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"أوضعُ العِلم ما وَقفَ علىٰ اللسان،وأرفعُهُ ما ظَهرَ في الجَوارِحِ والأركان" -مجموعة مِن طالبات طب الكوفة. Mcq + Cases + USMLE questions + medical informations and articles 📖📃 للتواصل بشكل مجهول؛ @TollaboilmBot
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الشهر الجاي هيچ وقت
نحط راسنا ع المخدة واحنه مخلصين الكلية😭😭
🙏 80😢 21❤ 6😱 5🎉 4👍 2🔥 1🤔 1
Repost from ECG made easy
📌مفاتيح حل كيسات الإمتحان الوزاري كل كيس بالامتحان اخذ منه فقط المهم وجاوب.
#Cardiology
CARDIOLOGY (PROBLEM SOLVING).
#Cases
Ddx of Chest pain + ST segment
Elevation
• Transmural myocardial infarction
• Prinzmetal angina.
• Pericarditis.
✒️✒️✒️✒️✒️✒️
1) ANGINA PECTORIS
Old male, smoker or e' hyperlipidemia.
retro-sternal chest pain, ↑ e' exercise,↓ by nitrates and rest, <30 min.
ECG = ↓ST segment.
ST depression
S. Troponin negative
💡💡💡
2) VARIANT ANGINA
Prinzmetal angina=
Young age, no risk factor.
Retro-sternal chest pain not related to exertion.
ECG = ↑ ST segment.⬆️
ST elevation
S. Troponin negative
📌📌📌
3) MYOCARDIAL INFARCTION
old male, smoker + sever chest pain at rest + ↑ ST segment.
ST elevation +-
S. Troponin positive ⬆️⬆️
📌• If complicated with Pulmonary odema dyspnea, orthopnea, pink frothy sputum, sense of impending death.
Bubbling crepitation all over the chest.
💡💡💡💡
4) RHEUMATIC FEVER
5-15 yrs old pt, sore throat (tonsillitis)
after 2-3 wks he developed asymmetrical arthritis, tachycardia, muffling of heart sounds, diastolic murmur.
Or 📌
Pansystolic Murmur ( Rheumatic Fever)
ECG↑ PR interval.
Prolonged PR interval ⬆️
📌📌📌📌
5) IEC = (FEVER + MURMUR)
Infective endocarditis
After a surgery or tooth extraction.
Fever in cardiac Patient . Rheumatic Activity / IEC/Chest Infections.
💡💡💡💡
6) VIRAL PERICARDITIS Viremia (flu like
History of flu or sore throat then after weeks patient with chest pain aggrivated by cough,sneezing
Relieve by rest.
Or 📌
Chest Pain when Taking Breath , FHMA [ Fever , Headache , Malaise , Anorexia ] , Pericardium Rub ,
(Elevated ST concave shape in All Leads ( Viral Pericarditis
✒️✒️✒️✒️✒️✒️
7) . CONSTRICTIVE PERICARDITIS
Patient past history of T. B
dyspnea, orthopnea, (neck veins)
+pulsus paradoxus.
📌📌📌📌📌
8) HOCM = Young Athlete + Sudden Death after Exercise. (Autosomal dominant + murmur ↑ )
Ddx Aortic stenosis 📌
MI
Mitral valve prolapse
Arhythmiogenic RIGHT ventricular cardiomyopathy
✒️✒️✒️💡💡
9) PULMONARY EMBOLISM
Cough, dyspnea, sudden chest pain (pleurisy) unexplained tachypnea pulmonary embolism.
Tachycardia
History of prolonged sitting no movement
In Ecg tachycardia or RBBB or S1 Q3 T3
D. Dimer high ⬆️⬆️
📌📌📌📌📌
10) DISSECTING AORTIC ANEURISM
Old male, un-controlled HTN.
Severe acute chest pain radiating to the back.
unequal pulse volume on both sides.
unequal blood pressure on both sides
✒️✒️✒️
11) Left atrial MYXOMA = Young female e' recurrent
syncopal attacks.
In Echo thrombus in left atrial.
🔖🔖🔖
12) MV PROLAPSE = Young female e' atypical
chest pain, recurrent arrhythmiae'
palpitation.
Fever + Murmur + Any thromb- embolic manifest. eg. Hemi-plegia
📌📌📌
13.) Diabetic Patient , Epigastric Pain Not Relieved by Antacids , Nausea , Vomiting ( Inferior MI).
St elevation in leads II, III, AVf
💡💡💡💡
14.) Murmurs
✒️✒️✒️✒️✒️
Mitral valve stenosis = mid diastolic localized to apex.
✒️✒️✒️✒️
MR = Systolic ("pan Systolic murmur and radiating to Axilla.
💡💡💡💡💡
AR = early Diastolic murmur in 2nd Aortic Area & AS = ejection Systolic murmur Radiating to Carotid Apex + Syncope
🔖🔖🔖🔖
Irregular Pulse & Stroke = atrial fibrillation
💡💡💡💡
Ischemic Pain ( If > Half hour = MI ... If < Half hour = Angina)
✒️✒️✒️✏️✏️
15.)
Persistant ST Elevation in Patient with MI
( Myocardial Aneurysm [ Late Complication . of MI ]
🖊️🖊️🖊️
16. )
Symptoms of Low Cop + Muffled Heart sound + Low voltage ECG ( Pericardial Effusion).
Or cardiac tamponade if with Severe chest pain, SOB.
💡💡💡
17. )
Multiparus Female + Dyspnea & Chest Pain +.
Loud S2 ( Pulmonary HTN “ Repeated Showering.
🔖🔖🔖🔖
18. )
Chest Pain + Cough + Dyspnea + Hemoptysis + tinge of jaundice ( Pulmonary Infarction).
🔖🔖🔖
19.)
Acute Shock + Cyanosis + Dyspnea + Low cop ( Massive Pulmonary Embolism).
🧩🧩🧩
20. )
Long Standing “ severe ” HTN + Disturbed Conscious Level Without Lateralization
( Hypertensive Encephalopathy).
✨✨✨
21.)
Anorexia , Nausea , Vomiting & Blurring of Vision in Patient with HF ( Digitalis toxicity).
#وزاري
👏 3
Repost from ECG made easy
🔮مفاتيح حل حالات الجهاز التنفسي Respiratory cases
#RESPIRATORY CASES
🩻🩻🩻🩻🩻🩻🩻🩻🩻
1. Dyspnea , Chest Tightness , Cough , Clear Sputum , Triggered by Exercise
( Bronchial Asthma).
🩻🩻🩻
2. Dyspnea , Cough , Wheezes 1 Hour after Aspirin ( Aspirin Induced Asthma).
🩻🩻
3. *Cough , Yellow Sputum , Dyspnea , Heavy Smoker , Hyper-Resonance of Lung ,
Expiratory Wheezes ( COPD).
🩻🩻🩻
4. Acute Dyspnea , Shortness of Breath , Sitting Too Much Time in Bed or Bus , Taking
( Pulmonary Embolism).
🩻🩻
5. Tall , Thin , Sudden Dyspnea , Smoker , Right Sided Chest Pain
( 1ry Spontaneous Pneumothorax).
🩻🩻🩻
6. Yellow Sputum , Dullness , XCR: Infiltration of Left Lower Lobe
( Community Acquired Pneumonia).
🩻🩻🩻
7. Hemoptysis , Chronic Bronchitis , Weight Loss , Heavy Smoker , Clubbing
( Bronchogenic Carcinoma).
🩻🩻🩻
8. History of Pneumonia , Dullness , Blunt Costophrenic Angles
( Exudative Pleural Effusion).
🩻🩻🩻
9. Dyspnea , Dry cough , Facial Congestion , Bluish Tinge
( Superior Mediastinal Syndrome).
🩻🩻🩻
10. COPD Patient Develops Sudden Stabbing Chest Pain ( Simple Pneumothorax).
🩻🩻🩻
11. Sputum-:
Smoker [ Chronic Bronchitis ] + Hemoptysis ( Bronchogenis Carcinoma).
🩻🩻🩻
12. Smoker [ Chronic Bronchitis ] + Dyspnea + May be Wheezes & Excessive Sputum
( COPD).
🩻🩻
13. Hemoptysis + Loss of body weight + Night sweating ( TB).
🩻🩻🩻
14. Purulent sputum = Suppurative ,, If After Operation ( 1ry Lung Abcess).
🩻🩻🩻
15. Wheezy Chest in Young Age ( Bronchail Asthma).
🩻🩻🩻
16. Chest troubles (cough, dyspnea...etc) With polyurea, polydypsea & normal blood glucose →SARCOIDOSIS PRESENTED BY DI
🩻🩻
17) Chest troubles with HSM,LN enlargement& erythema nodosum, weight loss, night sweating
In chest x ray bilateral lymphadenopathy
→ SARCOIDOSIS
🩻🩻🩻
18 ) Past history of TB then exertional dyspnea POST TB FIBROSIS
🩻🩻🩻
19) Past history of TB then dyspnea, orthopnea, ascites = CONSTRICTIVE PERICARDITIS
🩻🩻🩻
20) Past history of TB then hypotension & hyper-pigmentation= Addinosin disease
🩻🩻
21) Past history of TB. then headache & neck rigidity➡️ =TB MENINGITIS
🩻
22) Past history of TB... abdominal distension with unilateral shifting dullness ASCITES LOCULATED TB=
🩻
23) DVT congested neck veins, LL edema, enlarged tender liver➡️ COR-PULMONALE DUE TO THROMBO-EMBOLIC P**
🩻
24) Cough, chest pain, SVC obstruction, Associated with Myasthenia gravis or pure red cell aplasia. CXR: Mass in superior mediastinum →THYMOMA➡️
🩻
25.) Old Male heavy smoker, change in Cough. Hemoptysis pattern + Clubbing
→BRONCHIECTASIS OR BR. CARCINOMA
🩻
26) Cirrhosis + no viral & autoimmune markers + Emphysema, ➡️ANTITRYPSIN DEFICIENCY
🩻
27) Chest disease LL edema &puffiness of eye
lids heavy proteinuria Complicated by
AMYLOIDOSIS KIDNEY (NEPHROTIC)➡️
Ddx
. 📌chronic lung abscess Bronchiectasis
. 📌Chronic empyema
. 📌TB
🩻
28) Young adult + sudden chest pain after exertion (driving bicycle)→ RUPTURE BLEB
🩻
29) COPD patient presented with
sudden chest pain
→PNEUMOTHORAX (RUPTURE BULLAE)
🩻
30) SUDDEN DYSPNEA & CHEST PAIN
Different diagnosis
. 📌Pneumothorax
. 📌Myocardial infarction
. 📌Pulmonary embolism
🩻
31) ACUTE CHEST PAIN & SHOCK
Different diagnosis
📌Tension pneumothorax.
📌Extensive myocardial infarction.
📌Massive pulmonary embolism.
📌Dissecting aortic aneurysm.
🩻
32) pt. with peptic ulcer..upper endoscope was done..on the 2 day... severe retro-sternal chest pain, crunching sound with the heart
Freely you have received; freely give.
beats...CXR: air around the hear pneumo mediastinum &➡️ Acute mediastinitis
🩻
33) fever , dyspnea, chest pain, cough &expectoration & rusty/blood stained Sputum PNEUMONIA➡️
🩻
34) PNEUMONIA NOT RESPONDING TO treatment ,
Atypical pneumonia (Legionella, Mycoplasma) Resistant organism eg staph(MRSA) Underlying disease eg:
❤ 3👏 1