د.زايد آل زايد | Zayed Al-Asiri

A doctor, a dreamer, | MBBS - Internal Medicine resident 👨🏻‍⚕️🗣|. طبيب زمالة الطب الباطني (Internist)

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

مشاركتي البسيطة بتقاعد والدي..❤️

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

The specialty currently serves patients under the age of 14. In general, there are fewer patients with chronic diseases and fewer bedridden patients compared with adult specialties. Additionally, pediatric patients often respond to treatment more quickly, and their recovery is generally faster than that of adult patients.

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

🩺 A good reminder that not every patient presenting with vomiting has a gastrointestinal disease.

One of the cases I encountered presented with only one chief complaint: vomiting (4–5 episodes during the day).

After I performed a careful and comprehensive clinical assessment, I identified several concerning neurological findings🩺.

The patient was a 57-year-old man with diabetes mellitus, and on detailed history he reported:

Recurrent vomiting
Left-sided weakness
Left-sided numbness
Bulbar symptoms, including dysphagia (choking while drinking water)
Difficulty walking with gait imbalance

Neurological examination revealed:

Left upper and lower limb weakness
Left-sided sensory loss
Impaired swallowing
Positive left pronator drift
Hyperreflexia on the left side
Positive Babinski sign on the left
Gait ataxia

Based on these findings, I requested an urgent CT angiography of the brain.

CT angiography demonstrated an acute posterior circulation ischemic stroke, with an associated left cerebellar infarction.

🔺 Take-message:

Patients with acute stroke do not always present with the classic symptoms. Some patients may initially present only atypically symptoms like vomiting, while careful assessment reveals underlying bulbar signs and other focal neurological deficits. Anchoring on a single symptom can delay the diagnosis of a life-threatening condition. A thorough history, complete neurological examination, and careful clinical assessment remain the cornerstone of accurate diagnosis and timely management.

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

إياك أن تحلم إلى الدرجة
التي تنسى فيها الواقع..
وإياك أن يحاصرك الواقع
إلى الدرجة التي تنسى فيها أحلامك!

لا تسخر من أحلام الناس..
مهما كانت غريبة.
ولا تتنازل عن أحلامك..
مهما كانت صعبة.
لا طعم للحياة دون أحلام.

#محمد_الرطيان

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@Nephro2022 🫣

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@AHMEDNO62308298 Remember:

“Before diagnosing gastritis, rule out what can kill the patient.”

Always think:
ECG first. Gastritis later.

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@liveurlife777 @imo7a_7 @steur_1 Sometimes the total WBC count is normal, but blasts are still seen on the peripheral blood smear (PBS), especially in early leukemia or marrow disorders

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@hyderabaddoctor Primary polycythemia can cause thrombosis in any part of the body, and it may occur even in very young patients.

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@hyderabaddoctor 2️⃣

3- Smoking → major risk factor for atherosclerosis and vascular disease

All these factors may have contributed to his stroke risk.

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@hyderabaddoctor The patient developed a stroke.
He is a 60-year-old man :

1- Hypertension
2- Polycythemia — needs further evaluation to determine whether it is primary or secondary
→ We should check the JAK2 mutation and review the HCT level as well
1️⃣

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@o_o_dr ECG showed anterior ST elevation mainly in V2–V5.
Echocardiography showed LV systolic dysfunction with regional wall motion abnormality and dilated .
Chest X-ray showed pulmonary congestion.
Overall findings are consistent with anterior STEMI complicated with ADHF

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@AB_drmd WPW
Delta wave “ see v1-v6 also high lateral lead “

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@pandafightre @ANHMM1418 V2 – V4

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@ANHMM1418 But first thing VBG for make sure K

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@ANHMM1418 This ECG shows classic peaked T waves suggestive of hyperkalemia, which is a life-threatening condition requiring immediate treatment,

So :
Calcium gluconate IV
Insulin + glucose
Nebulized salbutamol

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@Ali_Asiri_97 @faalosaimi ماشاء الله
بالتوفيق د علي ويسر امرك

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@DocPriyamMD LM occlusion
AVR elevation

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@Drkhenaizan نتكلم على أن الدراسة غير دقيقة 😊

[د.زايد آل زايد | Zayed Al-Asiri @asiri_95]

@modernHealthMe Shock