Daily Medicine Journey

🔹Questions & Answers of the Final Written Exam…. 🔹Major 3…

#Respiratory_Cases 🔻Important in long case exam . #Dyspnea اذا SOB occur suddenly to its maximum intensity (within seconds)- The cause is either mechanical or vascular. Like pneumothorax or trauma leading to hemothorax Or pulmonary embolism. -If the dyspnea occurs over few hours most likely the cause is bronchial asthma. -If the dyspnea build up in 12hour to one day; most likely it is bacterial or viral cause. Like bacterial pneumonia or viral pneumonia. -If the dyspnea build up to its maximum intensity in 2 to 4 week; so the most likely cause is chronic infection. Like pleural effusion due to TB. -If the dyspnea build up and progress over months like 3 months; the most likely etiology is malignancy. -The dyspnea that progress over years it is due to pulmonary fibrosis. 🔺Take care COPD also progress over years like pulmonary fibrosis. But COPD has alot of fluctuation. While in pulmonary fibrosis it has little fluctuation. —————————— 1-Dyspnea associated with wheezing •acute severe asthma/ COPD/ sometimes acute LVF/ anaphylactic reaction. 2-Dyspnea with stridor (indicates upper airway obstruction) •foreign body or tumor/ acute epiglottitis / anaphylactic reaction/ aryngeal trauma/ laryngeal fracture. 3-Dyspnea with crepitation •acute LVF(due to pulmonary edema)/ bilateral extensive bronchiectasis. 4-Dyspnea but chest is clear مهم •pulmonary embolism / metabolic acidosis (diabetic ketoacidosis, renal failure, lactic acidosis, salicylate poisoning) / severe anemia/ shock 5-Dyspnea associated with unilateral chest pain •spontaneous pneumothorax. 6- Dyspnea associated with shock •acute myocardial infarction. 7- Dyspnea with high fever •pneumonia.

#Respiratory_Cases 🔻Important in long case exam . #pneumonia Pneumonia + hemolysis= mycoplasma Pneumonia + erythema multiforme = mycoplasma Pneumonia + hyponatremia = legionella Pneumonia + rusty sputum = strept pneumonie Pneumonia + presence of herpes labials = strept pneumonie Pneumonia + elderly / diabetic / alcoholic = klesiella Pneumonia + current jelly sputum = klesiella Pneumonia + bad dental hygiene = klesiella or actinomycs israelii Pneumonia + mutilple abscesses = staph aureus. Pneumonia + parrots = chalymdia Pneumonia + smoker = hemoph. influenze. Pneumonia + neutropenia / chemotherapy= pseudomonas auregenosa. Pneumonia + unconsiouness / anasthesia = anaerobes. Pneumonia in pt. With COPD = hemoph. influenze.

#Respiratory_Cases 🔻Important in long case exam . #Cough 1- Recent or acute onset: مهم Respiratory infection / pneumonia / acute bronchitis. 2-Chronic: مهم COPD / bronchial asthma / bronchiectasis / ILD / tuberculosis. 3-Occasional or paroxysmal cough: Bronchial asthma. 4- Dry cough: مهمم ACE inhibitor (captopril, lisinopril) / cough variant asthma / ILD / acute tracheobronchitis / tropical eosinophilia. 5-Cough with profuse expectoration: Bronchiectasis / lung abscess / resolution stage of pneumonia. 6- Nocturnal cough: Bronchial asthma / LVF / tropical eosinophilia / post-nasal drip / aspiration. 7- Cough with postural variation: Bronchiectasis / lung abscess / GERD. 8- Painful cough or retrosternal pain: Tracheal involvement (tracheitis). 9-Cough after eating or drinking: Esophageal reflux / tracheoesophageal Esophageal fistula. 10 -Cough with Yellowish or greenish or purulent sputum: Bronchiectasis / resolution stage of pneumonia. 11- Cough with  Foul smelling dark colored sputum: Lung abscess (usually with anaerobic infection). 12- Cough with Rusty sputum: Pneumococcal pneumonia. 13- Productive cough with frothy sputum occurs in pulmonary edema.

bacillus cereus=بالهستري ماكلين تمن بايت clostridium perfringens=بالهستري ماكلين بركر campylobacter=تسوي guillain barre enterohaemorrhagic e coli =don't give AB it will cause release of enterotoxin and cause hemolytic uremic syndrome clostridium difficile =hx of taking Ab علاجها 1st line metronidazole 500mg for 10 days second is vancomycin 125mg 4time daily for 10days clostridium botulism = cause diplopia نلكاها بالمواد المعلبه from dr mohammed abdullah

🔺شرح دكتور احمد عادل CPR .

شرح جدا راقي للACLS دكتور نصرت تدريسي طب بغداد