Medicine 💜

🩺 Toddler’s Diarrhea Definition A benign functional diarrhea seen in children 6 months–5 years with: Chronic loose stools Normal growth & development No systemic illness --- 🧠 Pathophysiology (Updated Concept) ↑ Intestinal motility Carbohydrate malabsorption (excess fructose/sorbitol) Low dietary fat → rapid gut transit Immature gut regulation (functional, not organic) --- 🧪 Clinical Diagnosis ✔ Chronic watery/loose stools (2–6/day) ✔ No blood, no nocturnal diarrhea ✔ Child is thriving ✔ Normal exam & growth charts 📌 Diagnosis is clinical 👉 No routine labs if red flags are absent --- 🚩 Red Flags → NOT Toddler’s Diarrhea ❌ Failure to thrive ❌ Blood/mucus in stool ❌ Severe abdominal pain ❌ Night diarrhea ❌ Anemia, hypoalbuminemia → Think: IBD, celiac, infection, malabsorption --- 🧾 Differential Diagnosis Celiac disease Cow’s milk protein allergy Chronic infection (Giardia) IBD Lactose intolerance --- 💊 Management (Evidence-Based) ✅ Parental reassurance (cornerstone) ✅ Reduce fruit juice (especially apple/pear) ✅ Avoid sorbitol & excess fructose ✅ Increase dietary fat ✅ Adequate fiber (age-appropriate) 🚫 No antidiarrheals 🚫 No unnecessary investigations --- ⏳ Prognosis Self-limited Resolves spontaneously by 3–5 years --- 🎯 Take-Home Message > Chronic diarrhea + normal growth = think functional Toddler’s diarrhea is a diagnosis of reassurance, not tests

🌸Bilateral hydronephrosis and hydroureter is a normal finding during pregnancy. When the gravid uterus rises out of the pelvis, it presses on the ureters, causing ureteral dilatation and hydronephrosis. It may also be due to a hormonal effect from progesterone. Ureteral dilatation tends to be greater on the right side due to dextrorotation of the uterus. #OBS-notes

🌸The finding of glucosuria is common during pregnancy and usually is not indicative of any pathology. During pregnancy, there is an increase in the glomerular filtration rate and a decrease in tubular reabsorption of filtered glucose. In fact, one of six women will spill glucose in the urine during pregnancy. #OBS notes

🌸Amniocentesis: performed in the second trimester has been associated with a 1 to 2% risk of amniotic fluid leakage, a fetal loss rate of less than 0.5%, transient transvaginal spotting, a less than 0.1% risk of chorioamnionitis, and a rare risk of cell culture failure. There has not been an association of amniocentesis in the second trimester with fetal limb reduction defects. 🌸Chorionic villus sampling: performed at a gestational age of less than 9 weeks has been associated with fetal limb reduction defects.

Hurlers syndrome VS Down syndrome

Antidote for warfarin & coumadin

Green strick fracture

Bronchial obstruction

📌 Schitosomasis.

📌Types of patient urachus

📌Patient: 19-year-old university student Chief Complaint: Sore throat and fever for 7 days. 🌿History of Present Illness: The patient presents with a 1-week history of fever, severe sore throat, malaise, and fatigue. He also complains of painful swelling on both sides of the neck and difficulty swallowing. He denies cough or rhinorrhea. He reports that his roommate recently had a similar illness. No recent travel. Past Medical History: No chronic illnesses. No regular medications. No known drug allergies. 🌸Examination: Temperature: 38.8°C Pulse: 96 bpm BP: 118/74 mmHg SpO₂: 99% on room air Bilateral tender posterior cervical lymphadenopathy Enlarged erythematous tonsils with white exudates Mild hepatosplenomegaly No respiratory distress 🌸Investigations: CBC: Lymphocytosis with atypical lymphocytes Monospot (heterophile antibody): Positive EBV VCA IgM: Positive Mildly elevated ALT and AST Rapid strep test: Negative 📌Diagnosis?!

🌸The ampulla is the most common tubal site (about 70%), followed by the isthmus, fimbria, and interstitial (cornual) portion

🌸Most ectopic pregnancies (≈95%) occur in the fallopian tube.

🌸Liver

ماذا يعني ارتفاع كل من WBC Neutrophil ESR CRP platelet كل هذه النتايج اضافة الى الهستوري هل تقدروا تتوقعو التشخيص الي يعرف يكتب لنا والي مايعرف يعمل اعجاب وتعليق ع المنشور والاجابه بتوصلكمالاجابة من الهستوري انه المريض ماشي مع infection والصداع يشير نوعا ما الى مصدر العدوى بال CNS ارتفاع WBC,neutrophil , CRP تدعم التشخيص infection لكن ارتفاع ESR and platelet تدعم تشخيص brain abscess وبكل الاحوال المريض يحتاج الى neuroimaging

Cxr of pts 📌Diagnosis?!

🌸Patient 45-year-old male Chief complaint: Fever and productive cough for 4 days. Shortness of breath worsening over the last 24 hours. 🌸History of Present Illness: Fever up to 39°C with chills. Productive cough with yellow-green sputum. Right-sided pleuritic chest pain. Increasing dyspnea on exertion. No hemoptysis. No recent travel or TB contact. Past Medical History: Hypertension. Smoker (20 pack-years). No asthma or COPD. No drug allergies. 🌸Examination: Temperature: 39.1°C Pulse: 112 bpm Blood pressure: 118/72 mmHg Respiratory rate: 28/min SpO₂: 90% on room air Chest: Reduced expansion on the right lower chest, dullness to percussion, bronchial breath sounds, coarse crackles over the right lower lobe. 🌸Investigations: CBC: WBC 17 ×10⁹/L (neutrophilia) CRP: Elevated Chest X-ray: Right lower lobe consolidation Sputum Gram stain and culture: Sent Blood cultures: Sent before antibiotics

📌Hyperthyroidism.