DR Medhat MRCP

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Non-alcoholic steatohepatitis (NASH) - Is a term used to describe liver biopsy findings similar to those seen in alcoholic hepatitis in the absence of a history of alcohol abuse i.e etanol intake < 40 g/week). - It is relatively common and though to affect around 3-4% of the general population. - The progression of disease in patients with NASH may be responsible for a proportion of patients previously labelled as cryptogenic cirrhosis. • Associated factors: 1) Obesity/ Hyperlipidaemia. 2) More in men (estrogen protect women) ‏(سؤال 3) Type 2 DM (Insulin resistance 4) Jejunoileal bypass. 5) Sudden weight loss/starvation. 6) 20% develop cirrhosis. • Features Obese T2DM with abnormal LFTs = ? non- سؤال هام alcoholic fatty liver disease 1) Usually asymptomatic. 2) Hepatomegaly. 3) ALT is typically greater than AST (AST/ALT
• Types according to the types of circulating antibodies present : Type I Type II Type III ANA and/or (SMA) (anti-smooth muscle antibodies) Affects both adults and children (LKM1) (Anti-liver/kidney microsomal type 1 antibodies). Affects children only Soluble liver-kidney antigen. Affects adults in middle-age • Features : Chronic liver disease. Acute hepatitis: fever, jaundice etc (only 25% present in this way) Amenorrhoea (common) ANA/SMA/LKM1 antibodies, raised IgG levels. liver biopsy: inflammation extending beyond limiting plate 'piecemeal necrosis', bridging necrosis • Management : Steroids . Immunosuppressants e.g. azathioprine liver transplantation. Portal tracts show a variable number of small lymphocytes admixed with plasma cells (arrowheads). In contrast to primary biliary cirrhosis (PBC) bile ducts are intact (arrow). The type and amount of chronic inflammation does not differentiate AIH from viral hepatides. 67
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A-PDF Merger DEMO : Purchase from w
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It contains : - 46 (23 pairs) of ch
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6. Glycolipids - signal molecules.
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Eukaryotic cell cycle : - Human bod
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• Regulation of the cell cycle :
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11
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• Morphology of apoptosis (EM) :
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Ion transport - Trans-membrane ion
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Disease Signal transduction Ligands
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Example of GP-CR → Adrenergic rec
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- There are around 30,000 gene , on
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- The language used by DNA is calle
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Autosomal dominant Autosomal recess
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Modes of disease inheritance Autos
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Autosomal dominant conditions Very
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X-linked dominant inheritance - The
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Fragile X syndrome : - Trinucleotid
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Some common genetic syndromes Triso
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Edwards Syndrome - Also known as Tr
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• Prognosis of Marfan syndrome -
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Noonan Syndrome - Often thought of
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Immune system - Immunity is the lin
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Classification of immunity Innate i
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Immune response to pathogen : A) In
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Expression Structure MHC I - In all
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C) Adaptive immune response : - The
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Cytokines produced by different kin
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ANCA o There are two main types of
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Tolerance & autoimmunity : o The im
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Complement system o It`s a group of
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Inflammation o Inflammation is a no
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o Immunosuppressive therapy is used
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C. Antimetabolites Cytotoxic Mechan
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o The mode of action of sirolimus i
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Primary immunodeficiency o Primary
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o Recently, a further category has
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- Reabsorption of HCO3 - (85% in PC
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Pathogenesis: Causes : Features : T
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A) Respiratory centers depression A
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o Treatment of chronic respiratory
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Saline - Responsive metabolic alkal
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Hypertonic Isotonic Hypotonic Plasm
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Hypernatremia (Na + > 145 mmol/L) :
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Hyperkalemia (K + > 5.2 mmo/L) : -
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Hypokalemia - Potassium and hydroge
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Medical statistics • Def : • St
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MEDIAN (=mid-point) Def : It is the
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Q : A study is performed to find th
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- Whilst correlation coefficients g
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Statistics which test differences P
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B. Statistics which test confidence
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P- VALUES • Def : - The P (propab
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Q 1: Q2 : If a drug reduces the inc
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Q4 : - CER (Aspirin) = 3% - EER (ne
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SPECIFICITY = →This is the rate a
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Q : 123
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Randomised controlled trial Experim
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Case-control study • Def : - It`s
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Study Design: Evidence and Recommen
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Intention to treat analysis Q - It
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CORONARY ARTERY DISEASES Definitio
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Risk factors of CAD: High risk fac
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Stable (chronic) angina (= angina o
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A) Medical ttt of stable angina(CKS
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DVLA rules: cardiovascular disorder
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STMI NSTMI/UA ACS < 12 hrs of symto
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• Treatment : A. Medical TTT : I
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Cardiac arrhythmias I. Tachyarrhyth
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Atrial fibrillation (AF) Def : - o
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2. Echocardiography: - Significant
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Acute newly detected AF Hemodynamic
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Rate vs rhythm control : Factors fa
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Digoxin and digoxin toxicity - Digo
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Long QT syndrome Def: - Long QT syn
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Conducting system of the heart : He
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Ventricular tachycardia Ventricular
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• Treatment of shockable rhythms
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Peri-arrest rhythms A. Peri-arrest
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B. Peri-arrest tachycardia Hemodyna
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QRS Deflection Inferior leads (II,I
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B-type natriuretic peptide (BNP) :
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Hypertension Clinic BP measurement
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Stepwise approach of treatment of H
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Pulmonary arterial hypertension(PAH
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Normal pulse in young (25y) person
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Jugular venous pulse(JVP) 52
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Valvular heart disease Aortic steno
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• Features Aortic regurgitation
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• Echocardiography : A 'tight' m
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Murmur Causes Character Point of ma
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Pericarditis Pericarditis is one of
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Myocarditis • Causes Viral: Coxs
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- Most of cardiologists proceeds to
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Causes of sudden cardiac death : In
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2) Atrial Septal Defects (ASDs) - T
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Eisenmenger's syndrome - In acyanot
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- When properly positioned, the dis
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Down syndrome - Down syndrome is th
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Marfan's syndrome - Marfan's syndro
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Causes: - Streptococcus viridans (m
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Treatment of IE : A) Medical ttt :
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CVS medications Antiarrhythmic drug
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Amiodarone Class : III antiarrhyth
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‣ Β- blockers cardiotoxicity : -
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Aspirin : Mechanism of action : -
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Diuretics : Thiazides Diuretics Act
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lesions Macule Patch Papule Nodule
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Acne vulgaris - Acne vulgaris is a
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Isotretinoin - Is an oral retinoid
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Pityriasis Versicolor (= tinea vers
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Plaque psoriasis Flexural psoriasis
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- Finger tip rule 1 finger tip uni
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D. Contact dermatitis - Contact der
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Pemphigus vulgaris - Is an autoimmu
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Erythematous skin rash Erythema mul
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Erythema nodosum - Idiopathic condi
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Lichen-like diseases - Lichens are
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Scabies • Overview : - It is a pr
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Diseases of hairs Hirsuitism & Hype
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Diseases of the nails Onycholysis -
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Skin infections Impetigo - Is a hig
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Pyoderma Gangrenosum - Is a conditi
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Granuloma annulare - Papular lesion
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Molluscum contagiosum - Flesh-white
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Skin disorders associated with mali
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*Langer lines were historically use
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Pituitary gland Anatomy : - Small
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Diseases of pituitary gland Anterio
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Anterior pituitary hpofunction in a
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Anterior pituitary hyperfunction I.
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o Hands & feet : - Spade-like hands
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Prolactin is unique amongst the pit
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Very rare drug causes of gynaecomas
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Investigations : 1) High plasma osm
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Treatment of DI : Cranial DI (ie wi
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Non-functioning adenoma (chromophob
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Thyroid gland Anatomy : - Butterfl
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Control of thyroid hormones (hypoth
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o Thyrotoxic crisis (thyroid storm)
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- Graves' disease is the most commo
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Subclinical Hyperthyroidism - It is
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Myxoedema Causes : Primary hypothy
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Subclinical Hypothyroidism Basics
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Thyroiditis - i.e Inflammation of t
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- It`s the commonest endocrine mali
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Amiodarone-induced thyroid disease
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Actions of parathyroid hormone ( pl
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Latent tetany +ve Provocative tests
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■ Clinical picture : Bones, Stone
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Hyperparathyroidism - i.e over prod
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Hypoparathyroidism - i.e decrease p
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- Histologically : bone is formed o
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• Management : (NICE 2011 ,2ndry
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8) Hip protectors : - Evidence to s
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Osteomalacia Def : - Defective min
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Osteogenesis Imperfecta (= brittle
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• Functions of adrenal hormones :
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Primary hyperaldosteronism Causes
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Investigations : A. Diagnosis of Cu
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Adrenal insufficiency Causes : o P
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Differences between 1ry & 2ndry adr
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Def : Diabetes Mellitus (DM) - Met
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سؤال اليخلو منه امت
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3)Other risk factor modification C
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I. Insulin sensitizers 1) Biguanide
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■ Management of type I DM [Insuli
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5) Insulin resistance (i.e requirem
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Complications of DM : Complication
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Diabetic foot ulcers : • Classifi
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Investigations : سؤال amylase.
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Treatment of HONK : as in DKA with
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D. Post delivery : DC TTT(in GDM) ,
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Insulinoma is a neuroendocrine tumo
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Def : body mass index ( BMI) > 30 O
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■ Sibutramine - Withdrawn January
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- Dietary fat (TG) is digested by b
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Classification of hyperlipidemia :
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• Management Referral to a speci
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• Physiology of reproductive syst
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• Def : Delayed growth & puberty
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Hypogonadism ■ Def: - A diminishe
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MRI →Absence of olfactory bulb.
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• Initial investigations Exclude
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■ Diagnostic approach of 2ndry am
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تبدو وتتصرف ك بنت و
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■ Diagnosis : ■ Treatment : Kar
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3) Infertility : (under specialist
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Carcinoid tumours - Group of slowly
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1
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• Hormones of GIT : Hormone Gastr
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• Treatment : A. Acute treatment
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• DD (causes of heart burn sensat
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Dysphagia - The table below gives c
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Disease Achalasia Scleroderma Manom
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Oesophageal cancer - The most commo
Page 407 and 408: سؤال مهم : dyspepsia Drug-in
Page 409 and 410: Management of endoscopy proven gast
Page 411 and 412: Management of endoscopy proven non-
Page 413 and 414: • Investigations of H.Pylori : س
Page 415 and 416: • Clinical features of ZES : Zoll
Page 417 and 418: • Diagnosis: • Staging : Endosc
Page 419 and 420: Coeliac disease • Def : - An auto
Page 421 and 422: B. Jejunal biopsy (see pathology).
Page 423 and 424: • Investigations : 1) Jejuna biop
Page 425 and 426: Short bowel syndrome - Malabsorptio
Page 427 and 428: Inherited (familial) colorectal can
Page 429 and 430: Pelvi-abdominal CT/MRI/PET scan wit
Page 431 and 432: Acute Intestinal ischemia • Def :
Page 433 and 434: سؤال امتحان Melanosis col
Page 435 and 436: Inflammatory bowel diseases (IBD)
Page 437 and 438: Histology Involve whole bowel wall
Page 439 and 440: B. Management of ulcerative colitis
Page 441 and 442: هام : UC) Colo-rectal cancer on
Page 443 and 444: Acute infective diarrhea (infective
Page 445 and 446: • Management : 1) Rest ,rehydrati
Page 447 and 448: Liver diseases Hepatitis • Def :
Page 449 and 450: • Complications: Hepatitis C : 80
Page 451 and 452: Viral hepatitis B - HBV is a double
Page 453 and 454: • Immunisation (vaccination) agai
Page 455 and 456: • Risk factors of ALD : - Men : w
Page 457: Fatty liver (steatosis) - It`s live
Page 461 and 462: liver: hepatitis, cirrhosis lentif
Page 463 and 464: • Features Homozygous PiZZ →(A
Page 465 and 466: • Complications Malabsorption: o
Page 467 and 468: Chronic liver disease (cirrhosis)
Page 469 and 470: سؤال امتحان classificatio
Page 471 and 472: Meigs' Syndrome : = Ovarian fibroma
Page 473 and 474: Type I HRS Rapidly progressive. D
Page 475 and 476: Hepatic Encephalopathy: • Def: A
Page 477 and 478: Haemochromatosis: - Is an autosomal
Page 479 and 480: Hepatomegaly : • Common causes of
Page 481 and 482: B. Causes of conjugated (direct) hy
Page 483 and 484: Crigler-Najjar Syndrome (CNS): - (C
Page 485 and 486: Diseases of pancreas Acute pancreat
Page 487 and 488: Chronic Pancreatitis - Is an inflam
Page 489 and 490: • Diagnosis: Contrast CT is used
Page 491 and 492: Liver biopsy • Contraindications
Page 493 and 494: Diseases of RBCs Include 3 main gro
Page 495 and 496: Microcytic hypochromic anemias I. I
Page 497 and 498: II.Thalassemia - It`s an inherited
Page 499 and 500: • Pathogenesis of thalassemia : -
Page 501 and 502: Hb electrophoresis : - The major Hb
Page 503 and 504: • Management : 1) Phlebotomy (ven
Page 505 and 506: Chronic Hemolytic Anemia with acute
Page 507 and 508: Autoimmune hemolytic anemia (AIHA)
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- Hemolysis which ↑↑ during sle
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• Causes: 1. Post-infection e.g.
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Glucose-6-phosphate dehydrogenase (
Page 515 and 516:
- These other forms of sickle-cell
Page 517 and 518:
• Investigations : CBC : normocy
Page 519 and 520:
• WHO 2008 classification of MDS
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Macrocytic megaloblastic anemias Ca
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• Incidence - Peaks in the sixth
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Hemoglobinopathies Quantitative (Im
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• Typical carboxyhemoglobin level
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Leukemoid reaction - Describes the
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Hyper Eesinophilic syndrome: - Rare
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B. Lympho-proliferative disorders (
Page 535 and 536:
- Further classification of each ty
Page 537 and 538:
• Management of AML : Chemothera
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Chronic Myeloid Leukemia (CML) - Th
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Chronic Lymphocytic Leukemia (CLL)
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Incdence Commonest acute leukemia
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• Ann-Arbor staging of Hodgkin's
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- Chemotherapy includes : 1. Doxoru
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Burkitt's Lymphoma : - Is a high-gr
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Multiple myeloma - It`s a neoplasm
Page 553 and 554:
Diseases of platelets 1. Thrombocyt
Page 555 and 556:
• Causes of severe thrombocytopen
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• Normal response to vessel injur
Page 559 and 560:
Von Willebrand's disease - Von Will
Page 561 and 562:
- There are two main types of hepar
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2. Warfarin - Warfarin is an oral a
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74
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Acquired Factor VIII Deficiency - I
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Thrombophilia ( = thrombotic tenden
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Hyposplenism e.g. post-splenectomy
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Graft versus host disease (GVHD) :
Page 575 and 576:
Tumour markers • Tumour markers m
Page 577 and 578:
C. Antimetabolites Cytotoxic Mechan
Page 579 and 580:
Therapeutic antibodies : Monoclonal
Page 581 and 582:
• Conversion between opioids From
Page 583 and 584:
Thymoma - Thymomas are the most com
Page 585 and 586:
Prostate cancer - Prostate cancer i
Page 587 and 588:
Oncogenes • Def : - They are endo
Page 589 and 590:
Classification of pathogens الح
Page 591 and 592:
Anaerobes Aerobes G-ve bacteria G-v
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B. Whole killed organism (= inactiv
Page 595 and 596:
Necrotizing fasciitis : - Is a medi
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A. Actinomycosis - Actynomyces is f
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Clostridium difficile: - Is a Gram
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1. Septic arthritis ( the most comm
Page 603 and 604:
Atypical bacteria I. Mycobacterium
Page 605 and 606:
Extra-pulmonary TB ( in immunocompr
Page 607 and 608:
هام جدا : TB Management of Ac
Page 609 and 610:
III. Spirockaetes A. Leptospirosis
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IV. Ricketsiae A. African Tick Typh
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• Management : A. Uncomplicated f
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- It is again advisable to avoid tr
Page 617 and 618:
• Diagnosis : Splenic or bone ma
Page 619 and 620:
• Investigation Antibody test S
Page 621 and 622:
Cryptosporidium : سؤال - It`s t
Page 623 and 624:
Antiretroviral group NRTI Examples
Page 625 and 626:
B. Focal neurological lesions : 1)
Page 627 and 628:
• Complications : A. Common compl
Page 629 and 630:
• Complications : 1) Encephalitis
Page 631 and 632:
6) Infectious mononucleosis (glandu
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8) Novel Coronavirus - Human corona
Page 635 and 636:
B. Trematodes (flat worms) Schistos
Page 637 and 638:
• Management (SIGN 2009) : Azyth
Page 639 and 640:
Genital ulcers : Common causes of g
Page 641 and 642:
Lymphogranuloma venereum سؤال t
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Mechanism of action of common antib
Page 645 and 646:
Leprosy liptospirosis Lyme disease
Page 647 and 648:
(Human papilloma virus) UTI in woma
Page 649 and 650:
Osteomyelitis : - Osteomyelitis des
Page 651 and 652:
مرض األغنام Orf - Orf is
Page 653 and 654:
1
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3
Page 657 and 658:
Diseases of thick ascending limb of
Page 659 and 660:
III. According to clinical presenta
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9
Page 663 and 664:
Minimal Change disease (MCD) - Near
Page 665 and 666:
Management Minimal change glomerulo
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Focal Segmental Glomerulosclerosis
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B. I.F : no immune deposits (C3 & I
Page 671 and 672:
3 rd line ttt Plasma exchange: - Th
Page 673 and 674:
Causes : 1ry ( idiopathic) MCGN .
Page 675 and 676:
New classification (according to th
Page 677 and 678:
2) Type II MCGN : 25
Page 679 and 680:
Membranous nephropathy (MN) - It`s
Page 681 and 682:
Approaching MN : - Careful history
Page 683 and 684:
Prognosis : (rule of thirds) 1/3 o
Page 685 and 686:
IgA nephropathy Basics: Also calle
Page 687 and 688:
Management of IgA nephropathy Low r
Page 689 and 690:
Renal parenchymatous diseases accor
Page 691 and 692:
NB : The antigens against which th
Page 693 and 694:
Management of nephritic syndrome :
Page 695 and 696:
Management: ACE-I ARBs Approximat
Page 697 and 698:
Acute renal failure (now termed acu
Page 699 and 700:
Causes of CKD : Common causes of CK
Page 701 and 702:
Anemia in CRF: All types of anemia
Page 703 and 704:
There is transformation among the p
Page 705 and 706:
III. Pauci-immune (ANCA+ve) nephrop
Page 707 and 708:
Hereditary renal disease I. Alport
Page 709 and 710:
NEUROLOGY DR. MEDHAT M.SLEAT 2013
Page 711 and 712:
Brain anatomy - It`s a gelatinous o
Page 713 and 714:
C. Cerebellum : o It lies behind th
Page 715 and 716:
Frontal lobe Area Site Function Les
Page 717 and 718:
Parietal lobe Cortical sensory area
Page 719 and 720:
Occipital lobe Visual sensory area
Page 721 and 722:
Upper & lower motor neurons - For a
Page 723 and 724:
U.M.N. Lesion L.M.N. Lesion Paralys
Page 725 and 726:
اللهم السهل اال ماج
Page 727 and 728:
II. Optic nerve • Pathway of visi
Page 729 and 730:
III. Oculomotor nerve - The nucleus
Page 731 and 732:
IV. Trochlear nerve : - The nucleus
Page 733 and 734:
V. Trigeminal nerve : - It`s a mixe
Page 735 and 736:
• Trigeminal nerve palsy: o Cause
Page 737 and 738:
سؤال هام فى اال متح
Page 739 and 740:
VII.Facial nerve : - it`s a mixed n
Page 741 and 742:
U.M.N.L Affects ∆ tract above fac
Page 743 and 744:
VI. Vestibule-cochlear nerve : - Th
Page 745 and 746:
VII. Glossopharyngeal nerve : - It`
Page 747 and 748:
Petrous apex syndrome : • Causes
Page 749 and 750:
Control of eye movement during head
Page 751 and 752:
Conjugate gaze palsy Supranuclear N
Page 753 and 754:
Carotid (anterior) system : Anterio
Page 755 and 756:
47
Page 757 and 758:
Basilar artery • Origin : - Forme
Page 759 and 760:
B. Total occlusion : is fatal 1. De
Page 761 and 762:
Middle cerebral artery Anterior cer
Page 763 and 764:
Posterior inferior cerebellar arter
Page 765 and 766:
IV. Carotid artery endarterectomy
Page 767 and 768:
Subarachnoid hge (rupture aneurysm)
Page 769 and 770:
• Clinical presentation : - Typic
Page 771 and 772:
Traumatic brain injury: Extradural
Page 773 and 774:
Medial pontine syndrome - e.g occlu
Page 775 and 776:
• Prognosis : - Variable prognosi
Page 777 and 778:
Incomplete lesions of spinal cord B
Page 779 and 780:
Investigations 1. Decreased red cel
Page 781 and 782:
• Management In primary care; a
Page 783 and 784:
Lewy body dementia - Is the second
Page 785 and 786:
Transient global amnesia (TGA) •
Page 787 and 788:
• Management : Riluzole 1. Anti-
Page 789 and 790:
Gower`s sign of Duchenne`s muscle d
Page 791 and 792:
• Management : - 1 st line invest
Page 793 and 794:
Pricipitating factors of myasthenia
Page 795 and 796:
- *In reality this is seen in only
Page 797 and 798:
- The basal ganglia and cerebellum
Page 799 and 800:
• Extra pyramidal tracts : Tract
Page 801 and 802:
• Main clinical features : Dyskin
Page 803 and 804:
2) Levodopa: Usually combined with
Page 805 and 806:
III. Hemiballism (subthalamus) - Oc
Page 807 and 808:
• Investigation of choice : MRI (
Page 809 and 810:
Cerebellar syndromes : Archicerebe
Page 811 and 812:
Herido-familaial ataxia : A. Friedr
Page 813 and 814:
سؤال امتحان Meniere's dis
Page 815 and 816:
Nystagmus - Oscillatory eye movemen
Page 817 and 818:
Diseases of the nerves • Def : -
Page 819 and 820:
2. Predominantly sensory : o Friedr
Page 821 and 822:
Common peroneal nerve (L4,5 & S1,2)
Page 823 and 824:
Femoral nerve o Origin : lumbar ple
Page 825 and 826:
L3 nerve root compression L4 nerve
Page 827 and 828:
Nerve supply of the upper limb Medi
Page 829 and 830:
121
Page 831 and 832:
Carpal tunnel syndrome • Def : Mo
Page 833 and 834:
Sensory to : 1. Dorsal aspect of la
Page 835 and 836:
Elbow Pain: - The table below detai
Page 837 and 838:
Reflex Biceps reflex Triceps reflex
Page 839 and 840:
131
Page 841 and 842:
Gastroparesis Symptoms include err
Page 843 and 844:
Nerve Conduction Studies (NCS) - Ar
Page 845 and 846:
- Complex partial seizures can take
Page 847 and 848:
8. It is advised that pregnant wome
Page 849 and 850:
سؤال امتحان : Cataplexy
Page 851 and 852:
• Management : o Aim: reducing th
Page 853 and 854:
Tuberous sclerosis (TS) - Autosomal
Page 855 and 856:
• General C/P : ( it`s not a must
Page 857 and 858:
Headache - Headache is the term use
Page 859 and 860:
Neuropathic pain - Neuropathic pain
Page 861 and 862:
• Management Stop antipsychotic
Page 863 and 864:
Lamotrogine (lamictal) • Uses : A
Page 865 and 866:
1
Page 867 and 868:
- Layers of the eyeball : Sclera :
Page 869 and 870:
N.B New classification of non-proli
Page 871 and 872:
Dry (geographic atrophy) macular de
Page 873 and 874:
B. Congenital causes 1. Friedreich'
Page 875 and 876:
Acute angle closure glaucoma - In a
Page 877 and 878:
سؤال هام فى االمتحا
Page 879 and 880:
Relative afferent pupillary defect
Page 881 and 882:
Homocystinuria - Homocystinuria is
Page 883 and 884:
Causes of bilateral ptosis 5. Myoto
Page 885 and 886:
1
Page 887 and 888:
- When a drug is administrated to t
Page 889 and 890:
2) Binding to plasma & tissue prote
Page 891 and 892:
- Metabolism of the drugs ccurs in
Page 893 and 894:
Metabolism of paracetamol in overdo
Page 895 and 896:
Management of paracetamol toxicity
Page 897 and 898:
NB : the most helpful test in deter
Page 899 and 900:
King's College Hospital criteria fo
Page 901 and 902:
• Time course of drug metabolism
Page 903 and 904:
Measurement of plasma drug level :
Page 905 and 906:
Digoxin and digoxin toxicity - Digo
Page 907 and 908:
Ectasy (= MDMA = Methylene-dioxy-me
Page 909 and 910:
Mood disorders Depression • Def :
Page 911 and 912:
Psychotic depression : - Major depr
Page 913 and 914:
More sedative Amitriptyline Clomi
Page 915 and 916:
• Discontinuation symptoms 1) Inc
Page 917 and 918:
• Examples of typical antipsychot
Page 919 and 920:
• Treatment of bipolar disorder :
Page 921 and 922:
Lithium - Lithium is a mood stabili
Page 923 and 924:
Post partum mental health problems
Page 925 and 926:
Functional deterioration : 1) Impai
Page 927 and 928:
B. Compulsions : - Stereotyped acti
Page 929 and 930:
Generalized anxiety disorder (GAD)
Page 931 and 932:
Somatoform disorders (unexplained s
Page 933 and 934:
Eating disorders 1. Anorexia nervos
Page 935 and 936:
Sleep disorders 1. Sleep paralysis
Page 937 and 938:
• Mechanism : • Features : Subs
Page 939:
• Diagnosis : Chronic fatigue syn
Page 942 and 943:
- Causes of defective lung perfusio
Page 944 and 945:
1) Central regulatory centres : A)
Page 946 and 947:
Lung capacities :
Page 948 and 949:
Functional Residual Capacity (FRC)
Page 950 and 951:
FEV1 Meaning (units) Description Fo
Page 952 and 953:
هام جداPFT Algorithm of inter
Page 954 and 955:
Interpretation of flow volume loope
Page 956 and 957:
Bronchial asthma - BA is a reversib
Page 958 and 959:
Diagnosis of BA in adults(British T
Page 960:
Step 4 Step 5 Consider trials of:
Page 963 and 964:
Causes : 1. Smoking (tobacco smooki
Page 965 and 966:
The severity of COPD is categorised
Page 967 and 968:
2. Bronchodilator therapy A short-
Page 969 and 970:
Bronchiolitis oblitrans(BO) - Progr
Page 971 and 972:
Extrinsic allergic alveolitis (=hyp
Page 973 and 974:
Subtypes a) Cylindrical (bronchi ha
Page 975 and 976:
Cystic fibrosis(CF) - Autosomal rec
Page 977 and 978:
Pulmonary embolism (PE) - PE is pre
Page 979 and 980:
CTPA or V/Q scan? The British Thor
Page 981 and 982:
Management of PE (The NICE guidelin
Page 983 and 984:
1- General constitutional symptoms
Page 985 and 986:
Mycoplasma pneumonia - Is a cause o
Page 987 and 988:
Investigation األهم diagnosis.
Page 989 and 990:
Aspergilloma : - A fungus ball that
Page 991 and 992:
Asbestos-related lung diseases Pleu
Page 993 and 994:
• Clinical features : Dyspnoea
Page 995 and 996:
• Investigations (NICE 2015) : Sy
Page 997 and 998:
Stage IIIb Stage IV T1 N0 - No L.N
Page 999 and 1000:
Non-small cell carcinoma : Squamous
Page 1001 and 1002:
Lung carcinoid - Neuro-endocrine tu
Page 1003 and 1004:
Pulmonary eosinophelia - Group of d
Page 1005 and 1006:
• Investigations : - There is no
Page 1007 and 1008:
Pleural diseases Pleural effusion -
Page 1009 and 1010:
3) Pleural(Abram`s) biopsy : - Indi
Page 1011 and 1012:
• Investigations : 1) Chest X-ray
Page 1013 and 1014:
- Tension pneumothorax ► Tension
Page 1015 and 1016:
Respiratory questions reveiw for MR
Page 1017 and 1018:
Q6 : A 63-year-old woman presents a
Page 1020 and 1021:
Evaluation & diagnosis of a case of
Page 1022 and 1023:
- It`s a common degenerative joint
Page 1024 and 1025:
Cervical spondylosis - It`s an age-
Page 1026 and 1027:
Rheumatoid arthritis (RA) • Def :
Page 1028 and 1029:
c) Boutonniere deformity (i.e exten
Page 1030 and 1031:
هام جدا : arthritis • Diagn
Page 1032 and 1033:
Methotrexate: - Methotrexate is an
Page 1034 and 1035:
Ankylosing spondilitis - One of HLA
Page 1036 and 1037:
• Management of AS: - Early diagn
Page 1038 and 1039:
The table below shows the organisms
Page 1040 and 1041:
Behcet's syndrome Behcet's syndrome
Page 1042 and 1043:
Crystal-induced arthritis GOUT - Go
Page 1044 and 1045:
IV. Gouty nephropathy : Acute gout
Page 1046 and 1047:
C. Lifestyle modifications: 1. Redu
Page 1048 and 1049:
Dermatomyositis • Def : - Inflamm
Page 1050 and 1051:
Inclusion body myositis (IBM) : - T
Page 1052 and 1053:
34
Page 1054 and 1055:
firm surface or flexed for extended
Page 1056 and 1057:
Ottawa rules: Def : - Are a set of
Page 1058 and 1059:
Autoimmune rheumatic diseases Syste
Page 1060 and 1061:
J. Neurological : 1. Lupus cerebrit
Page 1062 and 1063:
سؤال امتحان Discoid lupu
Page 1064 and 1065:
• Investigations : 1. Thrombocyto
Page 1066 and 1067:
• Antibodies: ANA positive in 90
Page 1068 and 1069:
Sjogren's syndrome - It is an autoi
Page 1070 and 1071:
Large vessel vasculitis Giant cell
Page 1072 and 1073:
• Investigations : ( there is no
Page 1074 and 1075:
Small vessel vasculitis ANCA +VE (
Page 1076 and 1077:
ANCA -VE vasculitis : Henoch-Schonl
Page 1078 and 1079:
Disorder Wegener`s granulomatosis G
Page 1080 and 1081:
Referral to specialist CFS : - With
Page 1082:
Leflunomide : • Mechanism of acti
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DR Medhat MRCP

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