DR Medhat MRCP

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• Prognosis : Poor (average life expectancy is around 3-4 yrs) . Lung cancer • Risk factors : 1) Smoking (→↑ risk by a factor of 10) 2) Other factors : Asbestos (→↑ risk by a factor of 5) Arsenic. Nickel. Chromate. Aromatic hydrocarbons. Radon. Cryptogenic fibrosing alveolitis. • Epidemiology : male : female = 2:1 , it`s the 2 nd common ca in UK (after ca-breast). • Clinical picture : ‣ Symptoms : 1. Cough. 2. Hemoptysis 3. SOB. 4. Chest pain (chest wall or pleural involvement),shoulder pain (Pancoast tumor). 5. Weight loss. ‣ Signs : 1. Pallor 2. Cachexia. 3. Clubbing. 4. Lymphadenopathy 5. Signs of complications : Metastasis : (liver,bone,brain,…..) Compression signs : o Stridor (larynx) , dysphagia (oesophagus). o Horner`s syndrome (sympathetic chain compression) o SVC obstruction (esp. small cell c.) Facial , peri-orbital oedema (10% ) Chemosis Congested non-pulsating neck veins Hoarseness ov voice (RLN palsy). Median survival of lung cancer with SVC obstruction even with TTT is 5 months
• Investigations (NICE 2015) : Symptoms & signs indicating urgent CXR Any of the following if unexplained or lasts > 3 weeks : 1. Cough 2. Chest/shoulder pain 3. Dyspnoea 4. Weight loss 5. Hoarseness of voice. 6. Finger clubbing 7. Signs of mets e.g brain, bone, LN. Urgent CXR If suggestive of cancer CT scan Indications of urgent referral to lung cancer MDT while waiting for CXR result : - Persistent hemoptysis in a smoker or exsmoker aged > 40 years old. Indications of immediate referral to lung cancer MDT while waiting for CXR result : - Signs of SVC obstruction. - Stridor. Site of lesion , mediastinal L.N ,metastasis
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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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• 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
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سؤال مهم : dyspepsia Drug-in
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Management of endoscopy proven gast
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Management of endoscopy proven non-
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• Investigations of H.Pylori : س
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• Clinical features of ZES : Zoll
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• Diagnosis: • Staging : Endosc
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Coeliac disease • Def : - An auto
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B. Jejunal biopsy (see pathology).
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• Investigations : 1) Jejuna biop
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Short bowel syndrome - Malabsorptio
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Inherited (familial) colorectal can
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Pelvi-abdominal CT/MRI/PET scan wit
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Acute Intestinal ischemia • Def :
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سؤال امتحان Melanosis col
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Inflammatory bowel diseases (IBD)
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Histology Involve whole bowel wall
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B. Management of ulcerative colitis
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هام : UC) Colo-rectal cancer on
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Acute infective diarrhea (infective
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• Management : 1) Rest ,rehydrati
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Liver diseases Hepatitis • Def :
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• Complications: Hepatitis C : 80
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Viral hepatitis B - HBV is a double
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• Immunisation (vaccination) agai
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• Risk factors of ALD : - Men : w
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Fatty liver (steatosis) - It`s live
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• Types according to the types of
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liver: hepatitis, cirrhosis lentif
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• Features Homozygous PiZZ →(A
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• Complications Malabsorption: o
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Chronic liver disease (cirrhosis)
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سؤال امتحان classificatio
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Meigs' Syndrome : = Ovarian fibroma
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Type I HRS Rapidly progressive. D
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Hepatic Encephalopathy: • Def: A
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Haemochromatosis: - Is an autosomal
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Hepatomegaly : • Common causes of
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B. Causes of conjugated (direct) hy
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Crigler-Najjar Syndrome (CNS): - (C
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Diseases of pancreas Acute pancreat
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Chronic Pancreatitis - Is an inflam
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• Diagnosis: Contrast CT is used
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Liver biopsy • Contraindications
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Diseases of RBCs Include 3 main gro
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Microcytic hypochromic anemias I. I
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II.Thalassemia - It`s an inherited
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• Pathogenesis of thalassemia : -
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Hb electrophoresis : - The major Hb
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• Management : 1) Phlebotomy (ven
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Chronic Hemolytic Anemia with acute
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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 (
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- These other forms of sickle-cell
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• Investigations : CBC : normocy
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• 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 (
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- Further classification of each ty
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• 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
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Diseases of platelets 1. Thrombocyt
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• Causes of severe thrombocytopen
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• Normal response to vessel injur
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Von Willebrand's disease - Von Will
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- 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) :
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Tumour markers • Tumour markers m
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C. Antimetabolites Cytotoxic Mechan
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Therapeutic antibodies : Monoclonal
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• Conversion between opioids From
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Thymoma - Thymomas are the most com
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Prostate cancer - Prostate cancer i
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Oncogenes • Def : - They are endo
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Classification of pathogens الح
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Anaerobes Aerobes G-ve bacteria G-v
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B. Whole killed organism (= inactiv
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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
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Atypical bacteria I. Mycobacterium
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Extra-pulmonary TB ( in immunocompr
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هام جدا : TB Management of Ac
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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
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• Diagnosis : Splenic or bone ma
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• Investigation Antibody test S
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Cryptosporidium : سؤال - It`s t
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Antiretroviral group NRTI Examples
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B. Focal neurological lesions : 1)
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• Complications : A. Common compl
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• Complications : 1) Encephalitis
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6) Infectious mononucleosis (glandu
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8) Novel Coronavirus - Human corona
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B. Trematodes (flat worms) Schistos
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• Management (SIGN 2009) : Azyth
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Genital ulcers : Common causes of g
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Lymphogranuloma venereum سؤال t
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Mechanism of action of common antib
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Leprosy liptospirosis Lyme disease
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(Human papilloma virus) UTI in woma
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Osteomyelitis : - Osteomyelitis des
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مرض األغنام Orf - Orf is
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1
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3
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Diseases of thick ascending limb of
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III. According to clinical presenta
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9
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Minimal Change disease (MCD) - Near
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Management Minimal change glomerulo
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Focal Segmental Glomerulosclerosis
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B. I.F : no immune deposits (C3 & I
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3 rd line ttt Plasma exchange: - Th
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Causes : 1ry ( idiopathic) MCGN .
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New classification (according to th
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2) Type II MCGN : 25
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Membranous nephropathy (MN) - It`s
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Approaching MN : - Careful history
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Prognosis : (rule of thirds) 1/3 o
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IgA nephropathy Basics: Also calle
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Management of IgA nephropathy Low r
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Renal parenchymatous diseases accor
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NB : The antigens against which th
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Management of nephritic syndrome :
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Management: ACE-I ARBs Approximat
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Acute renal failure (now termed acu
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Causes of CKD : Common causes of CK
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Anemia in CRF: All types of anemia
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There is transformation among the p
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III. Pauci-immune (ANCA+ve) nephrop
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Hereditary renal disease I. Alport
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NEUROLOGY DR. MEDHAT M.SLEAT 2013
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Brain anatomy - It`s a gelatinous o
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C. Cerebellum : o It lies behind th
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Frontal lobe Area Site Function Les
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Parietal lobe Cortical sensory area
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Occipital lobe Visual sensory area
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Upper & lower motor neurons - For a
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U.M.N. Lesion L.M.N. Lesion Paralys
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اللهم السهل اال ماج
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II. Optic nerve • Pathway of visi
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III. Oculomotor nerve - The nucleus
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IV. Trochlear nerve : - The nucleus
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V. Trigeminal nerve : - It`s a mixe
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• Trigeminal nerve palsy: o Cause
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سؤال هام فى اال متح
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VII.Facial nerve : - it`s a mixed n
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U.M.N.L Affects ∆ tract above fac
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VI. Vestibule-cochlear nerve : - Th
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VII. Glossopharyngeal nerve : - It`
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Petrous apex syndrome : • Causes
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Control of eye movement during head
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Conjugate gaze palsy Supranuclear N
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Carotid (anterior) system : Anterio
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47
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Basilar artery • Origin : - Forme
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B. Total occlusion : is fatal 1. De
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Middle cerebral artery Anterior cer
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Posterior inferior cerebellar arter
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IV. Carotid artery endarterectomy
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Subarachnoid hge (rupture aneurysm)
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• Clinical presentation : - Typic
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Traumatic brain injury: Extradural
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Medial pontine syndrome - e.g occlu
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• Prognosis : - Variable prognosi
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Incomplete lesions of spinal cord B
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Investigations 1. Decreased red cel
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• Management In primary care; a
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Lewy body dementia - Is the second
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Transient global amnesia (TGA) •
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• Management : Riluzole 1. Anti-
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Gower`s sign of Duchenne`s muscle d
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• Management : - 1 st line invest
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Pricipitating factors of myasthenia
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- *In reality this is seen in only
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- The basal ganglia and cerebellum
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• Extra pyramidal tracts : Tract
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• Main clinical features : Dyskin
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2) Levodopa: Usually combined with
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III. Hemiballism (subthalamus) - Oc
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• Investigation of choice : MRI (
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Cerebellar syndromes : Archicerebe
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Herido-familaial ataxia : A. Friedr
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سؤال امتحان Meniere's dis
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Nystagmus - Oscillatory eye movemen
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Diseases of the nerves • Def : -
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2. Predominantly sensory : o Friedr
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Common peroneal nerve (L4,5 & S1,2)
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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: • Clinical features : Dyspnoea
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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