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supraventricular Tachycardia management يكون كالتالي: 1- استخدام ال vagal manoveurs واهمها carotid sinus massage لمدة بضع ثواني (مثلا 15 ثانية) ونراقب تغير ال rhythm بال ECG 2- استخدام adenosine vial 6mg/2ml في حال عدم حصول استجابة، وريدي سريع IV rapidly بجرعة 6 mg (اي فيال واحد) ونراقب ال rhythm وننتظر 5 دقائق فاذا لم تحصل استجابة نعطي جرعة اخرى 12 mg (اي فيالين) وننتظر 5 دقائق فان لم تحصل استجابة نعطي جرعة اخرى 12 mg (يجب ان نعطي NS IV push حوالي 10 cc بعد كل جرعة ونرفع يد المريض من اجل وصول العلاج بسرعة الى قلب المريض) 3- استخدام metoprolol amp 5mg/5ml في حال عدم حصول استجابة، وريدي بطيء IV slowly بجرعة 5 mg (اي امبولة واحدة) ونراقب ال rhythm فان لم تحصل استجابة يمكن تكرار نفس الجرعة بعد كل 5 دقائق لغاية 3 مرات. 4- استخدام isoptin amp 2.5mg/1ml في حال عدم حصول استجابة، وريدي بطيء IV slowly بجرعة 5 mg (اي امبولتين) ونراقب ال rhythm ف ان لم تحصل استجابة يمكن تكرار نفس الجرعة بعد كل 15 دقيقة لغاية 3 مرات. 5- استخدام amiodarone amp 150mg/3ml في حال عدم حصول استجابة، تسريب وريدي IV infusion: اولا: loading dose بجرعة 300 mg (اي امبولتين) في 200 cc من NS لمدة 30 دقيقة ثانيا: maintenance dose بجرعة 300 mg (اي امبولتين) في 500 cc من NS لمدة 8 ساعات

نوع وجرعة السوائل الوريدية IV fluids اللي ننطيها للأطفال الخدج neonates هي كالتالي حسب العمر: أ- عمر 1 يوم: 10% glucose water بجرعة 60 سي سي لكل كيلوغرام في ال term baby وبجرعة 70 سي سي لكل كيلوغرام في ال preterm baby ب- عمر 2 يوم: 10% glucose water بجرعة 70 سي سي لكل كيلوغرام ج- عمر 3 يوم: 1/5 glucose saline بجرعة 80-90 سي سي لكل كيلوغرام د- عمر 4 يوم فما فوق: 1/5 glucose saline بجرعة 100 سي سي لكل كيلوغرام

Early vaginal bleeding in pregnancy *Female with vaginal bleeding but cervix closed —> threatened abortion *Female with vaginal bleeding and cervix open without expulsion of fetal tissue —> inevitable abortion *Female with vaginal bleeding and partial expulsion —> incomplete abortion *Female with complete expulsion of the fetus —> complete abortion * Female with dead fetus but no expulsion—> missed abortion

Giant cell arteritis (GCA) or temporal arteritis Which is autoimmune vasculitis of large and medium sized arteries... Jaw claudication , limb claudication, temporal artery abnormalities (e.g., tenderness, thickening, or loss of pulses), and signs of AION significantly increase the positive likelihood ratio for GCA The vital information here that you should put it in your mind that if giant cell arteritis is highly suspected, diagnostic measures SHOULD NOT DELAY the initiation of high-dose glucocorticoids to minimize the risk of vision loss. * Immediate administration of high-dose glucocorticoids is crucial to lowering the risk of permanent vision loss in patients with giant cell arteritis ...

Edward syndrome trisomy 18 ; which is the most common autosomal trisomy in which fetuses can survive to birth, after trisomy 21( Down syndrome )

- What are you seeing ? - What maybe the respiratory cause of this ? - What's the name of this syndrome ? Answers : - partial ptosis and miosis . - Pancoast tumor . - Horner's syndrome.

Tripod position which is dyspnea-relieving position , might seen in COPD and Asthma .

Semi-recumbent position ( sitting at 45 degree ) Seen in patients with Orthopnea

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Rule of two While reading X-ray in orthopedics, rule of two applies. That is when-ever you read an X ray you need to have 2 views, one joint above the suspected injury site and 1 joint below, comparing both the limbs . 2 View: AP and lateral view recommended in mostly to see the deformity/ displacement , angulation 2 abnormalities: If one abnormality found always look for the next one as finding one might mask the concurrent another injury. 2 Joints: One joint above and 1 joint below to rule out involvement of joints . 2 limbs: If doubtful always compare with contralateral limb. 2 occasions: Always compare with previous Xray if available. 2 brains : If doubtful should always be reviewed by another observer.

Coffee bean sign ☕️ The coffee bean sign (also called “kidney-bean sign” or “bent-inner-tube sign”) is a classic conventional radiographic finding of sigmoid volvulus. Sigmoid volvulus is condition in which the sigmoid colon wraps around itself and its own mesentery, causing a closed-loop obstruction . The patient presents with the traid of abdominal pain, distention, and constipation ... #radiology

Cauliflower ear, or boxer's ear results from accumulation of blood in the subperichondrial space. Without proper drainage, the underlying cartilage loses its blood supply, ultimately resulting in necrosis, fibrosis and neocartilage formation... #Clinical_sign

Red man syndrome " also called vancomycin flusing reaction . - This syndrome mainly occurs because of either a rapid infusion of vancomycin or the first administration of the drug ... -It's an anaphylactoid reaction caused by rapid infusion of vancomycin » Nonspecific mast cell degranulation rapid release of histamine.. - Symptoms : Diffuse flushing of the skin, pruritus mainly of the upper body Muscle spasms and pain in the back and chest , Possible hypotension and dyspnea . - Can be prevented by slowing the rate of infusion and pretreating with antihistamines ...

Blue man syndrome متلازمة الرجل الازرق Due to chronic use of amiodarone drug . السيناريو الي يجي بيه ، مريض on chronic atrial fib. treatment وصار عنده هذا ال discoloration .

This patient was admitted to the emergency department with a sharp object (knife) in his back. He was stabbed during an altercation Very important note : Do not remove the stabbing tool if it is still present in the body. Leave the stabbing tool in the body, because the tool helps reduce blood flow, and pulling the tool leads to increased bleeding and thus death. Also, moving it or putting pressure on the tool may cause more tearing of internal organs. It is best to leave it to the specialists... بالمختصر يعني مو صحيح تشيل السجين او الاداة الحادة المطعون بيها الشخص و انت ما تكدر تتخذ الاجراء الصحيح او متواجد بمستشفى او قريب منها ، لان هاي الأداة مشتغلة سدادّة plug , من تشيلها ممكن يصير نزيف قوي متسيطر علية او تسبب ضرر للانسجة او الاعضاء اذا طلعتها بطريقة خاطئة... التدخل العشوائي الاجتهادي والغير مدروس غالبا اضراره وعواقبه اكبر من عدم التدخل ..

هذا المريض Gingival hyperplasia والي تكون عادةً drug-induced  By history taking : Past medical history: epilepsy Drug history : phenytoin وضح ال cause ، ال phenytoin من اهم الأدوية الي تسوي GH Phenytoin induced gingval overgrowth. وهي هاي من ال Side effect المهمة للفنتوين ، ف الباحثين قسموا الموضوع قسمين آلفنتوين ديسوي tissue growth  فليش ما نستعمله بتسريع ال healing process  ، فحاليا طلع phenytoin cream يستخدموه عند ال  wounds اكو أدوية أخرى تسوي gingival hyperplasia؟ اي ، أهمها آل calcium channel blockers وال cyclosporine . Spontaneous regression usually occurs after cessation of the agent. Other causes include gingival inflammation, leukemia, and hereditary gingival fibromatosis.

One of the nice teaching cases that i have seen in the medical ward .. 80 years old male presents with SOB + productive cough + very long history of smoking History suggests COPD , and he already diagnosed with copd .. On general examination, he has Clubbing ( As shown above ) . And this is a RED FLAG 🚩🚩 in patient with COPD , because COPD itself doesn't cause clubbing .. 🌟Nail clubbing is not a finding specific to COPD; its presence usually suggests comorbidities such as bronchiectasis, pulmonary fibrosis, or lung cancer !!. Beside that the patient has significant weight loss !.. So our suspicion to malignancy here has rised just from few S&S from history and exam and after that we should do the appropriate workup ... Regardless this case , What i want to say is , History and exam most of the time are enough to know and diagnose the condition of the patient if we did it in the proper way and listen carefully to the patient . Unfortunately this art that differ physicians is undervalued by us and neglected ... actually we need to focus on these skills [ taking history and exam ] , and not be highly dependable on imaging and other Invesgations...

الكورسات الخاصة بمادة الباطنية والجراحة صارت كاملة لطلبة المرحلة الرابعة كلية الطب جامعة واسط للتوضيح والأستفسار تابع القناة https://t.me/Ahmedabdalkareem96