Sultan Alhomrani

Medical Intern In NGHA

SMLE Questions Corrector

[Sultan Alhomrani @SultanAlho27368]

Answer:

Interaction Btw Allopurinol & Azathioprine

AZA is Metabolised into 6-MP (6 Mercapto-Purine) . 6-MP Is The Active Form Of AZA

Normally , 6-MP Is INACTIVATED By Xanthine Oxidase

Allopurinol is Xanthine Oxidase Inhibitor That Prevents The Deactivation Of 6-MP And Thus , Increases The Toxic Effect Of It Causing Severe Life-Threatening Bone Marrow Suppression & Pancytopenia

This Interaction is Very Important Because Hyperuricemea is Common Among People With IBD + Azathioprine is COMMONLY Used In IBD (It's Also Used In Kidney Transplant , But Less Common Since Cyclosporin & Tacrolimus Do Better)

Take Home Massage:

Even If You Won't Prescribe Immune-Suppressents , It's Important To Know Side Effects Of Common Medications Because You Will Definitely Encounter Some Of These

[Sultan Alhomrani @SultanAlho27368]

A 25 YO Male K/C Of Crohn's Disease Following With GI Came To PHC With Labs Showing High Uric Acid (700)

You Prescribed Him Allopurinol And After 1 Month , Patient Prsebted To ER With Sepsis , Severe Bleed , Hb Of 6

What's The Cause Of This Presentation?

مستوى الصعوبة: 10/10

[Sultan Alhomrani @SultanAlho27368]

@md1talk Non-Cardiogenic Pulmonary Edema

Hamann-Rich Syndrome

I Literally Just Gave You The Rarest Cause Of NCPE
عطني لايك إذا صح 🤣🤣🤣

[Sultan Alhomrani @SultanAlho27368]

@albargawy مسكنات للضحك على الذقون :)

[Sultan Alhomrani @SultanAlho27368]

@DrLalibrahim يعجبني اللي يحاول يراضي نفسه ويسكت ضميره بصور كركتير

وقبل كم يوم ناشرة تغريدة "الذي يتكلم بالحق لا ينتظر تصفيق الناس" ، يعني الحين أقنعتي نفسك وأقنعتي الناس ان كلامك صح بشوية كلام شاعري؟

بصراحة استغرب أن مثل هذا الكلام يطلع من "طبيب" (:

[Sultan Alhomrani @SultanAlho27368]

@DrLalibrahim حلوة الصورة ، عذر جيد جدا عشان نقول ما لا يليق لا شرعا ولا أخلاقيا بحجة انه "ما يهمني راي الناس"

Keep Convincing Yourself That What You're Doing Is Correct Just Because People Are Against You

علعموم ، أسأل الله أن يذيقك من نفس الكأس (إن كان خيرا فخير وإن كان شرا فشر)

[Sultan Alhomrani @SultanAlho27368]

A 25 YO Male K/C Of Crohn's Disease Following With GI Came To PHC With Labs Showing High Uric Acid (700)

You Prescribed Him Allopurinol And After 1 Month , Patient Prsebted To ER With Sepsis , Severe Bleed , Hb Of 6

What's The Cause Of This Presentation?

مستوى الصعوبة: 10/10

[Sultan Alhomrani @SultanAlho27368]

@Abdulmajeed_345 ألف مبروك دكتور ، تستاهل أكثر ومن أعلى لأعلى

[Sultan Alhomrani @SultanAlho27368]

@md1talk Is Amboss Bank Representitive For USMLE? (Can I Use It Along With U World Or It's Useless?)

[Sultan Alhomrani @SultanAlho27368]

@md1talk Also How Useful are Key Words In Most Of Questions?

Eg, Some Times I See Long Case But In The Middle There Is Clue Of Cellulitis Following Dog Bite (Pasturella)

In Most Cases , Can I Strongly Rely On My First Thought & Solve The Question Based On It? Or There're Hidden Tricks?

[Sultan Alhomrani @SultanAlho27368]

@md1talk وأيضا هل الأسئلة موزعة بحيث يكون متوسط الوقت لكل سؤال هو دقيقة؟

يعني هل هم يتعمدون فرضا انهم يحطون نسبة معينة من الأسئلة تكون حالة طويلة وتحتاج دقيقتين ونسبة أخرى لأسئلة Straight Forward وما تحتاج قراية وتحله في نص دقيقة؟

[Sultan Alhomrani @SultanAlho27368]

@md1talk Do I Need To Focus On Microscopic Views In USMLE?

I Know Histopathologic Changes In Theory , But My Eyes Are Weak In Pattern Recognition

Is It Common To See Picture For Certain Bacteria OR Skin Lesion Or Pathology Slide?

ولا ينعدون على الأصابع وعايدي لو أبي أسحب عليهم؟

[Sultan Alhomrani @SultanAlho27368]

@md1talk I Plan For USMLE In Shaa Allah, I Want To Know:

1- Do I Need To Study Anatomy In Details? Or Anatomy Present In First Aid Step 1 Is Enough

2- Same For Biochem Do I Need To Study It In Depth , Or Biochem Of Certain Disorders (Eg B12 , Lysosomal Storage) & First Aid are Enough?

[Sultan Alhomrani @SultanAlho27368]

@md1talk من 100% كم تتوقع كتاب هاريسون يغطي من مستلزمات ال
R5 Internal Medicine?

Ofcoarse Not Counting Other Requirements Like Pediatrics & Obs/Gyn & ENT & Psych & Optha (These Are Mainly Family Requirement , But W/E)

[Sultan Alhomrani @SultanAlho27368]

@md1talk Warfarine:

High INR WO Bleed: Vit.K Only

Severe Bleed: 4F-PCC + Vit.K

UH = Protamine

LMWH = Adexanate Alfa (OR High Dose Protamine)

Anti-X = Adexanate Alfa

Dabi = Idrasuzumab

tPA = Aminocaproic Acid

LMWH's Factor 10 Selective & Has Low Response To Protamine (vs UH)

[Sultan Alhomrani @SultanAlho27368]

@md1talk Brucella Tx:

Doxy
Genta
Refampin
Bactrim
Ceftriaxone

Always Start 1+2, Then Replace 2 By 3

Spondylitis & IE & CNS = Serious Infection => Use All 3 Initially

BUT In CNS, Use 5 Instead Of 2 (Better Availability)

Age<8: Same Above, But Use 4 Instead Of 1

Pregnent: Avoid 1,2,4

[Sultan Alhomrani @SultanAlho27368]

@md1talk Brucella Tx:

Doxy
Genta
Refampin
Bactrim
Ceftriaxone

Always Start 1+2, Then Replace 2 By 3

Spondylitis & IE & CNS = Serious Infection => Use All 3 Initially

BUT In CNS, Use 5 Instead Of 2 (Better Availability)

Age<8: Same Above, But Use 4 Instead Of 1

Pregnent: Avoid 1,2,4

[ريان | MD1TALK🌟 @md1talk]

الاجابة هي Brucellosis

معلومة الطاير على brucellosis:

- البكتيريا ذي
can theoretically infect any organ

جدول رهيب مختصر المهم

[Sultan Alhomrani @SultanAlho27368]

@md1talk So Beautiful @.@

مدري وش الأجمل ، المايكروبايولوجي ، ولا الميديسن ، ولا ملخصاتك

Brucella , TB , Syphillis , The 3 Great Mimickers That Infect LITTERALLY EVERY Organ (Well , Almost)