Act as Internalist 👨🏻‍⚕️🫀🩺

Pathophysiology of Clubbing

Mechanisms of Arrhythmias

Treatment of HF MRA SGTI Decrease morbidity and /or mortality in HFpEF

Stages of heart failure

Mnemonic Murmur 🫀

🟣Causes of Upper GI Bleeding: (Above the ligament of Treitz — esophagus, stomach, duodenum) 1. Peptic Ulcer Disease (PUD) — 40–60% Most common cause of upper GI bleeding. Includes gastric and duodenal ulcers. 2. Esophageal Varices — 10–20% Second most common cause. Seen in liver cirrhosis and portal hypertension. High risk of severe bleeding. 3. Gastritis — 10–15% Inflammation of the stomach lining, usually due to NSAIDs, alcohol, or infection. 4. Mallory-Weiss Tear — 5–10% Mucosal tear at the gastroesophageal junction, usually after severe vomiting. 5. Esophagitis — 5–10% Often caused by gastroesophageal reflux disease (GERD). 6. Malignancy — <5% Cancers of the stomach, esophagus, or duodenum causing chronic or acute bleeding. 7. Dieulafoy’s Lesion / AVMs — <2% Abnormal blood vessels that bleed suddenly and may be hard to detect on endoscopy. --- 🟢Causes of Lower GI Bleeding: (Below the ligament of Treitz — small bowel, colon, rectum) 1. Diverticulosis — Most common cause Common in the elderly. Usually painless bleeding. 2. Angiodysplasia — Second most common cause Vascular malformations, typically in the right colon. 3. Ischemic Colitis Common in older adults. Causes abdominal pain with mild to moderate bloody diarrhea. 4. Hemorrhoids Bright red bleeding, usually during or after defecation. 5. Colorectal Cancer / Polyps May present with chronic, occult, or overt bleeding. 6. Inflammatory Bowel Disease (IBD) Includes Crohn’s disease and Ulcerative colitis. Often causes bloody diarrhea.

🛑Remember ✅Beta blockers contraindication in treatment of decompensated heart failure unless failure due to tachyarrhythmia. cardio_NOT

محاضرات الدكتور أيمن السياغي

Meningitis Signs. • Brudzinski = Neck flexion → Hip & knee flexion. • Kernig = Hip & knee 90° → Pain/resistance on knee extension.

🫁 Sarcoidosis.

مرض multisystem granulomatous disease بيتميز بوجود: 🔬 Non-caseating granulomas ⭐ أهم العلامات: 🔹 Bilateral hilar lymphadenopathy 🔹 Pulmonary symptoms: dry cough + dyspnea 🔹 Erythema nodosum 🔹 Uveitis 👁️ 🔹 ↑ ACE و↑ Calcium 🔥 Classic: Bilateral hilar lymphadenopathy + non-caseating granulomas = Sarcoidosis

📌 Löfgren syndrome:

Erythema nodosum + bilateral hilar lymphadenopathy + arthritis + fever.

Behçet Syndrome | متلازمة بهجت مرض التهابي جهازي Systemic vasculitis يتميز بـ Classic triad : 🔹 Recurrent oral ulcers. 🔹 Genital ulcers. 🔹 Uveitis. + Skin lesions & arthritis. 📌 Pathergy test قد يكون Positive.

✓Hampton's hump- It appears as a wedge-shaped pleural-based opacity on chest X-ray, indicating pulmonary infarction from distal embolization. ∆ Classic Association- It Represents hemorrhagic infarction due to pulmonary artery occlusion, seen in ~22% of Pulmonary Embolism cases (low sensitivity) but 82% specific. ∆ Radiology Features- Peripheral dome-shaped density with base at pleura, apex toward hilum, often with pleural effusion in severe PE. • Pairs with Westermark's sign (oligemia). • Prompts anticoagulation, not antibiotics.

#Pusus_Paradoxus