كل يوم case 🫀🩻🩺

Paroxysmal supraventicular tachycardia

A,B,C,D Adenosine B blockers Ca channel blockers Digitalis

Atrial flutter

B, C , D B blockers Ca channel blockers Digitalis

Ventricular tachycardia

ALBI Amiodarone Lidocaine B blockers ICD

Sinus bradycardia

Atropine , Artificial pacemaker in case of SSS

Nodal rhythm

Atropine , Artificial pacemakers

Atrial fibrillation

Reversion to normal sinus rhythm : Flacinide , propafenone or Amiodarone Control of ventilator rate : B blocker , Ca channel , Digitalis Prevention of thromboembolism : Anticoagulant

Premature extrasystoles

▪️Reassurance ▪️In chronic cases : Amiodarone , B blockers , Ca channel blockers or qunidine ▪️Lidocaine ( IV) in emergency cases #Medicine

A 4 years old boy presented to the outpatient clinic with painful swelling of right elbow joint after fall on ground and x ray revealed supracondylar fracture of humerus with posterior displacement of distal piece: the most fear complication? Brachial artery injury median nerve injury ulnar artery injury radial artery injury هذا السؤال جايبه حمدلله

Children with supracondylar fractures are at risk for acute compartment syndrome. There are three mechanisms as to why this occurs: (1) the fracture is often associated with an unrecognized brachial artery injury that leads to ischemia in the compart- ments of the arm; (2) if the subsequent cast is placed too tightly, this may contribute to compartment syndrome; and (3) initial bleeding and muscle damage/edema cause high pressures in the compartments of the arm leading to compartment syndrome. Compartment syndrome presents with the “six Ps”: pain, pallor, paresthesias, paralysis, poikilothermia, and pulselessness (late sign). Volkmann’s contracture is the manifesta- tion of unrecognized and untreated compartment syndrome. This occurs because prolonged ischemia can lead to muscle death and subsequent fibrotic changes within the tissue. Volkmann’s contracture presents with a tense, painful, weak, and shortened forearm with a claw-like deformity of the hand. Nerve entrapment is more likely to

7-year-old boy presents to his pediatrician with a tense, painful, weak, and short- ened forearm with a claw-like deformity of the hand. The mother states that 1 year earlier, the child fell backward on his outstretched hand and suffered a supracondylar fracture that was treated with closed reduction and casting. The most likely explana- tion for the current physical exam findings is: (A) Nerveentrapment (B) Suppurativetenosynovitis (C) Ischemia/necrosisofforearmmuscles (D) Complexregionalpainsyndrome (E) Improperly reduced fracture

An 85-year-old man who resides in a nursing home presents with a 3-day history of lower abdominal pain and increasing fatigue and lethargy. He is afebrile, his BP is 160/92, and RR 16. His lungs are clear and his heart examination normal. There is diffuse abdominal tenderness on palpation and a large area of fullness and dullness to percussion starting just below the umbilicus and extending to the suprapubic area. His serum sodium is 130 mEq/L, potassium 4.9 mEq/L, BUN 75 mg/dL, and creatinine is 3.5 mg/dL. His baseline BUN and creatinine were 25 and 1.3 respectively as recently as 1 month ago. A Foley catheter is placed and 1200 cc of urine is obtained. What will be the likely clinical course for this patient with regard to his renal function? A. His creatinine will continue to rise slowly for 2 to 3 more days. B. His creatinine will return to 1.3 over the next week. C. He will require dialysis within 24 hours. D. He will produce minimal urinary output for at least 3 days. E. His renal function is unlikely to show any improvement in the future and 3.5 will be his new baseline. الجواب C

هذا صعب ماعتقد يجينه هيج شي بس موجود عدنه 🥲

مهمه هواي شفتها مريض ابو ال AKI وعنده هايبر كليما اكثر من 6.5 وكايلي شنو المنجمت المناسبه اول شي اعالج الهايبر كليما لان فيتل وممكن تكتل المريض بعدين ابلش فلود او حسب حاله المريض

هيثم نبيل لام محاضره AKi بصفحتين فد شي يفيد مراجعه ودراسه اوليه هم

A 45-year-old man with no significant past medical history is admitted for nausea, vomiting and decreased urine output for 2 weeks. He is not on any medications. On physical exam, he is found to be alert, oriented, and well nourished. He has no urine output, and an ultrasound of the abdomen is consistent with hydronephrosis. A CT of abdomen shows retroperitoneal fibrosis, obstructing the ureters. Besides complete urinary tract obstruction, which one of the following conditions is ASSOCIATED with urine output <100 mL/24-h (anuria)? Acute Tuk A. Rapidly progressive glomerulonephritis (RPGN) B. Severe bilateral renal artery or vein occlusion C. Bilateral renal cortical necrosis D. Severe sepsis E.all above

📌 Massive bleeding per rectum in adults : • Diverticula. • Ulcerative colitis. • Ischemic colitis. • Angiodysplasia. • Massive bleeding from upper GIT. 📌 Massive bleeding per rectum in children : • Mecklel's diverticulum.

اقروا زين هسة حتى بالدور الثاني بس تراجعون

GIT Important themes Dyslepsia & GERD Infectious colitis Hydatid disease Appendicitis Acute abdomen Abdominal trauma Colonic cancer Perianal diseases Upper & lower GI bleeding Acute and chronic liver diseases