Data Show Review

DATA SHOW REVIEW
By: Dr.RoYaL
‫• الساليدات عبارة عن اجهتاد خشيص ‪ ..‬ذلكل أعتذر اذا اكن‬
‫فهيا أي خطأ ‪..‬‬
‫• ان شاء هللا يكون أغلب الاختبار مهنا ‪..‬‬
‫• الساليدات استغ;رقت وقت طويل ذلكل التنسوين من‬
‫دعواتمك‬
‫‪Batch 27‬‬ ‫‪By:Dr.RoYaL‬‬

Thyrotoxicosis
Finding:
Exophthalmos
Batch 27 By:Dr.RoYaL
acanthosis nigricans
Cause:
Insulin resistance
Liver cirrhosis
Finding:
Caput Medusae
Caput Medusae  flow is towards the legs

Inferior vena cava obstruction  flow is towards the head.
Liver cirrhosis
Finding:
Ascites
Causes:
1) Excess cortisone
2) Cushing syndrome
What is the treatment ?
hairy cell leukoplakia

treated by acyclovir
What is the diagnosis ?
Finding:
butter fly rash
Diagnosis:
SLE
The following pic. Is side effect of which
medication?
Angioedema is a side effect of ACEI
Ankylosing spondoylitis
Necrobiosis lipoidica
Caused by DM
Pleural effusion
Finding:
1- loss of CP angel.
2- increase density
3- Mediastinal shift
What's the next step?

Lateral decubitus CXR
Pleural effusion
Types:
1) Transudative:
• pleural fluid to serum total protein ratio of less than 0.5
• pleural fluid to serum LDH ratio < 0.6
• Causes: CHF, cirrhosis & Nephrotic syndrome
2) Exudative:
• pleural fluid to serum total protein ratio > 0.5
• pleural fluid to serum LDH ratio > 0.6
• Causes: bacterial pneumonia, malignancy & viral infection.
pneumothorax
Finding:
1-radiolucent space without
lung marking.
2-white line of lung edge.
3-volume loss of underlying
lung (size of another
lung).
4-slight shift of lung
&trachea to opposite site.
pulmonary edema
What is the management?
Oxygen & IV diuretic
Finding in pulmonary edema:
1) Kerly B line.
2) Cardiomegaly.
3) Prominent intestinal marking
4) Pleural effusion
ST- elevation MI (Inferior)
which wall is affected ?

Inferior wall
Inferior wall MI
Finding:
ST elevation in II, III & aVF
Anterior wall MI
Finding:
ST elevation in V2, V3 & V4
Anteroseptal MI
Lateral wall MI
Posterior wall MI
Finding:
1) Tall broad initial R wave in V1 & V2
2) ST depression in V1 & V2
Pericarditis
Finding:
1) diffuse ST-elevation What is the treatment ?
2) PR depression NSAID
Pericarditis
Ventricular fibrillation
Finding:
1) No QRS
2) Disorganized ECG
Ventricular fibrillation
Treatment:
1) CPR
2) unsynchronised cardioversion
3) Epinephrine followed by shock
4) Amiodarone.
Ventricular flatter
1st degree AV block
Finding:
1) Prolonged PR interval
Treatment :
2) No missed QRS. observation
2nd degree AV block (Mobitz type 1)
Treatment : Finding:
1) Progressive prolongation of PR interval
observation
2) Missed QRS complex
2nd degree AV block (Mobitz type 2)
Treatment : Finding:
1) Fixed prolonged PR interval
pacemaker 2) Missed QRS complex
Complete heart block “3rd degree”
Finding:
No relation between P wave & QRS complex
Treatment :
pacemaker
Right bundle branch block
Finding:
1) RSR pattern in V1
2) Wide QRS complex
Left bundle branch block
Finding:
1) R wave is steep and notched in V6 & lead I
2) Wide QRS complex
Hyperkalemia
Finding:
The QRS complex is diffusely broadened and continuous with the tall, tented T
wave in all leads
What is the next step?
IV Ca++ gluconate
Hypokalemia
Finding:
flattened T waves
Left ventricular hypertrophy
Finding:
1) Tall R wave in V5 & V6
2) Deep S wave in V1,V2 & V3
3) T wave inverted in lead I, aVL, V5 & V6
Right ventricular hypertrophy
Finding:
1) Tall R wave in V1
2) Deep S wave in V6
3) T wave inverted in V1, V2, V3 & V4
4) Right axis deviation
atrial fibrillation
atrial fibrillation
Treatment:
Stable patient :
a) Rate control by Calcium blocker or B blocker
b) cardioversion to sinus rhythm
c) IV heparin. If atrial fibrillation present > 48 hours
anticoagulate patient for 3 weeks before & 4 weeks
after cardioversion
Unstable patient
Immediate cardioversion.
Atrial flutter
What is the etiology of this lesion ?
Roth spot Caused by immunological phenomena
cotton-wool spots (retinal infarcts)
Cause:
1) hypertension.
2) DM.
Finding:
consolidation
Diagnosis:
Pneumonia
Horner’s syndrome
3 rd
nerve palsy
Finding:
• Left eye ptosis
• down & out.
• Dilated pupil
Kayser–Fleischer ring
Diagnosis:
Wilson's disease
Cataract
Deferential diagnosis:
1) Diabetes mellitus
2) Hyperparathyroidism
3) Hypervitaminosis D
4) Hypothyroidism
5) Wilson's disease
What's the causative organism ?
Treponema pallidum ) syphilis )

Microcytic hypochromic anemia
MCV 60  Deferential diagnosis:

MCH 20 1) Iron deficiency anemia.
2) Thalassemia.
Hb 9 3) Lead poisoning
Macrocytic anemia
 Deferential diagnosis:
MCV 120 a) Megaloblastic anemia.
1) Vitamin B12 deficiency.
Hb 9 2) Folic acid deficiency.
b) Non Megaloblastic anemia .
3) Liver disease.
4) Alcohol.
5) Drug.
Metabolic acidosis
 causes:
PH 7.25 a) Wide anion gap.
HCO3 12 1) Lactic acidosis.
2) Ketoacidosis.
Pco2 32 3) salicylate
b) Normal anion gap.
4) Renal tubular acidosis.
5) Diarrhea.
6) Pancreatic fistula.
Metabolic alkalosis
 causes:
PH a) Chloride-responsive (<10 mEq/L)
7.5 1) Vomiting & nasogastric tube
HCO3 32 “commonest”
2) Chloride diarrhea.
Pco2 45
3) Inadequate intake of chloride
a) Chloride-resistance (>20 mEq/L)
usually renal
‫مهـــسة‪:‬‬
‫أنت‪ ‬آل تكرهُين ‪ ،‬أنت‪“ ‬تكره ٌ‬
‫الصوره اليت كونهتآ عيّن ْ “‬
‫أ دو ْ‬
‫نيس‬
‫‪Batch 27‬‬ ‫‪By:Dr.RoYaL‬‬

Ischemic stroke
Causes:
1) Embolic stroke
2) Thrombotic stroke.
3) Lacunar stroke.
what will you find clinically?

left Hemiparesis & hemiplagia
Hemorrhagic stroke
Causes:
1) HTN.
2) Ischemic stroke.
3) Amyloid anigiopathy.
Subarachnoid hemorrhage
Epidural hematoma
Subdural hematoma
Acute chronic
Osteoarthritis
Finding:
1) Joint space narrowing.
2) Osteophytes “bony enlargement
of the joint”
3) Sclerosis.
4) Subchondral cyst
Rheumatoid Arthritis
Finding:
juxta-articular osteopenia
soft tissue swelling
loss of joint space
Aseptic meningitis
• patient with headache & seizure
• CSF was:
WBC 800
WBC differential Lymphocytes
Glucose 60
protein 62
What is the causative organism?

ECHO virus, HSV & Enterovirus
Treatment:
Supportive care
Acute bacterial meningitis
• CSF was:
WBC 5000
WBC differential PMNs
Glucose 20
protein 100
What is the causative organism?

N. meningitidis, s. pneumonia & H. Influenza
Treatment:
Empiric antibiotic
partially treated meningitis
• CSF was:
WBC 600
WBC differential PMNs 50 %
Lymphocyte 50%
Glucose 20
protein 100
Audible station
Heart sound:
-Best heard : at the base of heart radiating to
carotid artery
http://www.youtube.com/watch?v=Gbk2465HO
98
Diagnosis:
- Aortic stenosis
‫‪PRAY TO ME‬‬
‫أخوكم سعود المسلماني‬
‫‪Dr.RoYaL‬‬

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DATA SHOW REVIEW

‫‪Batch 27‬‬ ‫‪By:Dr.RoYaL‬‬

Caput Medusae  flow is towards the legs

hairy cell leukoplakia

Angioedema is a side effect of ACEI

What's the next step?

which wall is affected ?

Roth spot Caused by immunological phenomena

Treponema pallidum ) syphilis )

MCV 60  Deferential diagnosis:

‫‪Batch 27‬‬ ‫‪By:Dr.RoYaL‬‬

what will you find clinically?

What is the causative organism?

What is the causative organism?

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