Important knowledge

⚡️Basic investigation for short stature -------------------------------- ▪︎bone age ( هذا طماطة ندزة لكل كيس) ▪︎CBC (anemia, infection ) ▪︎serum phosphatase & calcium (hypo & pseudohypoparathyriodisim ) ▪︎ESR (IBD ) ▪︎GUE (recurrent UTI , Nephrotic, nephritic syndrome) ▪︎RFT >⬆️

Achondroplasia

Clinical features of achondroplasia

⚡️Any short stature female should be send for caryotype (to exclude Turner syndrome )

⚡️ جماعة ال growth hormone Deficiency يصير صوتهم ناعم لان عدهم ال larynx بعدها immature

⚡️Pellagra داء الذرى --------------------------------‐ Vit. B3 Deficiency Presentation : 3D ▪︎Dementia ▪︎Diarrhea ▪︎Dermatitis (& Death)

Blood smear of leishmaniasis (kala azar ) (OSCE 6th stage 4th rotation 2022-2023)

⚡️Post–kala-azar dermal leishmaniasis (مهم) -------------------------------- ▪︎hypopigmented, erythematous, or nodular ▪︎ commonly involve the face(around chin and nose) and trunk ▪︎appear during or shortly after therapy or up to several years later and may persist for several months or for many years ▪︎thought to be caused by treatment and complete eradication of the parasite in the circulation resulting in its escaping to the tissue and causing this reaction.

#bleeding Factor VII (الجوكر) هذا يسموه جوكر اذا مريض ينزف ومدانعرف شنو مشكلتة ننطي factor VII لانه يشغل ال Extrinsic pathway ويسويلنا ثرومبين مباشرة وحدة (ميحتاج هواي فاكترات مثل ال intrinsic pathway ) حتى ابو الهيموفيليا اذا صار resistance لل factor VIII ننطي Factor VII

elevated RDW and MCHC is the most important and suggestive finding in the hereditary Spherocytosis

Heinz bodies G6PD deficiency

Bronze skin ✨️

Hyperpigmentation (bronze skin ) in thalassemia due to secondary hemochromatosis

⚡️sickle cell anemia complications (اوسكي) ------------------------------- ▪︎vaso-occlusive episode ▪︎Dactylitis ▪︎Infections (due to auto-spleenectomy) ▪︎Acute splenic sequestration ( in infant ) ▪︎Acute chest syndrome (ACS) ▪︎stroke (overt or silent ) ▪︎aplastic episode (due to Human parvovirus B19 infection) ▪︎Priapism ▪︎Renal problems ( 7 problems) ---------------------------- others ------------------------ ▪︎Sickle cell retinopathy ▪︎Delayed onset of puberty ▪︎Avascular necrosis ▪︎Leg ulcers

Coarse basophilic stippling = lead poisoning سلايد مهم ( final course 1 / 5th stage )

⚡️Transferrin saturation TS ▪︎<20% (<15% in female) = Iron deficiency anemia ▪︎>50% = Iron over load (hemosiderosis, iron poisoning or hemochromatosis)

⚡️Important labrotary Finding in iron deficiency anemia Finding that increase ⬆️ : ----------------------------------------- -RDW ( normal in thalassemia) -Reticulocyte count ( زيادة تحت المتوقع) - iron saturation percentage(total iron binding capacity TIBC ) ( هذا يتاثر بالاكل وبي فارييشن ودايرنل رثم فمنعتمد عليه كلش ) - bone marrow cellularity - FEP (protophorphirin يصعد بسبب نقصان ال الارثروبويسس ) - Red blood cell (RBC) zinc protoporphyrin/heme ratio ( non specific raise ) - Soluble transferrin receptor (STfR) levels (اكثر فحص سينستف لان ميتاثر بالاكل وبالالتهاب والانفكشن ) Finding that decrease ⬇️ : -------------------------------------- - HB - RBC counts ( increase in thalasemia ) -MCV , MCH - corrected Reticulocyte count (Retc. × HCT/normal HCT ) [may be normal] - platelate count - Serum ferritin (sensitive +specific but cannot dependent in inflamation , infection , malignancy ) - serum Iron - percentage of transferrin saturation

⚡️polycystic kidney type 2 associated with brain aneurysm so have risk of ICH