Al-Azhar Assiut Medical School

IBD

MRCP Q Bank 🏦
.
Part 1

https://t.me/mrcp1material
.
Part 2

https://t.me/mrcpmaterial2
.
Good luck for All

لو بحثت دلوقتي عن ال CEA
(Carcinoembryonic Antigen)
في حالات ال
Colorectal cancer
هتلاقيه بيقولك:
Not Recommended for Screening
علشان مشهور في التحاليل كنوع من أنواع الاطمئنان واستبعاد الأورام !
ال
NHS
قالت:
Not for screening or diagnosis of colorectal cancer
Sensitivity and Specificity are both very low as levels are frequently normal in early disease and may be raised in benign disease
.
يعني في التشخيص مش هتعتمد عليه لوحده
ولا تقدر تستبعد به عدم وجود الأورام
.
في الأصل بتطلبه علشان متابعة مريض الـ
Colorectal cancer
وال
Prognosis
High level pre and post operative have been associated with worse outcomes
.
and so on
.
#brief_notes

EUS = endoscopic ultrasound, ERCP = endoscopic retrograde cholangiopancreatography, EMR = endoscopic mucosal resection, ESD = endoscopic submucosal dissection, PEG = percutaneous endoscopic gastroenterostomy

Guidelines for the management of patients on P2Y12 receptor antagonist antiplatelet agents undergoing endoscopic procedures

Measure pancreatic enzymes in stool (fecal elastase) to determine exocrine pancreatic insufficiency in case of ch pancreatitis

Emergency & Critical Care
Pocket Guide™™
ACLS Version Eighth Edition
https://drive.google.com/file/d/1ikmUrMg6ju8zEKjlpWAw5UX8YDUXF9va/view?usp=drivesdk

Amylase can sometimes be normal in acute pancreatitis especially if the etiology is hyperlipidemia
(Lipase is the best)
#brief_notes

Fox's sign
is a clinical sign in which bruising is seen over the inguinal ligament.
It occurs in patients with retroperitoneal bleeding, usually due to acute haemorrhagic pancreatitis
.
#brief_notes
.

History of Fox’s sign

1966 – John Adrian Fox detailed 2 fatal cases of non-traumatic ecchymosis determined as a diagnostic sign of retroperitoneal haemorrhage.
In both cases, this sign was noticed late in the course and produced by tracking of the fluid extraperitoneally along the fascia of psoas and iliacus beneath the inguinal ligament until it became subcutaneous in the upper thigh
.

https://litfl.com/foxs-sign/

Highlightsof the 2024 American Heart Association and American Red Cross Guidelines for First Aid
https://drive.google.com/file/d/1lOUTUkSJT-kv0JTxibbbOoTFuMqmNLZH/view?usp=drivesdk

Chest x-ray 🩻👇🏻

Tintinalli's
Emergency Medicine
Examination and Board Review
2023

https://t.me/Grawanje7/1759

دي آخر صورة ملف pdf علشان لو مش واضحة

تجميعة عظيمة جدا لأدوية السكر

LG = LG A/C تكييف
LeGionnaire's disease by contaminated air conditioning (A/C) systems.
#simple_to_remember

Your Parrot will repeat Psittacosis as ٦ causes !
(Psittacosis is an infection caught from parrots)
#simple_to_remember

Q & Q
Q fever is mainly transmitted by tiQs (ticks)
#simple_to_remember

https://www.nejm.org/doi/full/10.1056/NEJMoa2410027?fbclid=IwZXh0bgNhZW0CMTEAAR3uGs_H1d3AjwTZ6XiHVqvqlepBo6yZc1HoWRQ_MN7eYE2HL0D_F3uj_Ek_aem_h9AHdNHXSR12j_jRZlrvvg

Treatment with tirzepatide led to a lower risk of a composite of death from cardiovascular causes or worsening heart failure than placebo and improved health status in patients with heart failure with preserved ejection fraction and obesity

Treatment of gout in Pregnancy and Lactation:
.
Pregnancy and lactation — Gout flares are exceedingly uncommon during pregnancy and lactation, paralleling the low prevalence of hyperuricemia in women of childbearing age in most populations.
.
Thus, the occurrence of an acute inflammatory arthritis resembling gout during pregnancy or breastfeeding should direct attention to the exclusion of alternative diagnoses, such as septic arthritis.
.
Despite its rarity, gout flares during pregnancy and lactation have been reported among women with familial juvenile hyperuricemic nephropathy.
.
●Pregnancy :–
In pregnant women with a gout flare, we generally use oral glucocorticoid therapy.
In a patient with recurrent flares during pregnancy or breastfeeding, we use daily low-dose glucocorticoids for prophylaxis, given the need to avoid both colchicine and NSAIDs.
.
The use of NSAIDs is limited to the first 20 weeks of gestation, and short-term use of colchicine could be an option in pregnant women when glucocorticoids are contraindicated.
.
Potential contraindications to glucocorticoids in such patients include poorly controlled hypertension or diabetes, in addition to other usual concerns.
.
We also employ symptomatic treatment measures, such as icing.
.
●Lactation :–
In breastfeeding women, we use either glucocorticoids or NSAID therapy while continuing to avoid the use of colchicine.
.
Although antiinflammatory doses of an NSAID (eg, naproxen, ibuprofen, or indomethacin) have been effective in some pregnant patients with a gout flare, use of NSAIDs is limited to the first two trimesters of pregnancy because of concerns about NSAID-induced premature closure of the ductus arteriosus later in pregnancy.
.
NSAID therapy should also be withheld during pregnancy in the presence of impaired kidney function. The use of NSAIDs during pregnancy and lactation is described in detail separately.
.
Studies of colchicine in pregnant and breastfeeding patients with familial Mediterranean fever or pericardial diseases have not found increased adverse effects with its use. However, there are reports of colchicine in breast milk and chromosomal damage associated with colchicine exposure.
.
#uptodate
#brief_notes

Society of Critical Care Medicine and the
Infectious Diseases Society of America
Guidelines for Evaluating New Fever in
Adult Patients in the ICU

Fibromyalgia

https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2824%2905226-0

هدية عظيمة
From Our Great Prof
Hassan Hamdy
.
2024
AGA Clinical Practice Update on Integrating Potassium-
Competitive Acid Blockers Into Clinical Practice: Expert Review
.

https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2824%2905226-0

من ضمن الحاجات اللي لما تشوفها ابحث على ال
Occult malignancy
ال
Sjogren (NH Lymphoma ) and Dermatomyositis

Oxford Handbook of General Practice 5th Edition 2020

Influenza vaccine
Should be given annually in the autumn (September – November) to all over the age of 6
months. Vaccination should be given if the current immunisation season has not ended
(generally September – April) but ideally before influenza viruses start to circulate

Influenza vaccine Should be given annually in the autumn (September – November) to all over the age of 6 months.

#brief_notes
Dopamine --> D1 & 2 receptors
Histamine --> H1 & 2 receptors
Vasopressin --> V1 & 2 receptors
Acetylcholine --> M1, 2 & 3 recepotrs
epinephrine & norepinephrine--> alpha 1 & 2 & Beta 1
(Beta 2 for epinephrine and salbuterol)
.
All of the above mediated by: G protein-coupled receptors

In SLE:
clinically apparent synovitis with joint swelling is unusual
&
Joint erosion are not a feature

Osteophytes in osteoarthritis not in RA