Yassir A. Abd Al-Star medical learning channel

📌 85yo woman, previously healthy, heavy smoker (120 pack-years). with progressive right upper limb swelling and shoulder pain . 🔻 10kg weight loss ( last 3mo). 📌 examin ... right arm pitting edema. 🎈 Right breast enlargement/congestion. 🌬️ Trachea deviated left. 📌 diffuse rhonchi over chest . ✅Chest X-ray revealed a Golden S sign, suggestive of a central right upper lobe mass causing right upper lobe collapse. 📌 Contrast-enhanced CT of the chest confirmed a spiculated right upper lobe mass with associated lobar collapse. 📌The tumor was associated with internal jugular vein thrombosis and compression of the subclavian vein, resulting in right upper limb venous congestion and edema, consistent with superior venous outflow obstruction

Nice case هاي الحجية جتي قبل فتره جايبه تحاليلها وخايفه منهن 60 yrs old female pt with neg PMHX .... presented with just fatigue , no weight change , good appetite LFT : high ALP بالفحص لكيت Non tender nodular swelling of right parotid gland with multiple LAP , of firm consistency طبعا بهيجي Age وبهيجي فحص الموضوع يتحمل Chronic مو Acute condition بالتالي دزينه Abdominal and chest CT with neck US 🔺Results .... diffuse elargment of cervical , mediatinal , paraaortic LAP Yessss ... its lymphoma , that confirmed with hematological assessment . Why high ALP❓❓ its infilterating the liver 😳 سؤال اليوم .... what are classical presentation of lymphoma , that was missed in this case ??

من كيسات 💥💥💥 Old age patient with fatigue and productive cough...... Examination 👉 RT upper lobe dullness with fine crept . CXR 👉RT upper lobe consolidation 2nd to bronchggenic CA , hyperinflation chest , ribbon shaped heart , flattering of hemidiaphragms , widened intercostal spaces ... (pneumonia secondary to CA with COPD ) ..

من الكيسات التعليمية الجميلة الشخصناها 👉 59 yrs old heavy smoker female, complaining of generalized bone pain .. no systemic features , no B symptoms. O/E 👉 Bilateral distal forarm tenderness , bilateral distal tibial tenderness, poor air entery with diffuse rhonchi دزيناها Xray 👉 distal radius and ulnar periostitis . شتخلللون ببالكم تشخيص ❓❓

📌 42 yrs old male patient recently dx as wilson disease with moderate fibrosis , and started penicillamine .. after 2months , bilateral symmetrical non prupritic skin rash developed in lower and upper limbs , not responded to anti histamine . 🖍no other drug history nor FHX of dermatological disease . too many DDX are possible ... لكن الاهم لازم مننسه انو البنسلامين ممكن يسوي Drug induced lupus فدزيته المريض ANA + Anti dsDNA + 24 hr urinary protein : high (nephritic range). 🛎 so its most likely Penicillamine induced lupus 🔥 Note : any patient with wilson disease presented with palpable rash + proteinurea = rule out penicillamine induced lupus ., stopping pencillamine and subsitiute wit other item is key Mangement .

👆👆👆من كيسات الطوارى old case Acute Raynaud phenomenon

الى كل طبيب شاطر 📌any patient with Hx of DM , and poorly controlled with Oral hypoglycemia drugs , and start weight loss .... even age> 40yrs ... exclude insulin dependent type of DM ( DM1, LADA) . 📌save patient life and sent for auto antibodies ( anti GAD65 ab , Anti IA 2 Ab , Anti ICA ab )

📌 52 years old female patient with diabetes mellitus on oral treatment, presented with bilateral foot and peri orbital edema . 📌 no Hx of CVD , nor Hx peripheral arterial disease. 📌 DM is poorly controlled, and no dietary restriction ✅ Examination : bilateral piiting leg edema grade III , vitally stable , mild peri ocular edema . soft abdomen. ✅ Investigation.. unremarkable RFT , LFT ,TFT ,CBC ,CRP ,ESR , abdominal Us . but when we sent urinary albumin creatinin ratio interestingly, results as shown above . 🖍diabetic nephropathy is one of commonest nephropathy, when albuminuria is Hallmark of early damage. 🖍if expect that , do urinary albumin creatinin ratio test , that detect early renal insult.

كيس مهم جدااااا A 57-year-old female patient with no significant past medical or surgical history presented with intermittent, diffuse, colicky abdominal pain persisting for several weeks, which did not resolve with antispasmodic medication. 🏥 There was no associated weight loss or anorexia. On physical examination, the abdomen was tympanic and distended, with a painful, non-reducible swelling noted in the right inguinal region. ✅An erect abdominal X-ray revealed diffuse gaseous distension but no definitive signs of frank intestinal obstruction. In summary, an inguinal hernia with a possible partial intestinal obstruction must be considered. النقطة المهمة 🧐 The key clinical takeaway is that in cases of colicky abdominal pain, clinicians should not overlook the examination of the inguinal orifice. 🩺 لا تنسى تفحص ال inguinal orifice باي مريض عنده الم بالبطن .