قصص طبية Iraqi doctors

Nail disorders

👉 Half and half nail Causes : 1️⃣ Liver cirrhosis 2️⃣ Hypoalbuminemia 3️⃣ Half and half nails are seen in 20-50% of patients with chronic kidney disease

#ملاحظة_طوارئ 🔥 د محمد الحسيني : 60s yr-old male with hx of ckd on dialysis presented with chest pain and palpitation ECG as shown Regular ,very wide qrs(>200ms) This is Not VT This is Sinewave sign of hyperK Its one of VT mimics and can be difficult to distinguish The clue here is the history of ckd , the very wide qrs and also the rate Amiodarone here is Deadly So please whenever you see qrs duration 200ms and more, never consider it VT Unless you give calcium gluconate and the qrs doesnt get narrow Then you can start amiodarone طبعا البوتاسيوم جان 6.6 وهالشي اكيد غلط Sinewave is uncommon to see in practice

💥 Nice guidelines 2022 about #Osteoarthritis : 1. Non pharmacological measure 2. Topical NSAIDs (lowest dose) 3. Oral NSAID + Gastroprotection 4. Intra-articular injection of steroid لا دور أبدا لبقية الإجراءات مثل : ❌ Paracetamol or weak opiod (can be used intermittently) ❌ Glucosamin ❌ Strong opiod ❌ Intra-articular injection of hyalorunic acid https://www.nice.org.uk/guidance/ng226

#قصص_طبية 🔺 تتنوع حالات الأجوسة وال Malingering وتتطور مع الزمن من الحالات الغريبة طبيب أخصائي ينقل عن كيس young female وجدها في الطوارئ على أساس Snake bite 🐍🐍 بدون وجود أي ٱثار للعضة يگول بعد فترة نفس المريضة إجتني للإستشارية هم snake bite ووره فترة جابوها للعيادة مرة ثالثة لنفس السبب 😅 ومبينة المريضة healthy wealthy وماكو أي ٱثار يگول هنا أچوست انه وگلت الها: أدري هاي الحية ناصبتلج كمين ؟؟ 😂😂 شنو أغرب حالات الأجوسة اللي شايفينها ؟

☀️ Astute observation can often yield ‘spot’ diagnosis of endocrine disorders. * Astute (smart)

💥 Asymptomatic gallstones found incidentally should not be treated because the majority will never cause symptoms.

Myxedema Coma NCLEX Questions https://www.registerednursern.com/myxedema-coma-nclex-questions/?

#ملاحظة_طوارئ 💥 من الكيسات النادرة، اجتنا اليوم هاي الكيس 70 years old female حسب ما يگول الأهل ما عدها أي مشاكل صحية سابقا Presented with DLOC ☀️ O/E > #Coma Bp 90/60 Hr 33 Spo2 95 % (without O2) * ECG >> low voltage , Severe #Bradycardia 🩸 Normal RFT, RBS =113 💎 Looks Puffy face, Cool, dry thickened skin 🔥 Send for #TSH = 84 (0.3_4.5) << #Myxedema_ coma >> الشكر والتقدير للعم العزيز د علي عقيل Ali Akeel _________________________ 📁 #Medscape 👇 * ( TSH is elevated in most patients, indicating a primary thyroid disorder) * ( However, some patients will have undiagnosed hypothyroidism and myxedema coma will be the initial presentation )

#ملاحظة_طوارئ 💥 50 years old female Known case of Non Hodgkin #Lymphoma On chemotherapy 3 days Hx of #SOB * Spo2 70 % (without O2) Undetected Bp * #DDx ?

#ملاحظة_طوارئ 🔥 #Diclofenac is now contraindicated with any form ofcardiovascular disease * Topical Diclofenac can be used ✅ #Naproxen & low dose Brufen can be used (( Pass medicine ))

#ملاحظة_طوارئ 💥 30 years old female PMHx > negative Presented with 5 days Hx of #fever, dry cough ♦️ O/E: #Dyspnic Bp >> #Undetected Spo2 94% (without O2) ,,, 99% (with O2) HR 124 ☀️ #CXR >> Huge Cardiomegaly ... Chest CT .. 👉 #ECG >> Sinus tachy, electrical alternans تم إحالة المريضة فورا الى مركز الناصرية للقلب ¶ #Echo >> RV, RA collapse Confirmed ( #Cardiac_tamponade ) وتم اجراء Pericardiocentesis كل الشكر والتقدير لمركز القلب وكوادره العاملة ♥️

🔥 #Statins should be stopped whilst taking a course ofmacrolides. use both cocurently increase risk of myopathy & Rhabdomyolysis #Pass_medicine

#ملاحظة_طوارئ البارحة اجتنا هاي الكيس ♦️ 50 years old female PMHx > DM Presented with chest tightness after Psychological upset Same previous attack *Troponin _ve * Normal Vital signs 🔥 ECG >> #Brugada syndrome type 1

💎 Dose equivalents #Steroids ,, #Statins

🔥 #New Guidelines ( After lifestyle modifications, metformin is no longer the go-to drug for every patient in the management of hyperglycemia .... ) https://www.medscape.com/viewarticle/982504?src=mbl_msp_android&ref=share

🔥 #New Guidelines ( After lifestyle modifications, metformin is no longer the go-to drug for every patient in the management of hyperglycemia .... )

https://www.medscape.com/viewarticle/982504?src=mbl_msp_android&ref=share Sent using the Medscape App for Android™