Notes in medicine 🖤

ماننسى انو يقلل الوزن ورح يزيد الادرار عند المريض ننصحو يشرب مي كميات اكثر

Cbc finding ب adult تكون lukeopenia بالاطفال lukeocytosis هاي هم نقطة مهمة

Critical point Nefopam lower seizure threshold so it’s contraindicated in epilepsy also it’s considered arythmogenic drug so it’s contraindicated in IHD also

Iron supplements in pt with iron deficiency can cause SE constipation I know a case with iron deficiency and complain from constipation and once iron supplements started his condition improved and constipation resolved 1+1 is 3 not 2 in medicine 😂

In infant The episode Chocking , cyanosis , even apnea

Classical Uninterrupted cough on single exhalation Then loud whoop due to passage of air against partially closed airways

Whooping cough

جاك واحد مايسمع عمرو ٣ سنوات اولاً صار أبو صفار وطول ؟ (kernictures) ثانيا ماخذ gentamicin قبل ؟ (ototoxic ) ثالثا متعرض ل congenital infection like CMV or Rubella رابعا صاير التهاب سحايا قبل ؟ لان ممكن ال late complication of meningitis cause hearing loss

60 years old patient presented with low grade fever and tachycardia witin 72 h of femur fracture the patient confused and dyspneic , on Examination the patient has petechiae on conjuctival fold and trunk What's the most likely diagnosis?

Appendicular mass مريض acute abdomen مثلا وبالفحص شفت هاي الماس الجراحة بهذا الوضع خطرة لاسباب 1-impossible to find appendix 2- risk of iatrogenic fistula during OP (fraible and edematous tissue) العلاج يكون حسب ochsner sherren regimen 1-Iv fluid 2-Antibiotic and analgesia 3-pulse&Temp every 4 h 4-skin pencil for marking limits of mass Using this regime 90% of cases resolve Failure of resolution or patient develop spiking pyrexia indicate there's pus requiring percutaneous drainage under CT or US gauidence نادرا اذا مانجحت هالطريقة المريض ممكن يحتاج laparotomy and midline incision Clinical deterioration or evedince of peritonitis indication of early laparotomy Failure to resolve after excluding abscess Should rise suspicion of Crohn's disease or Carcinoma بكل الاحوال المريض يحتاج فترة من 8 الى 12 اسبوع علمود الانفلاميشن subside وراها نسوي appendectomy

You are a junior doctor in surgery and the senior ask you which of the following statement is indication for operation in esophegeal perforation

Vit d have a role in RAAS for control blood pressure And may affect blood vessels wall and inflammation