Joe’s SMLE Recall
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لا تنسوني ووالداي من الدعاء كل ما في القناة حلالكم بالتوفيق البحث عن التخصصات: OBGYN > #OB Pediatrics > #Pedia Internal medicine > #IM General surgery > #GS Most common > #MC Questions > #Q Pictures > #Pic #Summary Topic in 1 picture > #One_pic
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| Date | Subscriber Growth | Mentions | Channels | |
| 01 March | 0 |
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+3
بالتعاون مع انكي السعودية عملنا فلاش كاردز لملف JOE'S RECALLS 🤝🏻
سعر رمزي ب 39 ريال فقط!
وعليه خصم 50% لاول ١٠٠ طلب
+
كود خصم خاص لمتابعيني:
Joe
مميزات الفلاش كاردز 📚:
• ملف شامل جميع الاسئلة على شكل فلاش كاردز انكي
• تم مراجعته من صاحب الملف
• تقسيم للCHAPTERS يسهل الوصول
• جميع الشروحات مذكوره
للطلب👇🏻:
https://saudianki.com/lGynNBy
للاستفسار:
@Saudi_Anki
*يضمنون لك لو ماناسبك شغلهم يستردون لك المبلغ كامل 💯
| 2 | This is our updated SMLE pictures file with corrections and we added new pictures
تم تصحيح V10 السابق وتعديل وإضافة بعض الاسئلة
لا تنسوني ووالداي من دعواتكم الطيبة 🙏🏻
- Joe | 11 084 |
| 3 | This is my version of Dr.Wafa’s file
In which I have solved the questions that came in my exams or I think it was incorrectly solved , Also I have attached better recalls for some Questions
الحل شخصي وقد يحتمل الخطأ
لا تنسوني ووالداي من دعواتكم 🤍
-Joe | 11 397 |
| 4 | 01-10-2024🥼
For all new R1’s
May success follow you every step of the way🤍
اللهم افتح لنا فتوح العارفين
وانشر علينا رحمتك ورضاك وتوفيقك
اللهم ذكرنا ما نسينا وقوي عزيمتنا وارزقنا حلالاً طيباً.
اللهم اجعل عملنا صالحاً، ولوجهك الكريم خالصاً، ويسره لنا وبارك لنا فيه وتقبله منا🤍
-Joe🤍 | 3 218 |
| 5 | #IM 💊
Hematology🩸part 2
Venous thromboembolism
🟣 DVT
Clinical presentation: Pain, Swelling, ⬆️ temperature , Dilatation of the superficial vein , Typically unilateral “may be bilateral”
S&S: particularly in proximal thrombosis
Wells score for DVT: 1 point for each
( Active cancer, Recent immobility of the lower extremity, Major surgery within the past 12 weeks, Localized tenderness along the deep vein system, Swelling of the entire leg, Calf swelling to at least 3 cm larger than the asymptomatic leg, Collateral superficial veins pitting edema confined to symptomatic leg , Previously documented DVT
2 pointes are subtracted if an alternative diagnosis is just as likely as DVT
Wells score >= 2 >> Duplex US (high likelihood) Wells score < 2 >> D-dimer (low likelihood)
🔵 Pulmonary embolism (PE):
Clinical presentation: Chest pain, Shortness of breath, Tachycardia and may be hypotensive , Signs of DVT in lower limbs, Respiratory alkalosis in ABG, S1Q3T3 in ECG but (sinus tachycardia) is the most common, Normal chest x-ray in desaturated patient should raise suspicion of PE
Dx: Best modality is CTA , V/Q scan is an alternative if ( Renal impairment or Pregnancy)
Chest x-ray normal >> V/Q scan
Abnormal x-ray >> CTA
Echocardiography for unstable patient
If V/Q scan gave indeterminate result then proceed for CTA
Mx of VTE: Leg elevation, Analgesia, Either Oral Direct oral anti-Coagulant (DOAC): Xa inhibitor (Apixaban or Rivaroxaban) or anti-thrombin (Dabigatran) , Or Heparin followed by Warfarin (in certain conditions), Or Thrombolysis (only in limb-saving DVT or unstable PE) , IVC filter if contraindication for anticoagulation
🚩Investigate For PE with DVT patient >> only if clinically suspected massive PE or unexplained breathlessness
Reference:
UQU | 4 249 |
| 6 | If you still didn’t find an exam appointment yet follow those links:🔗
Notifications for all regions:
https://t.me/SmleSyncGroup
Riyadh:
https://t.me/SMLE_schedule
https://t.me/SmleNotifs
West region:
https://t.me/SmleNotifs_WEST
Alkhobar:
https://t.me/SmleNotifs_DMM
Dammam/ Al khobar/ Bahrain and Qatar:
https://t.me/SMLE_schedule_East
Jeddah/ Al Taif and Abha:
https://t.me/SMLE_schedule_We_So | 3 436 |
| 7 | #IM 💊
Hematology🩸part 1
🔴 IDA: chronic blood loss, menorrhagia or GI bleeding, celiac disease, PICA, koilonychia, restless leg syndrome, ⬇️ MCV, transferrin saturation and ferritin, ⬆️ TIBC and RDW, reactive thrombocytosis
⚫️ ACI: Hx of chronic inflammatory disease such as CKD, RA, caused by deficiency in Erythropoietin in CKD, normal MCV but may be ⬇️ MCV in late stage, normal or ⬆️ ferritin
🔵Thalassemia trait: asymptomatic , accidentally discovered, ⬇️ MCV, HbA2 > 3.5% with HbA about 90%, ⬆️ RBCs count on CBC
⚪️ Thalassemia major: transfusion dependent, thalassemic face, normal MCV, ⬆️ hemolytic parameters, HbA2 > 3.5% and HbA undetectable
N.B: Hemoglobin electrophoresis is normal in alpha thalassemia
🔴 Sickle cell anemia: recurrent pain due to VOC, auto-splenectomy (preserved in case of sickle thalassemia), normal MCV, ⬆️ hemolytic parameters, HbS is present in hemoglobin electrophoresis
🟢 Lead poisoning: Hx of eating wall paints, neurological symptoms, ⬇️ MCV, basophilic stippling on PBS.
🟤 Aplastic anemia: ⬇️ all CBC lines , anemia symptoms, recurrent infections, bleeding diathesis, normal or ⬆️ MCV
🟡 Hemolytic anemia: Jaundice, indirect hyperbilirubinemia, ⬆️ reticulocyte count and LDH, ⬇️ haptoglobin, +ve DAT in case of AIHA
🟣 B12 deficiency: pernicious anemia (intrinsic factor antibodies), Hx of bypass surgery, crohn’s disease, being vegetarian, neurological Sx (Combined subacute degeneration of spinal cord in form of weakness, paresthesia and ataxia), ⬆️ MCV > 115, hypersegmented neutrophil on PBS, ⬆️ MMA and homocysteine (to be ordered if B12 is borderline level 200-300)
🟠 Folate deficiency: pregnancy, anti-folate medications (Methotrexate), ⬆️ MCV > 115, hypersegmented neutrophil on PBS, ⬆️ homocysteine but normal MMA
N.B: do not treat with folate before ruling out 🚫 B12 deficiency and replete it first if deficient to avoid irreversible neurological damage
Reference:
UQU | 4 978 |
| 8 | #OB 🤰
🔴 Postpartum Hemorrhage:
Definition:
Vaginal delivery >> More than 500 mL blood loss.
C-Section >> More than 1000 mL blood loss.
Mx: Call for help >> look for the cause of bleeding; and then manage accordingly.
If cesarean section >> B-Lynch, failed >> Artery Embolization (ONLY if stable) and if unstable >> Laparotomy and Artery ligation, failed? >> Hysterectomy.
If Vaginal Delivery >> Bakri balloon, failed? >> Stable > Artery Embolization , unstable >> Laparotomy and Artery ligation, failed? >> Hysterectomy.
Uterine atony >> Oxytocin (1st line) , Methylergonovine (2nd line) , Carboprost ( 3rd line 🚫 asthma) , Misoprostol (4th line)
Tear >> know the grade >> stitch the tear
Retained products of conception >> will present mainly with heavy bleeding , Misoprostol or D&C
🔴 DVT:
Unilateral pain, swelling and tenderness over the leg swelling with erythema and warmth
Mx: Heparin
🔴 Vulvar hematoma:
Collection of blood in the vulva post Episiotomy.
Mx: Depend on the size >> if 5 cm or more, expanding or symptomatic (painful) >> Surgical evacuation and if smaller than 5 cm >> Observation with (RICE) Rest, Ice, Compression and Elevation.
References:
MOH
Wafa
UTD | 4 188 |
| 9 | #OB 🤰 | 9 270 |
| 10 | This is our schedule for August and September🔥🔥
🔴 ملاحظة لكل من سيختبر الأسبوع القادم الأولى تجميعات شهركم والشهر السابق إذا كان الوقت يسعفكم
🔴 For those who will take their exam Next week reviewing August Questions should be your number 1 priority, and if you have time go through July questions as well
🔴 If your exam will be (September / October or after) you can follow the atteched schedule or follow with our previous schedules + review previous months questions
Best of luck Doctors 🤝
-Joe | 4 181 |
| 11 | نعتذر لكم تم تأجيل اللقاء إلى الساعة ٩:٣٠ | 248 |
| 12 | نعتذر فيه اشكالية بالرابط القديم اعتمدوا هذا الرابط
https://us05web.zoom.us/j/89668714579?pwd=9LacbFpZ5daaFN3sUOalog8TdQo4Xb.1 | 278 |
| 13 | https://us06web.zoom.us/j/81844113836?pwd=KClSt6fawxA1PBIuQeSCMnhfamUzy3.1 | 257 |
| 14 |  For new Interns 📣
Zoom meeting tonight at 9:00pm
https://x.com/selah_imsiu/status/1819702781193732246?s=46&t=9fTxq5fR0mGVBWwYpBrnCg | 11 716 |
| 15 | مرفق لكم طريقة إصدار التصنيف والتسجيل لهيئة التخصصات الطبية
لا تنسوني ووالداي من دعواتكم
-Joe | 13 980 |
| 16 | Important Radiological signs in SMLE🪧:
- Boot shaped heart > TOF
- Heart shaped Egg on string > TGA
- Pearl necklace in ovaries > PCOS
- Snowstorm like appearance > Complete Hydatidiform mole
- Target sign in US > Intussusception
- Bird peak sign > Achalasia
- Deep sulcus sign > Pneumothorax
- Joint space narrowing > Osteoarthritis
- Coffee bean sign > Sigmoid Volvulus
- Lemon shaped hematoma > Extra-dural hematoma
- Joe | 5 782 |
| 17 | For newly joined Doctors those are important Channels you need to check them out:
To get daily SMLE Questions: ✍️
https://t.me/silent_2024Q
https://t.me/saudismle
For Medicine:💊
https://t.me/Elaf_Faisal
For surgery: 🔪
https://t.me/GSurgeryReview
https://t.me/SmleByHamza
https://t.me/SurgeryByHamoud
For Pediatrics: 👶🏻
https://t.me/smlepaediatrics
For OB-GYNE: 🤰
https://t.me/WafaOBGYN
For psychiatry: 🧠
https://t.me/psychsmlechannel
For ethics:🥼
https://t.me/smlebrain
For pictures and recalls: 🚩
https://t.me/joesrecall
For Doctor’s with high SMLE scores and they solve Questions: 💯
https://t.me/EySiSMLE
https://t.me/MajeedSMLE
https://t.me/Jehad_SMLE
For Free SMLE studying schedule / all files:📒📔
https://t.me/acedecmber
دعواتكم لنا جميعاً بالتوفيق والسداد ولكم اضعاف ما دعوتم 🙏🏻 | 3 624 |
| 18 | 2 Misleading questions with different answers Kindly focus on them:
A 21-year-old woman presented with an abnormal vaginal discharge, burning on micturition, and blood spotting for the past 2 months. On genital examination, the was an eroded and friable (strawberry appearance) cervix, with a yellowish-greenish mucopurulent discharge (see report).
Lab Testing:
>10 PMNs per oil immersion field.
Which of the following is the most likely diagnosis?
A. Gardnerella vaginalis
B. Trichomonas vaginalis
C. Neisseria gonorrhoeae
D. Chlamydia trachomatis ✅
A 27-year-old woman presented with vaginal itching and an unpleasant smelling discharge.
Itching gets worse at night and after intercourse. Physical examination confirmed a frothy and yellow-green vaginal discharge. Her vulva is erythematous and edematous and the
cervix is inflamed and friable
(see report).
Wet Preparation:
Flagellated protozoa.
Which of the following is the most likely diagnosis?
A. Chlamydia
B. Gonorrhea
C. Trichomoniasis ✅
D. Bacterial vaginosis
How can we differentiate?
1. focus on the whole scenario both can come with strawberry cervix and yellowish-greenish Discharge
2. The difference:
Burning on micturition, yellowish-greenish mucopurulent discharge , >10 PMNs per oil immersion field , strawberry cervix > Chlamydia trachomatis
Yellowish-greenish foul smelling discharge , flagellated protozoa , strawberry cervix > Trichomonas vaginalis
-Joe | 4 688 |
| 19 | Important #Pedia notes👶🏻
🚩Absent Moro reflex >> Brachial plexus injury
🚩 Most common Side effect of DTP vaccine >> erythema at injection site
🚩Stepping reflex >> disappears by 2m
🚩Rooting reflex >> disappears by 4m
🚩School Age vaccine >> DTap / OPV / Variecella / MMR
🚩Rota virus stool >> foul smelling watery and green diarrhea
🚩 Tetralogy of fallot >> Boot heart shape in X-ray
🚩Celiac Mx >> Gluten free diet
🚩Green meconium after delivery >> NICU transfer
🚩Kawasaki >> conjunctivitis , strawberry tongue , fever more than 5 days , rash
🚩 kwashiorkor >> Ascites , edema, severe muscle wasting, hyperkeratosis | 4 618 |
| 20 | Latest update with the best recalls we could find
نسآل الله العظيم أن يجعله علماً نافعاً
لا تنسوني ووالداي من دعواتكم🙏🏻🤍
- Joe | 10 922 |
