Data Basmaga 42

🪐Internal medicine - Notes

🔻 Symptoms of arthritis JIM joint tender and stiffness Inflammation Muscle wasting Restriction of movement of joint 🔻how diagnose arthritis US Xray Ct Biopsy ⭐️🔻ttt arthritis Pain killers Cortisone Surgical replacement Supportive as TENS Immune suppression by cyclosporine 🔻ttt rheumatoid Physiotherapy Exercise 🔻causes of IDA GI bleed GERD GI malignancies Renal loss by RCC 🔻 Earliest sign in IDA serum ferritin 🔻 Earliest sign in megaloblastic anemia hypersegmented neutrophil 🔻 bilobed neutrphil = pseudo pelgar heut anomaly. In MDS 🔻diagnostic for IDA. Ferritin < 20 mg 🔻indicate iron replacement in CKD Serum ferritin< 500 mg 🔻most common cause of megaloblastic anemia is pernicious anemia 🔻most common risk factor of CKD is HTN ⭐️🔻risk group for VTE Surgery Genetic Cancer HRT CHF most common ⭐️🔻 prophylaxis for VTE LMWH Unfractionated hepatin Fondaparinux 🔻 prophylaxis extended for 30 d 🔻ttt for 3 m 🔻VTE with pulmonary embolism ttt for 6 m 🔻vit k antagonist Not 🚫 for acute thrombosis as at least need 5 day to work 🔻hospitalized elderaly need VTE prophylaxis 🔻most common cause of chronic thrombocytoenia is MDS 🔻most frequent acuired inhibitor for factor 8 ⭐️🔻causes of bleeding elderly Liver dysfunction Anticoagulant Sepsis Acuired factor inhibitor 🔻 diagnostic test for MDS Bone marrow aspiration with cytogenetic 🔻CKD GFR <60 for 3 m 🔻 complications of subclinical thyrotoxicosis Osteoporosis AF ⭐️🔻osteoprotic fructure =pathological=fragility fr Marked with age Minimal trauma More in female More in caucasian Site in trabecular bone ⭐️🔻 screening for CKD urine analysis GFR Creatinine clearance Us 🔻CKD and proteinuria RF for CAD 🔻diet in CKD is low protein ⭐️🔻renal replacement therapy Hemodialysis Peritoneal dialysis Renal transplantation ⭐️🔻risks for malnutrition Loss of appetite Difficulty in chewing and swallowing Chronic conditions and medication Lower sense for taste and smell 🔻 screening tests for malnutrition MNA MUST 🔻 sarcopenia loss of muscle function and quality 🔻 Cachexia loss muscl and fat 🔻 complications of DM urine incontinence Fall Depression Cognitive dysfunction 🔻ttt hypothyroidism Thyroxine 25 u start low and go slow increase every 6-8 w 🔻ttt of ITP IV ig Cortisone Spleenectomy Cyclosporine 🔻ttt renal insufficient and anemia Or ACD erythropoietin and iron 🔻ttt bleeding in eldery 1 management bleed by recombinant activated f 7 2 cyclophosphamide and cortisone and ⭐️🔻RF for CKD ver very important #phc_internal

الرسالة المجمعة لليلة الأثقل في الترم ، فاينال PHC , CHC 👨‍👩‍👧‍👦

👨‍🦳تجميعة PHC [ ٢٥ درجة ]

♦️الامتحانات السابقة مجابة ♦️أهم التعريفات في المنهج ♦️فايل سبورت الشامل للريتن ▪︎Family [15 marks]: ♦️اسئلة الأسرة الانفيرتد مهمة ♦️بعض الزتون ▪︎Community [5 marks]: ♦️كل الmcq السابق ♦️المحاضرة الاونلاين ♦️تأكيدات الريتن ▪︎Internal [5 marks]: ♦️كل الmcq و الاسئلة السابقة ♦️تفريغ ينفع تراجع او تذاكر منه ♦️زتون سبورت

🍼تجميعة CHC [ ٢٥ درجة ]

♦️كل الامتحانات السابقة مجابة و غير ♦️فايل سبورت شامل الريتن 👶Pediatrics [15 marks]: ♦️نوتس مهمة طحن ♦️تجميعات الريكتس و الinheritance ♦️تجميعة ttt ل pem يدولي 💉Community [5 marks]: ♦️أهم الأسئلة في كوميو الثغننين 🤱Family [5 marks]: ♦️زتون كومفورت زون part 1 + part 2

اهم definitions ال PHC

indicator: An indicator is a statistical tool usually expressed in the form of rate or ratio and indicates the state of health. Valid: they should actually measure what they are supposed to measure.  Reliable: the answer should be the same if measured by different people at different times and under different circumstances.  Relevant: they should be relevant to the community needs and related to problems to be solved. primary health care: Is the essential health care based on practical and scientific methods that are easily accessible and socially acceptable to be provided to all individuals of the community. Community Participation: local population should be actively involved in planning, implementation and evaluation of health services based on their needs and awareness. Palliative Care: A holistic approach to provide relief to patients who are suffering from life-threatening illnesses and their families. Hospice Care: The care center designated for patients facing terminal illness, with expected survival of no longer than 6 months. #phc_اسئلة_بإجاباتها

بالنسبة لسؤال phases of life cycle المفروض نكتبهم بالترتيب الموجود هنا فالجدول دا + ركزوا عالجدول لأن بييجي منه #phc_family

سيادة اللواء فيزو بيقولك كوميو ستشسي ايه اللي تسيبها دي 🤨

بعض النقاط غاية في الخطوره مينفعش تتجاهلهم ▪️Definition: 1. Health. 2. Herd immunity. 3. Cold chain.(VIP) 4. Vaccine vial Monitor. ▪️Enumeration: 1. Objectives of child health program.(VIP) 2. Common social health problems. 3. Inactivated vaccines. 4. Live attenuated vaccines. 5. Arrangement of vaccines in referigator.(VIP) 6. Rules of vaccine keeping. 7. How to identify failure of vaccines.(VIP) 8. Contraindications of vaccines مهم أسرة وكوميو. 9. جدول التطعيمات مهم. 10. جدول Adverse effects فاكس مش بييجي. 11. Shaking test مهم. Shaking test: - DPTvaccine spoiled by freezing → on shaking→turbidity→if left for 30 min sediment will be formed in the bottom of the bottle. #chc_community

نوتس ميزو الشقية لملوك الأطفال ✍

ملخص اهم ال Milestones لجدول ال Development ⬇️ ان شاء الله ميخرجش منها اي case 🤲 🍼Birth: Blink to flashing light. 🍼2 Months: Raise head - Follow moving objects - Smile socially. 🍼3 Months: Head support - Coos. 🍼4 Months: Turn head to sound - Laugh loudly. 🍼6 Months: Sit with support - Bring objects to mouth - Recognize mother and aware of strangers. 🍼7 Months: Sit without support. 🍼9 Months: Say Dada, Mama. 🍼12 Months: Walk alone or with one hand - Say 2-3 words - Understanding. 🍼2 Years: Say 2-3 sentences - Sphincter control day and night.

Key Development Warning Signs

1.Discrepant head size or crossing centile lines (too large or too small). 2.Persistence of primitive reflexes > 6 months of age. 3.No response to environment or parent by 12 months. 4.Not walking by 18 months. 5.No clear spoken words by 18 months. 6.No two-word sentences by 2 years. 7.Problems with social interaction at 3 years. 8.Congenital anomalies, odd facies. 9.Any delay or failure to reach normal milestones. Parental concerns must always be taken seriously. #chc_pediatrics

هدية من صديقنا العامل بالصرف الصحي ، ريتن شابتر الهيم 🩸 LABORATORY FINDINGS

Iron deficiency anemia

CBC: - Microcytic hyochromic anemia - Normal WBCs count Biochemical findings: - Decreased serum iron level - Increased total iron binding capacity BM: - Decreased or absent BM iron

Macrocytic anemia

CBC: - Pancytopenia Biochemical findings: - Low Vit. B12 or folate BM: - Megaloplastic BM Peripheral smear: - Oval macrocytic RBCs - Neutropenia

Normocytic anemia

CBC: - Pancytopenia - Reticulocytopenia BM: - Hypocellular with predominance of fat cells - BM iron stores usually increased

Hemolytic anemia

- Red cell fragmentation - Hyperbilirubinemia - Increased plasma LDH - Reticulocytosis - Normoblastemia

Acute leukaemia

CBC: - Normocytic normochromic anemia - WBCs: increased, normal or below normal Biochemical findings: - Increased serum uric acid BM: - Hypercellular

Chronic (lymphocytic/myeloid) leukaemia

CBC: - Normocytic normochromic anemia - WBCs: increased Biochemical findings: - Increased serum uric acid BM: - Hypercellular CAUSES OF THROMBOCYTOPENIA

Congenital thrombocytopenia

- Fanconi syndrome - TAR syndrome - Wiskott Aldrich syndrome

Acquired thrombocytopenia

- BM failure - BM aplasia - BM infiltration with haematological malignancies - BM infiltration with non-haematological malignancies - Autoimmune disease (SLE) #clinical_patho