Showing posts with label Internal medicine. Show all posts
Showing posts with label Internal medicine. Show all posts

Wednesday, October 5, 2011

- Criteria of hypersplenism.

Criteria of hypersplenism.
  1. Splenomegally.
  2. Cytopenias (mono or pan).
  3. Hypercellular bone marrow.
  4. Scanning with Cr51 labelled with RBCs>> reversed liver to spleen ratio.
  5. Splenectomy will improve the condition.
(A huge spleen after splenectomy for female patient with hypersplenism)

Dr Ibrahim samaha

Tuesday, August 23, 2011

- Eye signs of thyrotoxicosis.

Eye signs of thyrotoxicosis.
"DR Joffroy may validate symptoms"

  • Dalrymple sign:- rim of sclera is seen all around the cornea, on looking straight forward.
  • Rosenbach's sign:- fine tremor of the upper eyelids on slight closure of the eye.
  • Joffroy's sign:-lack of wrinkling of the forehead when a patient looks upward.
  • Moebius sign:- lack of convergence on looking to near object.
  • Von Graefe's sign (lid lag sign):-lagging of the upper eyelid on looking downward without movinh the head.
  • Stellwag's sign:-staring look with infrequent blinking.
Dr Ibrahim,,

Sunday, August 7, 2011

- Causes of gynecomastia.

Causes of gynecomastia.
Gynecomastia.
  • Genetic : klinefelter syndrome.
  • Young boy (puberty): due to transient increase of plasma estradiol.
  • Neonate: due to persistent maternal or placental lactogens.
  • Estrogen and estrogen like drugs (e.g. digitalis).
  • Cirrohosis,Cimetidine,Cytotoxic drugs.
  • Old age(due to conversion of androgen to estrogen in extra glandular tissue),Overactive thyroid (Hyperthyroidism)
  • Myxedema,Marijuana.
  • Acromrgally.
  • Spironolactone,Steroids.
  • Tumour (e.g. testis,adrenal,bronchogenic carcinoma).
  • INH,Iron deposition in testis.
  • Alcoholism.

Friday, April 15, 2011

- Malignant Mesothelioma.

Malignant Mesothelioma.
Def:-
It is a rare form of cancer that develops from the protective lining that covers many of the body's internal organs,known as the mesothelium.
(CXR demonstrating Mesothelioma of left lower lung)
Sites:-
  • Pleura. (is the most common form of the disease, accounting for roughly 70% of cases).
  • Peritoneum.
  • The pericardium (1).
  • The tunica vaginalis.

Friday, April 1, 2011

- Exercise and COPD.

Exercise and COPD.

  • Exercise and staying active are an important part of rehabilitation for chronic obstructive lung disease. 
  • Regular exercise can help you feel less short of breath.
  • Regular exercise improves your heart and muscles.
  • It can help you feel good about yourself.

Sunday, March 13, 2011

- How to use your Metered Dose Inhaler .

How to use your Metered Dose Inhaler .
Many patient don't know how to use MDI and their doctors don't learn them how to use it so it lead to non compliance to treatment and you will lose your patient,so we should learn our patient how to use MDI.

The following video is an excellent video showing us in simple steps how to use Metered Dose Inhaler.. you may need it to learn yourself and your patient.....

Monday, March 7, 2011

- Adrenergic manifestations of Hypoglycemia.

Adrenergic manifestations of Hypoglycemia
(warning signs of hypoglycemic coma).


Due to release of catecholamines when blood sugar less than 50mg%.

"chat Msn"
Coldness, Clamminess
Hunger pain.
Anxiety
Tachycardia,Tremors.


Mydriasis (Dilated pupils).
Sweating.
Nervousness


enjoy,,
Dr Ibrahim

Wednesday, February 23, 2011

- Anderson's triad.

Anderson's triad
The association of :-
  1. Cystic fibrosis
  2. Celiac disease 
  3. Vitamin A deficiency
Dr Ibrahim
 
Return to other triads here.

Sunday, February 20, 2011

- Meosthelioma Symptoms.

Meosthelioma Symptoms
Dr. Michael Milano explains what mesothelioma is and its symptoms..

Tuesday, February 15, 2011

- Whipple's triad.

Whipple's triad
or 
Whipple's criteria

Suggest a patient's symptoms result from hypoglycemia:-

  1. Symptoms caused by hypoglycemia e.g. during fasting or exercise.
  2. A low plasma glucose measured at the time of the symptoms.
  3. Relief of symptoms with glucose administration.
     
    Dr Ibrahim
     
    Return to other triads here.

Thursday, February 10, 2011

- Asbestos Lung Cancer.

Asbestos Lung Cancer.
Dr. Michael Milano explains how lung cancer can be caused by asbestos exposure.

Friday, January 7, 2011

- Hutchinson’s Triad.

Hutchinson's triad

It is a common pattern of presentation for congenital syphilis.
It consists of :-
  1. Interstitial keratitis
  2. Hutchinson incisors
  3. Eighth nerve deafness.

Dr Ibrahim
Return to other triads here.

Thursday, November 11, 2010

- Side effects of antithyroid drugs.

Side effects of antithyroid drugs.
"Charge"
Cholestatic jaundice.
Hypothyroidism.
Allergy,Agranulocytosis.
Relapse on sudden stoppage.
Goiter,Git upsets.
Exophthalmos increase.

enjoy,,
Dr Ibrahim

Thursday, November 4, 2010

-Duhin-Johnson syndrome.

Duhin-Johnson syndrome.
It is Autosomal recessive disease characterized by Partial defect in excretion of conjugated bilirubin into the bile.

*Clinical picture:-It is usually asymptomatic.
  1. Jaundice.
  2. Good general condition.
*Investigations:-
  1. Bilirubin: mild elevation of direct bilirubin
  2. Biopsy (dark pigment inside hepatocytes i.e the liver is black in colour), it had been proved to be a metabolite of catecholamines.
  3. +ve Bromosulphthalein (BSP) Test: Normally 90% of this dye is removed from blood within 45 minutes after I.V injection in normal liver.
  4. In Dubin-Johnson syndrome there is a late rise in plasma SSP after an initial fall due to reflux of the dye from the liver reflecting hepatic excretion defect.
  5. No evidence of obstruction.
  6. No evidence of LCF.
*Treatment:-
No treatment (almost normal life span).

Dr Ibrahim
Return to list of medical syndromes here

Monday, August 9, 2010

-Local Complications of pneumonia.

Local Complications of pneumonia
"Idea"
Incomplete resolution and followed by bronchiectasis later on.
Delayed resolution.
Pleural Effusion,Empyema.
Lung Abscess,ARDS and respiratory failure.

Dr Ibrahim

Friday, July 23, 2010

- Wagner Grading System for Diabetic Foot Infections.

Wagner Grading System for Diabetic Foot Infections
  • Grade 0 :- Intact Skin,but high risky foot.
  • Grade 1 :- Superficial ulcer of skin or subcutaneous tissue.
  • Grade 2 :- Deep Ulcers but no abscess nor bone involvement.
  • Grade 3 :- Deep ulcer with osteomyelitis, or abscess.
  • Grade 4 : -Gangrene of toes,heel or forefoot (localized).
  • Grade 5 :- Gangrene of whole foot.
 Dr Ibrahim
Return to list of medical grades (click here) 

Thursday, July 15, 2010

-Physiological loss of abdominal superficial reflexes.


Physiological Causes of loss of abdominal superficial reflexes:-
"Foams"

Faulty techniques.
Obesity.
Attentive patient,Ascites.
Multiparous.
Scar.

Dr Ibrahim Samaha

Thursday, July 1, 2010

-Variants(Types)of Scleroderma.

Variants(Types)of Scleroderma.
"Sold"
A)Systemic sclerosis without Scleroderma:-
i.e internal organ involvement without cutaneous scleroderma.
B)Overlap syndrome:-
scleroderma associated with other autoimmune disease.
C)localized scleroderma:-
scleroderma without internal organ involvement.
Charachterized by Morphoea which are local patches of scleroderma.
D)Limited scleroderma(CREST Syndrome):-
There is minimal visceral involvement, positive anticentromere antibodies and good prognosis.
Skin hardening is limited to face,feet and fingers.
(Calcinosis,Raynaud's phenomenon,Esophageal dysfunction,Sclerodactly,Telangectasia.)
E)Diffuse scleroderma:-
Diffuse thickening of trunk,proximal and distal limbs with internal organ development and damage so it is life threatening.

Dr Ibrahim

Saturday, June 12, 2010

-Drugs causing intrahepatic Cholestasis.


Drugs causing intrahepatic Cholestasis
"Cheap"
Contraceptive pills,Chlorpromazine.
Hypoglycemic drugs.
Erythromycin.
Anti-thyroid drugs,Anti-coagulants,Anabolic steroids.
PAS.

Dr Ibrahim

Tuesday, June 8, 2010

-Complications of Tetralogy of fallot.

Complications of Tetralogy of fallot
"Inches"
Infective endocarditis,Low I.Q.
Neurological (e.g Brain abscess,cerebrovascular accidents)
Cyanotic spell,Clubbing.
Hematological(e.g polycythemia,IDA,Thrombosis).
Hyperuracemia and gout,Heart Failure (rare).
Exercise intolerance.
Squatting,scoliosis,Stunted growth.

Dr Ibrahim