Hamoud’s Approach
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A textbook based approach to high yield topics in the SMLE. Family Medicine channel: https://t.me/Hamoud_Almubki Twitter: Halmubki
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Channel Hamoud’s Approach (@surgerybyhamoud) is an active participant. Currently, the community unites 12 264 subscribers, ranking 1 976 in the Medicine category and 7 002 in the Saudi Arabia region.
📊 Audience metrics and dynamics
Since its creation on невідомо, the project has demonstrated rapid growth, gathering an audience of 12 264 subscribers.
According to the latest data from 28 April, 2025, the channel demonstrates stable activity. Although there has been a change in the number of participants by 69 over the last 30 days and by 0 over the last 24 hours, overall reach remains high.
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📝 Description and content policy
The author describes the resource as a platform for expressing subjective opinions:
“A textbook based approach to high yield topics in the SMLE.
Family Medicine channel: https://t.me/Hamoud_Almubki
Twitter: Halmubki”
Thanks to the high frequency of updates (latest data received on 29 April, 2025), the channel maintains relevance and a high level of publication reach. Analytics show that the audience actively interacts with content, making it an important point of influence in the Medicine category.
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بكرا بنزل لكم عدد بسيط جدا من الاسئلة اللي غيرت اجابتي او حاب اوضح على تفاصيل باد ريكول بعد ما شفت ريكول افضل، كنت مخطط على ملف لكن الوقت ما سمح لي للاسف، اقل شيء اسويه اني ارسلها هنا و تعدلون في الملف 👍🏻
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بعطيكم مصادر التصحيح اللي انا في النهاية اعتبرها الاصح في SMLE الجراحة:
In no particular order,
- Bailey & Love (SCFHS approved)
- Current Surgical Therapy (SCFHS approved),
- Schwartz
- Washington Manual
Although I personally haven’t tried it, Sabiston is quite solid (Part One approved).
AMBOSS is surprisingly decent but don’t rely on it as a major source
بالنسبة للمدسن، الافضل هو Harrison بدون شك
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سلام عليكم
الله يسعدك ويكتب اجرك على الملف الي سويته اقسم بالله اسطوري وافضل ملف بالنسبة لي ولاهو تقليل في الباقية
لكن اختباري جاني حدود ٥٠ سؤال جراحة
وجبت 94 في الجراحة
شكراً جداً
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ما شاء الله تبارك الله
الله يوفقه وين ما يروح. باذن الله تفرحونا بتجاربكم ♥️♥️
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والآن ارسل لك بعد ماطلعت درجتي الحمدلله جبت ٩٣ والسيرجري معتمد اعتماد كلي على ملفك 🤍🤍
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السلام عليكم و رحمة الله و بركاته.
مثل ما يعرف البعض منكم تخصصي ليس الجراحة. الملف و الشروحات كانت مبادرة مني لاني شخصيًا واجهت صعوبة في مذاكرة التخصص اثناء استعدادي للاختبار، وهدفي من البداية هو توصيل المعلومة للجميع بطريقة واضحة و مختصرة. انا ادري اني وعدتكم بإرسال ملف جديد، لكن اعتذر لاني بدات التجهيز للبورد و كل تركيزي عليه حاليًا. تطمنوا لان الملف يغطي نسبة كبيرة جدا من مواضيع الجراحة، بحثت كثير في اسئلة التجميعات و وجدت تكرار ممتاز.
لازم اوضح نقطة جدا جدا مهمة - اولاً، كل مصدر في كل تخصص يقول شيء مختلف، و بالإضافة الى ذلك ان اللي يكتب السؤال يفتي اجابة من عنده. بنك الاسئلة توفيق من ربي، و للاسف دقة اسئلة ال SMLE ليست جيدة، فلا تقيسون تجاربكم مع فلان و غيره من زملاءكم، اعملوا بالاسباب و توكلوا على الله. الهيئة نصاً ذكروا انهم وضعوا فرص كثيرة لهذا السبب.
مبديًا، سوف اترك القناة لفائدة الجميع، و ان وجدت الفرصة في المستقبل ممكن العودة في وقت لاحق. فتحت قناة جديدة خاصة لتخصص طب الاسرة و رحلتي العلمية في البورد ابتداء من Oct 1st، فلمن لديه رغبة في التقديم على تخصصي العظيم ارحب به في القناة.
Part One 😉
Link: https://t.me/Hamoud_Almubki
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Repost from Fair Q & A✨
من القرارات الحديثة لبرنامج طب الأسرة
١. الغاء اختبار الترقية السنوي
٢. إزالة logbook كجزء من التقييم السنوي
بقية المتطلبات كما هي:
١. تقييم شهري: ITER, DOPS, CBD, MINI CEX
٢. تطوع ٦٠ ساعة خلال كامل فترة التدريب
٣. بروبوزال بحث واحد خلال ثاني سنة
٤. اختبار اوسكي سنوي
٥. القاء ١-٢ محاضرة WADA سنويًا وحضور المحاضرات الاسبوعية (academic activities)
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Hyperkalemia approach
Hyperkalemia is defined as a plasma potassium level of ≥5.5. Evaluate the cause and manage accordingly, although a decrease in renal K excretion is the most frequent underlying cause. Plasma potassium at >6.0 requires urgent management as it often presents with ECG changes. If ECG changes are present at any level (peaked T wave first, then absence of P wave, then a widened QRS complex), or if ≥6.5 K, immediately go for calcium gluconate to protect the heart. Next, insulin dextrose to shift the potassium intercellularly as our preferred second line. Albuterol is also effective. Afterwards, for the third step we can use IV diuretics to reduce the plasma potassium in addition to supportive treatment. If the hyperkalemia is refractory to 3 treatments, or if signs of acute kidney injury are present, choose hemodialysis.
My reference is Harrison’s Principles of Internal Medicine.
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In regards to a very popular SMLE scenario, here’s how to make it easy:
Diabetes Insipidus -> hypernatremia
Hyponatremia:
SIADH -> high urine osmolality
Water overload -> normal urine osmolality
Psychogenic polydipsia -> low urine osmolality
That’s all you need to know.
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Subclinical hypothyroidism case. Examination: no goiter. Labs: TSH: 15 (high), T4: 6 (within normal limits). Most appropriate next step?
A- US of the neck
B- Start thyroxine replacement ✅
The approach to subclinical hypothyroidism is as follows:
If antibodies to thyroid peroxidase are present and/or if the TSH rises above 10 mU/L in patients with non-specific symptoms, a trial of levothyroxine therapy may be appropriate.
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صباح الخير. عندي نصيحة بسيطة بخصوص اسئلة فقر الدم لانها تكرر بشكل كبير. عشان تفرقون بين IDA و Thalassemia حتى بدون تفاصيل اضافية في السؤال، بكل بساطة احسبوا ال mentzer index. بناء على كتاب نلسون للبيديا، التشخيص يكون كالتالي:
If above 12.5? IDA. If below? Thalassemia.
قبل سنة كان فيه سؤال متكرر في التجميعات، المريض عنده علامات نقص الحديد بالاضافة الى high reticulocyte و فعلا هذا سؤال حقيقي و مو باد ريكول. الاجابة IDA لاني حسبت ال index و طلع 15.5.
موفقين جميعًا. 🙏🏻
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65 with DM and HTN admitted for elective ventral hernia repair, on examination he has bilateral Basal crackles and lower limb edema, what is most appropriate?
A-Open repair now
B-Laparoscopic repair now
C-Optimization then surgery ✅
D-No surgery unless there's obstruction
Another recall: 65 years old man admitted for elective ventral hernia repair, K/C of hypertension and BA, upon examination bilateral crepitation, ascites and bilateral edema, what to do?
A- Proceed with hernia repair.
B- Don’t repair unless obstruction has occurred
C- Delay until situation is controlled. ✅
Elective surgery should be deferred until the patient is medically optimized. I definitely would not wait until obstruction occurs.
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As a Family Medicine resident, it displeases me to read the thoughts of misguided individuals who continue to heavily downplay the importance of this field, while preaching the nonexistent job opportunities of competitive specialities for the sake of prestige and delusions of grandeur. Don’t be misled. Alongside other specialties in high demand, Family Medicine in particular is the pillar for which this country’s healthcare stands for, and it is the core of many current and planned upcoming changes as per Vision 2030. The shortage of family physicians in KSA is insane and it will take many years before we have enough.
Stop thinking about prestige and meaningless reputation. To be a decent family physician, it is a must to be versatile and updated on all fields, or else patients will avoid you. Anyone who claims otherwise is simply misinformed and clueless. Apply for what you truly want, no matter what it may be, while still keeping in mind your future life and career post-residency as it is becoming increasingly harder to find suitable jobs in certain specialties, and it may only get worse. I encourage people to think carefully about their choices before applying for residency. Healthcare as we know it is constantly evolving and changing, don’t expect to have opportunities similar to Dr. X and Dr. Y who you likely look up to.
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Old patient came for elective cholecystectomy you find out he was admitted 2 weeks ago in icu for management of MI, what will you do?
proper course of action in this case?
A- Open Cholecystectomy In Same Admission
B- Laparoscopic Cholecystectomy
C- Laparoscopic Cholecystectomy In 6 Months
D- Observation
It should be lap in 6 weeks, but with these choices, go for C. Bailey & Love:
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A 35 years old male has repeated attacks of hematemesis. On examination, he has spider angioma and bilateral gynecomastia with splenomegaly. Labs showing high liver enzymes. What is the most appropriate next atep after initial resuscitation with IV fluid?
A. Abdominal X-Ray.
B. Upper GI endoscopy.
C. Nasogastric tube insertion.
D. Give antibiotics.
Signs of portal HTN, therefore administering prophylactic antibiotics as the next step takes top priority before urgent upper endoscopy for esophageal varices. No need for NGT here as hematemesis is a feature of upper GI bleeding, and we only use NGT if there is diagnostic uncertainty in massive lower GI bleeding.
D then B.
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The next version will be corrected and double checked once more using 4 sources: Bailey & Love's Short Practice of Surgery, Washington Manual of Surgery, Schwartz's Principles of Surgery, and Current Surgical Therapy. Potentially more references for troublesome questions. Each reference has something different to say in Surgery notably, hence why 1-2 aren’t enough on their own. Generally speaking, in the SMLE you should not rely on a single reference.
Expect it sometime in late September.
