Medical notes

#JUST_REMEMBER CAUSE OF LMN 7th CN palsy : • Bell's palsy • Ramsay-Hunt • CPA tumor • Parotid gland tumor • Mononeuritis multiplex • Polio • Otitis media #JUST_REMEMBER Causes of Bilateral LMN 7th CN palsy : • GBS • Sarcoidosis • Bilateral Bell's palsy • MG • Lyme disease @clinicalnote

✨Typical presentations of chest pain: 1️⃣:Acute coronary syndrome: Sudden onset central crushing chest pain radiating to the left arm and/or jaw lasting longer than 20 minutes. Associated symptoms can include sweating, clamminess, nausea and shortness of breath. Symptoms are often worsened by exertion and improved with GTN spray. 2️⃣:Stable angina: Sudden onset central chest pain radiating to the left arm and/or jaw lasting fewer than 20 minutes with complete resolution of pain during rest. Often triggered by exertion and resolved with GTN spray and/or rest. Associated symptoms include shortness of breath. 3️⃣:Pericarditis: Gradual onset of central chest pain worsened by lying flat and improved by leaning forwards. Associated symptoms can include fever and fatigue. 4️⃣:Thoracic aortic dissection: Sudden onset central chest pain radiating through to the back and often described as 'tearing' in nature. Associated symptoms include pre-syncope and syncope secondary to haemodynamic instability. 5️⃣:Pneumonia: Gradual onset of sharp chest pain worsened by deep inspiration (pleuritic in nature). Associated symptoms include productive cough, shortness of breath, fever and malaise 6️⃣:Spontaneous pneumothorax: Sudden onset sharp chest pain worsened by deep inspiration. Associated with shortness of breath. 7️⃣:Pulmonary embolism: Sudden onset chest pain worsened by deep inspiration (pleuritic in nature). Associated symptoms include shortness of breath and haemoptysis (rare). 8️⃣:Gastro-oesophageal reflux: Gradual onset central chest pain that is typically described as burning in character and worsened by lying flat. Associated symptoms can include nausea and vomiting 9️⃣:Oesophageal spasm: Sudden onset central chest pain relieved by GTN spray (hence it is often confused with acute coronary syndrome). Associated symptoms can include dysphagia, heartburn and regurgitation.

🛑 DAWSON Cretiria for primary GI Lymphoma : 1_ absence of palpable Lymphadenopathy . 2_ absence of mediastenal lymphadenopathy on radiograph. 3_ normal BM biopsy and peripheral blood smear. 4_ disease grossly confined to the involved viscus. 5_  regional lymphadenopathy only 6_ Liver and spleen not effected , unless direct extention from primary site.

Drugs and Erectile Dysfunction

DM with HTN ADA 2024

2)#Just_remember #Sign Of Portal Hypertension: *Splenomegaly *Esophageal varices *Caput medusa *Venous hum In Epigastrium

#The reversible complications of haemochromatosis are: *DCM *skin pigmentations #the irrervesible complications are: *liver cirrhosis *hypopituitarism *arthritis *hypogonadotrophic hypogonadisim

Just_remember 💉HyPERcalcemia (⬆️ Ca) can causes Pancreatitis. But 💉Pancreatitis causes HyPOcalcemia (⬇️ Ca).

#Just_remember Lesions of the cerebellopontine angle Causes compression of  trigeminal, facial &vestibilocochler C Nerves #ENT @clinicwlnote

#Just_remember The commonest site for hypertensive intracerebral haemorrhage is >>basal ganglia

#Just_remember The most common physical finding in nasopharyng.ca. is a neck mass consisting of painless firm lymph node enlargement (80%) @clinicalnote

#Just_remember most common cause of painless hematuria in male above 50  yrs is transitional cell carcinoma of bladder @clinicalnote

Type Of Metabolic acidosis 1-Normal anion gap Mechanism :- • Loss of bicarbonate Etiologies :- • Severe diarrhea • Renal tubular acidosis • Excesssaline infusion • Intestinal or pancreatic fistula • CAI & MRA diuretics 2 -Elevated anion gap Mechanism :- • Accumulation of unmeasured acidic compounds Etiologies :- • Lactic acidosis • Diabetic ketoacidosis • Renal failure (uremia) • Methanol, ethylene glycol • Salicylate toxicity @clinicalnote

✔️Metabolic Acidosis Causes "KUSSMAL" Ketoacidosis Uremia Sepsis Salicylates Methanol Alcohol Lactic Acidosis @clinicalnote

-Investigations in case of septic arthitis ✨ CBC increased wbc count CRP raised Blood culture Joint US check for joint effusion Joint aspiration and c/s Joint xray -------------------------- -Treatment : (4A) Admit Antipyretic Analgesia Antibiotic IV @clinicalnote

Supraventricular Tachycardia Treatment: "ABCDE" Adenosine Beta-Blocker Calcium Channel Antagonist Digoxin Excitation (Vagal Stimulation) @clinicalnote

Anti-insulin hormones :- 1- Growth Hormone 2- cortisol 3- Andeogen 4- Glucagon .@clinicalnote

DDx Pulsus Paradoxus • Most etiologies of RV failure except restrictive cardiomyopathy (e.g. acute RV MI) • Constrictive pericarditis (rarely) • Severe obstructive pulmonary disease (e.g. asthma)  • Pneumothorax  • PE • Cardiogenic shock • Cardiac tamponade • Constrictive pericarditis @clinicalnote

✪ Types of insulin: 1. Short acting (Regular): ▹ Onest: 30 - 60 minutes ▹ Peak: 2 - 4 hours ▹ Duration: 6 hours ⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑ 2. Intermediate acting (NPH): ▹ Onest: 2 - 4 hours ▹ Peak: 6 hours ▹ Duration: 12 hours ⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑ 3. Insulin analogue: ► Rapid: ▹ Onest: 5 - 15 minutes ▹ Peak: 2 hours ▹ Duration: 4 hours • Lispro (Humalog) • Aspart (NovoRapid) • Glulisine (Apidra) ⌑⌑⌑⌑⌑⌑⌑⌑⌑⌑ ► Long (Based): ▹ Peakless ▹ Duration: 24 hours • Glargine (Lantus / Toujeo) • Detemir (Levemir) • Degludec (TRESIBA) #Endocrinology @clinicalnote

Predictors of Poor Prognosis in Precarditis Major • Fever >38o C • Subacute onset •Large pericardial effusion  •Cardiac tamponade •Lack of response to ASA or NSAIDs after at least a week of therapy Minor • Myopericarditis • Immunosuppression • Trauma • Oral anticoagulant therapy @clinicalnote