Important knowledge

⚡️when we found RBCs in GUE we send RBC morphology test for dysmorphic RBS to differentiate the source whether from upper urinary track or lower urinary track [ dysmorphic RBS indicate it from upper urinary track ( nephrons) ]

⚡️protein in GUE with picture of UTI is a normal finding

⚡️Type 2 DM pt. should be searched for micro-vasculer complication (eye & kidney) at time of presentation ( بينما type 1 ورة ٥ سنوات يالله ندور على ال microvasculer complication )

⚡️Sudden onset DKA in elderly pt. with severe abdominal pain suspect pancreatitis

⚡️The first system affected by Electrolytes disturbance is CNS

ملاحظات عمنا د ارشد فؤاد ❤️

⚡️اذا مريض ACS وعندة tachycardia وناطية Bete bloker بس بعدة tachy وبنفس الوقت ضغطة طبيعي او نازل منكدر نزود الدوز ننطيه ivabradine

⚡️lipid profile should be send within 24 h after onset of acute coronary syndrome because after 24h will be negatively normal or even low till 3 months after the onset (الخلاصة ال lipid profile اذا مدزيته باول ٢٤ ساعة لمريض ال ACS لتدزة بعد الا ورة ال ٣ اشهر لانو حيطلع طبيعي بالتحليل وهوه بالحقيقه صاعد فميفيدنا )

⚡️The first cardiac enzyme to be elevated is myoglobin

⚡️▪︎chest pain at exertion = chronic coronary syndrome ( angina) ▪︎chest pain at rest = acute coronary syndrome (unstable angina, STEMI , NSTEMI )

⚡️unstable angina & NSTEMI both of them presented with ST segment depression or T wave inversion or both but cardiac enzymes is elevated in NSTEMI ( Positive) and normal in unstable angina (negative)

COPD مقدسات

⚡️Kepra is the safest anti epileptic drug (have little side efforts) د.فرح

⚡️مريض ال DM بعد عمر ال ٤٠ mandatory ننطيهم statin لكن اذا تشخص بعد عمر ال ٧٥ مننطيه لانه ال life expectancy مالته قليل

⚡️Gallavardin phenomenon ( cardio auscultation) هذا المريض الي عندة aortic stenosis الي المفروض تسمع عندة systolic murmur بال aortic area's راح تلكي عندة وياها مرمر عالي بال mitral area's كذلك لانو يصير رادييشن للصوت بميكانزم معين وتشتبه بالتشخيص بين ال AS وال MR ▪︎ الزبدة اذا لكيت مرمرين عاليات واحد بال aortic area وواحد بال mitral area's فهذا aortic stenosis (وليس MR )

⚡️Ddx of bronchial breathing : (4C) ---------------- ▪︎consolidation (pneumonia ) ▪︎collapse ▪︎cavitation ▪︎cancer (tumor)

⚡️Internal medicine 💊