AAS Medical Notes

هذا الكلام حقيقة، اكثر مما هو ترويج . من تسألني تگلي اريد كتاب #لازم ادرس عليه قبل الروتيشن، اگلك هذا الكتاب لازم تتطلع عليه و تحفظ جميع البروتوكولات الي بيه. انا اشوف صعب على طبيب حديث التعيين يمشي الطوارىء أو ال CCU بدون هذا الكتاب. صح هو اسمه كارديو، بس راح تشوف نفسك ملم بأغلب الادوية الي متوفرة بالطوارىء، تشوف نفسك ضليع جدا بال ecg و تعرف تقرء التخطيط حتى لو ما شايف مثله قبل، لأن ببساطة هو يفهمك بالتخطيط مو يحفظك. و تگدر تسأل اي شخص مقتني الكتاب. متوفرة الطبعة الثالثة (آخر طبعة) عند مكتبة مشروع مثفف، تكدر تراسلهم و تطلب نسخة. هذا رابط المكتبة ع الأنستا https://www.instagram.com/educated_project/profilecard/?igsh=MTM3OHl0dzV6YXJz

بروتوكول الأتروبين في حالات organophosphate OP poisoining و أكيد هذا الشرح موجود بس بكتاب واحد، و ماكو داعي أذكر أسمه 😌😌😌

نسولف عنه شويه؟؟

نسوي فد بث بسيط؟؟ و لو الوقت متأخر ههه

According to UpToDate, the target of albumin therapy is not primarily to normalize serum albumin levels. Instead, the goals depend on the clinical context: A. Restoring intravascular volume: In cases like shock or hypovolemia, the focus is on improving hemodynamic stability and maintaining adequate perfusion, rather than achieving a specific serum albumin level. B. Managing hypoalbuminemia in specific conditions: In conditions such as nephrotic syndrome or liver disease, albumin therapy is used to help maintain oncotic pressure, reduce edema, and improve fluid balance, not necessarily to normalize serum albumin. C. Post-paracentesis in cirrhosis: Albumin is given to prevent circulatory dysfunction and renal impairment after large-volume paracentesis rather than targeting albumin levels. In summary, the therapeutic aim is usually symptom control (e.g., stabilizing circulation, reducing edema) and preventing complications rather than strictly normalizing serum albumin levels. Monitoring clinical response (e.g., blood pressure, urine output) is often more critical than achieving a target albumin concentration.

Croup Part of my lecture in paediatric emergency course. For more details, contact me on @AhmedAbdSam

An interesting case: young age male presented with fever + cola-like urine + hypertension. Renal indices were elevated GUE: proteinuria + RBC casts Dx: glomerulonephritis, but what is the cause?? next: send for complement level, which show severe hypocomplementenemia. Hypocomplementemia is more frequently present in all types of MPGN than in other glomerular disorders and provides supportive evidence of the diagnosis. In immunoglobulin/immune complex–mediated MPGN, the classic complement pathway is activated; C3 is normal or mildly decreased, and C4 is typically decreased. In complement-mediated MPGN, the alternate complement pathway is activated; C3 is decreased, but C4 is normal. In MPGN without immunoglobulin complement deposition, C3 and C4 are normal. The workup is pending .......

و اني جاي اراجع بكتاب ال Ahmed for ICU انتبهت على عدد الصفحات عابر ال 1250 صفحة فعليهِ راح ابدي اقلل بالمواضيع و اقلل بالشرح، حتى يكون الكتاب محمول. بس صدكوني-مو مدحاً-ما راح تحتاج تراجع او تقرأ اي كتاب يخص الطوارىء او ال ICU بعد هذا الكتاب. و انا مسؤول عن كلامي ان شاء الله.

Previously: acute AF: when the duration of AF <48 hr, in such states we can cardiovert the pt. new guideline (uploaded 3 days ago): acute AF where the duration <24 hrs. AF with >24 hrs, do not attempt to cardiovert the pt. ESC guideline 2024

الحمد لله أولاً و آخراً internal medicine emergency course pediatric emergency course for more, contact me @AhmedAbdSam

Neuro sign: Pronator Drift is the single best test for detecting SUBTLE upper motor neuron lesion (stroke), which may remain unrecognised by routine motor examination. Interpretation: drift with eye open >> motor deficit drift with eye closed >> sensory deficit up ward drift >> cerebellar deficit

فد معلومة بسيطة و ع السريع In allergy, shall I choose Difen or Allermine اثنينهم متوفرات و نفس الامبولة؟؟ better to choose difen... what is the dose?? 25-50 mg IV direct over 5 min, can be repeated يعني الجرعة مو امبولة عند الحاجة !!!!!! جاي تتخيل الفرق بين العلم و الواقع العملي !!! فدائما اي معلومة تسمعها، ارجع ابحث عنها، اتحقق من صحتها، يلا تطبقها.

Summary: 62 yr old M, hx of urine incontinence 9 months ago labelled as neurogenic bladder. 1 mn later, he developed backache + progressive lower limb weakness and paresthesia, labelled as disc prolapse and operation done with no improvement. 1 mn post op, the weakness involved the upper limbs equally and the patient developed hypotonic speech & nasal regurgitation with frequent chocking during eating or drinking. Area of hyposthesia from T4-T11. your ddx and management??

An interesting ECG: 1. STE in inferior leads, lead III >II 2. reciprocal STD in avL>lead I 3. upsloping STD in anterior leads with tall R wave. 4. first degree AVB. just remeber: in such cases: A. do not give angiseed (there is possibility of RVMI which is masked by post MI). B. beta blockers should be used with cautions. كيس من الحبيب د.حسن خشان

Nice case: difficile–Induced Diarrhea: Oral vancomycin or oral fidaxomicin is recommended by the American College of Gastroenterology for the treatment of a primary episode of nonsevere C. difficile–induced diarrhea. Fidaxomicin 200 mg orally every 12 hours for 10 days is recommended by the IDSA and SHEA as first-line therapy for C. difficile infection.  Fidaxomicin decreases the risk of recurrence more than vancomycin. Vancomycin 125 mg orally 4 times a day for 10 days is an alternative. Metronidazole is no longer recommended as first-line therapy for C. difficile–induced diarrhea. However, oral metronidazole can be used if vancomycin or fidaxomicin is not available. Vancomycin 500 mg orally or by nasogastric tube 4 times a day and metronidazole 500 mg IV every 8 hours are recommended by the ISDA/SHEA for fulminant disease without ileus. If ileus is present, a retention enema can be given as a dosage of vancomycin 500 mg in 10 mL saline per rectum 4 times a day.

Asthma flare up: typically, in asthma exacerbation there will be over wash up of CO2, resulting in low CO2 level (resp alkalosis with metabolic acidosis). Therefore, normal PaCO2 (relative CO2 retention) is very ominous in asthma exacerbation, and always is an indication for RCU admission. high PaCO2 is a sign of life-threatening asthma, and transient intubation is commonly needed.

بين فترة و فترة تجيني هيج رسائل محفزة، ف انشرها هنا حتى ابقى اتذكرها. الحمد لله

Hypertrophic cardiomyopathy HCM The ECG usually shows voltage criteria for LV hypertrophy (eg, S wave in lead V1 plus R wave in lead V5 or V6 > 35 mm). Very deep septal Q waves in leads I, aVL, V5, and V6 are often present with asymmetric septal hypertrophy; hypertrophic cardiomyopathy sometimes produces a QRS complex in V1 and V2, simulating previous septal infarction. T waves are usually abnormal; the most common finding is deep symmetric T-wave inversion in leads I, aVL, V5, and V6. ST-segment depression in the same leads is common (particularly in the apical obliterative form). The P wave is often broad and notched in leads II, III, and aVF, with a biphasic P wave in leads V1 and V2, indicating left atrial hypertrophy. Incidence of preexcitation phenomenon of the WPW type, which may cause palpitations, is increased. BBB is common.