.This skin reaction is pathognomonic. The reaction may result in necrosis and ulceration of the skin, subcutaneous fat, and muscle tissue

7 days neonate, he is febrile and has these skin lesions . Dx and mx .@AhmedAbdSambot

This is an interesting case This is an intermittent preexcitation Looks to extrasystole preceded by p wave with short PR interval and delts wave (W pattern) with widening ORS complex, Then followed by normal sinus beat ...... This patient need .... Exclusion of acute ischemia at top of work up Then send for holter study and electroohysiological study .

seronegative spondyloarthropathies مجموعة أمراض تشترك بالأعراض المرضية مع ال RA لكن تختلف عنها ببعض الشغلات المميزة اللي منها انو serology يطلع negative لل rheumatoid factor ومنها اجت التسمية بصورة عامة التشخيص صعب بس اكو common features ممكن نعتمد عليها ولا ننسى انو اكثر من مرض ضمن هاي المجموعة ومثل ماكو اشياء تشركهم سوة اكو اشياء اخرى تميزهم عن بعض -الاشياء اللي يشتركون بيها : negative for rheumatoid factor , genetic association with HLA-B27, generally more commonly affect men(عكس ال RA اكثر ب female), age onset between 20-40 yrs (بRA usually more than 40 yrs), عادةً يجون ب loser back pain و pain ب sacroiliac joint (especially at right,spared in RA), asymmetrical oligoarthritis (RA symmetrical) hallmark lesion هو enthesitis(site of ligament or tendon insertion into bone)e.g.achilodynia, usually respond to NSAIDS اما الصفات اللي تختلف بيها extra-articular manifestation vary according to type مثلاً ب reactive arthritis الeyes وال urethra involved الى جانب الarthritis لكي ماننساها نجمعها بعبارة can’t pee🚽,can’t see👁,can’t climb a tree🌲 the skin involved ب psoriatic arthritis بالإضافة الى bowel involvement spondyloarthropathies associated with crohn’s & UC

ضعيفين بالتخطيط، ضعيفين بالباطنيه، ضعيفين بالجراحه، بالاطفال، بالجلديه 😒😒😒

#ECG

Hypohidrotic ectodermal dysplasia (HED) is a genetic skin disease. Common symptoms include sparse scalp and body hair, reduced ability to sweat, and missing teeth. HED is caused by mutations in the Eda, EDAR, or EDARADD genes. It may be inherited in an X-linked recessive, autosomal recessive, or autosomal dominant manner depending on the genetic cause of the condition. The X-linked form is the most common form. The forms have similar signs and symptoms, however the the autosomal dominant form tends to be the mildest. Treatment of hypohidrotic ectodermal dysplasia may include special hair care formulas or wigs, measures to prevent overheating, removal of ear and nose concretions, and dental evaluations and treatment (e.g., restorations, dental implants, or dentures).

5 years +anaemic + thin hair + dry skin + this characteristic shape of teeth . Dx @AhmedAbdSambot

Remember these notes about Wolff Parkinoson White syndrome WPWS : 1- there is accessory pathway, which is called bundle of Kent, that conduct the impulses from atria to ventricles away from AV node. This pathway is faster than AV node, so the PR interval will be short 2- Those patients are inherently labile for AF, which will be dangerous, since the impulses will conducted rapidly into ventricles causing VT . 3- if you block AV node by drugs (like digoxin, verapamil, bisoprolol), the pathway will shifted from SV node to bundle of kent, that is mean you push the patient into severe form of arrhythmia. 4- amiodarone is Bundle of Kent inhibitor, so it is considered the safe anti arrhythmic in WPWS .

Ddx of elevated JVP + shock 1- Cardiogenic shock 2- Cardiac tampnade 3- Pulmonary embolism 4- Tension pneumothorax 5- Right ventricular infarction

Acral fibrokeratoma (AF) is a solitary, benign, round, firm lesion of the soft tissue. The body of the lesion usually appears as a hyperkeratotic, skin-colored projection with two main morphologic forms: 1) sessile, dome-shaped or 2) pedunculated. Acral fibrokeratomas continue to grow and usually do not regress spontaneously. Rx : surgical excision . Recurrence is rare after removal .