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مشروع صغير ؛ مردود كبير : مقولات طبية until proven otherwise


مشروع صغير ؛ مردود كبير : مقولات طبية until proven otherwise

مرحبا ...

مر معنا مقولات سريرية مثل :

أي شاب لا يشكو من قصة رض , يعاني من طنين وحيد الجانب عالي التوتر + نقص سمع حسي عصبي فهو ورم العصب السمعي حتى يثبت العكس

أي طفل مصاب بآلام بطنية و بيلة دموية => التشخيص الأمثل : فرفرية هينوخ شونلاين حتى يثبت العكس

أي طفل بقصة إسهال و ألم بطني و خضابه 6غ/دل => التشخيص التفريقي : HUS حتى يثبت العكس

المشروع :

إعداد قائمة تحتوي أهم المقولات الطبية التي تبدأ بـ : "كل *** ... هو *** حتى يثبت العكس". ( باللغة الإنكليزية "until proven otherwise" أو UPO.)

القائمة تضم :
المقولة + المرجع مع سنة النشر + التصنيف حسب الجهاز.

الهدف منها :
توجيه الطالب والطبيب إلى أهمية نفي الأسباب "الخطيرة" للمظاهر السريرية وتمييزها عن الأسباب "غير الخطيرة"، وغير ذلك.

آلية التنفيذ :
ربما أغنى المصادر هي المواضيع الإسعافية، ولكن تلك العبارات ترد في أي موضوع طبي ... لذلك سيتم البحث عن هذه المقولات من مختلف المراجع الطبية للوصول إلى القائمة المطلوبة ...

بدأت بتنفيذ الفكرة مع بعض المقولات ... و سأقوم بجمع المزيد منها بالبحث في أكبر عدد ممكن من الكتب الطبية الالكترونية و إضافتها تباعاً حتى إكتمال القائمة بإذن الله ... لتنشر في قسم ملائم في حكيم ...
من يود منكم المشاركة في تنفيذ الفكرة ... فليرسل المقولة - أو المقولات - التي يجدها ... ( حسب التصنيف : المقولة + المرجع مع سنة النشر + التصنيف حسب الجهاز ... بشكل رد على هذه المشاركة ...

أرجو من فريق العمل تثبيت المشاركة ...

بسم الله نبدأ ...

التصنيف حسب الجهاز OTOLARYNGOLOGY / ENT

*
ACOUSTIC NEUROMA - Presentation

المقولة Any unilateral sensorineural hearing loss is an acoustic neuroma until proven otherwise

MCCQE 2000 Review Notes and Lecture Series - ENT المرجع

*
NASAL OBSTRUCTION - Etiology

child with polyps - cystic fibrosis until proven otherwise

MCCQE 2000 Review Notes and Lecture Series - ENT

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Neurology

Seizure Disorders - clinical Pearl

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

MCCQE 2000 Review Notes and Lecture Series - Neurology

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Cardiology

*
Atrial Flutter - Clinical Pearl

Narrow complex tachycardia at a rate of 150 is atrial flutter with 2:1 block until proven otherwise

MCCQE 2000 Review Notes and Lecture Series - Cardiology

*
Pulmonary Valve Disease - signs

PR:associated with pumonary hypertenion early diastolic murmur at base - AR until proven otherwise

MCCQE 2000 Review Notes and Lecture Series - Cardiology

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Obstetrics/Gynecology

Abnormal Uterine Bleeding - Gynecological causes

Postmenopausal bleeding : endometrial cancer until proven otherwise

MCCQE 2000 Review Notes and Lecture Series - Gynecology

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Pediatrics

Gastrointestinal Disease

Maloration of the intestine

If vomiting with bilious material maloration with volvulus until proven otherwise

MCCQE 2000 Review Notes and Lecture Series - Pediatrics

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Sports Medicine

It has been suggested that an athlete will have no secondary gain issues so it is fair to infer that any athlete unable to participate has significant pathology until proven otherwise.

Arvidson EB, Micheli LJ. Spine and trunk problems in athletes. Curr Opin Orthop 1990;1(3):361–4.

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ACUTE MEDICAL EMERGENCIES

*
A structured approach to medical emergencies - Circulation

the hypotensive, warm, vasodilated pyrexial patient is “septic” until proven otherwise.

ACUTE MEDICAL EMERGENCIES - The Practical Approach - BMJ Books 2001

*
The patient with a rash

The presence of a purpuric rash in an ill patient is due to overwhelming septicaemia until proven otherwise

ACUTE MEDICAL EMERGENCIES - The Practical Approach - BMJ Books 2001

*
Management of specific tachydysrhythmias

Ventricular tachycardia (VT)

When in doubt about the etiology of a wide-complex
tachycardia, treat as ventricular tachycardia until proven
otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Traumatic injuries - Primary survey - Circulation

Always assume that hypovolemic shock is present, and treat it until proven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Allergic reactions and anaphylactic syndromes -
Differential diagnosis

clinical syndromes that appear to be anaphylaxis should be
treated as anaphylaxis until proven otherwise

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Altered mental status

An awake, alert patient with a unilateral dilated pupil has a posterior communicating aneurysm until proven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Ear pain, nosebleed and throat pain (ENT)

OE in an immunocompromised host,especially with erythema and/or fever,should be considered malignant OE until roven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
THROAT PAIN - How long has the pain been present?

A sore throat of greater than 2 weeks duration in a atient over the age of 40 years should be considered cancer until roven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Fever in adults

Localized pain, erythema, and swelling of a joint causing painful limited range of movement in the setting of systemic fever should prompt consideration of a septic joint until proven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Joint pain

In patients with monoarticular arthritis, septic arthritis should be presumed until proven otherwise, especially if these patients have systemic signs of toxicity.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Pelvic pain

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

All women of childbearing age should be considered regnant until proven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Rash

Fever with sudden onset of a petechial rash in a college student is meningococcemia until proven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Scrotal pain

Any asymptomatic testicular mass, firmness or induration is a malignancy until proven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Syncope

Any neurologic complaint that is accompanied by chest or upper back pain should be considered an aortic dissection until proven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

*
Vomiting

A history of bilious vomiting in a young child is an ominous finding and suggests malrotation of the gut or intussusception until proven otherwise.

An Introduction to Clinical Emergency Medicine - Cambridge University Press 2005

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Nephrology
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Respirology
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Hematology
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Dermatology
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Psychiatry
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Gastroenterology
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Infectious Diseases

He who asks is a fool for a minute
He who doesn’t ask is a fool forever

Chinese Proverb

dr.msh's picture
by
بعد التخرج

Cardiology

*
Diagnosis of acute chest pain

The maxim that any discomfort experienced between the jaw and the umbilicus that starts with exertion and stops with rest should be considered ischaemic until proven otherwise

Cardiovascular Emergencies
Edited by Crispin Davies and Yaver Bashir
BMJ Books 2001

*
Diagnosis of acute chest pain

Chest pain + ST elevation = myocardial infarction until proven otherwise (the diagnosis is rarely in doubt)

Cardiovascular Emergencies
Edited by Crispin Davies and Yaver Bashir
BMJ Books 2001

*
Arterial vascular disease

A patient presenting with constitutional symptoms, bruits, and discrepant blood pressures in the upper extremities has Takayasu’s arteritis until proven otherwise.

Cardiology Core Curriculum - A problem-based approach
Edited by John D Rutherford
BMJ Publishing Group 2003

*
Infective Endocarditis - Diagnosis

patients who present from the community with a fever of unknown origin who have multiple positive blood cultures for viridans group streptococci, enterococci, or the HACEK organisms, should be considered to have IE until proven otherwise

Evidence-based Cardiology - Second edition
©BMJ Books 1998, 2003

*
CAUSES OF CHEST DISCOMFORT AND PAIN

In the course of evaluating patients with chest pain, it is helpful to adopt the philosophy of “aortic dissection ntil proven otherwise” so that this diagnosis is never missed, even though it is a relatively uncommon entity in the current era of improved control of hypertension.

Lippincott - Textbook of Cardiovascular Medicine, 2nd Edition (March 2002 )

*
CARDIAC TRANSPLANTATION

Atrial or ventricular arrhythmias are considered indicative of allograft rejection until proven otherwise.

Lippincott - Textbook of Cardiovascular Medicine, 2nd Edition (March 2002 )

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CEREBROVASCULAR DISEASE - CEREBRAL HEMORRHAGE:

If a focal neurologic deficit with altered mental status occurs within 24 hours of thrombolytic therapy, the event should be presumed to be an ICH until proven otherwise.

Lippincott - Textbook of Cardiovascular Medicine, 2nd Edition (March 2002 )

*
Heart Failure - Etiology

Heart failure should be presumed to be of ischemic origin until proven otherwise

Critical Care Medicine

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ACUTE MEDICAL EMERGENCIES

Resuscitation of the patient with major trauma - Cervical spine

It is important to assume that all patients with major trauma have an unstable cervical spine injury until proven otherwise.

ABC OF RESUSCITATION - Fifth Edition

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To be continued ...
dr.msh's picture
dr.msh
بعد التخرج


قام القسم التقني مشكوراً بتصميم ركن خاص لإعداد القائمة ... و قد أضفت عدد من المقولات تجدونها في الرابط التالي :

https://www.hakeem-sy.com/main/taxonomy/term/220


يمكنك المشاركة في إضافة المقولة التي تحب كما يلي:بعد تسجيل الدخول :
أنشئ محتوى => حتى يثبت العكس => املأ الحقول التالية :

* " العنوان " : اختر العنوان الملائم لمحتوى المقولة ...

* ضمن بند " التصنيفات " تجد قائمتين فرعيتين " الصفحات الطبية " :
- الأولى : اختر التصنيف الطبي حسب الاختصاص ( الهضمية , الأطفال ... الخ )
- الثانية : اختر " حتى يثبت العكس " ... لتضمن إضافة المقولة إلى القائمة ( إياك أن تنساه ) Eye-wink !!

* " المعلومة " :

* " المرجع " : اسم المرجع الذي نقلت منه المقولة مع سنة النشر

و أخيراً ... " عاين " ثم " أرسل " => شكراً لك !

dr.msh's picture
dr.msh
بعد التخرج


الله يجزيك الخير
جهود تشكر عليها..

dr_bashar_x2's picture
dr_bashar_x2


This is excellent idea. The references should be from books as a first step, then from a primary reference as a second step

This is publishable and is important for all USMLE steps also

I would be happy to edit a final version in English

MD in USA


جهود مباركة
يعطيكم الف عافية

jemeni_boy's picture
jemeni_boy
السنة السادسة

Thank you Dr.MD in USA for your attention ... !!

I searched about a similar list for a while ... I just found separated UPO on many websites ... But didn’t find any list !!

Regarding to the UPO list :
The technical support has designed a specific part on Hakeen,the link above,to make the list refreshed so that anyone can provide any new UPO at any time later ...

Regarding to the references :

Quote:
The references should be from books as a first step

All of them ,till now, are from e-books ... Since It’s easy to search ... !!

And regarding to my documentaion of references ... Is it scientific documentaion or need more feedback ... !!??

Quote:
then from a primary reference as a second step

Sorry ... Do you mean websites for example !!??
If so ... Is it enough,for scientific documentaion,to mention the link which contain the UPO !!??

Thanx in advance ...

dr.msh's picture
dr.msh
بعد التخرج


For now, references from books (electronic or printed is fine), once you accumulated a large quantity and you have people helping you, you can find primary references (which means articles from peer reviewed journals)

MD in USA
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