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DR. YAZAN ABU CHARBIEH
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Chapter 1: Endocrinology
1
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Chapter 2: Rheumatology
31
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Chapter 3: Gastroenterology
45
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Chapter 4: Cardiology
83
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Chapter 5: Hematology
118
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Chapter 6: Infectious Disease
139
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Chapter 7: Nephrology
165
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Chapter 8: Pulmonology
193
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Chapter 9: Emergency Medicine
223
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Chapter 10: Neurology
234
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Community Medicine
249
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Clinical
pictures of Cushing's syndrome:
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1-
fat deposition: moon face, buffalo hump, mesenteric bed, truncal obesity
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2-
HTN
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3-
muscle weakness + fatigability
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4-
osteoporosis
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5-
cutaneous striae
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6-
easy bruisability
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7-
acne, hirsutism, amenorrhea
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8-
emotional changes irritability >> depression >> confusion
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9-
glucose intolerance >> DM
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10-
hypokalemia
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11- -
leukocytosis
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12-
delayed wound healing
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13-
Renal calculi 1
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14-
glaucoma
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15-
pyuria
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16-
susceptibility to infection.
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Difference between DKA and
HONK
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HONK
DKA
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Blood glucose
Very high > 30mmol/l
High >15 mmol/l
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Ketone body
None
Present
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Acidosis
Normal
Moderate/severe
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Bicarbonate
>15
<15
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Volume depletion
Marked
Mild
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Plasma anion gap
Normal
Increased
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Present in
Type 2
Type 1
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ECE osmolarity
Very high
Usually, normal
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Serum insulin
Mild to moderate lack
Sever lack
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Hyperventilation
Absent
Present
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Dehydration
Marked
Mild
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Mortality in admitted patient
10% or more
1-4 %
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Difference between type
1 DM and type 2 DM
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Type 1
Type 2
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Younge age
Middle age / elderly
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Not obese
Overweight / obese
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No family history
Family history
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Short duration of symptoms
Symptoms present over months
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Can present with DKA
Not present with DKA
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Insulin required
Insulin not necessarily
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1-
Bone pain
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2-
Pathological Fractures
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3-
Increase warmth over affected bone
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4-
Deformity
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5-
Neurological problems: deafness, cranial nerve defect, nerve root defect, spinal stenosis
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6-
Increase risk of osteosarcoma
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Category
BMI range kg/m2
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Sever thinness
<16
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Moderate thinness
16-17
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Mild thinness
17-18.5
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Normal
18.5-25
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Overweight
25-30
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Obese class I
30-35
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Obese class II
35-40
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Obese class III
>40
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1.
Alcohol abuse
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2.
Alkalosis (elevated pH of the blood)
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3.
Hyperventilation
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4.
Hypocalcemia
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5.
Hypoparathyroidism (underactive parathyroid glands)
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6.
Malnutrition
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7.
Medication side effects
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8.
Pancreatitis
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9.
Pregnancy and breastfeeding
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10.
Vitamin D deficiency
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11.
Clostridium tetany toxin
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Disease
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Appearance
PTH level
Ca
PO4
Hypoparathyroidism
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Normal
Low
Low
High
Pseudohypoparathyroidism
1A
Skeletal defect
High
Low
High
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1B
Normal
High
Low
High
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2
Normal
High
Low
High
Pseudo pseudohypoparathyroidism
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Skeletal defect
Normal
Normal
Normal
Major criteria
Minor criteria
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Recurrent febrile episodes associated with peritonitis, pleuritis or synovitis Amyloidosis of AA-type without a predisposing disease Favorable response to daily colchicine
Recurrent febrile episodes Erysipelas-like erythema Positive history of familial Mediterranean fever in a first degree relative
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Major criteria
Minor criteria
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Typical attacks of:
1-2 Incomplete attacks affecting one or more
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Peritonitis (generalized)
sites
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Pleuritis (unilateral) or pericarditis
Abdomen
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Monoarthritis (hip, knee, or ankle)
Chest
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Fever alone
Joint
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Exertional leg pain
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Response to colchicine
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Typical attacks
Incomplete attacks
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recurrent (>/=3 of the same type) febrile (rectal temperature of 38°C (100°F) or higher)
painful and recurrent, differing from typical attacks in 1 or 2 features, as follows: 1. The temperature is normal or lower than
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short (lasting between 12 hours and 3 days).
38°C (100°F) 2. The attacks are longer or shorter than
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specified (but no shorter than 6 hours or longer than a week)
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3. No signs of peritonitis are recorded during the abdominal attacks
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4. The abdominal attacks are localized
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