Archive

GOUT

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1. DDx:

    1. septic arteritis

2. Treatment:

    1. Tab colchicine 0.5 mg q1h (max dose 1.8 mg) first day then 0.5 mg bid for 2-3 days

    2. Tab indomethacin 50 mg

        1. or tab ibuprofen 800 mg tds

        2. or tab diclofenac tds

        3. or amp betamethasone 8 mg IM

    3. Tab Prednisolone 30-40 mg daily till resolving symptoms, taper in 1-2 weeks

3. Lab data:

    1. CBC, diff, ESR, CRP

    2. BUN, Cr, U/A

    3. Acid uric level

    4. Lipid profile

DDx
April 23, 2026 (0)

Giardia

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1. symptoms

    1. crampy abdominal pain

    2. inflammatory diarrhea

    3. weight loss

    4. bloating

    5. malodor diarrhea

    6. anorexia

2. Dx

    1. 3 times S/E

    2. Giardia Cyst or Antigen

3. Treatment

    1. Susp furazolidone 6mg/kg/day (2/2cc) qid (susp 50mg/5ml, tab 100 mg)

        1. or tab metronidazole 15mg/kg/day tds (syrup 125mg/5ml, tab 250 mg)

        2. or Tab tinidazole 500 mg #5 SD (50mg/kg, max dose 2gr)

        3. or Tab mebendazole 200mg #15 tds

DDx, Inf. Diseases
April 23, 2026 (0)

Genital lesions

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1. Vesicular with discharge

    1. Dx: Genital Herpes

    2. Treatment

        1. Tab acyclovir 400mg #30 tds

2. Singular, painless without discharge

    1. Dx: syphilis

    2. Tx:

        1. Amp Penicillin G Benzathine 1,200,000 IU/vial (Penador) #2 IM

3. Genital warts:

    1. Vaccination:

        1. Prefilled syringe Gardasil 0-1-6 m

4. Chancroids:

    1. Singular, 1-2cm in diameter, painful and erythematous stalk

    2. Tx:

        1. Tab erythromycin 400mg qid for 7 days

            1. or Amp Ceftriaxone 250mg SD

            2. or Tab azithromycin 1gr SD

5. Inguinal granuloma

    1. Tx:

        1. Tab TMP-SMX 800-160 bid for 20 days

DDx, Inf. Diseases
April 23, 2026 (0)

Genital Herpes Zoster

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1. Start treatment in first 24 hours

2. treatment

    1. tab acyclovir 400mg #15 tds for 5 days

    2. oint acyclovir #1 topical use

    3. if relapsing

        1. Tab acyclovir 400mg bid for 6 months

    4. if pregnancy

        1. Tab acyclovir 400mg bid for 6 months

    5. for infancy or severe cases

        1. Vial acyclovir 8mg/kg/dose q8h IV

        2. refer theses patients

DDx, Inf. Diseases
April 23, 2026 (0)

Functional Pediatric abdominal pain

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1. R/O

    1. weight loss

    2. chronic diarrhea

    3. growth retardation

    4. RLQ pain with fever

    5. GIB

    6. awakening pain

    7. Celiac disease

    8. functional and chronic pain

2. Treatment

    1. Drop dimethicone 5drop tds

        1. Syrup dicyclomine

DDx, Pediatrics
April 23, 2026 (0)

Foreign body ingestion

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1. Orders:

    1. Neck x-ray AP and lateral

    2. Chest x-ray AP and lateral

    3. Abdominal x-ray

    4. CT scan if the object is radiolucent

    5. For magnets:

        1. Endoscopy in 12 hours

    6. For batteries

        1. double density on x-rays

        2. upper endoscopy in 2 hours

    7. Other objects, endoscopy in 24 hours if

        1. obstruction

        2. no move in 24 hours

        3. no passage through esophagus

    8. in stomach and bowel, do surgery or endoscopy if:

        1. >4weeks

        2. >5*2.5 cm (>3cm for children)

        3. abnormal bowel picture

        4. >1week in one section

        5. for batteries in stomach, do endoscopy if:

            1. diameter >2cm

            2. ≥ 2days in stomach

            3. N/V and abdominal pain

    9. Sharp objects, do endoscopy ⇒ if ≥3 days stay in one place

DDx, General Topics
April 23, 2026 (0)

Foreign body in Eye

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1. Approach

    1. exam with slit lamp

    2. for anesthesia

        1. Drop opht tetracaine 0.5% 1-2 drop SD

    3. discharge if does not penetrate into globe with:

        1. oint opht erythromycin 0.5% #1 qid

        2. drop tear opht artificial 0.5% #1 qid

        3. drop opht sulfacetamide 10% #1 qid 2drops

DDx, General Topics
April 23, 2026 (0)