MEDICINEnotes

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شوفوا يا جماعة الـ LAD ينقسم Septal و Anterior لو لقينا الـ ECG changes في V1 - V2 = Septal V3 - V4 = Anterior لو لقيناه في VV1- V4 معناها Anteroseptal STEMI ونشكوا ان LAD متصكر معناها الجزء المتضرر من القلب هو Left ventricle مع interventricluar septum

V1–V2 = Septal V3–V4 = Anterior V5–V6 = Latera

Q1096. A 63-year-old woman presents with two hours of central chest pain and sweating. Her pulse is 88 beats/min and blood pressure is 132/80 mmHg. The 12-lead ECG demonstrates 3 mm horizontal ST-segment depression in leads V1–V3, with tall, broad R waves and upright T waves in V2–V3. There is no ST-segment elevation in any of the 12 standard leads. These changes raise suspicion of an acute myocardial infarction that may be poorly represented on the standard ECG.

نقصد ضغط او تشبع الاكسجين في Right atrium و Ventricle

نشرح الفكرة و السؤال

هذا من شيت الدكتور سيف ظريف، شوفوها وجاوبوا السؤال 🫩

اول شي انتم قاريين الـ Complications متعت MI و Early and late complications

بالنسبة للأسئلة ماتركزوش وتقول السؤال الطويل....

Q1095. A 65-year-old man is admitted with an extensive anterior STEMI and undergoes successful primary PCI. On the third day, he suddenly develops severe breathlessness, hypotension and pulmonary oedema. His blood pressure is 82/54 mmHg, and a new harsh pansystolic murmur with a palpable thrill is heard along the lower left sternal border. Echocardiography identifies a new ventricular septal defect with left-to-right flow.

#Investigation_in_Acute_Coronary_Syndrome@MediNote47

Oral hypoglycemic drugs

نديرلكم صور زي هك

وضحت الفكرة والا نفرغ في الهواء 😔

لو الـ Patients من البداية مايتحملش Metformin is not tolerated or contraindicated (CI) Initial monotherapy اختار واحد: Gliptin. Sulfonylurea. Pioglitazone. Dual therapy إذا HbA1c أكبر من (7.5%): Gliptin + Pioglitazone. Gliptin + Sulfonylurea. Pioglitazone + Sulfonylurea. Insulin If HbA1c remains greater than 58 mmol/mol (7.5%) نتنقلوا للـ Insulin.

#Metformin First-line treatment. 1. Rule out renal failure (RF) before starting Metformin. 2. Reassess HbA1c after 3 months. If HbA1c is greater than 58 mmol/mol (7.5%), add a second drug. #Dual_therapy اختار واحد من الاثنين اهما Metformin + Gliptin. Metformin + Sulfonylurea. Metformin + Pioglitazone. Metformin + SGLT-2 inhibitor. Reassess HbA1c after 3 months. If HbA1c remains greater than 58 mmol/mol (7.5%), proceed to Triple therapy. #Triple_therapy اختار واحد من الثلاثة اهما Metformin + Gliptin + Sulfonylurea. Metformin + Pioglitazone + Sulfonylurea.Metformin + Sulfonylurea + SGLT-2 inhibitor. Metformin + Pioglitazone + SGLT-2 inhibitor. If HbA1c remains above 7.5% despite triple therapy → Insulin therapy. لو كانت Triple therapy: Not effective. Not tolerated. Contraindicated. AND BMI greater than 35. نستخدموا: Metformin + Sulfonylurea + GLP-1 mimetic.