Surgical notes

West syndrome is a a Triad of :- 1- infantile spasm 2- hypsarrhythmia in EEG 3- Mental retardation #أطفال

Corticosteriod Dose Equivalents #باطنة

Thyrotoxicosis vs Throid Strom" crisis " #باطنة

🛑Hyperthyroidism is characterised by increased thyroid hormone synthesis and secretion from the thyroid gland, whereas 🛑thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, irrespective of the source. #باطنة

Toxins of E.coli Causes aggregation of Platelets in small Blood vessels " Glomeruli ... inducing Thrombocytopenia When the RBCs enters this Glomeri , It is destroyed. لانها بتدخل في Blood vessel مش طبيعي Causing " MAHA " ❤️ Micro -Angiopathic Heamolytic anemia وبسبب ال Platelets Aggregation:- Decrease the Glomerular Filtration >> AKI وبهذا :- 1- Heamolytic anemia 2- Thrombocytopenia 3- AKI With History of Diarrhea ( Hemolytic Uremic syndrome ) " HUS " #أطفال

بسم الله الرحمن الرحيم موضوعونا اليوم عن DKA اولا التعريف Metabolic error caused by acute insulin deficiensy طيب ايش الاسباب اللي عملت هذا الشي اولا في معانا اسباب في الانسولين1/decrease dose of insulin 2/increase demand 3/bad storage of insulin وفي معانا السبب الثاني وهو اي stress. ومختصر ب 5I 1/Infection :pneumonia, UTI, celluitis 2/inflammation:pancreatitis, cholycystis 3/increase use:alcohol, cocaine 4/infarction:MI, CVA 5/iatrogenic:Drug like steroid Surgery الان معانا pathophysiology اولا🔴 بالطبيعي انه الجلوكوز يدخل الى داخل الخلايا ويحصل aerobic and anerobic metabolism وبعدين يخرج ATP 🔴ثانيا K sensitive channel close which lead to activation of ca voltage channel This lead to increase of ca in cells which lead to activation of insulin vesicle then release insulin Another mechanism of activation of insulin vesicle is by Glutamic acid decarboxylase enzyme By conersion of gutamic acid to GABA Which lead to activation of vesicle and release insulin So in type one DM there are antibodies that affect this normal mechanism 1/anti ilet's cell antibody (in receptor of glucose) 2/anti glutamic acid decarboxylase enzyme antibody 3/anti insulin anti body In DKA: occur of any stress which mention above Lead to activation of sympathetic nervous system Lead to release of epinephrine and NE Lead to activation of Glucagon which lead to ☄1/lipolysis >FFA oxidation>acetyl CoA>krebs cycle >ketones bodies>Aceto actate decarboxylation to acetone and then go to lung , B-hydroxy butrate rlease hydrogen ions And lead to acidosis ☄2/Liver>gluconeogenesis and glycogenolysis >increase glucose The ketone bodies📍 activation of chemotriggor zone which lead to reflex vomiting Hydrogen ions lead to 📍 acidosis and abdominal pain 📍hyperkalemia by k out of cells And Na/k pump fialure 📍activation of peripheral chemoreceptor(aortic and carotid )lead to activation of vagus and glossopharngeal nerves which lead to reflex Increase R.R To out CO2 when the Glucose increase in blood this lead to increase osmolality of blood (hyper osmolar blood )and traction more water >polyuria The hyper osomolar blood lead to ctivation of osmoreceptor in hypothalamus (thirst center )>drink more water(polydipsia) when glucose decrease inside cells this lead to decrease ATP and the body need energy >polyphagia Pathophysioilogy of complication in two types in general( DM1, 2) When glucose increase in blood and don't enter the cells it conjugate with (lipid and proteins)this named (non enzymatic glycation This lead to form very potent inflammatory molecules which leads to. Inflammation of BVs with increase of LDL this 1/🔴deposits in basement membrane (hyline artriosclerosis)lead to decrease blood volume And gas exchange this can cause many disease such as(CAD, PAD, stroke, Retinopathy) 2/🔴damage of glomeruli which lead to increase filtration of protein like albumin (microalbuminurea)>chronic kidney disease Note⭐️ When insulin rlease also amyline released which functions are(inhibit food intake, delayed gastric empyting, decrease blood glucose, reduction of body weight ) So when there is no insulin production amyline may accumulate and lead to damage of cells #أطفال

ايش يهمنا نعرف بال Score هذا ؟! في عندنا قسمين :- 1) Pysical maturity. 2) Nueromuscular maturity. ال Score من -1 الى 5 او 4. في ال Pysical معانا ( 5 ) لو نبدء من ال Head وننزل :- 1- Ear lobule / eye 2- Breast 3- lanugo hair 4- Gentalia 5- planter Surface " creases" في ال Neuromuscular معانا " 6 " :- 1- Posture 2- Square window " Wrist " 3- Arm recoil 4- Scarf sign 5- Poplitial angle 6- Heel to ear نحسب ال كم حاصل جمع ال Score. و نحطه في الجدول ونعرف ما يقابله في ال Weeks للطفل .

ballard neonatal assessment

Both drug are contraindicated in Renal artery stenosis . Or Creatinine level more than 3 #باطنة

Effect of Angiotensin on the efferent Arteriole , Therefore, Using ACEI , Or ARB drugs are preferred in CKD patients بنلاحظ في اول استخدامنا لهذي الأدوية نتيجة ال Vasodilation اللي بيحصل انو ال GRF و ال Cr levels في أول اسبوع باترتفع .. لكن بعدها يعتبر مفيد لل Glomeruli لانه بيخفض الضغط فيها.. #باطنة

https://youtu.be/NQ_7LCwyHTE #أطفال

#أطفال

Side effects of Doxycycline #باطنة

Read This ..

Creatinine clearance with How to Calculate BM .. #باطنة

Creatinine clearance formula #باطنة

#باطنة

Corrected QT interval Especially in case of Tachycardia #باطنة

هذا من دايفدسون #باطنة