AAS Medical Notes

Summary : Variant angina, why is it called variant ?? 1- commonly seen in young persons,unlike all other types of angina 2- commonly seen in females, unlike all other types. 3- commonly affect right coronary, unlike all other types . 4- commonly cause rest chest pain, unlike all other types of angina (except unstable angina). 5- Cause ST elevation on ECG at time of attacks, unlike all other types of angina (cause ST depression) . 6- beta blockers are contraindicated , unlike all other types of angina . 7- when you do coronary catheterization, you will see nothing (normal coronary artery). That is why this type of angina called variant.

Remember : Anti platelet that not used in IHD is dypridamole due to risk of coronary steal phenomenon

Remember : Furosemide is the most common cause of drug-induced bullous pemphigoid .

نسيت اجاوب هالكيس ، سوري .

Nice picture to see, palmer erythema . Ddx include : pregnancy, hyperthyroidism, liver cirrhosis, COPD, polycythaemia, and wet Beriberi

الأجوبة ما تساعد؛ اشعجب؟؟ ؛ شو الكيس كمن نوعا ما 😑😑

Interesting case to see . 19 yo F presented to ER with orbital edema for more than 3 days, after receiving hydrocortisone injection by her nurse . O/E : there is what you see in the picture + kussmual breathing. Investigations showed hyperglycaemia and ketonuria. Your dx ?? @AhmedAbdSambot

Papulopustular subtype of rosacea

Spot dx . -ve past medical hx . It is not sarcoidosis (for those who want to say it is a sarcoidosis 😒😒) . @AhmedAbdSambot

Thiscis the book that I promise you to post it if I receive right answers . I will post one of the answer here, Cannon "A" waves - Cannon A waves are intermittent and irregular jugular venous pulsations of greater amplitude than normal waves. They reflect simultaneous atrial and ventricular activation, resulting in contraction of the right atrium against a closed tricuspid valve. Prominent A waves can also be seen during some SVTs. Such prominent waves result from simultaneous atrial and ventricular contraction occurring with every beat. Lancisi’s sign is found in cases of severe tricuspid regurgitation, as blood flow returns back into jugular vein, in which the pulsation from right ventricular contraction is fused with the c wave, which normally occurs during closure of the tricuspid valve with loss of the x descent and followed by an augmented y descent.  

The question of day: What is the difference between Cannon wave and Lancisi’s sign ?? الي يجاوب هالسؤال اول واحد و اجابه صحيحة ، اله هدية (كتاب جداً قيّم) . @AhmedAbdSambot

Always remember, hepatic encephalopathy characterized by hypertonia and hyperreflexia with planter flexion, if planter response was in extension (Babinski sign) so this mean a severe form of HE . Manual clinical medicine

Splanchinc vein thrombosis SVT may be early manifestation or late complication of COVID-19 patients, where portal vein considered a common site of thrombosis . Fulminant abdominal pain in a known case of COVID-19 patient, is SVT with or without concomitant arterial thrombosis till proven otherwise .

Cannon wave differ from Corrigan sign, drs . Cannon wave indicate giant a wave of JVP and is seen classically in dissociated AV block where the right atrium contract against closed tricuspid valve (due to synchronized RV contraction, since the atrium and ventricles not contract consecutively) . For those who ask about the difference between corrigan and cannon . Thanks

Corrigan’s sign : visible pulsation of carotid artery . Causes: aortic regurgitation, patent ductus arterioisus, and hyperdynmic circulation (thyrotoxicosis, anaemia, and fever) .