jonijoo

B.O.M.O

[Swahili Times @swahilitimes]

Mbunge wa Kigoma Mjini, Revocatus Chipando (Baba Levo) ameshauri wakamatwe wanaotoa elimu ya afya kiholela mtandaoni kwakuwa wanawachanganya wananchi.

[Tamale @256Rootyherman]

Angels when:

ure sinning. u need help

[MEDICINE MADNESS @Doctors_GUILD]

Surgery is beautiful?

Before. After

[Dr. Muhammad Moor @MoarSahitoPTI]

Why is Amphotericin B called “amphoterrible”? 🤔

[Haji Siyamuddin ANSARI @DrsansariOrd]

Correct answer: A) Acute pancreatitis✅

Key Clinical Clue in the Image

The patient is leaning forward on knees with the trunk flexed (similar to the knee-chest or leaning forward position).

Patients with acute pancreatitis often obtain pain relief by sitting up and leaning forward.

Why This Happens

Acute pancreatitis causes severe epigastric pain radiating to the back because the pancreas is retroperitoneal.

When the patient leans forward:

Pressure on the inflamed pancreas decreases

Stretch on retroperitoneal nerves reduces

Pain intensity improves

Thus patients instinctively adopt this forward-bending posture.

Typical Clinical Features of Acute Pancreatitis

Severe epigastric pain

Pain radiating to the back

Nausea and vomiting

Pain worse when lying supine

Relieved by sitting or leaning forward

Associated lab findings:

↑ Serum amylase

↑ Serum lipase

Why the Other Options Are Incorrect

B) Acute appendicitis

Appendicitis

Typical features:

Pain starts periumbilical → migrates to RLQ

McBurney’s point tenderness

Pain worsens with movement

No relief with leaning forward.

C) Acute cholecystitis

Cholecystitis

Typical features:

Right upper quadrant pain

Murphy sign positive

Pain after fatty meals

May radiate to right shoulder

Position change usually does not relieve pain.

D) GERD

Gastroesophageal reflux disease

Typical features:

Heartburn

Worse when lying down

Regurgitation

But severe abdominal pain relieved by leaning forward is not typical.

✅ Final Answer: A) Acute pancreatitis – because pancreatic pain classically improves when the patient leans forward or sits upright.

[jonijoo @jonijoooo]

@Teamgyokeres Add me

[jonijoo @jonijoooo]

@_onlyscott @grok answer this

[jonijoo @jonijoooo]

@zola_254 LGBT 🏳️‍🌈

[jonijoo @jonijoooo]

@ArsenalN10 Where is eze

[Forever Arsenal @Arsenal_N10]

12 matches to go! If you believe, REPOST !!!

[jonijoo @jonijoooo]

@Binamu01 @grok is this picture Ai

[Elon Musk @elonmusk]

Whoever said “money can’t buy happiness” really knew what they were talking about 😔

[FearBuck @FearedBuck]

Jason Luv reveals he had a daughter for 16 years before finding out last year she wasn’t his biological child

[jonijoo @jonijoooo]

@drsthanus Ring worm (tinea infection of the trunk) characterised by ring like skin lession itchy can be multiple the treatment is using topical antifungal agent ketoconazole cream and po griseafluvin

[jonijoo @jonijoooo]

@albertoortegana @dr_manish_ydv @DrAkhilX @Dr_Shiv_kumar_ @DrMedica_13 @IhabFathiSulima Normal ECG

[jonijoo @jonijoooo]

@buzz_because @TrackYourHeart Yeah gtfo am learning tooo

[jonijoo @jonijoooo]

@thenihiin Stop dreaming 🥹

[Dr. AK 🇮🇳 @docakx]

KDIGO relaeses 2026 Clinical Practice Guideline for the Management of Anemia in CKD updating the 2012 guideline.

📌 Key Recommendation Summaries👇

1) Diagnosis & Evaluation of Anemia

Screen all CKD patients for anemia at referral, with repeated testing during follow-up based on disease stage.

Diagnostic tests should include:

-CBC (complete blood count)

-Reticulocyte count

-Ferritin

-Transferrin saturation (TSAT)

Evaluate for other causes of anemia (e.g., iron deficiency, blood loss, inflammation).

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2) Iron Therapy Recommendations

Assess iron status before starting anemia therapy in CKD (not just hemoglobin).

Iron therapy can be given orally or intravenously, chosen based on:

-CKD stage

-Symptoms

-Tolerance and response to prior therapy

IV iron is often preferred in people on dialysis or with more severe deficiency.

Iron should be used to raise iron stores and support erythropoiesis before/alongside other agents.

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3) Use of Erythropoiesis-Stimulating Agents (ESAs)

ESAs are recommended for patients with symptomatic anemia after iron status has been optimized.

Target hemoglobin should be individualized, avoiding high hemoglobin targets that may increase cardiovascular risk.

ESA therapy decisions should balance:

-Quality-of-life benefits

-Risks (e.g., hypertension, thrombosis)

-Monitor hemoglobin regularly to adjust ESA dosing.

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4) Hypoxia-Inducible Factor Prolyl-Hydroxylase Inhibitors (HIF-PHIs)

Recognized as alternative treatments to ESAs in appropriate patients.

-Considered for people who:

-Cannot tolerate ESAs

-Have ESA hyporesponsiveness

Long-term safety and comparative outcomes with ESAs are still being defined.

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5) Red Blood Cell (RBC) Transfusion Guidance

Transfusions are NOT first-line therapy for anemia in CKD.

Limited to:

-Severe symptomatic anemia

-Life-threatening situations

Risks of transfusion (e.g., immune sensitization, volume overload) should be weighed carefully.

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6) Special Populations

Children, transplant recipients, and dialysis patients have specific considerations in anemia management (tests and targets may vary).

e.g., children may have age-specific hemoglobin thresholds.

[Hilda Newton @HildaNewton21]

Balozi Humphrey Polepole alikuwa mbele ya muda.