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 ...
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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

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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
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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
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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
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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
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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 )
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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 )
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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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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 )
* " المعلومة " :
* " المرجع " : اسم المرجع الذي نقلت منه المقولة مع سنة النشر
و أخيراً ... " عاين " ثم " أرسل " => شكراً لك !
الله يجزيك الخير
جهود تشكر عليها..
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
جهود مباركة
يعطيكم الف عافية
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 :
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 ... !!??
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 ...
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)