Medical notes

If the pt come to ER by relatives(not by him self ) as by his son or his wife ..... etc with this symptoms and signs 🥹shortness of breath, 🥹 salivation, 🥹 lacrimation, 🥲urination and defecation. oxygen saturation is 86% on room air. Examination shows increased bowel sounds. The most likely diagnosis is Organophosphorus poisoning https://t.me/clinicalnote

How to treat the ventricular dysrhythmias associated with TCA overdose? The antidysrhythmics use to treat 1- sodium bicarbonate the first line .....if not effective use 2_ lidocaine (2nd lines) If not effective use 3_ Bretylium is the third-line drug for TCA rhythm disturbances unresponsive to bicarbonate or lidocaine https://t.me/clinicalnote

😳Pt with elbow dislocation the most frequently neurovascular complication is Ulnar nerve injury then brachial artery injury 😳Pt with anterior shoulder dislocation the axillary nerve is at risk 😳Pt with Supra- condylar humeral fractures are associated with radial nerve and artery injuries.

😱Opioid overdose is characterized by respiratory depression, hypotension, bradypnea ,bradycardia, decreased bowel sounds, pinpoint pupils (may be of normal size), hypothermia and CNS depression (leading to coma).

Acute chest syndrome presents with: 1. Fever 2. Respiratory distress 3. Chest pain

most common cause of death in patient with sickle cell disease is Acute chest syndrome 😱

The most common causes of traveler's diarrhea is bacteria (E.coli)

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HOCM is the most common cause of sudden cardiac death in the young

Red Flags in Vertigo : * Age more than 55 years * Vertical Nystagmus * Cerebellar Signs * Abnormal Gait

Most common sites of hypertension intracerebral hemorrhage: *Pontine *Thalamic *Pons *Cerebellum

📝 OCP & headache: 👉 Always exclude cerebral venous sinus thrombosis in a young lady taking OCP with Headache with features of raised ICP 👉 Consider idiopathic intracranial hypertension in a young woman talking OCP when cerebral venous sinus thrombosis is excluded 👉 OCP aggravating headache suggests migraine, cerebral venous sinus thrombosis & idiopathic intracranial hypertension.

📝 YOUNG female, loss of weight, occasional diarrhea, anemia, Low calcium, LOW Albumin 👉 Celiac disease 📝 Young female, loss of weight, unusual fatigue, anemia, low calcium, NORMAL albumin 👉 Anorexia Nervosa. #notes

#Dyspnae with clear chest: Anxiety. Anaemia. Hypotension. Hypoglycemia . Sever Fatiguebility. DKA acidotic breathing. Neuromuscular diseases. Brain stroke . Morbid Obesity . Pregnancy. Polmonary embolism. Sarcoidosis. @clinicalnote

Phenytoin; adverse effects   👽PHENYTOIN    ⚡P­450 interactions    ⚡Hirsutism    ⚡Enlarged gums    ⚡Nystagmus    ⚡Yellow­browning of skin    ⚡Teratogenicity    ⚡Osteomalacia    ⚡Interference with B12 metabolism (hence anemia)    ⚡Neuropathies: vertigo, ataxia, headache #pharmacology      〰〰〰〰〰〰〰〰〰〰〰 @clinicalnote

D/D of postural hypotension 1.Hypovolemia(Vomiting, Diarrhoea, Diuretics) 2.Addison(Hypotensive) 3.Pheochromocytoma(Hypertensive) 4.Autonomic Neuropathy 7*Multiple system atrophy/Parkinson Diabetes Mellitus. *Amyloidosis. 5.Drugs(ACEi, α-blocker, Diuretics)

Emergency managment of #anaphylaxis @clinicalnote

# #Just_remember : .. .. 1 unit of insulin lowers the blood glucose level by 30–40 mg/dL Where as 10 g of carbohydrates increases the blood glucose level by 30–40 mg/dL @clinicalnote

-Ketonuria. ( Causes  of Ketonuria ) 1. diabetic ketoacidosis( DM type I )  --> absent of insulin --> increased beta oxidation --> Increased ketone bodies production --> ketonuria 2. Starvation  and malnutrition  -----> decreased of blood glucose -----> decreased or absent insulin ---> increased beta oxidation --> Increased ketone bodies production --> ketonuria 3. Von Gierke disease (glycogen stores cannot  be utilized) --> decreased blood glucose --> decreased insulin---> increased beta oxidation --->  ketonuria 4.  Increased vomiting --> carbohydrate loss--> decreased blood glucose --> decreased insulin ---> increased beta oxidation -->  ketonuria @clinicalnote

Important Diagnostic Points : 1:-Fever + constipation +relative bradycardia =Typhoid 2:-Fever (3 weeks) then 10 days free +arthralgia +lymphadenopathy + History of contact with milk products =Brucella 3:-Fever+tender hepatomegaly +GIT upset =ambeobic liver abscess 4:-Fever +chills +sweats+jaundice+travelling to endemic area =malaria 5:-Fever +lymphadenopathy+history of dealing with cats =Toxoplasmosis 6:-Night Fever = T.B , lymphoma , brucella or Malaria 7:-Fever + arthritis +UTI =gonococcal or chlamydia infection 8:-Fever +strawberry tongue =scarlet fever or kowasaki disease 9:-Fever +diarrhea +Heamolytic anemia =Hemolytic uremic syndrome or TTP 10:-Fever +fatigue +lymphadenopathy +bil hilar lymphadenopathy =sarciodosis or histocytosis X 12:-Fever +relative bradycardia=Typhoid 13:-Fever +low platletes+sub conjuctival hge = Dengue fever 14:-Fever +rigidity +history of atypical anti psychotic within 1 week =Neuroleptic Malignant syndrome 15-Fever +neck rigidty+photophopia+headache -+ agitation= meningitis 16-Fever +headache +nick stiffness+manifestation of cerebral dysfunction(aphasia , convulsion , monoplegia or flexion U.L and extension L.L ) +- urinary incontinence=encephalitis 17:-Fever + cardiac murmer +vegetations on Echo= infected endocarditis 18:-Fever +High E.S.R >100+renal impairment+hypercalcemia in old age =multiple myloma @clinicalnote