Important knowledge

⚡️3 sign in thyrotoxicosis is not caused by ⬆️ thyriod hormone ▪︎exophlamous ▪︎clupping ▪︎pretibial myxedema

⚡️surgical anastomosis leakage د علي عادل ▪︎ mostly occurr between day 6 & day 8 post op. because collagen changing occurred during this period ▪︎if it occurr on day 2 post op. It is due to surgical failure

⚡️Nail sign in thyriod diseases ------------------------------ ♦️hyperthyroidism ▪︎ koilonychia ( most common one ) ▪︎very Brittle nail ▪︎Clubbing ( thyroid acropachy ) in Graves disease ▪︎leukonychia ▪︎onycholysis ( due to excessive sweating) ♦️hypothyriodism ▪︎fragial nail (most common one 70% of patients) ▪︎slow growing ▪︎thin nail ▪︎leukonychia ▪︎onycholysis ▪︎nail pitting

⚡️The most common ocular muscles affected (ophthalmoplegia) in hyper thyriodism is : ▪︎superior rectus ▪︎inferior oblique

⚡️The earliest eye sign in hyperthyroidism is exophlamous ( د.علي عادل )

⚡️immediate life threatening chest injuries in trauma (6) : -------------------------------- ▪︎airway obstruction ▪︎flial chest ▪︎tension pneumothorax ▪︎open pneumothorax ▪︎hemothorax ▪︎cardiac temponad

⚡️FNA cannot distinguish between a benign follicular adenoma and follicular carcinoma in discrete thyriod swelling

⚡️اي مريض يجيك للطوارئ عندة اعراض مال basal skull fracture ممنوع منعا باتا تحطلة NG tube او endotrachial tube لانو ممكن يفوت بال fracture

⚡️Carcinoid syndrome not occour in Carcinoid tumor without liver metastasis

⚡️how to assess the fluid given for patient post op ?! We have 5 parameters ▪︎BP (systolic should be >100 mmHg) ▪︎HR ( should be <90 ) ▪︎RR ( should be <20 ) ▪︎capillary refilling time (should be <2 sec) ▪︎urine output (should be > 0.5 - 1.0 ml/kg/h )

⚡️the first sign of hypocalcemia is peri oral tingling

⚡️MRI is superior to CT at determining the presence of prevertebral fascia invasion of thyriod cancer

⚡️nerves that can be injured during mastectomy : ▪︎long thoracic nerve ( نخلي يدفع حايط يصير عندة scapuler winging) ▪︎supscapular nerve ▪︎intercostal nerve

⚡️The earliest sign of atelectasis & DVT is fever

⚡️Malignant breast mass --------------- ▪︎posative estrogen receptor = less aggressive (like femal ) ▪︎negative estrogen receptor = more aggressive ( like male ) بي استروجين رسبتر يشبهوها مثل الفيميل عدها استروجين تكون رقيقه ال aggressiveness مالته قليل اما الي مابي استروجين يشبهوه مثل الميل يكون aggressive اكثر

+ aczema respond to steriod treatment while paget's not responding

⚡️saphenous varus have Positive cough impalce