‫بسم الله الرحمن الرحيم‬

‫اللهم ال سهل إال ما جعلته سهال وأنت تجعل الحزن إذا شئت سهال‬
sml ‫طب اسره‬

MANAGEMENT
• Azithromycin, 1 g single oral dose for adults and 20 mg/kg for
children in a single dose.
• In pregnancy: erythromycin 500 mg twice daily for 7 days.
• Less effective: topical erythromycin and tetracycline.10

Conjunctivitis after more than 7 days post-delivery is most likely due to Chlamydia
Conjunctivitis in infants from days 2 to 7 postdelivery is most likely due to Neisseria
Gonorrhoea

NONPHARMACOLOGIC
Avoid sun exposure
Nonprescription artificial tears and/or topical lubricating drops
to soothe the inflammation.
Ophthalmologists will occasionallyprescribe a short course of topical corticosteroid antiinflammatory
drops when symptoms of the pterygia are more intense.
SURGICAL
• Pterygia are usually treated when they interfere with vision or
when they cause significant irritation or pain
 •
Staphylococcus aureus is the causative agent in most cases

• Chalazion is a nontender nodule on the eyelid

NONPHARMACOLOGIC
• Confirm diagnosis with fluorescein and a UV light (for abrasion) if no foreign body is readily visible
. Slit-lamp visualization may be needed to determine if the cornea has been penetrated
• Remove (or refer for removal) nonpenetrating foreign bodies.
Remove with irrigation, a wet-tipped cotton applicator, or a finegauge needle.
MEDICATIONS
• Prescribe ophthalmic NSAIDs for pain if needed.5
• Consider topical antibiotics. Chloramphenicol ointment reduced the risk of recurrent ulcer
REFERRAL
• Refer penetrating foreign bodies to an experienced eye surgeon.

keratoconjunctivitis sicca Dry eye syndrome

Symptoms Dry eyes, irritation, redness, discharge, blurred vision

Artificial tears, wrap around glasses,
Ciclosporin, steroid eye drops
MEDICATIONS
• Scleritis is initially treated with systemic NSAIDs and/or topical steroids

REFERRAL
• If you suspect scleritis, refer the patient to an ophthalmologist
immediately. This is especially important if there is any visual loss or eye pain.

MEDICATIONS
Episcleritis often resolves spontaneously. Eye redness and irritation
improve by 50% in less than a week. Treatment with topical
NSAIDs was no better than artificial tears on measures of redness
and comfort
Managements
• Milia, neonatal acne, mongolian spots, and ETN are benign conditions and parents
should be reassured that they resolve with time.
• Although acne treatment generally is not indicated, infants can be treated with a 2.5% benzoyl peroxide lotion if
lesions are extensive and persist for several months.

Erythema toxicum neonatorum

It typically appears within the first
2-4 days of life in term neonates and resolves within the first 2 weeks of
life.

Milia
Laser ablation
managements
• The majority of hemangiomas will eventually involute without complications and require no treatment,
• Propranolol is now the first line of therapy for function-impairing
and rapidly proliferating infantile hemangiomas. It has been successfully used to treat periorbital
infantile hemangiomas and other problematic infantile hemangiomas
•. Treatment should be maintained until the lesion is completely involuted or the child is 1 year of age

Lichen Planus
Tx: Spontaneous resolution
antifungal creams such as clotrimazole, miconazole after every diaper change until the rash
resolves.

For concomitant oral thrush, treat with oral nystatin swish and swallow 4 times daily.

Parental behavior change to keep the skin as exposed and dry as possible Frequent diaper changes

apply barrier preparations, including zinc oxide paste, petroleum jelly, Vitamin A & D ointment, or
to affected area after each diaper change

. • For moderate to severe inflammation, consider a nonfluorinated, low-potency topical steroid such as 1%
hydrocortisone ointment(up to 3 times daily) to the affected area until the dermatitis is gone.
Benzoyl peroxide at various strengths was equally efficacious in mild/moderate acne
Isotretinoin (Accutane) is the most powerful treatment for acne. It is especially useful for cystic and scarring
acne that has not responded to other therapies

When there are a limited number of papules and pustules, start with topical metronidazole
or topical azelaic acid

• If the skin lesions are more extensive, oral antibiotics, such as doxycycline (40 mg or
100 mg daily) is recommended.
Managements
topical mupirocin is equally or more
effective than oral treatment for people with limited impetigo

Erythema multiforme
the treatment of choice is oral erythromycin for 14 days

Topical therapy (antibacterial, antifungal, benzoic acid 6%) has been recommended in addition to oral
therapy in patients with hidden reservoirs of infection
Managements
The first decision is whether or not the patient needs hospitalization and IV antibiotics. It is often
best to hospitalize any immunocompromised patients

Standard oral therapy for cellulitis not requiring hospitalization (in the pre-MRSA era) involves covering
GABHS and S. aureus with cephalexin or dicloxacillin.4 typical duration is 7 to 10 days.

Penicillin-allergic patients may be treated with clindamycin cases of uncomplicated cellulitis, 5 days
of antibiotic treatment with levofloxacin is as effective as a 10-day course

• Parenteral treatment is usually done with penicillinase-resistant penicillins or first-generation

cephalosporins such as cefazolin, or, for patients with life-threatening penicillin allergies, clindamycin,
or vancomycin.
mANAgemeNT
NONPHARMACOLOGIC
• Pruritus can be treated with calamine lotion,
• Fingernails should be closely cropped to avoid significant excoriation and secondary bacterial infection.
MEDICATIONS
• Antihistamines are helpful in the symptomatic treatment of pruritus.
• Acetaminophen should be used to treat fever in children,
• Acyclovir should be given during the first 24 hours of rash.

• Early treatment with intravenous acyclovir may be effective for treatment of varicella hepatitis and
pneumonia, and immunosuppressed patients.

Preventions
• Varicella immunization (Varivax) can be used to prevent chickenpox. It is contraindicated in individuals
allergic to gelatin or neomycin and in immunosuppressed individuals (it is a live vaccine).

routinely administered 2 doses of varicella-containing vaccine, with the first dose

administered at 12 to 15 months of age and the second dose at 4 to 6 years of age
NONPHARMACOLOGIC
• Calamine lotion and topically administered lidocaine may be used to reduce pain and itching.

MEDICATIONS
• Antiviral agents used in the treatment of herpes zoster include acyclovir (Zovirax), famciclovir
(Famvir), and valacyclovir Valtrex), all started within 72 hours of the onset of the rash

• Adding corticosteroids to acyclovir therapy may accelerate times to crusting and healing, return to
uninterrupted sleep, resumption of full activity, and discontinuation of analgesic.
• Pain can be managed with nonprescription analgesics or narcotics

• Fifth disease is usually self-limited and requires no specific therapy.

• NSAID or acetaminophen therapy may alleviate fevers and arthralgias

.

NONPHARMACOLOGIC
• Women with active primary or recurrent genital herpetic lesions at the onset of labor should deliver by
cesarean section to lower the chance of neonatal HSV infection.

MEDICATIONS
Genital herpes:
• Antiviral therapy is recommended for an initial genital herpes outbreak oraly
IV acyclovir therapy followed by oral antiviral therapy for patients who have severe HSV disease
• Topical medication for HSV infection is generally not effective.
• Topical imiquimod

Curettage and cryotherapy are physical methods used to eradicate molluscum.

• Treatments for external genital warts include topical medications, cryotherapy, and
surgical method
• Griseofulvin remains the treatment of choice for tinea capitis

pityriasis versicolor
Because tinea versicolor is usually asymptomatic, the treatment is
mostly for cosmetic reasons.

oral fluconazole provided the best clinical and mycologic cure rate,
Tx: Antifungal (Selenium sulfide)
Treatment
includes administration of an antiscabicide and an antipruritic.
Permethrin 5% cream
Ivermectin is an oral treatment for resistant or crusted scabies

Oral thiabendazole
Topical steroids and emollients have been proven to work for AD and are the mainstay of
treatment
. Tx: Topical steroid => Tacrolimus

Managements
• Identify and avoid the offending agent
• Localized acute ACD lesions respond best with mid-potency to high-potency topical steroids
such as 0.1% triamcinolone to 0.05% clobetasol, respectively
• Avoid any causative agent, medication, stimulus, or antigen if found

Low-sedating, second-generation antihistamines should be prescribed as a first-line

treatment for chronic urticarial
• Oral corticosteroids should be restricted to short courses for severe acute urticaria or
angioedema affecting the mouth

• Epinephrine is valuable in severe acute urticaria or angioedema, especially if there is a

suspicion of airway compromise or anaphylaxis.
• Mainstay of treatment is topical antifungals.
• For seborrheic dermatitis of the scalp, patients should wash their hair with antifungal shampoos.

condyloma acuminatum First-line treatment is a trichloroacetic acid

application, followed by ablation or excision if unsuccessful
Tx: Mild => Topical steroid/ Moderate or severe => (>10%): Methotrexate
Clobetasol is an ultrahigh-potency steroid that is generic and comes in many vehicles for use on the body and scalp.
managements
Removal of the lesion
imiquimod 5% topical application

Actinic keratosis rough => squamous cell carcinoma.

Prevention: Avoid sun. Sun screen
• AKs are most often treated by cryosurgery using liquid nitrogen
• A shave biopsy may be used for diagnosis but is not an adequate final treatment.

• Smaller, less-aggressive KAs diagnosed with shave biopsy may be destroyed with curettage and
desiccation or cryotherapy with 3- to
5-mm margins.

It is a squamous cell carcinoma.

• Mohs micrographic surgery is the gold standard but is not needed for all BCCs
Concentric surgical margins are taken until all margins are clear This is the
treatment of choice for BCCs with poorly defined clinical margins or in areas of significant
cosmetic or functional importance such as the face
•. Start with potent corticosteroid ointments or tacrolimus ointment first-line therapy
in cases of localized PG that are not severe
• Systemic treatment with oral corticosteroids, or oral cyclosporine alone or together
appears to be effective in many cases and should be considered first-line therapy
Come with UC. Tx: Systemic Steroids

Dermatitis herpetiformis
association with celiac disease

pityriasis alba
Treatment involves gentle skin care, emollients such as petrolatum or
12% ammonium lactate lotion, and sun protection topical steroids, and topical
or oral PUVA.
• High-potency topical corticosteroids are considered first-line treatment for moderate to
severe generalized disease (e.g., clobetasol)

All patients can benefit from sun protection

• Hydroquinone is the main bleaching agent used to treat melasma.
Topical treatments used for vitiligo include corticosteroids, immunomodulators,
vitamin D analogs, and psoralens
Want to cure it in a short period => Melanocyte transfer
Skin graft

Erythema Annulare
resolved once the underlying diseases were treated
topical steroids usually cause involution of the treated lesions, but they do not prevent
the occurrence of new lesions or recurrence of the eruption

Onychomycosis
The most commonly used oral drugs for treatment of onychomycosis is griseofulvin,
terbinafine, itraconazole and ketoconazole
Creams and other topical medications are usually not effective against nail fungus.
Erythema multiforme
acute, self-limited
associated with certain infections, medications, and other various triggers

• Earlobe keloids can be treated with imiquimod 5% cream following tangential shave
excision on both sides of the earlobe.
• Cryosurgery and intralesional triamcinolone have been used to treat smaller keloids
MEDICATIONS
Benzathine penicillin is the treatment of choice for all stages of syphilis

MEDICATIONS
• Keratolytic agents (e.g., salicylic acid) can improve the cosmetic appearance
a 2-day history of fever, irritability, and frequent tugging of his left ear.
On otoscopy, his left tympanic membrane (TM) appears erythematous, cloudy, bulging,
and exudative
between 6 and 24 months of age
Management of OME primarily consists of watchful waiting. Most cases resolve
spontaneously within 3 months;

MEDICATIONS
• Oral acetaminophen (paracetamol) and ibuprofen may reduce earache
• Antibiotics seem to be most beneficial in children younger than, 2 years of age with
bilateral AOM, high fever, or vomiting and in children with both AOM and otorrhea
Amoxicillin or amoxicillin/clavulanic acid is preferable to the other
antibiotics.
cholesteatomas should be excised

Treatment is only required if there is hearing loss.

Surgery for tympanosclerosis
• Topical treatments alone are effective for uncomplicated acute OE.
Additional oral antibiotics are not required.
malignant otitis externa, a serious complication of otitis externa caused by
Pseudomonas aeruginosa.
High-dose IV ciprofloxacin is the first-line treatment of malignant otitis
externa, which may occur in elderly patients with poorly controlled diabetes
Ear FBs can be removed by irrigation, suction, or instrumentation.
The type of procedure depends on the type of FB being removed.
MEDICATIONS
• Analgesics (acetaminophen or nonsteroidal antiinflammatory drugs alone or in
combination with an opioid) should be used for pain.

• Oral and topical (nasal) decongestants may be offered for symptomatic relief;
• Topical corticosteroids appear to be of benefit in improvement and resolution of
symptoms for acute sinusitis.
• Patients who fail to improve or have severe symptoms may be offered oral antibiotics

~ Adults (after 7 days)—Amoxicillin (500 mg three times daily

or 875 mg twice daily) for 10 days1; alternatives include trimethoprim-
sulfamethoxazole (TMS-SMX) (1 DS twice daily) or a
macrolide for 10 days.1
~ Children (after 10 to 14 days of symptoms)—Amoxicillin (45 to
90 mg/kg divided twice daily), cefuroxime axetil (30 mg/kg divided
twice daily), or cefdinir (
treated by wearing a sling for 6 weeks
injured vessel ? - subclavian vein
Treatment. Reduction under GA or intravenous sedation. Then Immobilization for 2 to 3
weeks, then begin physical therapy
brachial plexus injuries, rotator cuff tears
shaft of the humerus fracture
Treatment. The weight of the arm effects reduction. A ‘U’ slab is applied to the upper arm and the
wrist supported with a collar and cuff initially.
Complications. Radial nerve damage and non-union

Close reduction and cast

. Management: Closed reduction followed by
application of a long-arm cast; open reduction if the fracture is intra-articular
Scaphoid bone fracture
Diagnosis is confirmed with MRI
Treatment
Non-displaced fractures (≤1 mm) of the distal scaphoid can be treated in a short-arm thumb spica
cast,
All fractures that are displaced (>1 mm) and those with a significantly increased or decreased scapholunate
angle should be immobilized in a thumb spica splint and referred for orthopedic evaluation.

mallet finger
treated by maintaining the DIP joint in full extension or minimally hyperextended using an appropriate splint
patient wakes up in the night and his finger is kept in a flexed position
and is unable to straighten it unless it is pulled with another hand

Steroid injection is the best line of therapy and surgery is last

Patients with a retinal detachment will generally be treated with one or more of the following procedures:
pneumatic retinopexy, scleral buckle, or vitrectomy . Patients with small peripheral retinal
detachments may be treated with barrier procedures such as laser photocoagulation. Some patients
with asymptomatic rhegmatogenous retinal detachments may be closely monitored without therapy or
treated with barrier procedures

who present with visual acuity of >20/40, we recommend observation

visual acuity ≤ 20/40, we suggest either intravitreal anti-VEGF agents (eg, ranibizumab ),
the dexamethasone 0.7 mg implant, or, if duration of symptoms is at least three months, macular grid
laser photocoagulation treatment
Rx: Blood pressure should be reduced to below 140/90mm Hg.
intensive insulin therapy for the management of type 1 diabetes

flame shape on the retina, cotton wool spots and

macular oedema
Fluorescein angiography. important diagnostic tool in the workup of diabetic
retinopathy

Rx: No reliably effective medical therapy is available

 There's no cure for retinitis pigmentosa

 Giant papillary conjunctivitis (GPC

 GPC is characterized by foreign-body sensation on the upper tarsus, associated with
formation of "giant" (>1 mm) papillae Patients often have intense pruritus and
increased mucus production.
 Diagnosis is made by eliciting a history of intolerance of contact lenses or another
foreign substance in the eye, and by everting the upper lid and observing enlarged
papillae.
 Signs and symptoms of GPC usually resolve in less than one week if the source
of mechanical irritation is removed.
 We suggest a trial of a topical mast cell inhibitor or dual acting mast
cell inhibitor and antihistamine for patients who do not improve with
removal of the inciting agent and other nonpharmacologic measures. We
recommend a short course of topical corticosteroids in patients who do
not respond to mast cell inhibitors and who have severe disease
The optimal management of a patient with uveitis will require consultation with an ophthalmologist

Treatment of uveitis due to an infectious agent is directed toward the responsible

organism. Infection with herpes simplex or herpes zoster may cause retinal destruction

anterior uveitis not due to infection is treated with topical glucocorticoids.

angle-closure glaucoma
Patients with signs and symptoms suggesting an acute attack of angle-closure glaucoma require
emergency treatment by an ophthalmologist.

We recommend emergency use of topical ophthalmic medications to reduce intraocular pressure. These
drugs may include a beta-blocker, an alpha agonist, and an agent to produce miosis.

Once the acute attack is controlled, definitive treatment for angle-closure glaucoma is a laser
peripheral iridotomy to provide a small drainage hole through the iris.
Painful swelling over the right parotid initially had clear saliva from Stensen duct

Antibiotics with coverage of Staphylococcus

Viral sialoadenitis, such as mumps parotitis, is the most common cause. It occurs with a
concomitant viral illness and is usually bilateral, whereas bacterial infections are primarily unilateral
Burns are classified as :
1. Superficial or first degree: Limited to epidermal layers. Look like
sunburn.
2. Partial thickness or second degree: painful burns as it involves
papillary dermis. Blister formation occurs and heals within weeks. Doesn’t
require a skin graft.
3. Full thickness or third-degree burns: These involve subcutaneous
tissues and have a leathery texture.
4. Devastating full thickness or fourth-degree burns: Burns that go
deep into the muscles and bone

Parkland formula= 4 ml/kg body wt x % total burnt Body surface

area (TBSA).
 Acute follicular tonsillitis

Amoxicillin + clauvlanic acid

shows a thumb sign

Epiglottitis is caused by H influenza

IV ceftriaxone is the drug of choice for gram negative bacteria.

Addison’s disease Primary aldosteronism
fatigue and depression poor appetite, and Conn’s syndrome
weight loss. Hyper pigmentation lethargy, limb paresthesia, and nocturia
hyporeflexia and weak muscles
sodium levels are low and ACTH levels hypertension difficult to control
are high with medications
hydrocortisone
Aldosterone/renin ratio higher than
normal

Cushing's syndrome
caused by a pituitary tumor leading to
excessive production of ACTH

the first-line investigation24-hour urinary free

cortisol
decreased libido, obesity/weight gain,
plethora, ound face (moon facies),
menstrual changes/irregularities,
hypertension ecchymoses, abnormal
glucose tolerance
Immediate defibrillator
Defibrillation
1st vagal manouver
2nd adenosine ‫مرتين‬
3rd verapamil

unstable cardoversion
permanent pacemaker placement in nearly all patients
Atropine and transcutaneous passing In the emergent setting,
Symptomatic implantation of a permanent pacemaker

asymptomatic bradycardia regularly follow up

reassurance and observation

 ‫نب َواللَ ِه ذَنبي لَستُ أَدفَعُهُ‬
‫الذَ ُ‬ ‫رزقا ً َو ِسوى الغايا ِ‬
‫ت تُقنُعُهُ‬ ‫ُمستَ ِ‬ ‫ال تعذليه فإن العذل يولعه ‪ ..‬ابن‬
‫زريق البغدادي‬
‫الرشدُ أَج َمعُهُ‬
‫أَال أَقمتَ َفكانَ ُ‬ ‫ق َواَلَرزا ِ‬
‫ق‬ ‫الرز ِ‬
‫رص في ِ‬ ‫الح ُ‬
‫َو ِ‬
‫قَد قُ ِس َمت‬ ‫ال تَعذَ ِليه فَإِ َّن العَذ َل يُو ِلعُهُ‬
‫الرشدُ ات َبعُهُ‬ ‫لو أَنَّ ِني َي َ‬
‫وم بانَ ُ‬
‫إِنّي ََلَق َ‬
‫عهُ‬
‫صر ُ‬
‫رء يَ َ‬ ‫ي أَ ّال ِإ َّن بَ َ‬
‫غي ال َم ِ‬ ‫بَ ِغ ُ‬ ‫ت َحقا ً َولَ ِكن لَ َ‬
‫يس يَس َمعُهُ‬ ‫قَد قَل ِ‬
‫ّامي َوأنفقُها‬
‫ط ُع أي ِ‬
‫عطي الفَتى ِمن َح ُ‬
‫يث‬ ‫الدهر يُ ِ‬
‫ُ‬ ‫َو‬ ‫ت فِي لومه َحدا ً أ َ َ‬
‫ض َّر ِب ِه‬ ‫جاوز ِ‬
‫َ‬
‫سرةٍ ِمنهُ فِي قَلبِي تُقَ ِ ّ‬
‫طعُهُ‬ ‫ب َح َ‬ ‫يَمنَعُه‬
‫ت أَ َّن اللوم َينفَعُهُ‬
‫يث قَدر ِ‬
‫ِمن َح َ‬
‫ت لَهُ‬
‫بِ َمن إِذا هَ َج َع النُ ّوا ُم بِ ُّ‬ ‫طمعُهُ‬ ‫ِإرثا ً َويَمنَعُهُ ِمن َحي ِ‬
‫ث يُ ِ‬
‫الرفق ِفي تَ ِأ ِني ِب ِه َب َدالً‬ ‫فَاستَ ِ‬
‫عم ِلي ِ‬
‫لَو َع ٍة ِمنهُ لَيلى لَستُ أَه َجعُهُ‬ ‫أستَو ِدعُ اللَهَ فِي بَغدا َد ِلي قَ َمرا ً‬
‫ِمن َعذ ِل ِه فَ ُه َو ُمضنى القَل ِ‬
‫ب‬
‫طم ُّ‬
‫ئن ِل َجنبي َمض َج ُع َو َكذا‬ ‫ال يَ ِ‬ ‫رخ ِمن فَلَ ِك اَل َ َ‬
‫زرار َمطلَعُهُ‬ ‫ِبال َك ِ‬ ‫ُموجعُهُ‬
‫ال يَط َمئِ ُّن لَهُ ُمذ ِبنتُ َمض َجعُهُ‬ ‫بودّي لَو يُ َو ِ ّد ُ‬
‫عنِي‬ ‫َودَّعتُهُ َو ُ‬ ‫حملُهُ‬ ‫طلَعا ً ِبالخَط ِ‬
‫ب يَ ِ‬ ‫قَد كانَ ُمض َ‬
‫الدهر َيف َجعُنِي‬
‫َ‬ ‫ب أَ َّن‬ ‫ما ُكنتُ أَح َ‬
‫س ُ‬ ‫فو ال َحيا ِة َوأَنّي ال أَود ُ‬
‫عهُ‬ ‫ص َ‬‫َ‬ ‫دهر أَضلُعُهُ‬
‫ب ال ِ‬ ‫ض ِلّ َع ْ‬
‫ت ِب ُخ ُ‬
‫طو ِ‬ ‫فَ ُ‬
‫ِب ِه َوال أَ َّن ِبي اَلَي َ‬
‫ّام تَفجعُهُ‬ ‫وكم تشفَّع فى أن ال أفارقه‬ ‫ت أَ َّن لَهُ‬
‫َيك ِفي ِه ِمن لَو َع ِة التَش ِتي ِ‬
‫َحتّى َجرى ال َبينُ ِفيما َبينَنا ِب َي ٍد‬ ‫ش ِفّعُه‬
‫وللضرورة حا ٌل ال ت ُ َ‬ ‫عهُ‬ ‫ِمنَ النَوى ُك َّل َي ٍ‬
‫وم ما يُرو ُ‬
‫َعسرا َء تَمنَعُنِي َح ّ‬
‫ظي َوتَمنَعُهُ‬ ‫ى‬
‫ض َح ً‬
‫الرحي ِل ُ‬
‫وم َ‬ ‫َو َكم تَشب َ‬
‫َّث بي يَ َ‬ ‫سفَ ٍر إِ ّال َوأَز َ‬
‫ع َجهُ‬ ‫آب ِمن َ‬
‫ما َ‬
‫جازعا ً‬
‫دهري ِ‬
‫ب ِ‬ ‫قَد ُكنتُ ِمن َري ِ‬ ‫ت َوأَد ُمعُهُ‬
‫َوأَد ُم ِعي ُمستَ ِه ّّل ٍ‬ ‫سفَ ٍر بِالعَ ِ‬
‫زم يَز َمعُهُ‬ ‫ي إِلى َ‬
‫َرأ ُ‬
‫فَ ِرقا ً‬
‫بر ُمنخَر ٌق‬
‫ص ِ‬‫ثوب ال َ‬
‫ُ‬ ‫ال أَ ُك ُ‬
‫ذب اللَهَ‬ ‫َكأَنَّما ه َُو فِي ِح ِّل َو ُمرتح ٍل‬
‫وق الَّذي قَد كُنتُ أَجزَ عُهُ‬
‫فَلَم أ َ َّ‬
‫َعنّي بِفُرقَتِ ِه لَ ِكن أَ َر ِقّعُهُ‬ ‫عهُ‬ ‫ضاء اللَ ِه يَ َ‬
‫ذر ُ‬ ‫ُم َو َّك ٍل بِفَ ِ‬
‫ِفي ِذ َّم ِة اللَ ِه ِمن أَص َب َحت َمنزلَهُ‬

‫ُمرعُهُ‬ ‫َوجا َد غ ٌ‬ ‫عذري فِي َجنايَتِ ِه‬ ‫ِإنّي أَ َو ِ ّ‬

‫س ُع ُ‬ ‫نى‬ ‫ِإ َّن الزَ مانَ أَراهُ في َ‬
‫الر ِحي ِل ِغ ً‬
‫على َمغناكَ ي ِ‬
‫َيث َ‬

‫ََلَص ِب َر َّن على دهر ال يُ َم ِت ّعُ ِني‬ ‫سعُهُ‬

‫البين ِعنهُ َو ُجرمي ال يُ َو ِ ّ‬
‫ِب ِ‬ ‫س ّد أَضحى َوه َُو يُز َمعُهُ‬
‫َولَو ِإلى ال َ‬

‫ي فِي حا ٍل يُ َم ِت ّعُهُ‬
‫بِ ِه َوال بِ َ‬ ‫ُر ِزقتُ ُملكا ً فَلَم أَح ِسن ِسيا َ‬
‫ستَهُ‬ ‫تأبى المطام ُع إال أن ت ُ َج ّ‬
‫شمه‬
‫ب فَ َرجا ً‬ ‫ِعلما ً بِأ َ َّن ا ِ‬
‫ِصطباري ُمع ِق ُ‬ ‫وس ال ُملكَ َيخلَعُهُ‬
‫س ُ‬‫َو ُك ُّل َمن ال يُ ُ‬ ‫للرزق كدا ً وكم ممن يود ُ‬
‫عهُ‬

‫مر ِإن فَ َّكرتَ أَو َ‬

‫سعُهُ‬ ‫فَأَضيَ ُق اَل َ ِ‬ ‫َو َمن غَدا البِسا ً ثَ َ‬
‫وب النَ ِعيم ِبّل‬ ‫واصلَةً‬
‫نسان ِ‬ ‫َوما ُمجا َه َدة ُ ِ‬
‫اإل ِ‬
‫عل اللَيالي الَّتي أَضنَت ِبفُرقَت َنا‬
‫َ‬ ‫َكر َعلَي ِه فَإِ َّن اللَهَ يَنزَ ُ‬
‫عهُ‬ ‫ش ٍ‬ ‫نسان تَق َ‬
‫طعُهُ‬ ‫اإل ِ‬‫رزقَا ً َوال َد َعةُ ِ‬
‫ست َج َمعُنِي َيوما ً َوت َج َمعُهُ‬
‫ِجسمي َ‬ ‫اِعتَضتُ ِمن َوج ِه ِخلّي بَع َد فُرقَ ِت ِه‬ ‫قَد َو َّزع اللَهُ بَينَ الخَل ِ‬
‫ق رزقَ ُه ُم‬
‫َوإِن تُنلُّ أ َ َح َدا ً ِمنّا َمنيَّتُهُ‬
‫كأسا ً أَ َج َّرعُ ِمنها ما أَ َج َّر ُ‬
‫عهُ‬ ‫ضيِّعُهُ‬ ‫لم يَخلُق اللَهُ ِمن خَل ٍ‬
‫ق يُ َ‬
‫فَما الَّذي ِبقَ ِ‬
‫ضاء اللَ ِه يَصنَعُهُ‬
‫َكم قائِ ٍل ِلي ذُقتُ البَينَ قُلتُ لَهُ‬ ‫لَ ِكنَّ ُهم ُك ِلّفُوا ِحرصا ً فلَستَ تَرى‬
Laryngotracheitis

runny nose, mild fever, distinct "a barking cough" and inspiratory stridor

caused by respiratory viruses such as parainfluenza

treated with a single dose of oral steroids.

Multiple sclerosis
Intravenous methylprednisolone

Allergic conjunctivitis
Patients should be advised to never rub their eyes and to
use topical antihistamines, artificial tears, and cool compresses
 Corneal abrasion
organisms is associated with contact lens induced corneal
abrasions? Pseudomonas

Most corneal abrasions heal in 24 to 72 hours and rarely progress to

corneal erosion or infection

Topical antibiotics

Topical NSAIDs

Uveitis
symptoms of photophobia, pain redness and blurred vision

Examination revealed keratic precipitate ‫ترسب‬and presence of cells in the

anterior chamber

Cyclopentolate with topical steroids

 ‫‪aspirin to prevent future complications‬‬
‫‪as well as the use of intravenous immunoglobulin‬‬

‫ماذا أقول له لو جاء يسألني‪ ..‬إن كنت أكرهه أو كنت أهواه؟‬

‫ماذا أقول ‪ ،‬إذا راحت أصابعه تلملم الليل عن شعري وترعاه؟‬
‫وكيف أسمح أن يدنو بمقعده؟ وأن تنام على خصري ذراعاه؟‬
‫غدا إذا جاء ‪ ..‬أعطيه رسائله ونطعم النار أحلى ما كتبناه‬
‫حبيبتي! هل أنا حقا حبيبته؟ وهل أصدق بعد الهجر دعواه؟‬
‫أما انتهت من سنين قصتي معه؟ ألم تمت كخيوط الشمس ذكراه؟‬
‫أما كسرنا كؤوس الحب من زمن فكيف نبكي على كأس كسرناه؟‬
‫رباه‪ ..‬أشياؤه الصغرى تعذبني فكيف أنجو من األشياء رباه؟‬
‫هنا جريدته في الركن مهملة هنا كتاب معا ‪ ..‬كنا قرأناه‬
‫‪..‬على المقاعد بعض من سجائره وفي الزوايا ‪ ..‬بقايا من بقاياه‬
‫ما لي أحدق في المرآة ‪ ..‬أسألها بأي ثوب من األثواب ألقاه‬
‫أأدعي أنني أصبحت أكرهه؟ وكيف أكره من في الجفن سكناه؟‬
‫وكيف أهرب منه؟ إنه قدري هل يملك النهر تغييرا لمجراه؟‬
‫أحبه ‪ ..‬لست أدري ما أحب به حتى خطاياه ما عادت خطاياه‬
‫الحب في األرض ‪ .‬بعض من تخيلنا لو لم نجده عليها ‪ ..‬الخترعناه‬
‫نزار قباني ―‬
right sensorial hearing loss

Mixed

left sensorial hearing loss

left conductive hearing loss

bilateral sensorial hearing loss

bilateral conductive hearing loss

bilateral sensorial hearing loss
soft palate tumor
Bartholin cyst

sigmoid volvulus

iron deficiency anemia

hypochromic microcytic anemia
Egg on a string" appearance
transposition of great arteries
Sporothrix schenckii

fungal infection caused Sporothrix schenckii complex.

Antifungal treatment (e.g., itraconazole, potassium iodide,

terbinafine and fluconazole)
septic arthritis
Patients often present, with acute monoarticular joint pain with joint erythema,
warmth, swelling and tenderness.

caused by Staphylococcus aureus

empirical intravenous antibiotic therapy

Achalasia
complaining of dysphagia with solids and liquids.

birds beak appearance.

most common cutaneous manifestation Ulcerative colitis Erythema

nodosumand pyoderma gangrenosum
most common cutaneous manifestation Celiac disease Dermatitis herpetiformis
most common cutaneous manifestation Crohn disease pyoderma gangrenosum
antibiotics should you recommended to traveler’s diarrhea Azithromycin
Ciprofloxacin Levofloxacin
 Pityriasis rosea

herald patch

Christmas-tree

 Corticosteroids

 Antihistamines

 acyclovir

granuloma annulare
self-limiting

Bullous pemphigoid
prednisone,
glucose-6-phosphate dehydrogenase deficiency
Heinz bodies bite cells
Crohn’s disease
The abdominal pain is worse before defecation
and is temporarily relieved after defecation.

Barium contrast enema

reveals a narrowed, thickened terminal ileum with
string sign

confirm the diagnosis Colonoscopy with ileoscopy

and biopsy cobbleston
 Volvulus
nonbloody, nonprojectile vomiting within the first days to
month of life

Upper GI barium contrast series bird’s-beak

corkscrew duodenal configuration

X-ray chest revealed a wedge-shaped opacity

Pulmonary emboli

Alteplase
Chest radiography may show cardiomegaly and a “water bottle-shaped”
Cardiac tamponade

Beck triad, are muffled (distant) heart sounds, jugular venous distension, and
hypotension

A triquetrum fracture

wrist immobilization. Fractures that are displaced treatment surgery

pyoderma gangrenosum
treatment is systemic steroids and immunosuppressants such as cyclosporine.

Cause –Bisprolol

Treatment - CCB
orbital cellulitis
bacterial rhinosinusitis is the most common cause of orbital cellulitis

Vancomycin iv



ischemic colitis
 Pain, tenderness or cramping in your belly, which can occur suddenly or gradually

 Bright red or maroon blood in your stool or, at times, passage of blood alone without stool

 A feeling of urgency to move your bowels

 Diarrhea

 Nausea
Pediculosis
Shampoos containing pyrethrin

tibial stress fracture

The main symptom is pain in the shin area. after running or exercising..

in general, the treatment regime (conservative management)

 growth chart growth hormone deficiency

A-representative-growth-chart-for-a-child-with-celiac-disease-Figure-3-A-representative
‫ابونون ‪2222/22/22‬‬