Junior in Medicine 🩺

🔰بتعليقات هذا البوست راح انزل قنوات الملازم مال الكليات وانتوا هم اذا تعرفون ملازم كاملة مرتبة هم نزلوها لزملائكم

خطييية عدهم دوام باجر 🐸 اللهم لا شماتة المهم الموضوع بسيط ترة لا تشيلون هم 🔰عندي فقط ملاحظات بسيطة الكم : ▪︎تقرون على المصادر الرسمية او على ملازم مرتبة وكاملة واساسها المصدر (لان امتحانكم وزاري من المصدر) ▪︎بعد ما تقرون كل مادة ، تجون هنا تراجعون الموضوع على جونير (حتى تستفادون اكثر وتتاكدون خاف فاتكم شي) ▪︎لازم تخلون جدول للمادة النظرية وتقرونها يوم بيومة خلال فترة الروتة (لان ما عدكم وقت ثاني غير الروتة) ▪︎لازم يكون عدكم ملخص للمادة تقرونه بوقت الامتحان (لان مستحيل تلحكون تقرون كلشي اثناء فترات إمتحانات الروتة) ▪︎تحضرون كل ايام العملي وتاخذون هتسري وتسوون فحص وتقرون طبلات شكد ما تكدرون ▪︎والباقي راح يكون سهل وممتع ان شاء الله لا تشيلون هم ▪︎فهرس القناة وكل محتواها مرتب وموجود بالمنشور المثبت

🔴Junior in Medicine 🩺 ▪︎🔥🔥 Joining Link 🔥🔥 ▪︎Aim ➡️ Summary Of Important Topics in Medicine For Medical Students & Junior Doctors 🔰Content الفهرس 📍1. Internal Medicine 📍2. Surgery ▪︎General Surgery ▪︎Orthopedic ▪︎Urology 📍3. Pediatric Medicine 📍4. Obstetrics & Gynecology 🔰Sources (Last Edition) المصادر : 📍1. Internal Medicine : •Davidson •Step Up •Medicine in Minutes 📍2. Surgery : •Bailey's & Love •Principles Of Surgery 📍3. Pediatrics : •Nelson (Essential & Textbook) •Illustrated Textbook Of Pediatrics 📍4. Obstetrics & Gynecology : •Ten Teacher •Essentials Of Obstetrics & Gynecology

اخر جمعة بحياة الاستاجيرية اللهم اجعله خيراً

خلص الاونلاين بخير وسلامة بقى الاوفلاين ان شاء الله يتساهلون ويانا ان شاء الله تكونون استفاديتوا واني هم صراحة تونست وياكم وتعرفت على بعضكم برغم الصعوبات وضيق الوقت 🐸

موعد حريتنا اقترب يا ستاجيرية

🔰Remaing Topics Of FemaleTology

🔸B. Delayed Puberty متأخرة ▪︎It's A Condition Of No Development Of The Secondary Sexual Characteristics At Age Of 14 Years (Or No Menstrual Cycle At Age Of 16 Years) ▪︎Central Causes Results in Delayed Puberty & Primary Amenorrhea  ▪︎Peripheral Causes Results in Delayed Puberty & Primary Or Secondary Amenorrhea 🔷Causes Of Delayed Puberty 📍1. HypoGonadoTrophic HypoGonadism (Central Causes) Due To : 🔻I. Constitutional Delay : ▪︎Normal Variant Causes Delay in The Initiation Of Puberty Process ▪︎+Ve Family Hx Of Same Condition & Short Stature 🔻II. CNS Lesions (Pituitary Tumours) 🔻III. Kallman Syndrome (Genetic Disorder Results in GnRh Deficiency) 🔻IV. Other Causes : ▪︎Anorexia Nervosa ▪︎Excessive Exercise ▪︎Chronic Illnesses (DM/Renal Failure) 📍2. HyperGonadoTrophic HypoGonadism (Gonadal Failure) Due To : ▪︎Turner Syndrome ▪︎XX Gonadal Dysgenesis ▪︎Premature Ovarian Failure 📍3. NormoGonadoTropic HypoGonadism (End Organ Defects) Due To : ▪︎Uterine Defects ▪︎Imperforated Hymen ▪︎PCOS ▪︎Tumours Secrete Androgen 🔷Mx Of Delayed Puberty 📍1. Determine & Treat The Known Cause 📍2. HRT (Hormonal Replacement Therapy) For Untreatable Causes 📍3. No Tx Needed For Constitutional Delay

🔴Disorders Of Puberty ▪︎Puberty It's The Process Of Changing A Child Into Adult Through The Development Of Secondary Sexual Characteristics & Reproductive Ability ▪︎Puberty Usually Starts To Develop At Age Of 8-9 Years 🔷Physiological Changes During Puberty 📍1. Hypothalamic Pituitary Axis (HPO) Starts To Function At Age Of 8-9 Years By Producing Pulsations Of GnRH (GonadoTropin-Releasing Hormone) 📍2. Pulsations Of GnRH Starts To Increase Gradually Over Time & Takes About 4-5 Years For Full-Maturation Of HPO (Adult Frequency & Amplitude) 📍3. GnRH Stimulates Anterior Pituitary For Secretion Of LH-FSH Hormones 📍4. LH-FSH Hormones Stimulates Gonads (Ovaries Or Testis) To Start Secretes Their Hormones (Estrogen Or Testosterone) 📍5. Estrogen Or Testosterone Stimulates Body Tissues & Organs To Starts Developing Secondary Sexual Characteristics & Reproductive Ability 📍6. Development Of Female Secondary Sexual Characteristics : 🔻I. Breast Development (Thelarche) : ▪︎1st Physical Sign Of Puberty in Females ▪︎Usually Occurs At Age Of 9-11 Years (2-3 Years Before Menarch) 🔻II. Pubic Hair Development (Adrenarche) : ▪︎Occurs After Breast Development ▪︎Depends On Adrenal Androgens (All Other Characteristics Depend On Ovarian Androgen Except Pubic Hair) 🔻III. Menstrual Cycle Development (Menarche) : ▪︎Usually Occurs At Age Of 9-17 Years (Average At Age Of 12.8) ▪︎Initial Cycle is AnOvulatory & Irregular ▪︎Takes About 5-8 Years For Full Maturation (Or About 3 Years According To Ten-Teacher) 🔻IV. Axillary Hair (Usually Last To Develop) 🔻V. Pubertal Growth Spurt : ▪︎It's The Peaking Of Growth Velocity 6-12m Before Onset Of Menstrual Cycle Then After That Growth Velocity Decline Due To Epiphyseal Closure ▪︎Final Height in Females Usually Reached At 14.5-15 Years Age 🔰Disorders Of Puberty 🔸A. Precocious Puberty مبكرة ▪︎It's The Onset Of Puberty Before 8 Years in Girls (9 Years in Boys) ▪︎High Risk Of Early Bone Epiphyseal Closure & Short Stature 🔷Types Of Precocious Puberty 📍1. True (Central/Cerebral) ➡ Occurs Due To Increase Production Of Pituitary GonadoTrophins (LH/FSH) 📍2. False (Pseudo-Precocious Puberty/Peripheral) : ▪︎Occurs Due To Increase Production Of Sex Hormones (Estrogen & Androgen) ▪︎Results in Iso-Sexual (Early Female Secondary SexualCharacteristics) Or Hetero-Sexual (Early Male Secondary SexualCharacteristics) 📍3. Incomplete ➡ Precocious Development Of Only One Secondary Sexual Characteristic (Like Only Breast Development) 🔷Causes Of Precocious Puberty 📍1. Central Causes : 🔻I. Constitutional (Idiopathic/Central/Primary) : ▪︎Most Common Cause ▪︎Occurs Due To Early Activation Of The Hypothalamic Pituitary Axis (HPO) Due To Unknown Ateiology 🔻II. Secondary To CNS Lesions (Trauma/Tumours/Meningitis/Encephalitis/Abscess/Malformations) 📍2. Peripheral Causes : ▪︎Adrenal Lesions (Hyperplasia/Adenoma/Carcinoma/Cushing's Syndrome) ▪︎Ovarian Lesions (Tumours) ▪︎Any Other Body Tumours Secrete Estrogen Or Stimulate Ovary To Secrete Estrogen ▪︎Juvenile Hypothyroidism (Low Thyroxine Increase FSH Secretion Then GnRh Secretion) ▪︎Iatrogenic Estrogen Intake ▪︎Syndromes (Silver & McCune-Albright Syndromes) 🔷Mx Of Precocious Puberty ▪︎Goal Of Mx is To Stops Puberty Until Enough Height Has Been Achieved 📍1. Determine & Treat The Known Cause : ▪︎Tumour Resection ▪︎Thyroxine For Hypothyroidism ▪︎Estrogen Inhibitors For Mccune-Albright Syndrome (TestoLactone/Tamoxifen/Fluvestrant) 📍2. Tx Of Idiopathic Precocious Puberty (Give One Of These Drugs Until Puberty Age Which is Usually At 12 Years) : ▪︎GnRh Agonist (Best Method) ▪︎MedroxyProgesterone Acetate ▪︎Danazol ▪︎Cyproterone Acetate 📍3. No Tx Needed For Incomplete Precocious Puberty

🔸D. 46XX Congenital Adrenal Hyperplasia (CAH) ▪︎Most Common Cause Of 46XX DSD ▪︎Occurs Due To Autosomal Recessive (AR) Mutation On Short Arm Of Chromosome 6 Causing Deficiency in Enzymes That Needed For Cortisol & Aldosterone Production ▪︎Results in : 📍1. High Levels Of Androgen (Due To -Ve FeedBack Mechanism Causes Adrenal Hyperplasia) 📍2. Cortisol & Aldosterone Deficiency ▪︎21-Hydroxylase Enzyme Deficiency is The Most Common Form Of CAH (90%) ▪︎11β-Hydroxylase Deficiency is The 2nd Most Common (5%) 🪀Results in : 📍1. Female Genotype (56XX) 📍2. Normal Female Internal Organs 📍3. Virtualization Of The Female External Genitalia (Male Phenotype Due To High Levels Of Androgen) Seen As : ▪︎ClitoroMegaly (Resemble Male Penis) ▪︎Labio-Scrotal Folds Fusion (Resemble Male Scrotum) ▪︎Upper Vagina Joining Urethra (To Open As Single Channel On Perineum) 📍4. Clinical Features : ▪︎Ambiguous Genitalia At Birth ▪︎Aggressive Boy Behaviour & Playing At Childhood چنها ولد ▪︎Acute Life Threatening Adrenal Insufficiency Crisis (Due To Aldosterone & Cortisol Deficiency That Occurs During Neonatal Or Later Life [Salt-Losing Crisis]) ▪︎Precious Puberty & Menstrual Irregularities & Infertility At Puberty (Due To High Androgen) 📍5. Confirm Dx : ▪︎Elevated Serum 17-HydroxyProgesterone (17-OHP) ▪︎Elevated Androgen ▪︎Low Serum Cortisol & Aldosterone (in Salt Losing Form) ▪︎Hyponatremia & Hyperkalaemia (5-7 Days After Birth) 🪀Mx Of CAH : 📍1. Should Live As Female شعجب 📍2. Adrenal Hormone Replacement (Hydrocortisone & Fludrocortisone) 📍3. Surgical Correction Of External Genitilia (Within 1st Year Of Life Usually At 2-6m Age)