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1-Heart

2-Blood Vessels
Predisposing risk factors of atherosclerosis :
3H 3S DEAD
3H :
H yperlipidemia
H ypertension
H eredity
3S :
S moking
S yphilitic aortitis
S ex
DEAD :
D iabetes
E ddy currents
A ge
D iet
*.*
Types of true aneurysm:
1-A-Atherosclerotic aneurysm (in Abdominal Aorta)
2-B-Berry aneurysm (at Bifurcation of Brain (cerebral) arteries &rupture leads to BLEEDING
3-B-Bilharzial (pulmonary) aneurysm
4-Syphilitic aneurysm (Saccular aneurysm of (thoracic ) aorta
5-D-Dissecting aneurysm
6) Mycotic aneurysm ( no:6 and has 6 s)
-Small aneyrsm
-affect Small artery
-cerebral &Coronary
-in Subacute infective endocarditis
-Complications:Thrombosis & Ischaemia
3-Respiratory
NBs
*#Hypertrophic chronic rhinitis>>>no end arteritis oblitrans

#Atrophic chronic rhinitis>>>End arteritis oblitrans>>common in


females(estrogen dep.)

#klebsiella ozanae>>>atrophic rhinitis


klebsiella rhinoscleromata>>>rhinoscleroma

#Mode of infection in tonsilitis>>ingestion and inhalation

#No broncheictasis in large(excess cartilage) or small bronchi(excess muscle)

#Complications of chronic
bronchitis>>>asthma...emphysema...spread(pneumonia)

#alpha 1 antitrypsin deficiency patient>>>ephysema and chirrhosis

#Take care>>lobar pneumonia # lobular(bronchopneumonia)

#Lobar pneumonia>>>Carnification

#Pulmonary oedema: Accumlation of fluid in interstitial and interalveolar spaces

*Important names:

-Mikulicz cells and Russel bodies>>>Rhinoscleroma


-Zenker's degeneration>>complication of dipheria
-Ebstein-Barr virus>>>Nasopharyngeal carcinoma
-Kartegener's syndrome>>Broncheictasis(congenital)
-Curschmann's spirals>>>Shed epithilium in Asthma

*.*

P.F of bronchial Carcinoma


BIG 5S
1-bronchectasis
2-irradiation
3-Gentic defect
4-SMOKING (IMP FACTOR)
5-smoker Air
6-scliosis
7-Scaring lung
8-substance (Nickel&Arsenic)

*.*

squamous cell papilloma of larynx


in children: ‫كان في أطفال كتير زي العفاريت قاعدين يلعبوا جوة و برة البيت و كل ما حد يمشيهم يرجعوا تاني‬
multiple ‫كتير‬
malignant change ‫زي العفاريت‬
in and outside vocal cords ‫بيلعبوا جوة و برة‬
recurrence after excision is common ‫كل ما حد يمشيهم يرجعوا تاني‬
in adults : ‫عكس اللي فوق بالظبط‬

*.*

**************************** NASOPHARYNGEAL
CARCINOMA***********************
..... Remember it's 2 Syllables .. Naso.....pharyngeal ...so RAKAM EL SA3D (2)
#2 WORDS : naso - pharyngeal
#2 AGE GROUPS : Young (15-25) & Old (60-70)
#2 Scientists discovered A VIRUS causing it : Ebstien & Barr >> (EBV)
#2 MAIN PATTERNS : Squamous cell carcinoma & Undifferentiated
lymphoepithelioma
#2 MAIN FATES : either treatable by Radiotherapy (if undiff. Type) .... or Fatal
inoperable (if sq.c.c type)
Kollo kollo kollo 2 7atta el virus men kelmeteen
*.*

*Predisposing factors of Lung Abscess ::


‫خبى عشانا بول زعلنا‬
5B Pul SAD
(2 Bronch= Brochiectasis , Bronchial Obstruction , 3 Bacterial = Infection ,
Secondary infection , Pneumonia )
Pulmonary Actinomycosis
ٍٍSeptic Emboli
Aspiration
Direct Spread of Septic infection
43 ‫ص‬
*.*
*Predisposing Factors For Bronchiogenic Carcinoma:
BIL GATES
-Bronchiectasis
-Irradiation
-Lung Scarring
-Genetic factors
-Air Pollution
-Tobacco Smoking
-Exhaust Fumes Of Tar & Diesel
-Silicosis

*.*

*Granulomatous lung diseases

‫نجمعهم فى كلمة " بحب ست اس‬

PAHB ST S

P.....Pneumoconiosis
A.....Actinomycosis
H.....Histoplasmosis
B.....Bilharziasis

S......Srcoidosis
T.....Tuberculosis

S.....Syphilis

*.*
*

*.*

4-GIT
*NBs
# Leukoplakia is differentiated from sq.cell papilloma by absence of hyperplastic
basal cells

#Tuberculous ulcer of tongue>>>in tip>>mechanism of ‫تففه‬

#Lymphatic spread in sq.cell carcinoma of tongue due to motility and rich lymph
nodes
#Sq.cell carcinoma of lip>>in lower>>>due to gravity (irritants)

#Pleomorphic adenoma is only benign tumor with recurrence after surgical


incision

#take care: Mikulicz disease>>>Sialadinitis


But Mikuliczcells>>>>Rhinoscleroma

#Complication of chronic gastritis: fibrosis-pyloric obstr.-dysplasia

#Autoimmune gastritis causes:micro and macrocytic anemia

#No spread in ch. Gastritis bec. H.pylori cannot live outside intestine

#Blood grp O >>>Dudenal ulcer


#Bloodgrp A >>>gastric carcinoma

*Important names:

-Mikulicz disease: Sialadinitis


-Barrett's metaplasia: oesophagus (GERD)
-Plummer vinsion syndrome: oesophagus>>female>>carcinoma
-Menterier's disease: Hypertrophic gastropathy
-Zollinger-Ellison syndrome: gastrin s. Tumor>>duodenalulcer
-Krukenburg tumor: bilateral ovarian metastasis(transceolomic spread)
-Gardner'sand turcot's syndromes: Colonic polypi (Adenomas)
-Peutz-jegher syndrome:Hamartomatous tumor of colon

*.*
InTussesception :
Aetiology
‫ مايكل اكل وحش فطلع له‬Polyp ‫ وجه له‬Gas
Mechel's Diverticulum > ‫مايكل‬
Irritant Food> ‫اكل‬
Parasites> ‫وحش‬
Polyp or tumor
Gas troenteritis
85 ‫ص‬
*.*
Bleeding per Rectum ‫*ولد صغير من كتر ماهو كانا مزنوق جه له‬
XD ‫ عند تيتا‬XD ‫فبابااه قال له اعمل ببى‬
PP
‫عند‬
TITA
‫يعنى‬
Piles
Polyps
Tumors
Idiopathic
TB & Inflammation
Anal Fissure
91 ‫ص‬

*.*

*non neoplastic colonic polypi > ‫البلهارسيا كدابة بتقول انها كبيرة بس هي صغيرة‬
‫ بلهارسيا‬bilaharzial polyp
‫ كدابة‬pseudopolyp
‫ كبيرة‬hyperplastic polyp
‫ صغيرة‬juvenile polyp

*.*

*Aetiology of acute gastritis


‫(ناس قاعدين يضربوا فى كيميا‬NSIAD&Chemical irritation)
‫و‬cigarette
‫( ومعاهم المزه بتاعتهم‬spicy food )
‫حصلهم‬irritation
‫( قاموا عوروا بعض‬truma )
‫( فدخلوا فى‬sever stress .ischemia and shock)
‫ ونزود‬uremia &infection
p67
*.*

*aetiology of chronic gastritis.. IIIIIA

1-Infection.. with H.pylori


2-Irritants.. drugs,bile reflux,spicy food, smoking&spirits.
3-Immunologic(autoimmune)
4-Inflammation.. granulomatous(Crohn's disease)
5-Irradiation
6-Amyloidosis(‫ معرفتش اجبلها حاجه تبدأ ب‬i)
*.*

*TYPHOID FEVER
Pathology:
Intestinal lesions: SINUS
1st week >>> SI Swollen Intestine
2 nd week >>> N Necrotic mucosa
3 rd week >>> U Ulcer formation
4 th week >>> S Scar formation of healed ulcer
Complications:
intestinal >>> ulcer formation = ulcer complication stump
hemorrhage
perforation
extraintestinal >>> 3 systems
1 skeletal system -bone and joints-
2 circulatory system -heart and vessels-
3 nervous system
rest in a word - GTLK- ‫اهى طريقة سهلة "جتلك" لحد عندك‬
Gall bladder
Toxic lesion
Lungs
Kidneys
*.*

*p 66
Causes of oesophageal hematemesis
it may be a serious case then <<<MOVE to ICU >>>>>
M... Malignant
OV ... oesophageal varices
E ...Else:: Aortic aneurysm

I...Inflammation (esophagitis)
C ....Carcinoma
U...Ulcers

*.*

* Page 66 Heamatemesis
‫ هو معروف أنا ال‬Aetilogy ‫ مقسوم لربع حاجات كبار‬Esophageal ,, Gastric ,, Duodenal,, General causes
**‫ بالنسبة لل‬General ‫ معروف من‬Stamp ‫فيصل‬.‫د‬
**‫ حاجات لو جم هيعملوا‬3 ‫ التانين هما‬3 ‫ بالنسبة لل‬Heamatemesis :
Inflammation Or Ulcers Or Tumors
‫مثل‬:
1-Gastric causes :
Gastritis .. Ulcers ( acute / peptic)..Tumors
2-Duodenal causes:
Duodenitis ..Ulcers(acute/peptic)..Tumors
3-Esophageal causes:
Oesophagitis .. Oesophageal ulcers .. Tumors ( carcinoma of Oesophagus or mediastinal Tumors
infilterating Oesophagus..
‫ لكن بما أنا ده أهم سبب فهنزود عليه حاجتين‬Artery & Vein
Artery>> Aortic aneurysm
Vein>>Oesophageal Varices
*.*

*Atiology of acute gastritis 7S +2C+2 I


Smoking
spicy food
salmonelosis
severe stress
shock
strong alkalies
Cytotoxic drugs
Consumption of alcohl
Irradiation
Ischemia
*.*

*Chronic Gastritis Page 67


Aetiology ‫ متجمعة في كلمة سيارة‬Ciara
C: Chemical irritation ex acids
I: infections ( Specific>>Crohn's disease .. Non specific>>H.pylori)
A:Autoimmune disease
R:Radiation
A:Amyloidosis

*.*
Causes of Bleeding Per Rectum :-
FRESH RED Blood ‫بماا إنه‬
.:.
"‫"يا حبيبتى اشربى العصير داا فيه فيتاميناات‬
......
HAPIPTI + 2 Vitamins
H ypertension & Hemophilia
A nal fissure
P iles
I nflammation
P olyps
T umors
I diopathic
+
Vitamins C & K

*.*

Bleeding per rectum


General causes
Hbl w deficiency in 2 vitamins
Intestinal causes (2i +ATP )
I >inflammation
I>idiopathic
A>anal fissure
T> tumors
P >polyps and piles

*.*

*
: ‫ فالبوست ممكن يبقي طويل شوية‬GIT ‫ في ال‬mnemonics ‫حبة‬
:Ulcers of oral cavity-1
( ‫ "مداس" سوري علي الكلمة بس ملقتش غيرها‬T +MDAS) Common in Tongue
T:tuberculous
M:malignant
D:Dental
A:Aphthous
S:Syphilitic
site &gross ‫نصيحة لو عايزين تذاكرهم يبقي في جدول و تقارنوا ما بينهم في ال‬
‫( و‬common & multiple) ‫( و الشباب الطايش و دول كتير‬small) ‫ ديه بتاعة العيال الصغيرة‬Aphthous ‫بس ال‬
remain for ‫ و الكلمة اللي بيقولوها النهاردة يرجعوا فيها بكره‬unknown aetilogy ‫محدش بيبقي فاهملهم حال‬
short time & recurrence
.....painful ‫و مشاعرهم حساسة و بيتألموا بسرعة‬

:squamous cell carcinoma of tongue-2


2 ‫رقم السعد بتاعها‬
‫ بس هنزود حاجتين‬git ‫ بتوع ال‬s 5 ‫ و هنرص ال‬cancer ‫ زي اي‬:Aetilogy
Human papilloma virus ,, leukoplakia
:Pathology
‫ مفيهوش مشكلة‬Site
Gross 1-exophytic : fungating polypoid / papillary
endophytic: ulcerative / diffuse ingilterative growth -2
Microscopic 1-sq cell carcinoma
verrcous carcinoma-2
‫ عادي‬Spread
Prognosis 1-verrcous is the best
ant 2/3 is better than post 1/3 -2
.........

:sialadenitis-3
Sm ‫ يا‬VIP ‫الغدة ديه فيها ايه !! فيها حاجات‬
Virus : Mumps-1
Pus: acute suppurative parotitis-2
Stone: chronic calcular sialdenitis-3
Inclusions : cytomegalic inclusion disease-4
Mikuilcz cell: mikuilcz disease-5

*.*

*Carcinoma of Large Intestine


"‫ فبيتحسدوا من "قرايبهم" و"جيرانهم‬.. ‫بتاع الغنيا اللى بياكلوا لحمة كتيرة وسلطة قليل‬
Inc. Dietary fat
Dec. Fibers
Carcinoma ‫ بيبقى‬Dysplasia ‫ لنه لما بيحصل له‬Ulcerative colitis ‫قريبه ال‬
‫ واخواتها‬Adenoma ‫جيرانه اللى على طول جمبه فبيبقى ال‬
88 ‫ص‬
*.*

*Carcinoma of stomach
Predisposing factors :
5A
A> Autoimmune chronic gastritis
A> Adenomatous polyp
A> peptic Ulcer (pronounciation U=A)
A> Blood group A
A> ‫( أكل‬smoked food ,food with nitrites)

*.*

*Complication of dysentry (moebic and bacillary) .. (7=5common+2different)


1- 5 Common in both
ulcer .. haemorrhage, fibrous stricture & perforation ‫( علشانا هما‬3)
dysentry .. rectal prolapse & intussusception ‫( علشانا هما‬2)
2- 2 different
(1)bacillary dysentry .. ‫ دي بكتريا فهتعمل‬secondary infection
toxaemia ‫ فهتعمل‬toxin ‫وبتطلع‬
(2)amoebic dysentry .. ‫بتعمل حاجتين علي اسمها‬
amoeboma & amoebic abscesses(spread)
*.*

*Complications of Acute Appendicitis :


‫ بتقولكوا باي باي بعد قروووونا من سيل الدم‬... ‫عصابه اسمها ماس متخصصه في الغتصاب‬
GANG--gangrene
MASS--.... Appendicular mass
RAPE--- Rapture
PYE----- pyemia
CHROON---chronicity
CELE ——mucocele

5-Liver
*NBs
#Hepatitis (A) virus
>>>commonest cause of (A)cute viral hepatitis

#Hepatitis (C) virus>>>commonest cause of(C)hronic hepatitis

#Post hepatitic cirrhosis cause brownish cutsection ofliver

#Ductopenia differentiates Primary biliary cirrhosis fromchronic viral hepatitis

#High level of alkaline phosphatase is present inblood in case of biliary cirrhosis


(primary and secondary)

#Estrogen is vasodilator so it causes palmer erythemaand arterial spider in liver


cirrhosis due to decreasing its inactivation

#Take care:
Aflatoxins>>>Hepatocellular carcinoma
Alpha fetoprotein increases due to Hepatocellularcarcinoma

*Important names:
-Councilman bodies>>>necrotic acidophilicshrunken liver cells in acute hepatitis
-Laennec's cirrhosis>>>Nutritional andalcoholic cirrhosis
-Wilsondisease>>>Macronodular cirrhosis due to excess copper absorption

*.*

*Microscopic picture of acute viral hepatitis:


bema eno commonly caused by HAV eli howa transmitted by contaminated food
--> Balloon IN KFC
Ballooning(hydropic degeneration)..
Inflamatory cells..
Necrosis of hepatocytes...
Kupffer cells..
Framework..
Cholestasis..

*.*

*.*

*‫؟؟‬..‫ليه الكبد سقط‬


‫عشانا جعفر حب جاد‬
Effect of Hepatocellular Failure ::
JAFER HP GADD
Jaundice
Anemia
Foetor Hepatis
Encepholopathy
Renal Failure
Hormone Disturbance
Proteinemia
Glycemia Hypo
Ascites
Deficiency in Vitamins
Defects in Coagulation
‫مع العتذار لجاد وجعفر‬
103 ‫ص‬

*.*
: Effects & Manifestations of Hepatocellular Failure
‫ راجل كبير عنده‬cirrhosis ..
‫!واحد صاحبه جيه يسأل عليه فبيقول هو الحاج فين ؟‬
‫ "الحاج راح فرح‬.. ‫ مش موجود وا‬: ‫"قالوله‬
HAJ RAH FARH
H .. Hypoproteinemia
A .. Anemia
J .. Jaundice
R .. Renal Failure
A .. Ascites
H .. Hypoglycemia
F .. Foeter Hepatis
A .. Ammonia Encephalopathy & Coma
"R .. Reduced vitamins "vitamins deficiency
H ..Hormonal Disturbances
*.*

‫ فدكتور الكبد دخل عيادته‬XD ‫على طول عيانينهم بيتلغبطوا مع بعض‬, ‫* دكتور غدد وقلب فاتح جمب دكتور كبد‬
‫لقاها زحمة فقال اطرد بتوع السكر والقلب‬
BAN IDM & CVS
Causes of Hepatomegaly ‫ودى تبقى‬
Blood
Amyloidosis
Neoplastic
Inflammatory
Degenerative
Metabolic
Cirrhosis
Vascular
Subcapsular heamatoma
105 ‫ص‬
*.*
*hepatomegaly
I'M SAD Because there is No TV
I inflammatory
M metabolic
S some types of cirrhosis
A amyloidosis
D degenerative
B blood disease
N neoplastic
T trauma
V vascular

*.*

*Chronic hepatitis
aetiology is ' AMVC '
A . Autoimmune
M . Metabolic diseases
V . Viral ' b w c '
C . Cryptogenic
‫ ناخد أخر حرف‬C ‫ نجيب منه ال‬complications
3C ' cirrhosis .. Carcinoma .. Cellular failure '
page 96 :))

*.*

*Aetiology and types of cirrhosis:


that a moment ‫لما تلقى السؤال دا صفحة و نص فى الكتاب و مش عارف تروح و ل تيجى فيه و د فيصل يقول اللى مش‬
‫بعد الشر علينا‬- ‫ عارفه هيسقط‬-
u feel like ( ‫هنلبس ___ اشوفك فى الصيف )د فيصل استايل‬
HNLBC ___ CU IN Summer
H post Hepatic cirrhosis
N post Necrotic cirrhosis
L Laennec's cirrhosis
B Billiary cirrhosis
C Congenital - Circulatory
C Crytogenic
U Ulcerative
IN INdian childhood
S Syphilitic
*.*
*Cause of secondry biliary cirrhosis
‫هناخد اول حرف من كل كلمه‬
S>stones
Biliary>biliary atresia
C >cancer head of pancreas & compression by lymph nodes
P 101

6-Gall Bladder ,Pancreas &


Peritoneum
*Ascitis
‫عشان‬
(T)‫روق‬
‫ ال‬G
‫اتفرج علي‬.
MPPC
T = transudative
G generalized oedema
M Meig's syndrome
P portal hypertension
P pedunculated ovarian cyst
C constrictive pericarditis
١١٤ ‫ص‬
*.*
*Gall stones :
‫ سنـة‬40 ‫ <<< واحـدة ست تخينة عندها‬fatty fertile female above 40
‫ قبض عليها ال‬CSI <<< aetiology :
C _ Composition of bile
S_ stasis of bile
I_infection
‫ فعينت‬m ‫ حامى‬m ‫ حترف بـ‬C ( ‫ << ـرش )يعنى بياخد فلوس كتير‬types : MMC
M_metabolic
M_mixed
C_compound
‫( بس المحامى دا اسمه‬ISMO) ‫( معقد‬COMPLICATIONS )
I_infection
S_squamous metaplasia + malignancy
M_migration of stones
O_obstruction , due to migration
pge 109 & 110
*.*
*complications of Gall stones :
(MIMO)
migration
infection
malignancy
obstruction
*.*
*Risk factors of carcinoma of pancreas :
4Ds
-DM
-Dietary factors
-Do5an (smoking)
-Dah 3ndo chronic pancreatits
*.*
Aetiology of acute haemorrhagic pancreatitis :
1-obstruction of Ampulla of vater
(alcohol) ‫الملك سعود‬-2
(surgical injury)‫شاه ايرانا‬-3
4-3Ps

*.*
Acute Pancreatitis
Etiology & Pathogenesis :-
3 A)cute (P)ancreatitis)
3A & 3P
-A mpulla of Vater obstruction
-A lcohol abuse
-A ccidental surgery
-P olyarteritis nodusa
- +++P arathyroidism
-P eptic ulcer

*.*

Complications of Acute Hemorrhagic Pancreatitis :-


2 ‫بيموتوا‬
‫ ف البنكريااس‬2 ‫و‬
- Shock
- Gangrene

- Chronic pancreatitis
- Pancreatic pseudocyst

P 112