Joe’s SMLE Recall

#Medicine 💊 #Summary

🔴 SMLE lesions/ Findings : - 🍯 Honey crust > Impetigo (S.aureus) - 🍇 Grape like vesicopustular on top of aczema > Herpes simplex virus - Red spots on cervix > Trichomonas vaginalis (🍓Stwaberry cervix) - White spots inside the mouth > measles (Koplik's spots) - Multifocal rounded macular erythematous lesions > Trichomonas vaginalis - Lichen sclerosus > Histopathology with Squamous cell carcinoma - Villous atrophy > Celiac disease - Velvety hyperpigmented plaques on her neck and axillae > Acanthosis nigricans ( PCOS , DM1 ) - Ascites and focal liver lesion in a cirrhotic liver > Hepatocelluar carcinoma - Tender sharply demarcated red lesion with no ulcer > Erysipelas - Dermatitis herpitiformis > Celiac disease - Most common congenital heart lesion > Ventricular septal defect - Painful vesicular lesions on the lips, gums > Herpes simplex virus - Slowly enlarging lesion not heal and bleeds when traumatized > Basal cell carcinoma (With old patient)

#OB 🤰 🔴 SMLE Numbers in OBGYN : - Pap smear > starts at age of 21y / every 3y - HPV screening > 30-65y - Cervical cerclage > Cervix length less 25mm or less 2.5 cm - Mono-Mono twin cleavage > 4-8 day - Di-Di twin cleavage > 0-3 day - Ectopic if 1 previous > (10%) - Ectopic if 2 or more previous > (25%) - Mortality rate in Ectopic > (<1%) - Mortality rate in ruptured Ectopic > (~25%) - Mammogram > 50y (grade B) , 40y (grade C) - Abortion > (less than 20w) - Stillbirth > (More than 20w) - HPV vaccine > 9-14y - AUB older than 45y > Endometrial biopsy - Folic acid in a healthy women > 1mg - GBS swab screening > 35-37w - Blood volume increase in pregnancy > 40-45%

#OB 🤰 Endometriosis: • Definition: Endometrial like tissue grows outside the uterus • Clinical picture: dysmenorrhea , Pain not improved with NSAID , infertility , dyspareunia , chronic lower abdominal pain , dyschezia and dysuria • Dx: Laparoscopy > gold standard • Malignancy potential > Risk of epithelial ovarian tumor • Mx: - Medical: 1st line > Combined estrogen and progestin therapy (OCP) 2nd line > progestin releasing IUD or GnRH agonists with HT add-back - Surgical: Conservative > Laparoscopic ablation, lysis or excision of lesions Indications: Women of reproductive age who wish to conceive , To avoid induction of menopause at an early age , No respond to medical therapy or recurrent pain Definitive > Bilateral oophorectomy Indications: significant pain and Sx despite conservative mx , Doesn’t want to conceive and have severe disease , Undergoing hysterectomy because of other pelvic conditions ( fibroids or menorrhagia ) • Postmenopausal endometriosis: - 1st line > Progestogen only > alternative OCP In conclusion mx : OCP > IUD > GnRH agonists with HT add-back > Laparoscopic > Bilateral oophorectomy References : Wafa ACOG

الملف بالحلول (يتحمل الخطأ لان الحلول اجتهاد شخصي)

#IM 💊 #summary HTN: • An average threshold of 140/90 mm Hg for office Dx of hypertension, but 135/85 mm Hg for home and 130/80 mm Hg for 24-hour ambulatory monitoring • Non-African American > Calcium Channel Blocker • Old Patients (>55 YO) > Calcium Channel Blocker • Young (<55 YO) > angiotensin-converting enzyme inhibitor (ACE-1) • African American patients > thiazide-type diuretic or CCB • HTN + DM = ACEI • HTN + CKD = ACEI • HTN + CHF or CAD = ACEI • Essential tremor + HTN > Beta blocker • Hyperthyroidism + HTN > Beta blocker • Migraine + HTN > Beta blocker 🚩Beta blockers should not be used as a 1st line except in case of CAD In other words : Beta blocker is 1st line > CAD patients