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درر طبية


الأخماج المرتبطة بالتحال البريتواني : Peritoneal Dialysis-Related Infections |

المعلومة

Any patient on PD who presents with abdominal pain should be considered to have peritonitis until proven otherwise.

كل مريض على التحال البريتواني و يشكو من ألم بطني ’ فهو التهاب البريتوان حتى يثبت العكس .

المرجع

Diseases of the Kidney and Urinary Tract 7th edition (October 15, 2001) (3-Volume Set): by Robert W., Md. Schrier (Editor)
By Lippincott Williams & Wilkins Publishers

ما قبل الإرجاج الباكر - الرحى العدارية : Early Preeclampsia - Hydatidiform Mole |

المعلومة

All early ( less than 20 weeks) preeclampsia is molar pregnancy until proven otherwise.

كل حالة ما قبل الإرجاج ( أقل من 20 أسبوع ) , هي حمل رحويّ حتى يثبت العكس .

المرجع

First Aid for the Obstetrics & Gynecology Clerkship

هجمة جديدة لنوبات الصرع عند الحامل : New Onset of Seizures in Pregnancy |

المعلومة

If the seizures occur in the third trimester, they are eclampsia until proven otherwise

إذا حدثت نوبات الصرع في الثلث الأخير من الحمل , فهي إرجاج حتى يثبت العكس .

المرجع

Gabbe: Obstetrics - Normal and Problem Pregnancies, 4th ed., Copyright © 2002 Churchill Livingstone, Inc

الكتلة المؤلمة في الصفن Painful Scrotal Mass |

المعلومة

The painful scrotal mass is a surgical emergency and is considered to be testicular torsion until proven otherwise.

الكتلة المؤلمة في الصفن ( عند طفل ) هي حالة إسعافية جراحية و تعتبر انفتال خصوي حتى يثبت العكس .

المرجع

Arce JD, Cortes M, Vargas JC. Sonographic diagnosis of acute spermatic cord torsion. Rotation of the cord: a key to the diagnosis. Pediatr Radiol 2002.

اليرقان المرضي عند الوليد Pathologic jaundice |

المعلومة

Pathologic jaundice is diagnosed when there is clinical jaundice in the first 24 hours of life or serum bilirubin level increasing at a rate of >5 mg/dL/day.
A peak serum bilirubin level higher than that mentioned above in a term infant and >15 mg/dL in a preterm infant should always be considered pathologic until proven otherwise.

يُشخَّص اليرقان المرضي عندما يوجد يرقان سريري خلال الـ 24 ساعة الأولى من الحياة أو عندما يرتفع مستوى بيلروبين المصل بمعدل أكبر من 5 مغ/دل/اليوم .

إن ارتفاع مستوى بيلروبين المصل بمعدل أكبر من المذكور أعلاه عند الوليد بتمام الحمل أو أكبر من 15 مغ/دل/اليوم عند الخديج ؛ يجب اعتباره يرقان مرضي حتى يثبت العكس .

المرجع

Thomas P,Wayne H,Robert R.(2005).Pediatrics just the facts.The McGraw-Hill Companies.

A sugar can be used to treat the hepatic encephalopathy in cirrohsis. |

المعلومة

A sugar can be used to treat the hepatic encephalopathy in cirrohsis. what is it?
Lactulose because it acidifes the stool and decrease diffusoin of NH3 and other toxins from the colon to the blood.

المرجع

Pharmcards والأستاذ الدكتور مازن مصري زادة


Aspirin toxicity and acid base abnormality |

المعلومة

Aspirin toxicity and acid base abnormality:
low toxicity "high theraputic dose": mild uncouping of oxidative phosphorylation=> increase the temperature=> increase the respiration to release the excess of the heat=> respiratory alkalosis=>renal compensation=> increase in HCO3 elemination => compensated respiratory alkalosis => pH is normal, with decreased HCO3 and P CO2. The respiratory alkalosis is not experinced in child has ingested a low dose of ASA for unknown reasons.

Toxic doses: suppresses the respiratory center in the medulla oblongata=> decreased respiration and increased P CO2 => respiratory acidosis. There will be also metabolic acidosis because of the ASA is already an acid so it will cause metabolic acidosis with high anion gap. Other causes of metabolica acidosis in ASA toxicity is because of inhibiting Krebs cycle and severe uncoupling of oxidative phoshporylation "decreased ATP"=> hyperthermia and decreased potassium + vasomotor collapse coours with both respiratory and renal failure.

Toxic doses in adults is 150mg/Kg about 30 adult tablets
in children 4-6 tablets

So the only case with respiratory acidosis and metabolic acidosis is ASA high dose toxicity

المرجع

Kaplan Pharmacology


Antidepressant agents and priapism |

المعلومة

A pt is treating with one of the antidepressant agent experinced priap[=red]ism
What is the drug
Trazadone
It is one of the heterocyclic antidepressants that blocks the serotonin reuptake
other side effects sedation, nausea ,and postural hypotension

المرجع

H.Y psychaitry, Kaplan pharmacology, First Aid 2006


Klinefelter Syndrome |

المعلومة

Klinfelter Syndrome 47,XXY
At least 2X chromosomes and 1 or more Y chromosome
The pt is male because he has testes but atrophic testes "atrophy of smeiniferous tubules" and he is tall, so he his a tall infertile male.
What else? enuchoid appearance, gynecomastia, decreased testosterone and elevated FSH and LH
The pt is not mentally retarded unless he has more that 2X chromosomes.
Cannot be diagnosed until puberty

المرجع

BRS pathology, Kaplan Biochemistery and Genetics

Turner Syndrome |

المعلومة

:"Turner Syndrom "45X0
reduced structure, webbed neck, lymphedema of the ankles and wrists esp at bitrh, cystic hygroma, sheildlike chest with widely shaped nipples and wide carrying angle of the arm, decreased spatial perception.
Ovaries are replaced by fibrous streaks => hypogonadism=> amenorrhea=> increased FSH and LH + infnatile genitalia.
Associated with preductal coarctation and autoantibodies mediatied hypothyrodism.

المرجع

Robbins 7th edition, BRS pathology, Kaplan Biochemistery and Genetics


Treatment of Hypertension and the difference of treatment in race |

المعلومة

ABCD
A= ACE inhibitors
B= Beta blockers
C= CCB "Ca channel blockers
D= Duritics
A+B for white people
C+D for black people

المرجع

Kaplan Pharmacology and Harrison's textbook 16th edtion


Treatment of AML M3 |

المعلومة

What is the treatment of AML M3?
all trans retinoic acid

المرجع

Harrison's textbook 16th edition


perimenarchal child

المعلومة



Any child that is perimenarchal should be assumed pregnant until proven otherwise.

المرجع


An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

Seizure Disorders

المعلومة


any Motor and/or sensory partial seizures indicates structural disease until proven otherwise

المرجع


MCCQE 2000 Review Notes and Lecture Series - Neurology
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