Note
Open in Telegram
لاتتُوقف إلاّ عندمَا تكُون فخوراً بنفِسك 💚 for any question or note 💜 contact with me 😊 @zahrahumaidi
Show more3 082
Subscribers
No data24 hours
No data7 days
-630 days
Posts Archive
3 082
A 59-year-old man presents with a cramping pain in his left calf that occurs with walking.
select the next most appropriate investigation.
3 082
Leriche syndrome is a clinical syndrome described by intermittent claudication, impotence, and significantly decreased or absent femoral pulses. This syndrome indicates chronic peripheral arterial insufficiency due to narrowing of the distal aorta
3 082
A 14-year-old girl is brought by her parents to the emergency department with a 12-month history of indigestion, nausea and stomach upsets. She has a history of psychiatric problems, for which she is under regular follow-up. Abdominal examination is unremarkable. A barium swallow shows an irregular, round filling defect in the duodenum.
3 082
A 42-year-old woman presents with a 24-hour history of central abdominal pain and vomiting. On examination, she has a midline laparotomy scar but no other abnormality.
3 082
ℹ The most common causes of small bowel obstruction are (1) adhesions, (2) hernia and (3) tumours.
ℹ The most common cause of a large bowel obstruction is tumour.
✔ When the intestines become obstructed, the bowel distal to the obstruction collapses and the proximal portion dilates.
✔There is increased peristalsis in an attempt to relieve the obstruction, resulting in colic. Eventually, the blood supply to the bowel becomes impaired (ulceration, gangrene and perforation) and pathogens can transudate into the peritoneal cavity (peritonitis).
✔The four cardinal symptoms of intestinal obstruction are colicky abdominal pain + distension + vomiting + obstipation (an inability to pass flatus or faeces).
3 082
+1🍯Honeycomb lung : is the term used to describe severe pulmonary fibrosis.
Amiodarone-induced lung disease is a common side effect, and occurs in about 1 in 10 patients.
✔Patients typically present with exertional dyspnea as the dominant symptom. Low-grade fever, anorexia, muscle weakness have also been reported . In approximately a third of patients, the presentation may mimic pulmonary infection .
3 082
🔪💊💣 An important drug reaction occurs between verapamil and b-blockers. These two drugs must not be given together because of the risk of hypotension and asystole.
3 082
⚠life-saving indications of steroids :
1. Adrenal crisis: It is acute adrenal insufficiency precipitated by sepsis, trauma, anticoagulant therapy or sudden withdrawal of steroids from a patient with presumed adrenal atrophy owing to chronic steroid administration.
2. Acute systemic anaphylaxis.
3. Acute severe asthma with hypoxia (status asthmaticus).
4. Acute cerebral oedema.
5. Waterhouse-Friderichsen syndrome: It is acute adrenal insufficiency associated with septicaemia due to Pseudomonas or meningococcemia in children without an evidence of prior adrenal insufficiency (healthy children).
6. Acute attack of multiple sclerosis or acute disseminated encephalomyelitis.
7. Unexplained shock.
3 082
ℹ Causes of anaemia in chronic renal failure :
The anaemia is normocytic normochronic. It is due to;
• Iron or folate or both deficiency .
• Haemolysis (extracorpuscular destruction).
•Bone marrow suppression by uraemic toxins .
• Impaired erythropoietin synthesis.
• Bleeding from GI tract (chronic blood loss) .
• Blood loss is exaggerated in patients on haemodialysis because of use of heparin during dialysis and the retention of blood in the dialyzer and associated tubing.
3 082
Contraindications
• AV blocks
• Gross CHF refractory to digitalis
• Bronchial asthma or allergic conditions
• Cardiogenic shock
• Anaesthesia
• Oesophageal stricture and/or obstructive changes in GI tract.
Special precaution to be observed
• Betablockers should not be stopped abruptly. They should be withdrawn slowly
• They should not be used in CHF unless patient is fully digitalised. Carvidolol and nebivolol are only used in CHF.
• They should be avoided in combination with calcium channel blockers because of their potentiating effects
• Avoid their use in diabetes mellitus as they may mask features of hypoglycaemia, if it develops.
• When used I.V, give slowly or with atropine so to avoid severe bradycardia
• Pregnancy safety has not be proved.
3 082
🔮Uses of betablockers :
They are used in the treatment of:
• Hypertension
• Angina
• Arrhythmias
• Some patients of CHF (e.g. carvidelol)
• Phaeochromocytoma
• Mitral valve prolapse
• Anxiety neurosis
• Thyrotoxicosis
• Migrainous headache
• Essential tremors
• Glaucoma (timolol eye drops)
• Esmolol is the only betablocker used in the treatment of narrow QRS tachycardia (PSVT).
3 082
اختصارا للوقت رتبت الحل بالنسبة لل mcq, EMQ 👍
اوصيكم به خيرا زملائي في طب الكوفة وادعولي 😆😉
