My Medical journey💉💊

Obstetrics

A 6-year-old child with cirrhosis due to autoimmune hepatitis presents with confusion, impaired coordination, and mild cognitive impairment. Which dietary component should be restricted?

Surgery

A 30-year-old nulligravid woman undergoes myomectomy for multiple subserosal fibroids. The operative note states that the endometrial cavity was entered during surgery. What is the effect on her risk of placenta accreta in a future pregnancy?

Obstetrics

⭕️ General Practitioner (GP) : 🩺🩺 🖇 Cases a GP can manage independently - Common medical illnesses (hypertension, diabetes, asthma, infections, gastroenteritis, UTI, etc.). - Minor surgical conditions (wound suturing, abscess drainage, minor burns, superficial foreign body removal). - Routine antenatal care for low-risk pregnancies. - Normal vaginal delivery (if trained and credentialed). - Common gynecological conditions and family planning. - Common pediatric illnesses, immunization, and growth monitoring. - Mild mental health conditions (anxiety, depression, insomnia). - Chronic disease follow-up and preventive healthcare. - Basic diagnostic procedures (ECG interpretation, laboratory interpretation, etc.). - Basic clinical procedures (IV cannulation, urinary catheterization, nasogastric tube insertion, wound care, splinting, local anesthesia, etc.). 🖇 Cases a GP should stabilize and refer: - Acute myocardial infarction (heart attack). - Stroke. - Severe trauma or polytrauma. - Septic shock. - Diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). - Severe asthma or respiratory failure. - Status epilepticus. - Acute abdomen or intestinal obstruction. - Severe gastrointestinal bleeding. - Complicated fractures or neurovascular injuries. - Obstetric emergencies (eclampsia, postpartum hemorrhage, ectopic pregnancy, fetal distress, obstructed labor). - Neonatal emergencies. 🖇 Cases requiring specialist referral - Patients requiring major surgery. - Patients needing intensive care (ICU). - Cancer requiring chemotherapy or radiotherapy. - Complex neurological, cardiac, renal, endocrine, or autoimmune diseases. - High-risk pregnancies or complicated deliveries. - Any condition beyond the GP's competence, available resources, or local scope of practice. 📍 Working guidance for a GP - Take a thorough history and perform a complete physical examination. - Establish an appropriate differential diagnosis. - Request only the necessary investigations. - Initiate evidence-based treatment. - Perform basic procedures within your competence. - Recognize red flags and medical emergencies early. - Stabilize the patient before referral when necessary. - Refer promptly when the patient's needs exceed your skills, facility capabilities, or available resources. - Educate patients on disease prevention, medications, and follow-up. - Document all findings, treatments, and referrals clearly. - Always practice within your level of training, competence, and local regulations, and seek senior advice whenever in doubt. #GP

NOTE: In hypertensive urgency : Oral captopril Oral clonidine Oral labetalol Oral minoxidil All available choices are ORAL #Emergency

ملخص للدكتور أسام. مستشفى الجمهوري _ عدن للواقع العملي في الطوارئ #Emergency_Course

Oxford Handbook of emergency medicine #Emergency_Course

د. أسام جبلي... بروتوكول طوارئ #Emergency_Course

Emergency medicine 2 #Emergency_Course

Emergency medicine 1 #Emergency_Course

Glasgow coma scale #level_3 #surgery

Tri-modal distribution of trauma deaths #surgery #level_3 #Trauma

Carbon monoxide removal is unafected, so cyanosis and tachypnea are less likely.

ملخص للدكتور أسام. مستشفى الجمهوري _ عدن للواقع العملي في الطوارئ #Emergency_Course

#neoplasia #level_3

- multidisciplinary team: ⭕️ 3 surgeons: 1. Site specialist surgeon 2. Surgical oncologist 3. Plastic & reconstructive surgeon ⭕️ 2 cancer treatment doctors: 1. Clinical oncologist 2. Medical oncologist ⭕️ 3 diagnosis: 1. Palliative care physician 2. Diagnostic radiologist 3. Pathologist ⭕️ 3 rehabilitation: 1. Speech therapist 2. Physiotherapist 3. Prosthetist ⭕️ 2 nursing: 1. Clinical nurse specialist 2. Macmillan nurse ⭕️ 3 support and administration 1. Social worker/Counselor 2. Medical secretary 3. Audit & information coordinator #neoplasia #surgery #level_3

⭕️ Previously AK and keratoacanthoma considered premalignant; now considered part of a continuum #skin_tumors #surgery

- This redundancy helps protect cells from some mutations. For example, if a mutation changes one codon into another codon that still codes for the same amino acid, the protein may remain unchanged. ⭕️ Example: A mutation changes a codon from: CUU → CUC Both code for leucine, so the protein may remain normal. #molecular_biology