حَكيمْ- ملاحظات IMLE

** anorexia Electrolyte imbalance- hypokalemia, hypochloremia Cardiovascular disorders- ECG changes Metabolic changes- hypercholesterolemia, hypoglycemia Endocrine abnormalities- mild hypothyroidism, amenorrhea

*** 30% of patients with PTSD recover without treatment while 60% continue to have mild to moderate symptoms, and 10% experience severe symptoms.

** methylphenidate (Ritalin), pretreatment evaluation with LFTs, renal function tests, and cardiac profile monitoring (ECG) is mandatory.

** life-threatening syndromes like Stevens-Johnson syndrome or toxic epidermal necrolysis may occur after treatment with lamotrigine and carbamazepine. **

Common adverse effects of lithium include: postural tremor weight gain renal injury thyroid injury acne

methadone - less opioid toxic ***

Thiazides, NSAIDs, ACE inhibitors affecting lithium clearance

‎**كل الي بنتهين ب azine - بعملن اكثر movement side effect

Halopirdol- for hospital delirium

Quintipine - less extrapyrmdal SE (movement side effects) better choice for psychosis in Parkinson Better choice for depression symptoms in bipolar patient

** Arpiprazole - no weight gain Olanzapine - weight gain اكثر دوا بعمل

*** Lithium - has NO liver toxicity Teratogenic effect on fetus CVS Monitor TSH (could be the cause of depression) Causes diabetes insipidus

** SSRI- Most common side effect is sexual dysfunction Can cause hyponatremia SIADH Can induce mania Lithium can’t be combined with SSRI they both cause seretonin syndrome

*** carbamazepine- can also cause agranulocytosis

* Clozapine- Most common side effects increased salivation + constipation Can also cause serious rash Good option if resistant to other drugs Agranulocytosis (stop if wbc<3 k, granulocyte < 1500) Don’t combine it with carbamazepine

Lamotrigine- good choice in pregnancy Stop it if there is a rash (serious Side effect)

#psychiatry

السلام عليكم اي شخص عنده ملخص لمادة / موضوع معين صورة مفيدة او ملاحظة مفيدة وحاب ننشرها بالقناة بقدر يبعثلي وبالتوفيق الكم جميعًز

Diagnostic conization: Unsatisfactory colposcopy Discrepancy between high-grade cytology and colposcopy ______ Therapeutic conization: CIN 3 Stage 1A1 invasive cancer in woman who wants to preserve fertility

During colposcopy? •Take biopsy •Look at the epithelium( punctuation, Mosaicism)- more with cancer •You can add acetic acid dye –reveal pathology as white lesion •Schiller's Iodine test -applied to the cervix positive if cervical cancer