Bdran’s Space

‏سلام عليكم ورحمة الله وبركاته ‏مساء الخير دكتور بدران ‏كيف حالك عساك طيب ؟ ‏تكفى اذا تقدر تسأل في قناتك اذا يعرفون احد اعترض على درجة اختبار SMLE وتعدلت الدرجة حقته او لا ؟ ‏لاني اختبرت الشهر الماضي وطلعت وانا واثق ومتفائل جداً من حلي وضامن فوق ٩٠ لكن طلعت الدرجة ٨٥! ‏ودي اعترض لكن الاعتراض ب ٥٠٠ ريال واخاف مافيه فايده ‏فاودي اعرف اذا فعلاً فيه احد قد اعترض وتعدلت نتيجته احد يعرف؟

اللي استفادوا من القناة بشكل عام وارسلوا الله يبيض وجيهكم على الدعاوي اللي توصلني على الخاص والله ياخوان اني ما ادري وش اقول واني مبسوط جداً.. شيء يثلج الصدر صراحه ❤️ عسى الله يوفقكم جميعاً ويسر اموركم ويختار لكم اللي فيه الخير والخيره بالنسبة للي يعلق معاه رابط النتائج يدخل عن طريق ممارس بلس ويدخل على خانة " اختباراتي " وان شاء الله تطلع له مع رابط تحميل الرسم البياني..

نزلت درجات ديسمبر بشرونا ..

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﴿ إِنَّ الله وَمَلَائِكَتَهُ يُصَلُّونَ عَلَى النَّبِيِّ ۚ يَأَيُّهَا الَّذِينَ آمَنُوا صَلُّوا عَلَيْهِ وَسَلِّمُوا تَسْلِيمًا ﴾.

UTD: You do Venous duplex in Spider Nevi ( Telangectasia ) only if associated wtih Sx or have Risk factors for chronic venous insufficiency. 37 yo male have spider nevi over righ thigh want to do cosmotic examination normal pulse and no varicosity what investigation to do? 1-no need ✅ 2- venous duplex 3- venous CT angio 4- venous plethysmography 46 yo female known to have varicose veins for 6 years presented with bilateral leg swelling and pain after prolonged standing No hx of claudication After examination there’s various veins in the great sephonus vein territory What is the investigation of choice: A. CT venography B. Venous duplex ✅ C. venous plethysmography D. No investigation required

اللي اختبارهم بكره وبعده ويحتاجون مساعده في أي سؤال ارسلوا لي عالخاص : @itsBdran For exam takers on Wednesday and Thursday and in need of assistance in Solving Questions don’t hesitate to contact me at @itsBdran الله يوفقكم جميعاً ويرزقكم اعلى الدرجات يارب..

A 4-month-old uncircumcised boy. He has low-grade fever. Many negative symptoms. He looks well and changed diaper multiple times. Temp: 39.1 Urine analysis: High WBC. Positive nitirte. Posiitve leukocyte. What is the most appropriate management? A. Oral cephalexin. ✅ B. Oral azithromycin. C. IV ceftriaxone. D. IV cefuroxime. جاني بالنص في نوڤمبر

Peripheral Arterial Disease ( PAD ) Investigations: 1st ( Start By simple ) Laboratory tests: CBC, Hgb, RBS, Lipid profile, RFTs. 2nd ( Vascular Labs ): - Doppler US to detect the pulse by Sound. - Ankle-Brachial Index at rest and exercise if drop > 20% —> ischemia - Segmental pressure measurement: to find the location of stenotic artery. 3rd ( Imaging ) If Asked Next? Start by Duplex US If asked the Gold standard or best investigation to detect PAD? Choose Conventional Angiography. Usually we start by US if not diagnostic we use CTA If the patient have renal impairment and we cannot use CTA due to the contrast usually we go for MRA. If none of the above is Diagnostic? Conventional Angio is the gold standard for theraputic and diagnostic purposes. Note: If the patient have PAD then presented suddenly with leg pain and suspicion of Acute ischemia? Give Heparin. Heparinization immediately required. Now with the Qs: DM with hx of pad, had pain when he walks 300m and relieved by rest what will you do A- CTA B- vascular ultrasound C- conventional Angio D- MRA Next? B ✅ Best or Gold standard or most diagnostic? C ✅ Scenario of critical limb ischemia, what’s the most diagnostic investigation? A- CTA B- MRA C- Conventional angiography ✅ D- ultrasound Patient with chronic limb ischemia, presented with sudden leg pain, diminished popliteal and distal pulses in right leg, and diminished distal pulse with intact popliteal in the left, what's the appropriate next action? A. Heparin ✅ B. CT angio C. US D. conventional angio Reference: Washington Manual Book for Surgery.

Pt has long history of cardiovascular disease with chest pain, he was anxious. On examination: peripheral cyanosis, JVP around 8 cm above normal, nicotine stain on his fingers, he wants to quit smoking. What is the next step: A- Motivational therapy ✅ B- Bupropion C- Varenicline D- Nicotine replacement therapy 9-month Hx of MI came to clinic for smoking cessation he was in respiratory distress raised JVP nicotine tear in his hand what is the most appropriate drug? - A. Nicotine replacement therapy - B. Varenicline ✅ - C. Bupropion 53 years old male patient heavy smoker presented with SOB,cyanosis and distended JVP. The patient is heavy smoker for many years and wants to quit now. What is the *best* way to help him quit? A. Varenicline ✅ B. Nicotine replacement therapy C. Bupropion D. Behavioral therapy. ابغاكم تعرفون ٣ معلومات بس: 1- Most important initial step in smoking cessation is Motivational support to the patient. 2- Most effective drug is Varenicline and it’s also Safe in Cardiac Patients 3- If written in the Q ( Hospitalized patient ) Best option is Nicotine replacement therapy. زي ماتلاحظون السؤال الثاني كاتب لك Came to the clinic “ He is not Hospitalized. السؤال الثاني جاني في نوڤمبر

Female after trauma to anterioc chest clear breath sounds bilaterally with pounding pulse,distended jvp bp110/70 pulse 90 (nearly) A- Cardiac tamponade B- Cardiac contusions✅ C- Tension pneumothorax D- Pleural effusion Another recall: A patient with Anterior chest trauma with bruising in the sternum. Patient vitally stable, clear cardiac and respiratory exam, except for pounding pulse. ECG: Arrhythmia X-ray: Sternal Fracture. Echo: Normal What is the diagnosis: A. Pneumothorax B. Cardiac contusion✅ C. Cardiac Tamponade D. Ventricular rupture Answer is Cardiac contusion. Arrhythmia on ECG and Sternal fracture Plus Non-complete Beck’s triad Makes the answer more with Cardiac contusion جاني فالاختبار

4 Diseases that usually comes together in the choices Epididymo-orchitis Testicular torsion Appendicular torsion Inguinal hernia How Can I differentiate? Let’s take them one by one. ◻️ Epididymo-orchitis: - Gradual pain in the scrotum Usually >24h. - Tender edematous cord - Red scroutm - Fever, Dysuria, urethral discharge can be present - High WBCs and inflammatory markers. Mx: Antibiotics. ◻️Testicular torsion: - Scrotal pain less than 12 hours ( مهم ) لانه بعد ١٢ ساعه يصير Necrosis ومايحس بالالم. - Previous episode or trauma. - High riding testis ( Horizontal ) - negative phren sign and absent cremasteric reflex. - Low doppler flow Mx: Surgical exploration ASAP. ◻️Appendicular torsion: - Tenderness over the upper pole - Vertical ( Longitudinal ) testis - Blue dot sign Mx: NSAIDs and Rest. ◻️Inguinal hernia: - Mass extended to the groin. Let’s take some Questions: A child has scrotal pain since 1 day, on exploration the cord was edematous and inflamed with red right hemiscrotum, what is the diagnosis? A. Testicular torsion B. Inguinal hernia C. Testicular appendages torsion D. Epididymoorchitis ✅ 14 years old came with sever sudden scrotal pain and on examination high riding and sever tenderness on palpate.. dx? A. Testicular torsion ✅ B. Orchitis C. Hydrocele 2 years boy signs of testicular torsion , redness pain , absent cremastric reflex , previous episode same sx2 weeks (I think ) A- Surgical exploration ✅ B- NSAID C- Antibiotic D- Testicular elevation 12 y boy presented with 2 days of tenderness in upper pole of right testis with right scrotal inflammation (redness …),the testis is in longitudinal position (no high riding testis) diagnosis? A-Testicular torsion B-Appendicular torsion ✅ C-Cry..orchitis D- Hydrocele 12 year old with testicular pain for 2 days. Vertical testes, tender apex, with skin changes. Most likely diagnosis? A-Epididymo-orchitis, B-torsion of testicular appendix✅ C- testicular torsion Child came with painfull red swollen hemiscrotum. On examination, mass was palpated with -ve cough impulse. The mass was tender and extended to the inguinal area. Left testes cannot be palpable. Which of the following is the most likely diagnosis? A- testicular torsion B- Epidydomorchitis C- Incarcerated inguinal hernia ✅ D- Testicular appendicular torsion pediatric patient came with pain and redness in Rt hemiscrotum , on examination , there is bulging or something like that extended from scrotum to inguinal area , tender , red , Rt testes not palpable , what is the Dx? A-testicular torsion B-testicular appedoges torsion C-epidydemoorchitis D-incarcerated inguinal hernia✅

A female patient presented with joint stiffness, she also has photosensitivity, malar rash with healed ulcers, her proximal muscle strength is 3/5. Labs ANA +ve Rheumatoid factor +ve CBC shows anemia Which of the following serves the highest diagnostic value? A-Anti DsDNA B-Anti CCP C-Anti RNP✅ Answer is AntiRNP Mixed Connective tissue disease.

DM Rt leg swelling .. Angiography showed diffuse disease 2 days later developed firm tender partially mobile swelling irreducible nonexpansile below the inguinal crease .dx ? A. Psoas abscess B. Saphena varix C. Femoral hernia D. Pseudoaneurysm ✅ This Q is present in DrThawabh course. I will follow DrThawabh’s Answer here.

23 years old male, have proteinuria & was diagnosed with nephrotic syndrome 2ndry to minimal change in glomerulonephritis (written exactly like this). What is the most appropriate treatment to decrease protein levels in the urine? A- Prednisone ✅ B- ACEi C- No treatment needed D- forgot but irrelevant Answer is Prednisolone. See UTD below.

3yrs child , the mother noticed blood in his diaper for 2 days , no abdominal pain or constipation , he has similar episode 3months back .. what is the Dx ? A- juvenile polyp B- Michele’s diverticulum ✅ C- Intussusception D- hirschsprung disease Pediatric age 6 years old Case about lower GI Bleeding with blood seen coming from ileocecal valve during colonoscopy A. Angiodysplasia B. Crohns C. Meckle diverticulum ✅ 573- 11 month old child, brought by his parents they reported a 1 day history of fresh blood in stool associated with foul smell and dark brown stool on examination the child was pale (they didn’t mention pain or any abdominal examination), What’s the best diagnostic tool: A- barium enema B- barium meal C- radioisotope scan ✅ D- US abdomen Answer is Meckle’s diverticulum. Note: Painless lower GI bleeding is the most common symptom of Meckle’s diverticulum. Another Q: Best diagnostic tool? Nuclear scan as Radioisotope scan ✅.

SLE pt on medication and present to the ER with urinary incontinence and lower limb weakness during examination you found hyperreflexia and paraplegia, what you will order ? -LP + MRI brain -LP + MRI spine ✅ -LP + CT brain -LP + MRI MRA MRV brain Young SLE female pt on treament. Developed urinary incontinence, hypereflexia, paraplegic or paresthesia. (Sx mostly neuro) what the most important test to do immediately? Lumber puncture & MRI brain Lumbar puncture & ct brain Lumbar puncture & MRI spine ✅ LP, MRI, MRA, and MRV of the brain Answer is LP and MRI of the spine. This is a case of Transverse myelitis as a neurological complication of SLE. Management is IV steroid and Cyclophosphamide.