Medical notes

Acute chest syndrome should be treated with careful hydration, adequate  analgesics, O2, and either transfusion to a hemoglobin of 10 g/dL or exchange transfusion if the hemoglobin is already ≥10 g/dL. In addition, antibiotics to cover for S pneumoniae, H influenzae, Neisseria, M pneumoniae, and C pneumoniae should be  administered.

Causes of Sinus tachycardia  1- Anxiety  2- Fever  3- Anaemia  4- Heart failure  5- Thyrotoxicosis  6- Phaeochromocytoma  7- Drugs, e.g. β-agonists (bronchodilators)

Symptoms of migraines— POUND Pulsating One day Unilateral Nausea Disabling Can diagnose migraine in patients with >3 of these criteria without further evaluation.

❇️Causes of Localized Oedema: 👉🏼Acute inflammatory oedema 👉🏼Hypersensitivity oedema 👉🏼Oedema due to venous obstruction 👉🏼Oedema due to Lymphatic obstruction (e.g. Filariasis) 👉🏼Pulmonary oedema, Peritoneal effusion etc 👉🏼Cyclical or periodic oedema ❇️Causes of Generalized Oedema: 👉🏿Cardiac oedema (e.g. CCF) 👉🏿Renal oedema (e.g. Nephrotic syndrome) 👉🏿Nutritinal oedema→ Famine oedema, Protein losing gastro-enteropathy 👉🏿Hepatic oedema (e.g. HCC, Liver cirrhosis) 👉🏿Oedema due to Adrenal hormones 👉🏿Anaphylaxis 👉🏿Cyclical or periodic oedema Rapid Revise (FCPS, MD, Diploma)

Hyperthyroidism treatment in pregnancy Propylthiouracil in 1st trimester, methimazole in 2nd &3re trimesters

#Cardiac_pearls 1. Dextrocardia ± situs inversus, possible Kartagener Syndrome if with lung crepitations. 2. Mitral valve prolapse with mid-systolic click ± late systolic murmur. 3. HOCM with jerky pulse, double apex beat, systolic thrill at LLSE and harsh ejection systolic murmur. 4. Trivial mitral stenosis, to exercise the patient and turn to left lateral position and hold breath in expiration for mid-diastolic murmur. 5. Coarctation of aorta with radiofemoral delay, weak femoral pulse, scapular bruit, systolic murmur at left scapula, hypertension. 6. Pericardial effusion with muffled heart sound, elevated JVP and enlargement of cardiac dullness. 7. Constrictive pericarditis or restrictive cardiomyopathy with elevated JVP, oedema, ascites, soft diffuse apex

Just reminder HIV common cerebral lesions . Toxoplasmosis = multiple ring enhancing lesions >>> sulfadiazine +pentamidine+folinic acid . Crytococcal meningitis= very high CSF pressure with lymphocytosis and positive India ink >>>> steroids plus antifungal IV. CMV encephalitis = infarction like lesions with excess protein and mononuclear leucocytosis in CSF >>> IV Ganciclovir .

🔘《Intrauterine Infections》 Causes《Cataract》In Newborns🔻        🔹Rubella 🔹Herpes simplex 🔹Varicella 🔹Toxoplasmosis 🔹Syphilis #USMLE

Rheumatoid arthritis commonly involves the joints of hands, wrist, elbow, knees, ankle, and feet in a symmetrical manner. Axial skeleton involvement is usually limited to Upper Cervical Spine.

Trigeminal neuralgia presents with brief episodes of sudden and severe "electric shock-like" or "stabbing" pain in the distribution of CN V (particularly V2 and V3). Carbamazepine is the drug of choice for ttt

Complications of diverticular disease ● Diverticulitis ● Abscess ● Peritonitis ● Intestinal obstruction ● Haemorrhage ● Fistula formatio

‘Red flags’: when present in patients with back pain, red flags suggest the likelihood of serious underlying pathology ● Age <20 years or >50 years  ● Recent significant trauma  ● History of malignant disease  ● Unexplained weight loss ● Constitutional symptoms (fever, chills)  ● Immunosuppression (intravenous drug abuse, prolonged corticosteroid use) ● Severe or progressive sensory alteration or motor weakness  ● Acute difficulty with micturition (painless retention)  ● Numbness in perineum or buttocks and/or faecal incontinence

Intracerebral haemorrhage ● These account for 10–15% of strokes ● Presentation is with headache, focal deficits and signs of  raised ICP ● High blood pressure may be chronic so should only be reduced with care ● Anticoagulants should be reversed ● In fit patients, clot evacuation is an option to relieve raised ICP but not reverse deficits ● Further imaging may be required to exclude an underlying vascular or neoplastic lesion

Subarachnoid haemorrhage ● Most result from rupture of an aneurysm of the circle of Willis ● Plain CT and LP are first line investigations ● Even ‘good grade’ patients treated promptly have a significant  morbidity due to vasospasm, cardiac arrhythmias, neurogenic  pulmonary oedema, etc

Congenital diaphragmatic hernia is  more common on the left (as liver  blocks the right). Bochdalek is the most common form.

Triad of abdominal pain, hypotension,pulsatile abdominal mass = AAA until proven otherwise.

The most common location of AAA  rupture in emergency department (ED) patients = retroperitoneum.

Urticaria, angioedema, anaphylaxis, and atopic dermatitis are examples of type I hypersensitivity reactions occurring in the skin.

#Potato nose-Rhinophyma #Nasopharyngeal ca cause - Ebv #True about BERA- used for SNHL #Atrophic rhinitis - youngs operation #Decreased bone conduction-cochlear pathology #Laryngeal crepitus seen in all, except-post cricoid ca #High arched palate, mouth breathing, child-adenoid hypertrophy #Laryngomalacia image #Causative agent of croup-parainfluenza virus

The mammary glands enlarge significantly during pregnancy as a result of proliferation of alveoli at the ends of the terminal ducts