HiMed NUCOM 32

السلام عليكم اعلاه ملفات تحتوي على تلخيص كامل أغلب محاضرات الكسور ( ortho and truma) وملف تلخيص أغلب محاضرات النسائية ورابط يحتوي على محاضرات الجراحة ملخصه بنفس الطريقة ان شاء الله يكونن نافعات ويختصرن عليكم وقت ولا تنسونا من صالح دعاءكم ويهدى ثواب العمل اعلاه الى روح المرحوم الدكتور عباس ياسر عاصي رحمه الله ولا تنسوه من الدعاء والفاتحة

55 yrs old with poorly controlled DM presented with blurring of vision O/E: he has weakness in rt eye adduction and downward rotation and the primary position is in outward and upward position with ptosis. To complete the examination we should examine the pupillary reflex to discriminate between surgical and medical causes of 3rd CN palsy and full neurological exam to determine the site of the lesion After doing all these measures, he had diabetic 3rd CN palsy كل الشكر لعمنا غيث مقيم اقدم نيورو على شرحه وتوضيحه بالفديو ❤️ @ghaithmt #medicine

This type of presentation with multi-system involvement should alarm us to look for possible vasculitic process inside our body Vasculitis، you haven't taken it yet, you will take this subject in rheumatology from its name is inflammation of blood vessel with multi-systemic involvement which means any organ can be involved.

Poor prognostic factors in IgA nephropathy : Presentation at later age Male patient Heavy proteinuria Renal impairment at the time of presentation (possible RPGN) Presence of hypertension

48 yrs old male smoker with -ve PMH presented to the emergency with his son complaining of decreased urine output with this rash for 4 days duration. His condition started when they noticed this pinpoint petechial-like spots only on his extremities, not itchy, no history of drug intake before the rash. The rash lasted for 2 days and disappeared.Then, he reported 2 episodes of painless red color urine and decrease in the amount of urine during these 2 days. He also reported bilateral leg swelling which was gradually increasing, not time-specific, no abdominal distension (ascites).No history of epistaxis, chronic sinusitis, hemoptysis, weight loss nor drenching night sweat but he reported sore throat with rhinorrhea days before his condition. Investigations showed Urea 124 mg/dl Creatinine 8.55 mg/dl Serum K 4.1 GUE RBC consistent with acute kidney injury and decision was made to do 3 sessions of dialysis Later on he was diagnosed with IgA nephropathy by renal biopsy #medicine

This skin rash is in a patient with ESRD on dialysis showing umbilicated violaceous papules with central scaly hyperkeratotic core, with post- inflammatory hyperpigmentation suggestive of perforating dermatosis Other DDx can be considered are Guttate lichen planus and perforating folliculitis #medicine

Chest radiograph of young male with history of productive cough with copious amount of sputum at early morning and chronic sinusitis which shows dextrocardia, right-sided aortic arch, peribronchial cuffing and bronchial dilatation(bronchiectatic changes) suggestive of Kartagener syndrome. #medicine

Excellent Khalid This px has pellagra which is B3 deficiency Characterized by 3 Ds(dermatitis, dementia and diarrhea). What supports our dx is that the px is alcoholic (alcohol decrease B3) And HIV +ve px (anti-retroviral tx decreases absorption of B3) 1-well defined hyperpigmented scaly rash or plaque on the sun exposed area 2- it's called casal's sign or necklace 4-porphyria is on top of the differential diagnosis, in addition to Lichen Planus actinicus and PLE 5-Niacin supplements orally 250-500 mg once daily and treatment of his condition

34 years old homeless who is alcohlic diagnosed with HIV 6 months ago with his CD4<200 cells , recently started to develop loss of memory with Occasional aggressive behavior On exam there was this rash 1-describe the rash 2-what do you name this rash around his neck 3-what is his dx 4-what are the ddx for this rash 5-what is the tx #medicine

عاشت ايدكم ع الاجوبة Causes of greasy stool: 1-Intestine: (coeliac IBD) 2-Pancreas: (Chronic pancreatitis cystic fibrosis) 3-Liver: (primary biliary cholangitis , primary sclerosing cholangitis , biliary atresia) 4-Drugs: cholysteramine 5-Infection: giardiasis

What are the causes of greasy oily stool? #medicine

Excellent shahad This patient's complaint is SOB because he's a case of COPD This is the tripod position of COPD px in order to reduce the work of breathing and the activity of scalenes and sternocleidomastoid muscles 3-BODE index is an assessment for prognosis which you should have know idea about when encountering px with COPD 4-Long Term O2 Therapy is only factor shown to be improve prognosis

1-What do you think the complaint of this patient? 2-What is his possible disease? 3-Are there any prognostic factors for his disease? 4-What is the treatment line that improves his prognosis? #spot_diagnosis #medicine

Psoriatic arthritis (DIP joint involvement, nail changes like subungual hyperkeratosis and nail pitting) Also there's difference in the size of digits (called dactylitis or sausage digits) Causes of sausage digits: 1- seronegative spondylo-arthropathy 2- TB 3- sickle cell anemia 4- sarcoidosis 5- gout #medicine #spot_diagnosis

🔴This patient has telangiectasia and dilated vein with microstomia, radial furrowing of lips and beaked nose The Dx is systemic sclerosis 🔵Causes of telangiectasia : 1- systemic sclerosis 2- cirrhosis 3- dermatomyositis 4-SLE 5-steroid intake 6-hereditary hemorrhagic telangiectasia 7- atxia-telangiectasia 8- carcinoid 9- systemic mastocytosis #spot_diagnosis #medicine

Causes of Erythema Nodusum: 1-infections: TB, Streptococcal, Mycoplasma 2-drugs: sulphonamides, halogens, penicillin 3-pregnancy, OCP 4-autoimmune: IBD, sarcoidosis, Behçet's disease 5-malignancies: lymphoma, carcinoid #medicine

Causes of diarrhoea associated with skin manifestations: 1-Coeliac disease (dermatitis herpeteformis) 2-IBD (erythema nodusum and pyoderma gangrenosum) 3-Addison's disease( usually present as GI complaints and hyperpigmentation) 4-Viral infections in pediatrics( measles, roseola) 5-Acrodermatitis enteropathica in children (zinc deficiency) 6-Pellagra (vitamin B3 deficiency with its famous 3Ds) 7-Carcinoid syndrome 8-Henoch-schonlein purpura in children 9-Systemic mastocytosis #medicine