كل يوم case 🫀🩻🩺

هذا مهم هواي جاي الcast شنو معناها معناها نفرتك سندروم شندزه اندزه بلود برجر وGFR وسيروم كرياتنين والبومين ونشوف البروتين كرياتينين ريشيو اذا طلعن بوزتف او واحد من العائله عنده رينل دزيز معناها nephritic ادزه بايوبسي الكتابه هاي شلون نسوي ابروج للبروتين يوريا وهيماجوريا. هوه يجينا يمكن لو Sle لو dm ويصير عده مشكله يكلك شتسويله تحاليل

هستري ثايرود سلام عليكم اني فلانه مرحله رابعه محتاجة منج كم معلومه ما اخذ من وقتج هواي 🤕تفضلي بعد السلام والتحيه والاسم والعنوان نبلش شنو الشي الخلاج تجين اليوم ولله عدي ورمه بركبتي بعد ما اطبق وياها هستري ال lump الكلناه سبع نقاط https://t.me/everydaycases/1526 هنا ☝🏻☝🏻 من نوصل للسبتم نفصخها حتى تعرف هاي هايبو لو هايبر اسئلها عن انو هيه شلونها بالشته شعرها بشرتها صوتها من تتكلم معاي الخ بعدين نوصل للنقطه الثامنه الي ايضا كتلكم هنا https://t.me/everydaycases/1526 تسئلوها عن ماضيها مسويه عمليه سابقه للغده عدج مرض سكر السكر يفيدني لان هذا هم ايوتواميون دزيز ضغط امراض القلب تاخذين ادويه ثايروكسين اشعاع لهاي المنطقه متعرضه سابقا احد من اهلج نفس مشكلتج

79 year old smoker patient with DM, hypertension presented with abdominal distention, abdominal mass and flank pain, What is the likely diagnosis?.. #CR

Pulmonary embolism والسيناريو دائماً شخص صارله فترة قصيرة مسوي عملية وعلى فجأة يكولولك دكتور "اختنگ"😳 يعني يصير له SOB Chest pain Tachycardia هاي تشوفها بpulse oximeter طبعاً وراها أنت راح تشتغل بالمتوفر من investigation 🙄 فممكن تدزه ECG وتشوف عنده tachycardia غالباً همين وممكن تشوف S1Q3T3 بس مو دائماً موجودة تدز D_ dimer يكون عالي but not specific 🙂 تدز ABG تلاگي Respiratory alkalosis ممكن V/Q حتى نشوف perfusion for lungs بينما عدنا golden standard 🤫 للتشخيص بهذه الحالة هو CTPA نجي بعد للتشخيص للفقرة المهمة وهي العلاج هاي تعتمد على إذا كان 1_ massive PE Hemodynamically unstable (hypotensive) هنا العلاج المفروض ABCDE🧐 وراها  thrombolytic or embloectomy 2_ Non Massive Hemodynamically stable Normotensive ننطي LMWH=Enoxparin=Glexane 1.5 mg/kg/day أما في حالة renal impairment أو إذا المريض old age أو prone to bleeding يفضل ننطي UH بجرعة 75mg iv/bolus وراها ننطي 15 mg/kg/h iv طبعاً يكون أسهل لأن متوفر antidote Protamine sulfate Monitor by APTT وأخيراً إذا المريض چان عنده Contraindications for anticoagulant or "recurrent PE" 💔 لازم نسوي IVC filter 🤝

دكتور فاضل جايبها لاحد الكروبات

Lump Stoma Hernia Breast Urology Pediatric Sutures Git Foly catheter Chest tube Nasogastric tube Plastic Vascular Neurosurgery Special test Diabetic foot Anaesthesia Fistula Digital rectal exam Thyroid Endo Rheumato Radio C-R ECG Interpretation data Communication skills Break bad news station هاي سوالف المفروض ماخذيها بالعملي ثبتوها يمكم وسوها مثل الجيك لست

بس يعلمونه نحافظ على خصوصية المريض طيب وخصوصية الطالب هاي كلها تضحك على اجوبتي

💠BREAST DISORDERS: 🎀 Brown/Green/ Coloured discharge per nipple → Duct Ectasia. . 🎀 Painful, fluctuating mass over the breast or near the nipple → Nipple Abscess (Pus Collection). . 🎀 Hx of Trauma to the Breast (redness or bruises around the lump) + firm, round, solitary and localized lump → Fat Necrosis. . 🎀 Bleeding per nipple in 20-40 Y female + skin changes → Ductal Papilloma . 🎀 Firm, non-tender, mobile mass in a breast of a young female (15-30 Y ) → Fibroadenoma. 🎀 Breast pain (Mastalgia), ↑ breast size, lumpiness (nodularity) / Multiple lumps of the breast, female in the reproductive age, tend to appear just before or during menstrual cycle and disappear after it → Fibroadenosis (Fibrocystic disorder) 🎀 Fixed, irregular, hard, painless lump ± nipple retraction + fixed to skin (Peau d'orange) or muscle (+) Local, fixed, firm, axillary lymph nodes → Breast Cancer . 🎀 Offensive yellow discharge from an area near the nipple + Hx of Abscess near this area that was surgically treated → Ductal Fistula (Mamillary fistula). 🎀 Bleeding discharge per nipple in an Old woman with eczema-like changes in the nipple ± areola ± Ulcers → Paget's disease (Malignant) . #Peri_Op

💠BREAST DISORDERS: 🎀 Brown/Green/ Coloured discharge per nipple → Duct Ectasia. . 🎀 Painful, fluctuating mass over the breast or near the nipple → Nipple Abscess (Pus Collection). . 🎀 Hx of Trauma to the Breast (redness or bruises around the lump) + firm, round, solitary and localized lump → Fat Necrosis. . 🎀 Bleeding per nipple in 20-40 Y female + skin changes → Ductal Papilloma . 🎀 Firm, non-tender, mobile mass in a breast of a young female (15-30 Y ) → Fibroadenoma. 🎀 Breast pain (Mastalgia), ↑ breast size, lumpiness (nodularity) of the breast, female in the reproductive age, tend to appear just before or during menstrual cycle and disappear after it → Fibroadenosis. 🎀 Fixed, irregular, hard, painless lump ± nipple retraction + fixed to skin (Peau d'orange) or muscle (+) Local, fixed, firm, axillary lymph nodes → Breast Cancer . 🎀 Offensive yellow discharge from an area near the nipple + Hx of Abscess near this area that was surgically treated → Ductal Fistula (Mamillary fistula). 🎀 Bleeding discharge per nipple in an Old woman with eczema-like changes in the nipple ± areola ± Ulcers → Paget's disease (Malignant) . #Peri_Op

β-Adrenoceptor antagonists (β-blockers) are used in which of the following situations? A. Acute left ventricular failure B. Cardiac failure associated with bradycardia C. Cardiogenic shock D. Chronic left ventricular systolic dysfunction E. High-output cardiac failure #CR

A 72 year old hypertensive woman presents with a history of sudden-onset, rapid, irregular palpitation. She has had several episodes over the previous 3 months, which have resolved within 1 hour. She feels tired and slightly lightheaded during episodes. From this history, which of the following most likely explains her symptoms? A. Atrial fibrillation B. Sinus arrhythmia C. Supraventricular tachycardia D. Ventricular ectopic beats (extrasystoles) E. Ventricular tachycardia #CR

A 62-year-old man with congestive heart failure (CHF) and emphysema has symptoms of substernal chest pain and regurgitation after meals and at bedtime. He obtains incomplete relief of his symptoms with ranitidine. An endoscopy confirms mild esophagitis. Which of the following is the most appropriate next step? A. Reassure him that continued occurrence of symptoms while receiving ther- apy is normal. B. Prescribe omeprazole 20 mg per day. C. Schedule him for 24-hour pH monitoring, manometry, and a barium esoph- agogram for further evaluation. D. Schedule him for a laparoscopic Nissen fundoplication. E. Recommend dietary changes.#surg1

A51-year-oldwomanhasa6-monthhistoryofsubsternalchestpainandvague upper abdominal discomfort. She has been taking antacid therapy with minimal relief and has had a negative upper endoscopy. Which of the following is the best next step in her workup? A. Barium esophagogram to evaluate for a hiatal hernia B. Performing manometry to rule out a motility disorder such as diffuse esoph- ageal spasm or achalasia C. Referring the patient for cardiac workup as a potential cause of her chest pain D. Referring to a psychiatrist for a possible conversion reaction E. Performing a CT of the chest and #surg1 abdomen

A45-year-oldmanhashadadiagnosisofGERDfor3yearswithtreatmentwith H2-blocking agents. Recently, he has complained of epigastric pain. An upper endoscopy was performed showing Barrett esophagus at the distal esophagus. Which of the following is the best next step in the treatment of this individual? A. Initiate a PPI. B. Advise the patient to continue to take the H2 blocker. C. Perform a laparoscopic Nissen fundoplication. D. Advise surgical therapy involving gastrectomy and esophageal bypass. E. Discontinue the H2 blocker and initiate antacids. #surg1

A 24-year-old man with long-standing GERD, currently taking PPIs, is being evaluated for possible surgical therapy. Which of the following is an indication for surgery? A. Inability to tolerate PPIs B Inability to afford PPIs C. Incomplete relief of symptoms despite a maximum dosage of medical therapy D. The patient’s desire to discontinue medication E. All of the above

A 72-year-old man presents to the emergency center with abdominal pain and the passage of bloody stools. His past medical history is significant for hypertension, non–insulin-dependent diabetes, and coronary artery disease. His blood pressure is 90/60 mm Hg, with a pulse rate of 120 beats/min. His temperature is 38.8°C. Palpation of his abdomen reveals tenderness in the left upper and lower quadrants. There is no evidence of peritonitis. Which of the following is the most appropriate next step? A. EGD B. Abdominal CT scan with oral and intravenous contrast C. Colonoscopy D. Tag RBC scan E. Abdominal CT scan with intravenous contrast only

عليكم السلام . 1 . A 2 .C 3. H 4. I بالنسبة ل A هناك من يحلها ب الاختيار J لكن هذا لايبدو مقبولا من الناحية الانسانية