@Usmle_in_arabic
Toronto notes 2023

السلام عليكم دكاتره انشاء الله تكونون بخير ❤️
تزامناً مع مبادرة الدكتور مصعب بشرح مواضيع طب الطوارىء مجاناً
راح نبادر ايضاً بشرح مادة ال GIT جراحة وباطنيه معاً على مصدر TORONTO
المصدر الشامل لكل التفاصيل خصوصاً ال undergraduates وايضا. بعض الزيادات لل postgraduate اثناء الشرح حيكون لقاءنا live اربع ايام في الأسبوع
هاي المحاضرات موجهه لصف الرابع والخامس والسادس وايضاً الخريجين الجدد الي ممكن يراجعون معلوماتهم وحنركز ايضاً على جانب الطوارىء و how to approach GI symptoms الها محاضرات ايضاً بشكل مفصل
إبتداء من يوم الجمعه حنبدي الساعه 10 مساءاً بتوقيت بغداد
وايضاً انشاء الله دكتور مصعب حيكمل ويانه ال cardiology بقادم الأيام

اول موضوع حنبدي بيه انشاء الesophagus
حاولوا تطلعون عليه

تنويه هذا المصدر يشمل جميع المعلومات سواء محاضرات اي كلية او سمنارات بأي نظام سواء فصلي او موديول او وايضاً اذا اكو معلومات زايده من أي كلية تكدرون تدزونها بالكروب ونشرحها ايضاً
Stay tuned❤️

بلنسبه لجماعتنه الرابعه بطب الزهراء اصعب بلوك عدكم ال GIT والستاف صعبين يعني بمجرد متعبر هذا البلوك انته بلسليم

nice tip

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اليوم الساعه ١٠ مساءاً
First lecture in GIT block
Esophagial diseases

TOP VIP NOTES about using thrombolytic therpay:

In patient with STEMI with cardiac arrest with no return of spontaneous circulation ( ROSC) there's no role of thrombolytic therapy

But in Pulmonary embolism with same condition there's a role of thrombolytic

in this condition give thrombolytic and continue CPR up to 90 minutes (Don't give up)

regard ❤️

بعد عشر دقائق نبدي على هذا الرابط

Yassen Ayad is inviting you to join their FreeConferenceCall Meeting Room.

Join the meeting using one of these easy options:

1) One Tap Mobile Dialing: +16053135527,,1989076
2) Tap here to have us call you: https://www.freeconferencecall.com/backup?dial_number=6053135527&access_code=1989076
3) Join online for Video and Screen Sharing: https://join.freeconferencecall.com/zmc19191

Additional Options to connect:
Dial-in number (US): (605) 313-5527
Access code: 1989076
Find your local number: https://fccdl.in/i/zmc19191

Having trouble connecting?
Text 'Call Me' to (605) 313-5527 to receive a call back; then dial 1989076 to join the meeting. Standard Messaging rates may apply.

دكاترة تأكدو من تفعيل هذا الزر حتى الصوت يكون واضح

https://fccdl.in/ld1jnGpKjI

https://fccdl.in/bg7NrvUpfu

Lecture one GIT Block
esophagus

why we should not use thrombolytic in patient with acute chest pain + widespread ST depression with ST elevation in AVR ?
او عموماً بل NSTEMI??
ليش ما كدر استخدم ويكلك مرات تزود الحاله سوء ؟
نجاوب هلسؤال :

-as patient in this category are heterogeneous
-some of them have a totally occlusive thrombus (the same as STEMI)(patient 1)

-while others have only non occlusive thrombus ( such as NSTEMI) (patient 2)

فرضاً انطيت thrombolytic

(patient 1 )ممكن يستفاد عادي وهذوله نسبتهم قليله

(patient 2)
هذوله المشكله ليش؟؟
if we give thrombolytic for non occlusive thrombus it can result in haemorrhage inside plaque turning it into a totally occlusive thrombus 😅( that's why we don't give thrombolytic therapy in NSTEMI)

we cannot know our patient belong to which type and we will never know , so in these atypical presentations the only safe option is primary PCI.

البوست شويه طويل بس مهم وتقابله هوايه بحياتك العمليه وتعبني😅

اكو مصطلحين ضروري نميز بينهن ونعرف الفرق

What's a difference between Myocardial injury

VS myocardial infarction

شنو الفرق؟؟؟
حسب ESC guideline 2018

Detection of an elevated cTn value above the 99th percentile upper reference limit (URL) is defined as myocardial injury. The injury is considered acute if there is a rise and/or fall of cTn values.

Myocardial infarction ncludes detection of a rise and/or fall of cTn with at least one value above the 99th percentile and with at least one of the following:

1-Symptoms of acute myocardial ischemia;
2-New ischemic electrocardiographic (ECG) changes;
3-Development of pathological Q waves;
4-Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality in a pattern consistent with an ischemic etiology;
5-Identification of a coronary thrombus by angiography including intracoronary imaging or by autopsy.

يعني شلون ؟ انطيك مثال وانت حتفهم

اجاك بيشنت ٣٥ سنه وعنده CKD and regular dialysis وايضاً هو hypertensive واستشاروك عليه
وكالولك يابه هذا عنده troponin positive
ال ECG عنده نورمال بس عنده LVH and nonspecific T wave changes وهو كان a symptomatic من كلشي وايضاً Echo نورمال

هسه هذا شنو تعتبره هنا؟؟
اعتبره myocardial injures
شراح تسويله؟

the best approach is :
1-serial ECG
2-second set troponin
3-ECHO

سويت الفحوصات ورجعتلك :
1 -NO dynamic ECG change
2-No significant chang in troponin
2-hypertensive heart in ECHO

Final diagnosis:
chronic myocardial injury secondery to uremic toxin and hypertension

Management:
Bp control,proper management of renal condition

regard ❤️

Presence of P wave dose not exclude Atrial fibrillation, because summation of fibrillatory wave can produce P wave ...

https://litfl.com/atrial-fibrillation-ecg-library/
#yassin_Ayad

سامعين بهلموضوع ؟
Very interesting topic

this is MD question

Drug-induced valvular heart disease
(DIVHD)

Valvular abnormalities have been described in association with anorectic drugs and with ergot derivatives including drugs used for treatment or prophylaxis of migraine, particularly ergotamine and methysergide, and drugs used in the treatment of Parkinson disease, particularly pergolide and cabergoline . Use of 3,4-methylenedioxymethamphetamine (MDMA, also known as ecstasy , which is a psychoactive drug primarily used as a recreational drug.[ ) may also induce valve disease.
The common pathogenetic link is increased serotonin activity.

لهنا ما خطر ابالكم شي😅؟ نكمل

The echocardiographic and pathologic features are similar to those occurring in carcinoid heart valve disease however, it is mainly affecting left sided valves aortic and mitral ( mitral and aortic regurgitation)
‎يعني ممكن تكول عليها Acquired carcinoid😂
‎بس هنا على اليمنى اكثر مو ع اليسره

‏The likelihood of DIVHD increases if more than one heart valve is affected and the patient is young.

‏The history of exposure to drugs potentially causing valve disease is fundamental to the diagnosis .

#yassin_Ayad

صح تأخرت عليكم بس راح نطلع بمحتوى وكورس احترافي متكامل اوعدكم تفاصيل التفاصيل حتنشرح ، موبس راح نجاوب بالامتحان وانما تطور نفسك بالناحية العلمية قبل الدرجه وهذا هدفي الأساس زبدة المصادر المعتمده انجمعت بهاي المحاضرات وبيها جميع التفاصيل بمكان واحد وتكدرون تتأكدون وهاي نبذه بسيطه الي حتنزل باچر

Stay tuned ❤️