Dr. Siraj

طبيب عراقي 🇮🇶 resident doctor internal medicine MBChB

[Dr. Siraj @Surige_q]

@SeeFisch According to NICE
type 2 goes to QRISK score
Type 1 if > 10 years or above age of 40 or nephropathy.
I never heard of this criteria of 7.5 % ?!

[Scholarship for PhD @ScholarshipfPhd]

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[Dr. Siraj @Surige_q]

@SeeFisch I think step 2 ck provides a better insight since it’s more clinically correlated.

[Dr. Siraj @Surige_q]

@SeeFisch @SeeFisch
What do you think of this proposed pathway?

[Dr. Siraj @Surige_q]

@flaterth211 الله يرحمه ، الرجل كان مضطرب نفسيا و غير مؤهل علميا

[Dr. Siraj @Surige_q]

@vukandric Any ipad wallpaper?

[Dr. Siraj @Surige_q]

@BritSimonSays The court decision is final. It’s a little bit shocking to see administration that preaches about the importance of immigration and immigrants yet fight so aggressively against the very law that provides the best pathway for immigration. I just can’t understand why they did this

[Dr. Siraj @Surige_q]

@malkeasaad MRCP certification have any value ??

[Dr. Siraj @Surige_q]

@curtismorrison Thank you for your tremendous effort much appreciated Mr morris.
Wish you the best.

[Dr. Siraj @Surige_q]

@Doctors__squad These are not pathognomonic

[Dr. Siraj @Surige_q]

@rabea_says @curtismorrison Eid mubark god bless you

[Dr. Siraj @Surige_q]

@curtismorrison Looking good , eternal youth man

[Dr. Siraj @Surige_q]

@IraqiWazir محاضر اجتماعات رئاسة الوزراء من بعد السقوط الى اليوم ترسل بأنتظام الى الارجنتين.

[BritSimon @BritSimonSays]

DV Lottery Greencard | Live Q&A April 7, 2024 https://t.co/hAoRkdrDwB

[Dr. Siraj @Surige_q]

@curtismorrison @USAinUAE Can you explain more ? I think the US embassy in Baghdad is still close for security reasons!

[Dejene Guyasa Page @Dejuguyasa]

Appealing the 2020-2021 Diversity Visa winners' case is concerning.I urge President @POTUS Biden to swiftly resolve this, withdraw the appeal, and uphold American values by granting them the opportunity they deserve.
@SecBlinken @VP @curtismorrison #Immigration #DV2020 #DV2021

[Conrad Fischer @SeeFisch]

SGLT2 inhibitors (Empagliflozin, Dapagliflozin, Canagliflozin)
*CHF with reduced ejection fraction (EF)
*CHF w/preserved EF
*Diabetic kidney disease
*Persistent proteinuria despite ACE/ARB
Weakest use?.....
Diabetes alone!!!
only half a point of HgA1c

SGLT drugs=MUST KNOW

[Conrad Fischer @SeeFisch]

Best ways to know your effusion is infected:
*Yes, LDH >60%/Protein >50% of serum (But cancer can do this)
*Cell count >1,000 WBCs
AND!!!

*pH <7.2

"Hey! 7.2 does not seem horrible!"

"That is because you do not know that the normal pleural fluid pH is 7.6"

[Conrad Fischer @SeeFisch]

Finerenone
*Mineralocorticoid antagonist
*For diabetics with CKD
*Finerenone is an ADDITION to ACE/ARB, SGLT2
^Hyperkalemia? YES!
*Expensive? $10,000 a YEAR. Crazy American financing. YES!

Miracle?
no
Incremental improvement? 14% progression drops to 12%?
Yes, incremental

[Conrad Fischer @SeeFisch]

Cirrhosis/Ascites
*Hepatorenal syndrome treatment: Terlipressin and Albumin
*Ascites: Spironolactone AND furosemide in 5/4 ratio. 100 Spiro/40 furosemide. or 400 spiro/160 furosemide
*SBP prophylaxis if: Variceal bleed or previous SBP or Ascites albumin <1 = Cipro or TMP/SMZ