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24/11/2025

🛑🛑Tips and tricks for management of Arrhythmias

🟥 Supraventricular Arrhythmias (SVT / AF / Atrial Flutter)

1. 🟥 Young patient with sudden palpitations (AVNRT confirmed on ECG)
👉 Treatment: Adenosine (acute termination).

2. 🟥 Patient with SVT and severe asthma
👉 Avoid adenosine & β-blockers → Use Verapamil or Diltiazem.

3. 🟥 Hemodynamically unstable SVT
👉 Immediate synchronized cardioversion.

4. 🟥 New-onset AF (

14/11/2025

🫆Clinical Tip: "Initial imaging in Budd-Chiari is Doppler U/S."

🫆Significance: Budd-Chiari Syndrome is a rare condition characterized by the obstruction of blood flow from the liver (hepatic vein occlusion). A Doppler ultrasound is the non-invasive, first-line investigation of choice because it can quickly and accurately visualize the patency and direction of blood flow in the hepatic and portal veins.

👉🏽The majority of patients with acute-onset Budd-Chiari Syndrome present with the classic triad of symptoms resulting from liver congestion and portal hypertension:

🔺1. Abdominal Pain: Usually severe, sudden-onset pain in the upper right quadrant of the abdomen, caused by the stretching of the swollen liver capsule.
🔺2. Ascites: The accumulation of fluid in the abdominal cavity, often massive and rapid in onset, due to increased pressure in the congested liver veins (portal hypertension).
🔺3. Hepatomegaly: Enlargement of the liver, which is often tender to the touch due to the increased blood volume trapped within it.

08/11/2025

The most common cause of polycythemia is a mutation in the JAK2 gene, which leads to polycythemia vera.
In other cases, the most common causes are related to secondary polycythemia, which are due to factors that reduce oxygen levels in the body.
These can include high-altitude living, smoking, chronic lung or heart disease, and certain tumors that produce erythropoietin (EPO).Other factors are Dehydration and Medications.

If see Hypoglycemia with Metformin think-:-Renal failure/Impairment,Missed Meal/Poor Nutrition,Intense Exercise,Drug Ove...
07/11/2025

If see Hypoglycemia with Metformin think-:-Renal failure/Impairment,Missed Meal/Poor Nutrition,Intense Exercise,Drug Overdose,Excessive Alcohol Intake or Combination with Other Medications.

18/10/2025

🚫 Arrhythmias where Amiodarone is Contraindicated or Avoided:



1. Torsades de Pointes (TdP) / Polymorphic VT due to QT prolongation
• Reason: Amiodarone prolongs the QT interval, which can worsen or trigger Torsades.
• Preferred drugs: Magnesium sulfate, isoproterenol (if bradycardic), or overdrive pacing.



2. Sinus Bradycardia
• Reason: Amiodarone has bradycardic effects, which can cause severe symptomatic bradycardia or asystole.



3. High-grade AV Blocks (e.g., 2nd degree Mobitz II or 3rd-degree AV block)
• Reason: Amiodarone can further depress conduction, leading to complete heart block or asystole.
• Unless a pacemaker is in place, it should be avoided.



4. Sick Sinus Syndrome
• Reason: Amiodarone may worsen sinus node dysfunction, causing pauses or arrest.



5. Atrial Fibrillation with Pre-excitation (i.e., WPW syndrome)
• Reason: Amiodarone can slow AV node conduction, allowing faster conduction through the accessory pathway, which may lead to ventricular fibrillation.
• Preferred treatment: Procainamide or electrical cardioversion.

14/09/2025

🩶Common Signs and Symptoms of some diseases🩶

Pls take note! Also available po in flashcards, pm to order!

01. PTB – low-grade afternoon fever.
02. PNEUMONIA – rusty sputum.
03. ASTHMA – wheezing on expiration.
04. EMPHYSEMA – barrel chest.
05. KAWASAKI SYNDROME – strawberry tongue.
06. PERNICIOUS ANEMIA – red beefy tongue.
07. DOWN SYNDROME – protruding tongue.
08. CHOLERA – rice watery stool.
09. MALARIA – stepladder like fever with chills.
10. TYPHOID – rose spots in abdomen.
11. DIPTHERIA – pseudo membrane formation
12. MEASLES – koplik’s spots.
13. SLE – butterfly rashes.
14. LIVER CIRRHOSIS – spider like varices.
15. LEPROSY – lioning face.
16. BULIMIA – chipmunk face.
17. APPENDICITIS – rebound tenderness.
18. DENGUE – petechiae or (+) Herman’s sign.
19. MENINGITIS – Kernig’s sign (leg flex then leg pain on extension), Brudzinski sign (neck flex =
lower leg flex).
20. TETANY – hypocalcemia (+) Trousseau’s sign/carpopedal spasm; Chvostek sign (facial
spasm).
21. TETANUS – risus sardonicus.
22. PANCREATITIS – Cullen’s sign (ecchymosis of umbilicus); (+) Grey turners spots.
23. PYLORIC STENOSIS – olive like mass.
24. PDA – machine like murmur.
25. ADDISON’S DISEASE – bronze like skin pigmentation.
26. CUSHING’S SYNDROME – moon face appearance and buffalo hump.
27. HYPERTHYROIDISM/GRAVE’S DISEASE – exopthalmus.
28. INTUSSUSCEPTION – sausage shaped mass, Dance Sign (empty portion of RLQ)
29. MS – Charcot’s Triad (IAN)
30. MG – descending muscle weakness
31. Guillain Barre Syndrome – ascending muscle weakness
32. DVT – Homan’s Sign
33. CHICKEN POX – Vesicular Rash (central to distal) dew drop on rose petal
34. ANGINA – Crushing stubbing pain relieved by NTG
35. MI – Crushing stubbing pain which radiates to left shoulder, neck, arms, unrelieved by NTG
36. LTB – inspiratory stridor
37. TEF – 4Cs’ Coughing, Choking, Cyanosis, Continous Drooling
38. EPIGLOTITIS – 3Ds’ Drooling, Dysphonia, Dysphagia
39. HODGEKIN’S DSE/LYMPHOMA – painless, progressive enlargement of

11/06/2025

👩‍⚕️Any febrile aphasia is herpes meningoencephalitis until proven otherwise.

11/06/2025

👩‍⚕️In bacterial meningitis, IV dexamethasone 💉 should ideally be administered before the first antibiotic injection, or at the latest within 12 hours of starting antibiotic therapy.
➡️ The total duration of treatment is 4 days.

11/06/2025

▫️Epididy-orchitis in young people ➡️ STIs.
▫️Epididy-orchitis in old people ➡️ Urinary tract infections.

11/06/2025

👩‍⚕️ In the presence of hypereosinophilia in the context of a stay in a tropical region and if the diagnostic approach is non-contributory ➡️ a presumptive treatment for imported helminthosis 🐛 combining 3 drugs active on helminths:
1️⃣ Albendazole
2️⃣ Ivermectin
3️⃣ Praziquantel

11/06/2025

👩‍⚕️In the investigation of anemia🩸: ⤵️
If the ferritin level is just above the lower normal value in a context of inflammation that normally elevates ferritin ➡️ in this case, associated iron deficiency anemia (iron deficiency) should be considered.

11/06/2025

👩‍⚕️NSAIDs are contraindicated in combination with ACE inhibitors:
➡️ Risk of functional acute renal failure due to ⤵️
▫️ Vasoconstriction of the afferent arteriole under the effect of NSAIDs.
▫️ Vasodilation of the efferent arteriole under the effect of ACE inhibitors.
➡️ Leading to a decrease in GFR by reducing glomerular filtration pressure.

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