bronchial asthma

patient said he is asthmatic

complain of chest allergy
dyspnea and chest wheeze

examination
bilateral diffuse sibilant ronchi

bronchial asthma
250



cardiac patient
ventolin








2






vomiting

cortigen B6 ampoule
**************************************************
*******************
)80 (60

500

effortil 10

urine retention
sudden decomprition of
bladder wall haematuria
**************************************************
***************************************
)(epistaxis

 nasal pack pressure

)(full flexed to avoid aspiration
haemostatic hemostop
local
:
Ruta-C tablets 1X3
hemostop tablets 1X3


epinefrine

c

:
-1

-2 dressing
-3 10 ) (
-4 )
(


.....
) (

 ....



* 6
* *

hepatic coma
250 % 5



) 5 + 2
(

**************************************
gastritis
heart pain
nausea

250





zantac 150 or 300 mg tab
mucogel susp

proton pump inhibitor omez or omepack or losec

hypertension
more than 140/90


3


cerebral oedema capoten 25 mg

25
220 120
90 25
sudden myocardial
infaraction .
hypertension
urgency hypertension emergency

 hypertension urgency 130

end organ damage by oral
capoten .
hypertension emergency
130 end organ damage renal impairment papiloedema


hypertension emergency
intravenous

macburny point
tender rigidity
cross tenerness

rebound tenderness also
cough tenderness


%25

 analgisic not mask the

diagnosic

11

history

analgisic acute abdomen

gastritis hcl
renal colic
.1 diuresis

.2 analgesic adolor
amp tramadol or tramal amp
appendix
.3 aminophylline
) smooth muscle relaxant
(
.4
canula ) (
. 5 ca diastole


crystals or pus or other
crystals

 urate
uroslolvin eff

zyloric 100 mg up to 900 mg tab
oxalate
epimag eff



phoshate
vitacid c tab
pus

5 30 uvamine retard cap
30 50 ciprofar
50


organophospherous poisoning

nausea vomiting dizzness
hypersalivation

pin pointpupil bradycardia and hypotension


16 60

15
pupil fully dilated or pulse reaches 120


500
clear
300

spasmdigestin tab
gastrofit

organophospherous poisoning
pin point pupil bradycardiia hypotension
secretion
salvitation sweeting diarrhea
secretion

) (

 electrolytes
)(hypekalemia
3.5 5
asystole

100 10

direct iv
Acidosis
ph HCO3 deficit
100 %25 5 10
IVI Intracelluar shift of K ion



beta agonist
tachycardia cardiac

-1

-2
-3 ACEI
Beta blockers spironolactone
-4
Acidosis -5
renal tubular acidosis type 4 -6
-7

-8
hemolysis ]"[rhabdomyolysis[COLOR="Silver

HOW TO MANAGE ACASE OF HEMATURIA

Diagnosis
passage of clots or heavy dark coloured urine
N.B passage of smoky coloured urine ( cocacola colored ) is
diagnostic of
acute glomerulonephritis (not a urological case
mangement
check vital signs ( BL.PR. Resp.rate pulse temp
hemostatics
cyclokapron amp IV
dicynone amp IV
vit k amp IM
CBC is mandatory
bladder wash
insert nelaton 20 (size is 20 ch.) and with the use of 50
cc syringe inject 100 cc saline in the catheter then
aspirate u will aspirate clotted blood
repeat injection ,, aspiration till the urine becomes clear
clear means normal color of urine
if the bleeding not stopped u must referr the patient
immediatly for cystoscopy
IF THE BLEEDING STOPS
KUB for stones ,,,,US for renal mass
outpatient clinic
medications
diosed c tab t.d.s

Case of wheezy chest in a child

DD
BA
Bronchitis with spasm
Bronchpneumonia with spasm
Final diagnosis can be setteled after management of spasm
management
line 1: nebulizer setting
0.5ml salbutamol solution for inhalation + 0.5ml atrovent +
1.5ml normal saline
can be repeated upto 3 times with 20 min interval between each
other
line 2: hydrocortisone (solucortef) iv
10mg/kg/dose or 2ml/10kg body weight
then wait for 30 min
line 3: if wheezes still present........ aminophylline infusion
1ml (diluted) aminophylline/5kg body weight in 30ml G5% over
20 min
in severe cases fortecortine (half amp) can be added
if the case is very severe i.e no air entry, proceed to aggressive
line directly e.g nebulizer setting + solucortef
NB: fever should be treated before management of wheezes