Possible Future Cancer treatment for Breast, Prostate and Pancreatic Cancers

An FDA-approved drug normally used to treat diabetes could control the growth of certain cancers, according to a new study.

What Drug is it?

It's ' METFORMIN'. Yes, Metformin..

Metformin targets the liver to lower blood glucose in type 2 diabetes patients. 

But now in an unprecedented finding, scientists at Massachusetts General Hospital have found that same process has an anti-cancer effect. 

Specifically, tests have shown the drug targets cells' mitochondria (the 'battery' of the cell) in a way that restricts the growth of *breast, pancreas and prostate cancer* .

The somewhat accidental discovery about a drug for a different disease could be groundbreaking for cancer control and treatment. 

We hope for the better Future..

Pastest MRCP Part 1 2016

Pastest for MRCP Part 1 2016

  Download Links 

media4up

Google Drive

Hope it Helps

Onexamination 2016 for MRCP Part1

Onexamination 2016 for MRCP Part1

Download Links

Mediafire

Media4up

Media1fire

Hope it helps, Remember in prayers.

Easy Steps to Use MUMARIS System SCFHS

Easy Steps to Use MUMARIS System SCFHS

Follow these steps to complete your MUMARIS Account:

Information needed for the registration: Saudi Council ID; Iqama Number; Passport information, email, Address

Website: www.scfhs.org.sa/en/eservices/momares using the browser GOOGLE CHROME OR FIREFOX

CLICK MUMARIS

CLICK PRACTITIONERS

UPDATE INFORMATION SERVICE

WATCH VIDEO (OPTIONAL)

GO TO ACCESS MUMARIS C

MUMARIS ACCOUNT REGISTRATION

PAGE → PROVIDER NEW ACCOUNT

CREATE YOUR MUMARIS ACCOUNT

CONFIRMING YOUR PERSONAL INFORMATION

Within 2 weeks you will receive an email to confirm registration then you can access your account and use MUMARIS services. If you apply for a new card or renewal of your current card, you need to complete the whole application till you reach “Finish” icon. You will receive a notification if your application is complete or missing any document. However, if all documents were sent completely, then you will be asked to pay the fees and at later stage you will receive your card.

MRCP part 2 written study materials

MRCP part 2 written materials

Get through MRCP Part 2 : RadiologyDownload Link

-----------------------

On Exam Part II Notes

• Download Link

--------------------------

MasterClass Part II Notes 

• Download Link

------------------
Sanjay Sharma

Download here

-------------------- MRCP part2 : Best of 5 clinical Guides

download here

----------------------------------
My First MRCP BOOK

download here

----------------------------------

MRCP Question By Dr.Azmy Shebl

Download here

----------------------------------

ECG for MRCP

Download here

----------------------

Www somalidoc com ecg for mrcp teaching notes and best of fives with ecg pictures 2ed pdf

Download here

PACES station 3

Cardiovascular System: Murmurs

PACES station 3 CVS (systolic murmur)

1-Systolic murmur in the aortic area
(a) Aortic stenosis: low volume pulse/difficult to feel, radiation to carotid (check both side)
(b) Aortic sclerosis: normal pulse volume, no carotid radiation (say mild AS and flow murmur as your differentials)
(c) HOCM: associated MR may be present (dynamic auscultation)
(d) Flow murmur: associated aortic valve replacement (AVR)

2-Systolic murmur in pulmonary area
(a) ASD: thrill, pulmonary hypertension, fixed splitting of S2, atrial fibrillation
(b) Pulmonary stenosis (PS): thrill, rare
(c) Pulmonary flow murmur: associated cyanosis, clubbing & polycythemia in Tetralogy of Fallot (TOF)
(d) HOCM: associated MR may be present (dynamic auscultation)

3-Systolic murmur in tricuspid/lower left sternal area
(a) VSD: younger age, pulmonary hypertension
(b) Tricuspid regurgitation: secondary to MS/pulmonary HTN, Ebstein anomaly (cyanosis, clubbing), pulsatile liver or epigastrium
(c) Mitral regurgitation: axilla radiation, apical thrill, more prominent in apex, atrial fibrillation

4-Systolic murmur in apical area
(a) MR including mitral valve prolapse (MVP) and HOCM
(b) TR
(c) VSD
(d) AS (radiation, also present in aortic area with carotid radiation)

Nephrology for MRCP written

Nephrology for MRCP written

1-Hydration versus N-acetylcysteine in contrast nephrotoxicity

2-Renal biopsy in childhood nephrotic syndrome versus adult-onset nephrotic syndrome

3-Transabdominal renal biopsy versus transjugular renal biopsy

4-Glomerular haematuria versus lower urinary tract haematuria

5-Haematuria versus myoglobinuria

6-Thin GBM disease versus Alport’s syndrome

7-Microalbuminuria

8-Cystitis versus pyelonephritis

9-Nitrofurantoin in UTI

10-Micturating cystourethrogram versus DMSA isotope renogram in VUR (reflux nephropathy)

11-Acute kidney injury (AKI) versus chronic kidney disease (CKD)

12-Pre-renal azotemia versus acute tubular necrosis (ATN)

13-Seven steps of CKD management

14-Role of ACE inhibitors in CKD

15-Role of calcium carbonate in CKD

16-Hyperparathyroid bone disease versus adynamic bone disease in CKD

17-Cinacalcet

18-Erythropoietin deficiency versus iron deficiency anemia in CKD

19-Side effects of erythropoietin therapy

20-Monitoring during erythropoietin therapy

Common Question appearing in SLE Exam- Saudi Licensing Exam

Here are the Common Question appearing in SLE Exam- Saudi Licensing Exam

Thanks to Dr. SOSo for sharing this qbank with us

This licensing exam is necessary for all doctors who want to practice medicine as a general practitioner or as a specialist in Saudi Arabia. The exams are different for different specialities and for general practice.

One can appear in this exam anywhere in the world, while for appearing in saudi arabia you need an eligibility number.

The exam is SINGLE BEST TYPE MCQs. and as the questions are repeated so it is better to take a look at past papers of SLE.


This QBANK CAN BE READ HERE

Saudi License Exam for General Dentist-Updated

Today I am sharing important q bank for General Dentist Exam for SCHS- Saudi Licensing Exam

Hope it helps. Remember in prayers

We present here  'A Comprehensive Review for Saudi Licence Exam for General Dentist'

Saudi Licensing Exam (SLE) for Dentist is a ‘Saudi Commission for Health Specialties’ (SCHS) exam forDental speciality.

This licensing exam is necessary for all dentists who want to practice dentistry as a general practitioner inSaudi Arabia. The exams are different for different specialities and for general practice.

It can either be taken inside Saudi Arabia (where you need an eligibility number from the SaudiCommission for Health Specialties, which is a hassle) or in several countries of the world (where noeligibility requirement applies, which is great).

The quickest and easiest way to make yourregistration on-line.

This exam counts when you apply for jobs in Saudi Arabia. An organization calledPrometricarranges thisexam inside as well as outside of Saudi Arabia.

Passing this exam is one of the requirements for license to work in Kingdom of Saudi Arabia. Moreover, Iyou pass the test, you did not get practice license, it just means that you have reached the standard asrequired by the SCFHS to practice in your chosen speciality

Result of examination is valid for three years.

You have to answer 70 MCQs and the time is 2 hours

Passing Score is 60 %

Thanks to Dr Younis for sharing his book with us..

This book can be read HERE

Jobs for dental nurse at CANADIAN SPECIALIST HOSPITAL

Jobs for dental nurse at CANADIAN SPECIALIST HOSPITAL

Completion of a formal program of professional nursing education and current licensure as a professional registered nurse.

Experience
Two years clinical nursing experience following licensure/registration in the country of origin with DHA license to practice Dubai, U.A.E.

No of Positions
1

Closing Date
31 December 2016
These responsibilities include placement and removal of the rubber dam, placement of temporary dressings, taking alginate impressions for study models, removal of surgical sutures, and removal of excess cement following crown and/or bridge cementation.

The clinical functions performed include;

preparing and dismissing patients;

point of use cleaning of instrumentation and disinfecting equipment;

providing post-operative instructions prescribed by the dentist;

maintaining supply order;

maintaining applicable records, and others as requested by the dentist.

Participates with the dentist in the examination and treatment of patients by retracting cheeks and tissues and by irrigating and aspirating mouth fluids without harm or discomfort to the patient.

Anticipates the dentist’s needs and practices four-handed dentistry to provide efficient operative procedures for the patient or as assigned to a dental surgical operating team.

Performs expanded duty procedures under the supervision of the dentist as required.


TO APPLY TO THIS JOB

CLICK HERE

Family Medicine Consultant jobs in Riyadh & Qassim, Saudi Arabia

Family Medicine Consultant jobs in Riyadh & Qassim, Saudi Arabia

The Medical Group is One of the largest providers of comprehensive healthcare services in the Middle East. Currently operating 9 Medical Facilities including General Hospitals, Specialized Hospitals and Medical Centers. The Hospitals are JCIA & ISO Accredited. The Medical Group is proud to have 900+ doctors, 2800+ nurses. Highly Attractive 2 Year Family or Single contract packages available for international candidates. Benefits such as Free Fully furnished accommodation, Free Flight tickets, educational allowance for children, medical insurance etc. If you feel your qualifications, skills and experience is a good match for this position we encourage you to contact us using the +APPLY BUTTON (on your right). Not suitable for you? Why not pass this position on to a friend or colleague? Note: Global Medical Recruiting will not charge you, the applicant any placement fees.

To APPLY THIS JOB CLICK HERE

MRCP PACES COURSE Preparation

PACES COURSE preparation

Download MRCP Past test part 1 2016

Download past test Free download part 1

Latest 2016 @ The Online Medicals FOAMed#


Follow the link

HIGHEST Yield Pearls for MRCP 1 2 & PACES

HIGHEST Yield Pearls for MRCP 1 2 & PACES

1) Hepatitis "D" Virus has HIGHEST mortality in ALL people EXCEPT#Pregnancy.
In Pregnant women: MOST LETHAL is Hepatitis E virus.
2) "While calculating Serum Osmolality the serum Na is multiplied by 2 to account for the accompanying ANIONS (mostly Cl- & HCO3-)."
3) Most Common cause of Metastasis to LIVER is primary cancers of Lung.
LLLLLungs send metastasis to LLLLLLiver.
4) Ketamine is the ONLY induction agent that causes Bronchodilation.
Again:
Ketamine is the ONLY induction agent that causes Bronchodilation.
5) AANNencephaly: failure of AANNterior neuropore to close.(at day 25)
SSSpinda bifida: failure of poSSSterior neuropore to close.(at day 27)
6) Muscle Spindles: Innervated by 1a fibers - cause skeletal muscle to CONTRACT.
GTOs: innervated by 1b - cause contracting muscle to RELAX
7) In SSSpontaneous pneumothorax: trachea shifts to ipSSSilateral side.
In TTTension pneumothorax: trachea deviates to conTTTralateral side.
8) Antibiotics SAFE in pregnancy:
All Penicillins.
All Cephalosporins.
All Carbapenems.
Aztreonam.
Azithromycin.
Nitrofurantoin (Avoid in last trimester bcoz can cause hemolysis in G6PD deficient fetus).
Metronidazole (SAFE in ALL trimesters).

Free Exam Resources for doctors

Following are free resources for exam Practice
Specefically MRCP, PLAB, MRCGP and clinical revision

MRCPass

• Notes on topics covered in MRCP Part 1
• 130 MCQ questions
• Bookmark questions
• Choose questions by topic
• Track statistics
• Look back over wrong answers

Revise MRCP

• Covers MRCP Parts 1 and 2
• Over 5,000 MCQs arranged by topic
• Free to sign up
• Past papers going back to September 2010

Medexam.net 

• Over 1,800 MCQs with detailed answers

The Only MRCP Notes you will ever need 5th Edition: 2015 Edition

The Only MRCP Notes you will ever need 5th Edition

This is a solid book for consolidating your knowledge before the exam, Most of the data is updated than the 4th edition, But still few topics you should see through Passmedicine.com like ACS, STROKE, ARRHYTHMIA management. 

Also latest Treatment for diabetes according to NICE December 2015 guidelines 

Terminology of Acid-Base Disorders

Definitions

The definitions of the terms used here to describe acid-base disorders are those suggested by the Ad-Hoc Committee of the New York Academy of Sciences in 1965. Though this is over 35 years ago, the definitions and discussion remain valid today.

Basic Definitions

• Acidosis - an abnormal process or condition which would lower arterial pH if there were no secondary changes in response to the primary aetiological factor.
• Alkalosis - an abnormal process or condition which would raise arterial pH if there were no secondary changes in response to the primary aetiological factor.
• Simple (Acid-Base) Disorders ¹ are those in which there is a single primary aetiological acid-base disorder.
• Mixed (acid-Base) Disorders ^2,3 are those in which two or more primary aetiological disorders are present simultaneously.
• Acidaemia - Arterial pH < 7.36 (ie [H⁺] > 44 nM )
• Alkalaemia - Arterial pH > 7.44 (ie [H⁺] < 36 nM )

Regulation of Intracellular Hydrogen Ion Concentration

Importance of Intracellular [H⁺]

The most important [H⁺] for the body is the intracellular [H⁺]

Why? Because of its profound effects on metabolism and other cell processes which occur due to the effects of [H⁺] on the degree of ionisation of intracellular compounds. Specifically:

• Small molecule effect: Intracellular trapping function -due to the ionisation of metabolic intermediates.
• Large molecule effect: Effects on protein function: The function of many intracellular proteins (esp the activities of enzymes) is altered by effects on the ionisation of amino acid residues (esp histidine residues)

Renal Regulation of Acid-Base Balance

The organs involved in regulation of external acid-base balance are the lungs are the kidneys.

The lungs are important for excretion of carbon dioxide (the respiratory acid) and there is a huge amount of this to be excreted: at least 12,000 to 13,000 mmols/day.

In contrast the kidneys are responsible for excretion of the fixed acids and this is also a critical role even though the amounts involved (70-100 mmols/day) are much smaller. The main reason for this renal importance is because there is no other way to excrete these acids and it should be appreciated that the amounts involved are still very large when compared to the plasma [H⁺] of only 40 nanomoles/litre.

There is a second extremely important role that the kidneys play in acid-base balance, namely the reabsorption of the filtered bicarbonate. Bicarbonate is the predominant extracellular buffer against the fixed acids and it important that its plasma concentration should be defended against renal loss.

In acid-base balance, the kidney is responsible for 2 major activities:

• Reabsorption of filtered bicarbonate: 4,000 to 5,000 mmol/day
• Excretion of the fixed acids (acid anion and associated H⁺): about 1 mmol/kg/day.

Both these processes involve secretion of H⁺ into the lumen by the renal tubule cells but only the second leads to excretion of H⁺ from the body.

The renal mechanisms involved in acid-base balance can be difficult to understand so as a simplification we will consider the processes occurring in the kidney as involving 2 aspects:

• Proximal tubular mechanism
• Distal tubular mechanism

Respiratory Regulation of Acid-Base Balance: Acid Base Learner Series

How is the Respiratory System Linked to Acid-base Changes?

‘Respiratory regulation’ refers to changes in pH due to pCO2 changes from alterations in ventilation. This change in ventilation can occur rapidly with significant effects on pH. Carbon dioxide is lipid soluble and crosses cell membranes rapidly, so changes in pCO2 result in rapid changes in [H+] in all body fluid compartments.

A quantitative appreciation of respiratory regulation requires knowledge of two relationships which provide the connection between alveolar ventilation and pH via pCO₂. These 2 relationships are:

• First equation - relates alveolar ventilation (V_A) and pCO₂
• Second equation - relates pCO₂ and pH.

Acid Base Learner Series: Buffers

Definition of a Buffer

A buffer is a solution containing substances which have the ability to minimise changes in pH when an acid or base is added to it ¹.

A buffer typically consists of a solution which contains a weak acid HA mixed with the salt of that acid & a strong base eg NaA. The principle is that the salt provides a reservoir of A^- to replenish [A^-] when A^- is removed by reaction with H⁺.

Buffers in the Body

The body has a very large buffer capacity.

This can be illustrated by considering an old experiment (see below) where dilute hydrochloric acid was infused into a dog.

Acid Base Physiology: Acid Base Learner Series

Acid Base Physiology

Each day there is always a production of acid by the body’s metabolic processes and to maintain balance, these acids need to be excreted or metabolised. The various acids produced by the body are classified as respiratory (or volatile) acids and as metabolic (or fixed) acids. The body normally can respond very effectively to perturbations in acid or base production.

Respiratory Acid

The acid is more correctly carbonic acid (H₂CO₃) but the term 'respiratory acid' is usually used to mean carbon dioxide. But CO₂ itself is not an acid in the Bronsted-Lowry system as it does not contain a hydrogen so cannot be a proton donor. However CO₂ can instead be thought of as representing a potential to create an equivalent amount of carbonic acid. Carbon dioxide is the end-product of complete oxidation of carbohydrates and fatty acids. It is called a volatile acid meaning in this context it can be excreted via the lungs. Of necessity, considering the amounts involved there must be an efficient system to rapidly excrete CO₂.

The amount of CO₂ produced each day is huge compared to the amount of production of fixed acids. Basal CO₂production is typically quoted at 12,000 to 13,000 mmols/day.

Basal Carbon Dioxide Production Consider a resting adult with an oxygen consumption of 250 mls/min and a CO2 production of 200 mls/min (Respiratory quotient 0.8): Daily CO2 production = 0.2 x 60 x 24 litres/day divided by 22.4 litres/mole = 12,857 mmoles/day.

Increased levels of activity will increase oxygen consumption

Manchester Metropolitan Postgraduate Courses Fairs

Postgraduate Courses for 2016 entry At the event you will be able to attend subjects sessions, meet staff, pick up a prospectus and find out about postgraduate loans. The Faculty of Humanities, Languages and Social Science is also pleased to announce we will be offering sixteen scholarships to assist students with financing their Masters studies. Students applying for full or part-time study on any taught Masters Programmes in the Faculty are eligible for these scholarships which will pay 50% of the fees

Acid Base Learner Series: Respiratory Acidosis in detail

A respiratory acidosis is a primary acid-base disorder in which arterial pCO₂ rises to a level higher than expected.

At onset, the acidosis is designated as an 'acute respiratory acidosis'. The body's initial compensatory response is limited during this phase.
As the body's renal compensatory response increases over the next few days, the pH returns towards the normal value and the condition is now a 'chronic respiratory acidosis'.
The differentiation between acute and chronic
is determined by time but occurs because of the renal compensatory response (which is slow).

 Causes of Respiratory Acidosis:
The arterial pCO₂ is normally maintained at a level of about 40 mmHg by a balance between production of CO₂ by the body and its removal by alveolar ventilation. If the inspired gas contains no CO₂ then this relationship can be expressed by:

paCO₂ is proportional to V_CO2 / V_A

where:
V_CO2 is CO₂ production by the body
V_A is Alveolar ventilation

An increase in arterial pCO₂ can occur by one of three possible mechanisms:

• Presence of excess CO₂ in the inspired gas
• Decreased alveolar ventilation
• Increased production of CO₂ by the body

CO₂ gas can be added to the inspired gas or it may be present because of rebreathing : Anaesthetists are familiar with both these mechanisms. In these situations, hypercapnia can be induced even in the presence of normal alveolar ventilation and normal carbon dioxide production by the body.
An adult at rest produces about 200mls of CO₂ per minute

Acid Base Balance Series: What is the 'osmolar gap'?

NB: 'Osmolar gap' has several alternative names: 'osmol gap', 'osmole gap', 'osmolarity gap' & 'osmolal gap'; these all refer to the same thing. For consistency, the term "osmolar gap" is used exclusively through this book.

What is the 'osmolar gap'?

Definitions An osmole is the amount of a substance that yields, in ideal solution, that number of particles (Avogadro’s number) that would depress the freezing point of the solvent by 1.86K Osmolality of a solution is the number of osmoles of solute per kilogram of solvent. Osmolarity of a solution is the number of osmoles of solute per litre of solution.

So osmolality is a measure of the number of particles present in a unit weight of solvent. It is independent of the size, shape or weight of the particles. It can only be measured by use of a property of the solution that is dependent on the particle concentration. These properties are collectively referred to as Colligative Properties. Osmolality is measured in the laboratory by machines called osmometers. The units of osmolality are mOsm/kg of solute
Osmolarity is calculated from a formula which represents the solutes which under ordinary circumstances contribute nearly all of the osmolality of the sample. There are many such formulae which have been used. One widely used formula for plasma which is used at my hospital is:

Calculated osmolarity = (1.86 x [Na⁺]) + [glucose] + [urea] + 9

Note regarding units: For the above equation, all concentrations are in mmol/l, and not mg/100mls. The result will then be in mOsm/l of solution. This equation is often expressed differently in North America where glucose & blood urea nitrogen (BUN) are reported in

Acid Base Learner Series: The Urinary Anion Gap

The Urinary Anion Gap

The cations normally present in urine are Na⁺, K⁺, NH₄⁺, Ca⁺⁺ and Mg⁺⁺.
The anions normally present are Cl^-, HCO₃^-, sulphate, phosphate and some organic anions.
Only Na⁺, K⁺ and Cl^- are commonly measured in urine so the other charged species are the unmeasured anions (UA) and cations (UC).
Because of the requirement for macroscopic electroneutrality, total anion charge always equals total cation charge, so:

Cl- + UA = Na⁺ + K⁺ + UC

Rearranging:

Urinary Anion Gap = ( UA - UC ) = [Na⁺]+ [K⁺] - [Cl^-]

Clinical Use

Key Fact: The urinary anion gap can help to differentiate between GIT and renal causes of a hyperchloraemic metabolic acidosis.

It has been found experimentally that the Urinary Anion Gap (UAG) provides a rough index of urinary ammonium excretion. Ammonium is positively charged so a rise in its urinary concentration (ie increased unmeasured cations) will cause a fall in UAG

Acid Base Learner Series: The Delta Ratio

Definition

This Delta Ratio is sometimes useful in the assessment of metabolic acidosis. As this concept is related to the anion gap (AG) and buffering, it will be discussed here before a discussion of metabolic acidosis. The Delta Ratio is defined as:

Delta ratio = (Increase in Anion Gap / Decrease in bicarbonate)

Others have used the delta gap (defined as rise in AG minus the fall in bicarbonate), but this uses the same information as the delta ratio and has does not offer any advantage over it.

How is this useful?

In order to understand this, consider the following:
If one molecule of metabolic acid (HA) is added to the ECF and dissociates, the one H⁺ released will react with one molecule of HCO₃^- to produce CO₂ and H₂O. This is the process of buffering. The net effect will be an increase in unmeasured anions by the one acid anion A^- (ie anion gap increases by one) and a decrease in the bicarbonate by one.
Now, if all the acid dissociated in the ECF and all the buffering was by bicarbonate, then the increase in the AG should be equal to the decrease in bicarbonate so the

Acid Base Learner Series: The Anion Gap

The Anion Gap: A balance 

Definition & Clinical Use

The term anion gap (AG) represents the concentration of all the unmeasured anions in the plasma. The negatively charged proteins account for about 10% of plasma anions and make up the majority of the unmeasured anion represented by the anion gap under normal circumstances. The acid anions (eg lactate, acetoacetate, sulphate) produced during a metabolic acidosis are not measured as part of the usual laboratory biochemical profile. The H⁺ produced reacts with bicarbonate anions (buffering) and the CO₂ produced is excreted via the lungs (respiratory compensation). The net effect is a decrease in the concentration of measured anions (ie HCO₃) and an increase in the concentration of unmeasured anions (the acid anions) so the anion gap increases.
AG is calculated from the following formula:

Anion gap = [Na⁺] - [Cl^-] - [HCO₃^-]

Reference range is 8 to 16 mmol/l. An alternative formula which includes K⁺ is sometimes used particularly by Nephrologists. In Renal Units, K⁺ can vary over a wider range and have more effect on the measured Anion Gap. This alternative formula is:

AG = [Na⁺] + [K⁺] - [Cl^-] - [HCO₃^-]

The reference range is slightly higher with this

Acid base balance: A complete explanation for Students, postgraduate Physicians especially Anesthesia Students

Definitions

The definitions of the terms used here to describe acid-base disorders are those suggested by the Ad-Hoc Committee of the New York Academy of Sciences in 1965. Though this is over 35 years ago, the definitions and discussion remain valid today.

Basic Definitions

• Acidosis - an abnormal process or condition which would lower arterial pH if there were no secondary changes in response to the primary aetiological factor.
• Alkalosis - an abnormal process or condition which would raise arterial pH if there were no secondary changes in response to the primary aetiological factor.
• Simple (Acid-Base) Disorders  are those in which there is a single primary aetiological acid-base disorder.
• Mixed (acid-Base) Disorders are those in which two or more primary aetiological disorders are present simultaneously.
• Acidaemia - Arterial pH < 7.36 (ie [H⁺] > 44 nM )
• Alkalaemia - Arterial pH > 7.44 (ie [H⁺] < 36 nM )

An acidaemia of course must be due to an acidosis so is an indicator of the presence of this disorder. In mixed acid-base disorders, there may be co-existing disorders each having opposite effects on the ECF pH so a quick check of the arterial pH is insufficient to fully indicate all primary acid-base disorders. In mixed disorders, it does indicate in general terms the most severe disorder. That is, if the arterial pH is 7.2 (an acidaemia), there must be an acidosis present, and any alkalosis present must be of lesser magnitude. (This idea is the basis of an initial step in the systematic approach to analysis of arterial blood gas results).

The Disorders

The 4 simple acid base disorders are:

• Respiratory acidosis
• Respiratory alkalosis
• Metabolic acidosis
• Metabolic alkalosis.

Respiratory disorders are caused by abnormal processes which tend to alter pH because of a primary change in pCO₂ levels.
Metabolic disorders are caused by abnormal processes which tend to alter pH because of a primary change in [HCO₃^-].

Correct Termin

First Aid USMLE collection

Download Usmle First Aid collection as FOAMed

1. First Aid for the USMLE Step 1 2016, 26e (51.7 MB) Download

2. First Aid for the USMLE Step 2 CK, 8e (31.56 MB) Download
3. First Aid for the USMLE Step 2 CS, 5e (2.81 MB) Download
4. First Aid for the USMLE Step 3, 3e (11.81 MB) Download
5. First Aid Cases for the USMLE Step 1, 3e (19.05 MB) Download
6. First Aid Cases for the USMLE Step 2 CK, 2e (5.16 MB) Download
7. First Aid Q&A for the USMLE Step 1, 3e (5.85 MB) Download
8. First Aid Q&A for the USMLE Step 2 CK, 2e (5.11 MB) Download
9. First Aid for the Basic Sciences Organ Systems, 2e (24.97 MB) Download
10. First Aid for the Basic Sciences, General Principles, 2e (29.99 MB) Download

credit: Sharer

#Foamed

Pediatrics Saudi Licensing exam Questions for practice

Pediatrics Saudi Licensing exam Questions

The correct answers -as I hope- is clear by (T) sign. When you notice any wrong answer, tell me with your reference or discussion, please, so we can update to help others.

1. Mother brought her 18 month old infant to ER with history of URTI for the last 2 days with mild respiratory distress. This evening the infant start to have hard barking cough with respiratory distress. O/E: T 38C, RR 40/min, associated with nasal flaring, suprasternal & intercostal recessions. Auscultation to the chest shows equal air entry bilaterally, prolonged expiratory phase, and crackles. What is the most likely diagnosis?
a. Viral Pneumonia
b. Bacterial Pneumonia
c. Bronchiolitis
d. Acute epiglottitis
e. Trachiobronchiolitis ( T )

2. A 3 years old child woke from sleep with croup, the differential diagnosis should include all except:
a. Pneumonia ( T )
b. Tonsillitis
c. Cystic fibrosis
d. Airway foreign body
e. bronchial asthma

3. Regarding treatment of CROUP, All are TRUE EXCEPT:
a. IV fluids
b. Humidified oxygen
c. Sedative ( T )
d. Racemic epinephrine
e. Corticosteroid

4. An 8 months infant came complaining of croup, coryza, air trapping, tachy

Saudi Medical Selection Exam or Saudi Medical Licensing Exam

Saudi Medical Selection Exam
(Previously called Saudi Licensing exam or Selection exam)

* Saudi Medical Selection Exam (SMSE) previously known as Saudi License Exam (SLE): is intended for
medical college graduates who wish to join postgraduate education i.e. Saudi Board Programs.
* You can enter this exam three times in each Gregorian year.
* You have the choice to choose the exam center and date.

* This exam is an electronic multiple choice questions exam which consists 100 MCQs as following