D’ NOTES
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All women should be offered screening for Down syndrome in
their 2nd trimester by means of 4 maternal serum tests (free β-
human chorionic gonadotropin[β-hCG], unconjugated estriol,
inhibin, and α-fetoprotein). This is known as the quad screen; it
can detect up to 80% of Down syndrome pregnancies compared to
70% in the triple screen
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وَأنتَ الرَّؤوفُ الرَّحيمُ، البَرُّ الكَريمُ الَّذي لا يُخَيِّبُ قاصِديهِ، وَلا يَطرُدُ عَن فِنائِهِ آمِليهِ.
يا مُسهل الأمور 🍀♥️
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يا الله يا محمد يا علي 🔥
A 16-year-old IV drug user presents with
high-grade fever, pleuritic chest pain, and hemoptysis. On auscultation, a murmur is heard over the tricuspid area.
1. What is the most likely diagnosis?
A. Pneumonia
B. Right-sided infective endocarditis
C. Pulmonary embolism
D. Pericarditis
E. Tuberculosis
2. What is the most common causative organism in this patient?
A. Streptococcus bovis
B. Pseudomonas aeruginosa
C. Enterococcus faecalis
D. Staphylococcus aureus
E. Candida
3. What is the expected site of embolization in this patient?
A. Brain
B. Spleen
C. Lungs
D. Retina
E. Kidneys
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يا الله يا محمد يا علي 🔥
A 12-year-old boy with a history of a repaired VSD 4 months ago presents with fever for the last 3 weeks, weight loss, and fatigue. On examination, he has a new systolic murmur and petechiae over his lower limbs. Blood cultures are negative.
1. What is the most likely diagnosis?
A. Viral myocarditis
B. Bacterial pneumonia
C. Infective endocarditis
D. Acute rheumatic fever
E. Systemic lupus erythematosus
2. What is the most likely cause of culture-negative endocarditis in this case?
A. Fungal infection
B. Congenital immunodeficiency
C. Previous antibiotic use
D. Poor lab technique
E. Staphylococcus aureus
3. Which of the following is a major criterion for diagnosis?
A. Petechiae
B. New murmur
C. Preexisting heart disease
D. Positive echocardiogram with vegetation
E. Fever > 38°C
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Rolls over in both directions
Good head control
Sit momentarily with straight back Start mouthing
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Head lag partially in sitting position , open hand spontaneously , smiles appropriately
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In all the fallowing we keep PDA open to maintain saturation of patient except
