Medbullets by Muhammad Jamal Attia
internal medicine pearls
medical notes in capsule
Facial nerve palsy + hepatomegaly + peripheral Lymphadenopathy........... Think sarcoidosis........ BNS : CXR // confirm dx : excisional LN biopsy
-If diabetic patient experience hypoglycemia symptoms after eating......... Suspect Diabetic gastroparesis*
-Anticonvulsant if hepatic failure....... Topiramate*
-Anticonvulsant if pregnant......... Lamotrigine & & levetiracetam (started before getting pregnant // if already pregnant and on other anticonvulsant then continue + add folic acid 4mg daily for the fear of NTD)
20s patient with DVT or any thrombosis..... Think of congenital thrombophilia ( here if u wanna rule out AT3 def by bedside test from other 3 causes........ Give heparin..... If APTT no change : its AT3 def (as heparin is antithrombin so no thrombin no action)
25/06/2020
plaques
-patient gave consent for explanatory laparotomy for bowel perforation but just before procedure he/she refused + he has decision Making capacity......... Bns.. .. Cancel operation*
-patient gave consent for cholecystectomy but during procedure surgeon found AMI+ necrotic bowel......... Bns........ Resect it and proceed without need for re-consent as AMI is immediate threat to patient life*!
clinical vignette + proteinuria +2*.....warrant .......renal biopsy*(for staging lupus nephritis and guide rx!!
disease
Recurrent painful* oro-genital ulcers(means >= 3 episodes over 1 year) + DVT
22/06/2020
syndrome!
-inc calcidiol .....vit.D TOXICITY*
-Inc calcitriol..... Granuloma & lymphoma*
22/06/2020
ear dt blunt trauma!
Cause bloody diarrhea + seizure