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Heart Murmurs at a Glance: A High-Yield Clinical Guide.
@medics_AbuSaif
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I LOVE THIS! 😍
Gazini, Ahtisa, MJ, and Michelle back to serving their iconic Miss Universe introductions. 🇵🇭💫
If you followed their journey alam mo agad paano nila sasabihin yung intro.🤭
#GaziniGanados #AhtisaManalo #MichelleDee #MJLastimosa
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Neuro Terminology Made Easy ✨
How are the movements different?
1. SEIZURE
Abnormal, excessive electrical activity in the brain.
• Clue: Convulsions, staring spells, or altered awareness.
• Remember: Not every seizure causes shaking.
2. MYOCLONUS
Sudden, brief, shock-like muscle jerks.
• Clue: A quick jerk of the arms or legs.
• Example: Myoclonic jerks in Creutzfeldt-Jakob disease.
3. TREMOR
Rhythmic, involuntary back-and-forth movement.
• Clue: Shaking at rest or during movement.
• Example: Resting tremor in Parkinson disease.
4. TREMULOUS
Describes a person or body part that is trembling or shaky.
• Clue: Shaky hands during alcohol withdrawal or anxiety.
• Remember: It describes an appearance, not a specific neurologic diagnosis.
5. FASCICULATIONS
Brief, involuntary twitches of individual muscle fibers.
• Clue: Visible muscle twitching beneath the skin.
• Example: Lower motor neuron disorders, such as ALS.
6. ATAXIA
Impaired coordination of voluntary movements.
• Clue: Unsteady gait or difficulty with the finger-to-nose test.
• Example: Cerebellar dysfunction.
USMLE MEMORY TRICK
Seizure = Abnormal brain electrical activity
Myoclonus = Sudden jerk
Tremor = Rhythmic shaking
Tremulous = Shaky appearance
Fasciculations = Small muscle twitches
Ataxia = Poor coordination
✨
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Ako ito!! Our Feminist Diva Aussie Kween Dawn Chang! She was so ahead of her time!
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✨Antiplatelets vs Anticoagulants
Both prevent thrombosis, but they hit different steps of clot formation.
ANTIPLATELETS
Target: Platelet activation and aggregation
Examples: Aspirin (irreversible COX-1 inhibitor → ↓TXA2), clopidogrel (P2Y12 ADP receptor blocker)
Classic uses: ACS, coronary stents, secondary prevention of noncardioembolic ischemic stroke
ANTICOAGULANTS
Target: Coagulation factors → ↓ fibrin formation
Examples: Heparin (activates antithrombin), warfarin (vitamin K antagonist → ↓ II, VII, IX, X), apixaban (factor Xa inhibitor)
Classic uses: DVT, PE, stroke prevention in AFib
USMLE MEMORY TRICK
Platelet-rich “white” arterial clot → antiplatelets
Fibrin-rich “red” venous clot → anticoagulants
HIGH-YIELD EXTRAS
Heparin → monitor aPTT, reverse with protamine
Warfarin → monitor PT/INR, reverse with vitamin K + PCC
Key distinction: This is a pattern, not an absolute rule. Treatment depends on the cause of thrombosis and the clinical indication.✨
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KUNG IGNORANTE PALA KAMI, PWES SAGUTIN N'YO NA LANG ITO. TOTAL, MATATALINO KAYO.
Sa mga miyembro ng Kongreso, ito ang mga tanong mula sa mga red flags na inilabas ng People's Budget Coalition at BetterGov.PH tungkol sa proposed 2027 national budget:
1. ₱199 BILLION SA BUDGET CHANGES. Bakit lumobo ang House reallocations mula sa unang inanunsyong ₱116 billion tungong halos ₱199 billion? Sino ang nagpanukala ng mga karagdagang pagbabago, at nasaan ang kumpletong dokumentasyon?
2. ₱190 BILLION SA HALOS 7,000 BAGONG PROYEKTO. Bakit walang publicly available supporting attachments ang libo-libong House-added infrastructure projects? Paano napatunayang kailangan, feasible, at properly costed ang mga ito?
3. MGA KALSADA SA DAGAT? Bakit may farm-to-market roads na ang coordinates ay lumilitaw sa Celebes Sea at Philippine Rise, at mga gusaling lumilitaw sa Algeria at Nigeria? Kung clerical errors lang, nasaan ang validated locations at corrected project documents?
4. ₱72 BILLION SA DAGDAG NA INFRASTRUCTURE. Bakit nadagdagan ng ₱42.7 billion ang multipurpose buildings at ₱29.2 billion ang access roads? Ano ang pamantayan sa pagpili at sino ang nagpanukala ng mga ito?
5. BILYON-BILYONG BAWAS SA HEALTHCARE. Bakit binawasan ng ₱4.9 billion ang immunization at family health commodities at ₱4.5 billion ang Health Facilities Enhancement Program, habang dinagdagan ng ₱24 billion ang MAIFIP? Bakit mas pinapalakas ang medical assistance kaysa sa pag-iwas sa sakit at pagpapahusay ng mga ospital?
6. AYUDA O POLITICAL PATRONAGE? Bakit tinaasan ang MAIFIP mula ₱24.2 billion tungong ₱48.2 billion at dinagdagan ng ₱24.8 billion ang AICS? Anong safeguards ang magtitiyak na hindi nakadepende sa political referrals ang pagtanggap ng tulong?
7. BAWAS SA TRANSPORTASYON AT DISASTER PREPAREDNESS. Bakit may malaking reductions sa Metro Manila Subway, North-South Commuter Railway, calamity funding, at flood management? Ano ang epekto nito sa commuters, project timelines, at disaster preparedness?
8. MULA ₱414 MILLION TUNGONG ₱4.8 BILLION? Bakit ganoon kalaki ang itinaas ng allocation sa Ilocos Norte 1st District Engineering Office? Ano ang objective criteria sa pamamahagi ng infrastructure funds sa bawat distrito?
9. ₱112 BILLION SA UNPROGRAMMED APPROPRIATIONS. Anong legal at transparency safeguards ang inilagay matapos ang mga naging constitutional issues sa nakaraang national budgets?
Mga kongresista, hindi namin sinasabing lahat ng red flags ay korapsyon. Pero hindi rin kailangang may criminal conviction muna bago magkaroon ng karapatan ang taumbayang magtanong.
At huwag ninyong sabihing taga-review lang ang Kongreso. Sa Article VI ng Konstitusyon, may kapangyarihan kayong amyendahan at ipasa ang appropriations bill, alinsunod sa constitutional limits. Hindi kayo simpleng tagabasa ng budget na ipinasa ng Executive.
Pagod na ang mga Pilipinong magbayad ng buwis habang naghihintay ng disenteng ospital, paaralan, kalsada, at serbisyong pampubliko.
Hindi namin kailangan ng panibagong lecture tungkol sa budget process. Kailangan namin ng dokumento, paliwanag, at pananagutan.
Kung mali ang findings ng People's Budget Coalition at BetterGovPH, ilabas ang ebidensiya at itama ang mga ito.
Hindi ignorance ang paghingi ng resibo. At hindi kailangang maging eksperto sa public finance para maging karapat-dapat sa tapat na gobyerno.
Pera namin iyan. Karapatan naming magtanong. Trabaho ninyong sumagot.
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هذه الوضعية هي الوضع الجانبي الأيسر (Left Lateral Decubitus Position) ويستخدمها الطبيب للأسباب التالية:
● فحص قمة القلب (Apex) بدقة وسماع الأصوات القلبية منخفضة التردد.
ايش يريد يسمع بالضبط؟
⓵فترات الامتلاء أو الأصوات الإضافية: مثل الصوت الرابع (S4) والصوت الثالث (S3).
②نفخات الصمام المترالي (Mitral Stenosis Murmurs): مثل النفخة الانبساطية الوسطى أو المتأخرة مع "Mid-diastolic murmur" و"Opening snap".
●ليش حطه كذا؟ لأن هذه الوضعية تقرب قمة القلب من جدار الصدر الأمامي، وتجعل الصوت يتركز بشكل أفضل وتمنح الطبيب فرصة لسماعه بوضوح باستخدام السماعة (Bell).
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Acute pancreatitis causes hypocalcemia due to fat saponification.
Pancreatic lipase breaks down peripancreatic fat into free fatty acids.
These fatty acids bind calcium, forming insoluble calcium soaps (saponification).
Calcium gets deposited in areas of fat necrosis, reducing serum calcium levels.
Hypocalcemia in acute pancreatitis is associated with severe disease and is a poor prognostic indicator (Ranson's criteria).
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I LIVE FOR OUR RETOKE QUEEN!!!! HAYUPCCA MARENG BELA 😭✋ #PBBCollab3UnangUmaga
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The difference between Normal Saline (0.9% NaCl) and Ringer’s Lactate:
Normal Saline
• Contains sodium and chloride.
• Used for fluid replacement.
• Commonly used with dehydration and fluid loss.
• Large volumes may cause hyperchloremic metabolic acidosis.
Ringer’s Lactate 👇
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Correct Answer: A) Rheumatoid Arthritis
Explanation:
Methotrexate is a conventional synthetic disease-modifying antirheumatic drug (csDMARD) commonly used as a first-line treatment for rheumatoid arthritis.
It inhibits folate-dependent pathways and reduces inflammation and immune activity, helping control disease activity and prevent joint damage.
Folic acid is prescribed alongside methotrexate to reduce adverse effects, particularly gastrointestinal symptoms, mouth ulcers, and liver enzyme elevations.
Clinical Pearl: Methotrexate for rheumatoid arthritis is administered once weekly, not daily. Accidental daily administration can cause severe, potentially fatal toxicity.
Important: The folic acid dose and schedule vary according to the treatment protocol. Patients should follow their prescribed regimen and undergo appropriate monitoring, including complete blood count, liver function, and renal function.
