Important Tips in Internal Medicine‼️👌

Regarding cardiac tamponade - Diagnosed by beck’s triad (decreased BP, distended neck veins, distant heart sounds) - Most diagnostic is ECHO - Emergency pericardiocentesis

bouchard nodules ➡️ Hand pip Herberden nodules ➡️ Dip joint

بص علي الديسكريشن يسطاااا لينك الورق https://t.me/c/1795251...​ Distributive shock is the most common type of shock, followed by hypovolemic and cardiogenic shock.  عذرا علي الخطأ hypovolemic اشهر في الاطفال الدكتورة قالت في الميتنج ان معظم حالات الشوك بتكون septic shock stage 1 : normal BP stage 2 : blood pressure decrease يحصل leakage و DIC و acidosis و weak or no pluse HR not always increase with shock ⬇️ capillary refill = ⬆️ CRT بدل ما تاخد ثانيتن او تلاتة بقت بتاخد وقت اكتر in anaphylaxis : type 1 hypersensitivity B cell تعمل IgE يروح علي mast و basophils يرفقعها 🕰the commonest cause of cardiogenic shock is ➡️ acute myocardial infarction. 🕰the most common cause of neurogenic shock is ➡️ cervical spinal cord injury. 20%➡️above 6th thoracic spine. 🕰 Septic shock ➡️ antibiotics ➡️ multidrug regimens ➡️ piperacillin / tazobactam combination. في المحاضرة مكتوب اعطي iv fluid in cardiogenic shock بس بحذر انما ع البوتيوب بيقول contraindicated اصلا عليها mcq عالقناة بيحصل hypothermia لما تضرب sympathetic في neurogenic shock عليها بردو mcq اخر حاجة في فرق بين pcwp و pawp و cvp لو متخيل من محاضرة mointering مكان كل واحد بنقيس فيه هتعرف تجيب paramter صح معلش يسطا مخدتش بالي من صوت الماوس غير بعد ما خلصت :( كنت هسجل علي التابلت بس مفيش مساحة :(

🔻ال distributive shock الوحيدة ال parameters دي فيها مختلفة عن باقي أنواع ال shock COP⬆️ in all EXCEPT distributive SVR ⬆️ in all EXCEPT distributive SvO2 ⬇️ in all EXCEPT distributive 🔻ال PAWP ⬆️ عالي في اتنين Cardiogenic & obstructive 🔻 كل أنواع ال shock فيها hypotension & reflex tachycardia ماعدا Neurogenic shock فيها (Triad)➡️ hypotension, bradycardia, flushing"d2 v.d".

ARDS Ttt is supportive *Mechanical ventilation, lung protective strategy* TV 4_8ml /kg ideal body weight RR up to 35 Ins/Exp less than 1 PEEP 5_ 20 relative to FIo2 Spo2 88_95 Pao2 50_80 Prone position more than 12 h Non respiratory supportive Antibiotics " Nosocomial infection mainly psudimonas.aeruginosa " Fluid Steroid Neuromuscular blockade PGE1 &Inhaled NO Antiinflammatory ..pentoxifelin Exogenous surfactant 👉cause of death spesis and MOF

وصلحوا دي بردو ف جزء ال osteomalacia Day not week 🥹

السؤال دا مهم ف محاضره ال metabolic مش موجود ف علم بينتفع به

Acute flaccid paralysis

Complication of DKA is BAAD *B 👉 Brain edema _ Pancreatitis *A 👉 ATN & ARDS *A 👉 Arterial and venous thrombosis *D 👉DIC

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👉🏻 upper respiratory tract involvement = Epistaxis, nasal polyps,nasal septum perforation,saddle shaped deformity > Think Wegner’s granulomatosis 👉🏻Remember : LaryngoTracheoBronchial involvement in relapsing polychondritis 🟣 Rheumatoid arthritis associated Syndromes 1.Caplan Syndrome ( pulmonary nodules , Lung fibrosis, Pneumoconiosis) 2.Carpel tunnel syndrome 3.Felty syndrome ( triad of neutropenia+Spleenomegaly+Rheumatoid) #rheumatology

تجميعه لكل ال genetic mutations فى الروماتولوجى

في محاضرة ال Pulmonary embolism دي هنا هتبقي and مش or .

👉Post cardiac arrest Start immediately after ROSC ABCD approach هشوف العيان محتاج يتيب ولا لأ O2 saturation 94-98% PaO2 75_100 Tv 6_8 ml/kg ideal body weight PaCo2 35_45 TTM 32_36 " prevent fever at least 72h" SBP more than 100 Avoid hypotension less than 65 Blood glucose 140_180 avoid HypOglycemia "less than 70" 👉Give levetiracetam and  sodium valproate .. seizures after ROSC 🔻 Routine Stress ulcer Prophylaxis DVT prophylaxis Feeding 👉 Not routine Prophylaxis anti seizures Giving Steroids Prophylactic AB not recommend 👉TTM only for comatose      👉 Prognostication 👈 * Clinical Examination *Electrophysiology *Biomarkers *Imaging 🔻 Poor out come * Absent pupillary and corneal reflex>72 * Status myoclonus >72h *Highly malignant EEG >24 *Bilateral absent N2o SSEP >24 *Increase NSE *Diffuse anoxic injury on Brain CT &MRI *Glasgow Motor score<= 3

اللي هيسيب المحاضره دي يبص علي دول