Clinical medicine

🚨 Pulmonary Embolism (PE) Educational Pearl 🚨 💉 You can start the first dose of therapeutic anticoagulation based on clinical suspicion of pulmonary embolism before imaging 📸 👉 especially if there is an anticipated delay in confirming the diagnosis. ❓What is the definition of a suspected case of pulmonary embolism (PE)? A patient is considered to have a suspected PE when either of the following is present: 1️⃣ High probability of pulmonary embolism OR 2️⃣ Intermediate or low probability of pulmonary embolism ➕ positive D-dimer 🧪 📊 The probability of pulmonary embolism is assessed using validated clinical prediction tools such as: ✅ Wells score ✅ Geneva score The next step in suspected cases to confirm the diagnosis of pulmonary embolism is: CT pulmonary angiography. 🫀 Early recognition and timely anticoagulation can be lifesaving in selected patients ⏳💊 📚 Reference: European Society of Cardiology 2019 Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism.

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🏥جالنا شاب ٢٠ سنة في الطوارىء بيشتكي من تورم بالخصية اليمين مع وجود الم بقالها قد ايه؟ يومين ، رحت الصيدلية اخدت حقنة اتحسنت و رجعت تاني في افرازات صفراء بتنزل من العضو مع حرقان في البول؟ ايوا بنرفع الخصية لفوق الألم بيقل شوية positive prehn sign و ده دليل على وجود التهاب البربخ و ليس التواء بالخصية testicular torsion ، لو كان التواء بالخصية كان الألم هيزيد لما نرفعها لفوق كمان التحسن على الحقنة اللي اخدها في الصيدلية بتأكد انه مش التواء خصية كمان بنعمل cremasteric reflex بنجيب ظهر الhammer و بنمشيها على الجانب الداخلي للفخد حيث يوجد dermatome L1 اللي بيعمل reflex epsilateral testicular elevation و ده دليل على سلامة genital branch of genitofemoral nerve داخل الspermatic cord و ده بيأكد انه مش testicular torsion❌ ⚠️نخلي بالنا ان الprehn sign و الcremasteric reflex مش sensitive للحالة دي يعني ممكن يبقى شخص طبيعي و معندوش cremasteric reflex 🗨️شوية anatomy.. الgenital branch of genitofemoral nerve ده الefferent ، اما الafferent هو ilioinguinal nerve و ده ماشي جنب الspermatic cord مش جواه ، و هما الاتنين جوا الinguinal canal الilioinguinal nerve بيخرج من الsuperficial inguinal ring عشان يغذي الجلد في ال upper thigh & anterior scrotum التشخيص هنا هو عدوي الgonorrhea✅ اللي بتحصل بعد العلاقة الجنسية ب ٢-٥ ايام اما الchlamydia بتحصل بعدها باسبوعين او ثلاثة و ممكن يكون الاتنين موجودين مع بعض بنأكد التشخيص بإننا ناخد مسحة من العضو و نعمل urine analysis & culture🧪 العدوى بتيجي من علاقة جنسية او التهاب مجرى بول او التهاب بروستاتا و علاجهم 🔸azithromycin 1 gm or ofloxacin 400 or cifixime 800 mg signle dose for gonorrhea or single dose ceftriaxone 500 IM 🔸Azithromycin 1 gm for chlamydia 🔸Or doxycyclin 100 mg 1×2 for 7 days days for both chlamydia & Gonorrhea مهم برضو نستبعد وجود الم مفاصل او التهابات بالعينين🦵🏻👁️ لاستبعاد Reactive Arthritis اللي بتحصل بعد الchlamydia بأسبوعين او ثلاثة .. و هنا الblood culture بتبقى negative لأن دن reaction بس كده .. سلام❤️ د/عمر رشوان

✅ UpToDate is the leading clinical decision support resource with evidence-based clinical information – including drug topics and recommendations that clinicians rely on at the point of care. ✅Uptodate (1 year) ✅Advanced (Offline + Online): 35$ 👉All accounts are genuine to use on the official website and mobile app, and can be used on 2 seperate devices simultaneously.#UpToDateSubscription 👤Contact us now to get your subscription : @Amboss_Uptodate_medicine

https://t.me/+CRqLmho6qSM3ZmU0 High Quality information in pharmacology

Lichen planus: 6 P’s” (Purple, Pruritic, Polygonal, Planar, Papules, Plaques)

Congenital heart disease on X-RAY

👉 “Acute close glaucoma = A-B-C-D” A = Acetazolamide B = Beta blockers C = Carbonic anhydrase inhibitor D = Definitive laser

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6 posts with meeting with Beta blockers : 1️⃣ Meeting with Beta Blockers 2️⃣ Beta Blockers in Heart Failure 3️⃣ Beta Blockers in Hypertension 4️⃣ Beta Blockers in Arrhythmias 5️⃣ Beta Blockers in non cardiac uses 6️⃣ Special Beta Blockers

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