9138
قناة طبيه تهتم بالكتب الطبيه واي شي۽ متعلق بالطب #BRS #pathoma @Yaqob_alsomaii
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🏥جالنا شاب ٢٠ سنة في الطوارىء بيشتكي من تورم بالخصية اليمين مع وجود الم
بقالها قد ايه؟
يومين ، رحت الصيدلية اخدت حقنة اتحسنت و رجعت تاني
في افرازات صفراء بتنزل من العضو مع حرقان في البول؟
ايوا
بنرفع الخصية لفوق الألم بيقل شوية positive prehn sign و ده دليل على وجود التهاب البربخ و ليس التواء بالخصية testicular torsion ، لو كان التواء بالخصية كان الألم هيزيد لما نرفعها لفوق
كمان التحسن على الحقنة اللي اخدها في الصيدلية بتأكد انه مش التواء خصية
كمان بنعمل cremasteric reflex بنجيب ظهر الhammer و بنمشيها على الجانب الداخلي للفخد حيث يوجد dermatome L1 اللي بيعمل
reflex epsilateral testicular elevation
و ده دليل على سلامة genital branch of genitofemoral nerve داخل الspermatic cord و ده بيأكد انه مش testicular torsion❌
⚠️نخلي بالنا ان الprehn sign و الcremasteric reflex مش sensitive للحالة دي
يعني ممكن يبقى شخص طبيعي و معندوش cremasteric reflex
🗨️شوية anatomy..
الgenital branch of genitofemoral nerve ده الefferent ، اما الafferent هو ilioinguinal nerve و ده ماشي جنب الspermatic cord مش جواه ، و هما الاتنين جوا الinguinal canal
الilioinguinal nerve بيخرج من الsuperficial inguinal ring عشان يغذي الجلد في ال upper thigh & anterior scrotum
التشخيص هنا هو عدوي الgonorrhea✅ اللي بتحصل بعد العلاقة الجنسية ب ٢-٥ ايام
اما الchlamydia بتحصل بعدها باسبوعين او ثلاثة
و ممكن يكون الاتنين موجودين مع بعض
بنأكد التشخيص بإننا ناخد مسحة من العضو و نعمل urine analysis & culture🧪
العدوى بتيجي من علاقة جنسية او التهاب مجرى بول او التهاب بروستاتا
و علاجهم
🔸azithromycin 1 gm or ofloxacin 400 or cifixime 800 mg signle dose for gonorrhea or single dose ceftriaxone 500 IM
🔸Azithromycin 1 gm for chlamydia
🔸Or doxycyclin 100 mg 1×2 for 7 days days for both chlamydia & Gonorrhea
مهم برضو نستبعد وجود الم مفاصل او التهابات بالعينين🦵🏻👁️ لاستبعاد Reactive Arthritis اللي بتحصل بعد الchlamydia بأسبوعين او ثلاثة .. و هنا الblood culture بتبقى negative لأن دن reaction
بس كده .. سلام❤️
د/عمر رشوان
/channel/+CRqLmho6qSM3ZmU0
High Quality information in pharmacology
Lichen planus:
6 P’s” (Purple, Pruritic, Polygonal, Planar, Papules, Plaques)
👉 “Acute close glaucoma = A-B-C-D”
A = Acetazolamide
B = Beta blockers
C = Carbonic anhydrase inhibitor
D = Definitive laser
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6 posts with meeting with Beta blockers :
1️⃣ Meeting with Beta Blockers
2️⃣ Beta Blockers in Heart Failure
3️⃣ Beta Blockers in Hypertension
4️⃣ Beta Blockers in Arrhythmias
5️⃣ Beta Blockers in non cardiac uses
6️⃣ Special Beta Blockers
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يوجد قناتين لنشر حالات طواري interesting
الحالات مرتبه ومنضمه مع تصوير الclinical findings وتصوير الادوية كما بالصور👆
تنشرح الحالة وكانها امامك بالمستشفى
القنوات مناسبة لاطباء العموم GP وحديثي التخرج والامتياز والسنوات الاخيىره
رابط القناة المجانية ⬇️
/channel/+EiwGHQjgHPcwZWY0
وقناة مدفوعة بمبلغ رمزي تعود لصالح الحالات المنشوره⬇
/channel/+rZNUPZYpwVQxNjE0
التواصل ع حساب
@Medcase134_r
✍️Spinal stenosis --> pain improved with leaning forward
✍️ Disc prolapse --> pain worse with leaning forward
Ahmed Alaskary
👨🏻⚕Q: What is the early sign of clubbing?
🚨 Pulmonary Embolism (PE) Educational Pearl 🚨
💉 You can start the first dose of therapeutic anticoagulation based on clinical suspicion of pulmonary embolism before imaging 📸
👉 especially if there is an anticipated delay in confirming the diagnosis.
❓What is the definition of a suspected case of pulmonary embolism (PE)?
A patient is considered to have a suspected PE when either of the following is present:
1️⃣ High probability of pulmonary embolism
OR
2️⃣ Intermediate or low probability of pulmonary embolism ➕ positive D-dimer 🧪
📊 The probability of pulmonary embolism is assessed using validated clinical prediction tools such as:
✅ Wells score
✅ Geneva score
The next step in suspected cases to confirm the diagnosis of pulmonary embolism is: CT pulmonary angiography.
🫀 Early recognition and timely anticoagulation can be lifesaving in selected patients ⏳💊
📚 Reference:
European Society of Cardiology 2019 Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism.
✅ UpToDate is the leading clinical decision support resource with evidence-based clinical information – including drug topics and recommendations that clinicians rely on at the point of care.
✅Uptodate (1 year)
✅Advanced (Offline + Online): 35$
👉All accounts are genuine to use on the official website and mobile app, and can be used on 2 seperate devices simultaneously.#UpToDateSubscription
👤Contact us now to get your subscription : @Amboss_Uptodate_medicine
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الحالات حقيقية في الواقع مع طريقة التعامل معها في الطوارئ
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Meeting 🤝 with Drug :
Ciprofloxacine
Azithromycin
Cephalxine
Heparine
Aspirin
Amlodipin
Ceftriaxone
Metformin
Dapagloflazine
Noradrenaline
Adrenaline
Propranolol
Amidarone
Adenosine
Vancomycin
Antihistamines1
Antihistamine2
Drug in picture 🖼️ :
🔹Metformin
🔹Azithromycin
🔹Ciprofloxacine
🔹Dapagloflazine
🔹Amlodipine
🔹🔹Heparine
🔹Noradrenaline
🔹 Aspirin
🔹 Propranolol
🔹 Amidarone
🔹 Doubtamine ..
🔹Doubtamine_nursing
🔹 Adenosine
🔹 Antihistamines&vestibular_drug
🔹 Antihistamines2
🧑🏼⚕A: Softening of nail bed with obliteration of the angle of nail bed.
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