MedicoSurgical Notes

🛑 Sick day card ! in pateint with CKD using ACEI , NSAIDS,diuretics , metformin stop taking these drugs when the pateint devalop fever , diarrhia or vomiting and re take them after 36 hours of eating and drinking normally.

سرطان القولون ماعد له عمر معين مريض 17 سنة جاء يشتكي من نقصان شديد في الوزن وفقدان شهية ونزيف شرجي ، من خلال تنظير القولون تبين وجود ورم سرطاني على بعد 65 سم من فتحة الشرج وبطول اكثر من 10 سم ومنتشر على الجدار بالكامل احتماليه حدوث السرطانات تزيد مع التقدم بالعمر ، لكن ما نلاحظه ان هناك مصابين في مقتبل العمر ربنا يشفيهم ويعافيهم اجمعين .

🛑 pateint with renal artery stenosis may present with repeated attacks of pulmonary edema occuring typically at night

🛑 In non_oligouric acute kidney injury , acute interstitial nephritis should be suspected.

🛑الminimal change disease هو غالبا يجي severe nephrotic . ويتسجيب بشكل رهيب لل high dose prednisolone1mg/kg و في حال في resistant نبحث عن سبب اخر و ناخذ biopsy واذا ثبت انه minimal change برضه ف هنا غالبا يكون سببه genetic defect.

🛑 Carcinoma pancreas should be suspected when an elderly person develops diabetes and in spite of adequate treatment, continues to loose weight.

It is safer to look and see than to wait and see. #surgical_role.!

🛑 Murmur of aortic stenosis sometimes has a sound like " mew" of a seagull !

🛑 SAINT's Triad : * Gall stones * colon divertoculosis * Haitus hernia

🛑 when the pateint clincally is highly suspected to have stable angina , but with normal exercise ECG , further imaging in the form of stress ECHO or myocardial perfusion scanning is indicated.

🛑 the swellings which appear and disappear : * choledochal cyst * pseudopancreatic cyst * hydronephrosis * intussusception

Carnett's sign. To differentiate whether or not the source is abdominal pain is somatic (originating from abdominal wall) or visceral (from the organs). A +ve carnett's sign(when the pain increase during the test) suggests a somatic pain, the most common cause of which is acute cutaneous nerve entrapment syndrome. negative carnnett test means decrease pain during test indicate visceral pain .

فحص مهم يجب عدم نسيانه عند فحص اي مريض يشتكي من Abdominal pain التوضيح👇

🛑ال Neurotransmitters اللي الخلل فيها يؤدي للأمراض : Schizophrenia - Dopamine Alzheimers - Ach Depression -Serotonin / NE Parkinsons - Dopamine Huntingtons - Ach Anxiety - GABA Mania- Serotonin / NE

Gall Bladder Surgery Done At Long Distance 4650 km Away in Aral,Xinjiang Uygur ,With 5G Tech! Liang Xiao, a surgeon, carries out a gallbladder operation through a 5G-powered and four-arm endoscopic model robot, in Hangzhou, Zhejiang province, on Feb 16, 2023.

لُوحظَ أن ال Furosemide ( lasix) بيخفف اعراض ال dyspnea (pulmonary edema) from acute congestive heart failure خلال دقائق حتي قبل ظهور أثره المدر للبول Diuretic effect ب mechanism غير معروف !

Serum creatinine is increased in hyperthyroidism; decreased in hypothyroidism. . Serum cholesterol is increased in hypothyroidism and decreased in hyperthyroidism.

الحالات اللي فيها السكر التراكمي HbA1c لا يستخدم في تشخيص السكري D.M: 1-haemoglobinopathies 2-haemolytic anaemia 3-untreated iron deficiency anaemia 4-suspected gestational diabetes 5-children 6-HIV 7-chronic kidney disease 8- medication that may cause hyperglycaemia (for example corticosteroids)

التغيرات التالية في ال ECG تكون طبيعية في الرياضين athlete -sinus bradycardia -junctional rhythm -first degree heart block -Mobitz type 1 (Wenckebach phenomenon)