SLE 2008 -1
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Transcript of SLE 2008 -1
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8/10/2019 SLE 2008 -1
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MARCH
SLE 2008COLLECTED AND TRIED TO BE ANSWERD AND SENT BYDR.ABULMALIK ALBAKER [email protected]
1 ,')*+,-./*,- )*+,-.)'&%$#"!*-,3-*3435'"6!79:%;!???
@. ),* -. BD .- ). 3- F.#GI>J!K!N
OP2 Q:'+,T,@343OGUV5W=>XVYZ>!X![#5\#QN*T.5_`>
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ET*-)*, .D.3 Q,est felt than see T- .-/painful red nodules treated ,y S1./s
2346766896;*?@=6
44-4, } 4 3, g.* .g3-T/-4. QArectB CDRA -AST E F supine a,dominal GH ray
)4'I6J?K6L
/)4D 4-) */*, ,T* + )* 43 . 3-*T.4D ,D ),4k 4-/)4k D43-Tg )433**+4k@ ,3*T -. k4* ,-4)43-,4* .T 3-*T.4D /T*, vv
6M6N+2O6Q846'*U=6V*='if angioedema HHH epinephrine~.D 3-,D,TD 4,k4k 4 ,/-* +,/*T4,-4-43 Q'W9 XT scan if less than YZh no value d[ on clinical and al,s
+T*k,- ,D@ 28 F3 4-) /),@D, 4|*/-4. Q
a\ithromycin not pregnanterythromycin in pregnant ,est ] treat partners if amo[ B,estEdo[cyline not pregnant
/.. /,3* .| ,* 4|*T-44-@Q The most common cause is a low sperm countprimary hypogonadism most common cause is ^linefeter syndrome Y_[[ysecondary hypogonadisme`aculation o,structionThe mos !ommo" congenital!#$se %s K&%"e'e&e( s)"*(ome
18@*,T3 .D g.@ 4-) g,/F +,4 4*3-4k,-4. -. D. *}/*+- QX-X #ASRG Hray,one scanif lytic lesion ,one scan is ,est
4T. D*B/4*/@ ,*,4, Qserum iron
ferritin B dierence ,t chronic anemia HT.-X,one marrow B ,est if not there ferritin E
H@+.-)@T.4D434 Qfree TYTSbTY
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4 )4/) kT.+ @. 4 D. .*T *D.3/.+@ |.T +,-4*-3 4-) 4T. D*B/4*/@,*,4, 4 4-) . g*4k /,3*Qmale all age groupchildrenpermanupausal women & male more than 59 ywomen DXP
=2346)6
/)4D 4-) +4*/* .| k,33 g*,3 g,--*T@ D**+ 4 *,T /,, ),- -. D.Qno irrigation ,,,,,, , best pick with forceps34D* **/-3 .| L*.D.+, Qdys^inesiaspeechfatal hepatic to[icity""#
A+"o(m#& h%",%"- ho&*%"- '#&se +e&%e's h# !#""o +e !h#"-e* +) '#! A-%#%o" A"/%e)
C&e"!h%"- o( -(%"*%"- o' eeh C&$ms%"ess o( $"se#*%"ess Co"'$s%o"D%''%!$&) s#&&o%"- D%%"ess E/!ess%e #e(%"- o' mo$h 3#&se se"se o' e&& +e%"- 3ee&%"- '#%" 4e"e(#& 'ee&%"- o' *%s!om'o( o( %&&"ess H#&&$!%"#%o"s 5see%"-6 he#(%"-6 o( 'ee&%"- h%"-s h# #(e "o he(e7 H#"* (emo(6 %"!(e#se*
N#$se# o( om%%"- N$m+"ess
1b +,-4*- )4* )* +,@4k |..- g, -)*T* 43 .* /.* +.+ )43 F** |T.-)* ,-*T, 34D* /.* -. -)* ).3+4-, ),- 43 -)* .3- +T.g,g@ /- 4T@ .//TvHmedial collateral ligament
#&-$s 'o(!e #88&%e* o # '&e/e* ,"ee m#) !#$se # e#( o' he me*%#& me"%s!$s. A #($s 'o(!e o" # '&e/e* ,"ee %h he'em$( e/e("#&&) (o#e* m#) &e#* o # e(#& me"%s!$s &es%o". A!!o(*%"- o R%!,&%"6 he me*%#& me"%s!$s %s ##!he* mo(e'%(m&) h#" he (e%e&) mo+%&e e(#& me"%s!$s6 #"* h%s m#) (es$& %" # -(e#e( %"!%*e"!e o' me*%#& me"%s!$s %"$().
2b .T -)43 /,3* -)* -T*,-*- 43Q1H conservativeACLQ R*3-3 |T. , ./.-,/- -43-4k */),43 |.T/*D )@+*T*}-*34. .T4+,/- -. , *}-*D*D F** ,-*T4.T DT,*T ,D L,/), -*3-3 R* .- ,*43/, .T MCL 4T@CLQ R*3-3 |T. |.T/*D )@+*T*}-*34. +.3-*T4.T DT,*T -*3- M*43/, -*,T3 Q R*3- |T. , ,/-* -43-4k 4T@ C4/F4k .T ./F4k ,@ g*+T*3*- E}, 3).3 .4- 4* -*D*T*33 ,D , M/MTT,@3 -*3-
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ab o0 .T oo +,-4*- +T*3*- 4-) 4,-*T, 3).D*T ++*T .*T 4++,4 4-) .T4k 3-4*33 .| .T* 4-*34-@ ,|-*T ,F* + -)*T* 43 4D|**T -)* +,-4*- 43 D*+T*33*D Q4,k.343Q1HR"1-H Polymyalgia rheumatic ASR"
rb M,* +,-4*- F. /,3* .| M /.* 4-) Hg A1C Q 8 )* 43 -,F4k
*-|.T4 k4g*/,4D -. T*k,-* -)* g..D 3k,T **D Q1H """"""""""""insulin-H""""""""""""insulinXH metformin F acar,ose "
ob /,3* 3/*,T4. +,-4*- +T*3*- 4-) /.3-4+,-4. } Q )@+.-)@T.4D43. /.BT -),- -)* +,-4*- ),3 )@+.-)@T.4D43Q1HTY-HTSbXHfree TY
b C,3* 3/*,T4. +,-4*- +T*3*- 4-) 3@+-.3 .| )@+*T-)@T.4D43-*D*T */F 3*4k Q4,k.343Qsu,acute thyroiditis -T,-*D 4-) SA A SER
b .-)*T gT4k )*T g,g@ -. @. )* 3)* /.+,4 .| D4,+*T T,3) 3)**- -. D4*T*- DTk g*|.T* 3)* /.* -. @. 3)* 3*D a D4*T*-/.T-4/.3-*T.4D DTk +T*3/T4g*D g@ D4*T*- +)@34/4,
-)* T,3) 43 * D*,T/,-*D 3/,@ Q4,k.343Q
1Hse,orrheic dermatitis-Hcontact dermatitis include la,i wheras candida notXH#
b )* -T*,-*-Qvv,.4D ,*Tk* ,D 3-*T.4D |.T /.-,/- D*T
8b |*,* +,-4*- ,k*T 34/* 3).T- -4* g*/.* D*+T*33*D 3)* 3,4D3)* /,- ,,k* -)* /.4/-3 -),- ),++* 4 -)* .TF g*-** -)**+.@**34,k.343Q
1H/epression"-Hjenerali\ed an[iety disorder"XH1d`ustment /isorders
b C,3* 3/*,T4. |*,* +,-4*- +T*3*- 4-) *}/*334* |*,T 4 )*T/)4DT* @ .+44. 4- 43 , /,3* k**T,4*D ,}4*-@ D43.TD*TT*,-*-Qv
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10b ,-4*- g*|.T* *3-T,-4. g@ 2ba D,@3 +T*3*- 4-) D*+T*33*D ..D-),- D43,++*,T g@ 2ba D,@ ,|-*T -)* g*k44k .| *3-T,-4.4,k.343Q1HPremenstrual dysphoric disorder if sever symptoms Bor premenstrualsyndrome #E"
11b *,* +,-4*- gT*,3- |**D4k +T*3*- 4-) ,3-4-43 4 ++*T .-*T
,DT,-QT*,-*-Q1Hstope ,reast feeding F evacuate the mil^ ,y the ,reast pump"-H jive"""""anti,iotic to the mother F anti,iotic to the ,a,y"cH anti,iotics with continue ,reast feeding
12b /,3* 3/*,T4. g,g@ +T*3*- 4-) 4,-*T, D*|.T4-@ 4 -)* |..-,++*,T )* 4- 43 g*/.* -)* *4k)- g*,T4k 43 4 -)* .-)*T |..- g- )*4- 43 -)* *4k)- g*,T4k -)* D*|.T4-@ D43,++*,T -)* +,-4*- ),3 D*|*/- 4D.T34*}4. .| -),- |..- -)4F -)*@ ,T* -,F4k ,g.- /g |..- -T*,-*- Q
1Horthopedic correction """#-Hshoe""""XHsurgery """"
TE: %s !#$se* +) -e"e%!'#!o(s s$!h #s E*#(*s s)"*(om18 /)T..3.*se(%#& !#s%"-6 o( s8&%"s !#&&e* ,"ee #",&e 'oo o(hoses 5KA3O7 '%(s %' "o (es8o"s 6 s$(-e().
1ab /,3* 3/*,T4. +,-4*- +T*3*- +,-*T |,3/4-43T*,-*-Q g*3- 4-) SA HE SER H AH1HXorticosteroid in`ection"-Hsilicon"""
1rb ,-4*- +T*3*- 4-) T*-4, ,T-*T@ .//34. )4/) 43 T.kQ1H Painful loss of vision"-HH Painless loss of vision"
1ob ,-4*- +T*3*- 4-) /.T*, ,gT,34.QT*,-*-Q1HXover the eye with a dressing"-H1nti,iotic ointment put it in the home without covering the eye#
1b ,-4*- +T*3*- 4-) *+43-,}43Q)* g*3- ,,k**-Q
H the patient leaning forward ma^e pressure in the lower side of the nose "1b ,-4*- +T*3*- 4-) 4,-*T, ,3, D43/),Tk* |. 3*4k 4 -)* .3* M.3- +T.g,g@ D4,k.343QH 1denoidH koreign ,odyThe 8(ese"!e o' unilateral foul smelling nasal discharge%s #)s #" %"*%!#%o" o' 'o(e%-" +o*) %" he nose
b 18 .-)3 g,g@ +T*3*- -),- )* .@ 3,@4k ,, g,g, )4/) 43,g.T, |.T )43 ,k* . .-)*T 3@+-.3 .T 34k ,g.T, BT3- -)4k -.
http://en.wikipedia.org/wiki/Geneticshttp://en.wikipedia.org/wiki/Edwards_syndromehttp://en.wikipedia.org/wiki/Geneticshttp://en.wikipedia.org/wiki/Edwards_syndrome -
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g* ,33*3 QH Hhearing assessment "H Hdevelopmental assessment "
1b C,3* 3/*,T4. /)4D +T*3*- 4-) T)4.TT)*, 3.T* -)T.,- |.T o D,@3+T*3*- 4-) 4DD* *,T +*T|34. *},4,-4. .| -)* *,T Q . T*D*33 4-)* *,T-)* /,3* .| +*T|34. Q
H otitis media ,ecause no pain "H pper respiratory infection"20 C,3* 3/*,T4. +,-4*- F. /,3* .| /.T.,T@ ,T-*T@ D43*,3* +T*3*-4-) , 3@+-.3 .| 4- -. D4,k.3* -),- +,-4*- ),3 M .T .- g@ rst AXjand X1R/.1X ACA1H A[ercise stress test "-H Xoronary angiographyXH A[ercise""""
21b ,-4*- +T*3*- 4-) ,/-* +T*/,TD4-43 EC~ * 3** ECE Qb Sb 3*k*- **,-4.
Hq wavesHprolonged PR interval b - ,* 4*T34. 3- **,-4.
22b/,3* 3/*,T4. +,-4*- +T*3*- 4-) /,T.-4D ,T-*T@ .g3-T/-4. g@ 80-T*,-*- g@H carotid endarterectomy"H """"""""surgical ,ypass.f more than _0 % go to surgery
2ab ,-4*- +T*3*- 4-) k**T,4*D 3*4T*3 .- F. /,3* g*|.T* .|,@ 34*T . +*T4.3 )43-.T@ 4F* -),- Q
)* .3- 4+.T-,- -)4k -. D. . 43QH AAj" 1fter thatH a,oratory test "in AR
.f sei\ures are newHonset or if e[amination results are a,normal for the rst timeneuroimaging is required"AAj is less li^ely to detect a,normalities if sei\ures are infrequent"Alectroencephalograms are an important tool in determining prognosis for futuresei\ures and should ,e strongly considered for all children with a rst sei\urethe AAj will ,e normal in 50% of patients following a rst sei\ure
2rb C,3* 3/*,T4. +,-4*- +T*3*- 4-) /,T+, -* 3@DT.*T*,-*-QHcorticosteroid in`ection
Splint the wrist in a neutral position at night and during the day if possi,le"1dminister S1./s"Xonservative treatment can include corticosteroid in`ection of the carpalcanal" H XTS"- they didnt mention a surgery in the CX
2ob/,3* 3/*,T4. +,-4*- +T*3*- 4-) SLE
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)* *,3- DTk ),3 34D* **/-QH methotre[ateH name of other chemotherapy
2b /,3* 3/*,T4. +,-4*- +T*3*- 4-) +T.3-,-4-43 g@ /-T* kT,*k,-4* T.D* -T*,-*- Q
H Trimethoprim and Sulfametho[a\ole or urqunilonesH ampicillin if suspected sepsis with gentamicinH gentamicin if suspected sepsis with ampicillin
2b /,3* 3/*,T4. +,-4*- +T*3*- 4-) R ,|-*T 1 **F -)* +,-4*-+T*3*- -. ),* )*,-T4, *D*, .3- +T.g,g@ D4,k.343QH .g1 nephropathyH post streptococcus j
Postinfectious glomerulonephritis : Dliguria edema hypertensionteaH or colaHcoloredurine" !H wee^s ttt supprtive
.g1 nephropathy : hematuria ormal X ttt : jlucocorticoids
28b -)* .3- 4+.T-,- D4,k.3-4/ -*3- |.T -),- 43 Qb Cicroscopic R-XHCacroscopic R-X"H R-X cast"
2b /,3* 3/*,T4. +,-4*- F. /,3* .| )@+*T/).*3-*T*4, M Qa1T*3*- 4-) 4*3-4k,-4. 3).4k g*T3 Q)4k) -.-, /).*3-*T. )4k)LL )4k) ~
| -)*3* 4*3-4k,-4. ),- 43 -)* D,k*T .* |.T D**.+4k /.T.,T@ ,T-*T@D43*,3 QH/
Total cholesterol !00 mgd / 0 mgd triglycerides 500 mgd and b/ x Y0 mgd are ris^ factors for X1/
a0b C,3* 3/*,T4. +,-4*- +T*3*- 4-) ,/-* +,/T*,-4-43 g*3- D4,k.343 g@ QH CR.H Xontrast computed tomographyH GHray
a1b C,3* 3/*,T4. +,-4*- +T*3*- 4-) a D,@3 )43-.T@ .| g**D4k +*T T*/- +T*3*- .| +,4 ,|-*T D*|*/,-4. g@ *},4,-4. ,33 ,- a ././F QT*,-*-Q1HPut a sit\ ,ath 5 time a day "-H S1./ ointment locally "XH ligate the mass then remove it "
1cute kissurevery painful ,right red ,leeding especially after ,owel movementtreatment is conservative: stool softeners sit\ ,aths
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a2b /,3* 3/*,T4. |*,* +,-4*- +T*3*- 4-) T-4/,T4, -)*T* 43 , )43-.T@ .|3*4k 4 -)* 4+ 3.* -4*3 D4,k.343 Q4,k.343QH angioedema ####around mouth
aab ,g.- +*+-4/ /*T ). -. F. 4| 4- 43 D* [email protected] .T .-
arb +,-4*- @.T D4,k.343 |.T )* 43 /,/*T ). -. gT*,F -),- g,D *|.T )* QH see the patient how many ^now a,out the disease"b
aob oo ,* +,-4*- +T*3*- |.T /)*/F + +)@34/, *},4,-4. 43 .T,,g 4*3-4k,-4. 4/T./@-4/ )@+./)T.4/ ,*4, Hg Q-)* .3- 4F*@ /,3* -. *}/D* 43H lymphoma"H gastroenterology malignancy"b
ab+,-4*- ). 43 3.F*T -)* *,3- D43*,3* -. .//T 4 )4 43 QHrinary cancer"H Xolon cancer"
ab /,3* 3/*,T4. +,-4*- +T*3*- 4-) ,/-* 3@+-.3 .| g..D@ D4,TT)*, 4,k.343 ,/-* /*T,-4* /.4-43 Q-)* 44-4, -T*,-*- |.T -)43 +,-4*- QHcorticosteroid therapy "H methotre[ate"H 5H1minosalicylic acidHsulfasal\ine
a8b T*k,- .* +T*3*- 4-) , ,33 4 )*T .-) g**D4k )* gT3) )*T-**-)g@ *},4,-4. ,33 a}2 / D4,k.343 QH aphthous ulcer"H """""cancerH """""granuloma
;)o-e"%! -(#"$&om# *$(%"- 8(e-"#"!)6 he 'o(m !o"s%*e(e* #s # 8(e-"#"!) $mo( +e!#$se o' %s eme(-e"!e %" he mo$h#(e#6 ;)o-e"%! -(#"$&om# 5#&so ,"o" #s E($8%e hem#"-%om#64(#"$%o" %ss$e
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H Arythema to[icumbr1b *,* +,-4*- +T*3*- 4-) 4-/)4k 4 -)* ,k4, ,33./4,-*D 4-) -)*,k4, D43/),Tk* H Q o . T4/)..,3 4|*/-4. +3*D.)@+),* g@ /-T*D4,k.343 QH physiological discharge "H Xandida infection "
r2b |*,* +,-4*- +T*3*- 4-) -)4/F ,k4, D43/),Tk* /..T . 4-/)4k,k4, *},4,-4. g@ 3+*/ .T, H Q r4,k.343QHphysiological discharge
rab /,3* 3/*,T4. +,-4*- ). 43 F. /,3* .| )*+,-4-43 *3-4k,-4.3).3Q)4k) ,F,4* +).3+),-*3 ,4.-T,3|*T,3*H3 Ak Q *H3 ,g Q b*4,k.343Q
Ho,struction of ,iliary tract ##rrb*+4D*4..k4/, 3-D@ |.T 3.F*T 3,4D -)*T* 43 10000 3.F*T 4 -)* ,T*, ,-3-,T- .| -)* 3-D@ -)*T* 43 2000 ,- -)* *D .| -)* 3-D@ -)*T* 43 1000 -)*4/4D*/* .| -)43 3-D@ 43 Q1H 0% 000 0000-H 0%.ncidence proportion Balso ^nown as cumulative incidenceE is the num,er of new cases within a speciedtime period divided ,y the si\e of the population initially at ris^" kor e[ample if a population initially contains000 nonHdiseased persons and !Z develop a condition over two years of o,servation the incidenceproportion is !Z cases per 000 persons i"e" !"Z%"
rob *+4D*4..k4/, 3-D@ ,- -. 3** -)* ,*/- .| 3.F4k 4 -)* gT./).k*4//,T/4., -)*@ 3, -),- 43 0 .| 3.F*T ),3 gT./).k*4/ /,T/4., a0 .| . 3.F*T ),3 -)* D43*,3* -)* 3+*/4B/4-@ .| -)* D43*,3* ,3 , T43F|,/-.T 43 QH_0%H0%
rb |*,* +,-4*- /.+,44k .| -)4T3-@ DT4F , .- .| ,-*T |T**-T4,-4. 3)* ),3 , )43-.T@ .| D4,k.3*D ,3 g4+.,T 34/* 2 **F 3-,T- 4-) ,
*D4/,-4..| 4-)4H psychogenic polydipsia"H central dia,etes insipidus"nephrogenic dia,etes insipidus "
ithiumHinduced nephrogenic /. may ,e eectively managed with the administration of amiloride apotassiumHsparing diuretic often used in con`unction with thia\ide or loop diuretics"
rb /,3* 3/*,T4. |*,* +,-4*- +T*3*- 4-) .*T ,gD.4, +,4 .T g,/F+,4
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2ba D,@ g*|.T* *3-T,-4. -)* 2ba D,@ ,|-*T g*k44k .| 4- Q4,k.343QHprimary dysmenorrhea"H secondary dysmenorrhea "
r8b*DT@ .* +T*3*- 4-) D4,TT)*, )4k) |**T /)43 .-)*T +)@34/,*},4,-4. 43 .T, 4/D4k g,/F +,4 43 .T, 4,k.343Q
1H Pyelonephritis"-H -acterial gastroenteritis"XH ziral gastroenteritis"
rb ,-4*- -,F4k ,-4D*+T*33,- DTk ,*3 .| , DTk /,- T**g*T 4- g-),- T**g*T 4- , DTk .| )@+*T-*34. -)* ,-4D*+T*33,- DTk ,F* DTk DTk 4-*T,/-4. 4-) .* .| -)* |..4kDTk QH on of the a,ove"
o0b ,-4*- +T*3*- 4-) 3**T gT./)4, ,3-), )4/) .| -)* |..4k DTk
.- T*/.*D*D -. k4* 4- Q1H Sodium gluconate "-H Xorticosteroid Bin`ection or orally# EXH Xorticosteroid ne,uli\er"
o1b g,g@ +T*3*- 4-) +,4 4 -)* *,T g@ *},4,-4. -)*T* 43 +4*/* .| , k,33D**+ 4 )43 *,T /,, -)* .-)*T *-4. , )43-.T@ .| , gT.F* k,33 4 -)*F4-/)* g- 3)* /*, -),- /.+*-*@ * -T*,- -),- g@Q . 4TT4k,-4.1H -y applying a stream of solution to syringing the ear"-H Remove it ,y forceps"
o2b C,3* 3/*,T4. g,g@ 2 @*,T3 ,k* +T*3*- 4-) , )43-.T@ .| R ,3, D43/),Tk* ,|-*T -),-/.+4/,-*D -. )**4k -)*T* 43 T,*3 4 -)* *D 43+4T,-.T@ *,T@*}+4T,-.T@ +),3* +T..k*D *}+4T,-.T@ +),3* 3**T T*3+4T,-.T@ D43-T*33 34k-)* ,//*33.T@ 3/* 4 T*3+4T,-4.4,k.343Q1Hziral pneumonia"-H-ronchilitis"XH-acterial pneumonia"
oab M.-)*T gT4k )*T g,g@ -. @. )* )* +T*3*- 4-) )*,-., 4 )43 ,4H. -. ,,k* -)43 +,-4*-Q1Ho need things F as^ him to go to the home"-H,ring a sharp metal B {6 E F press in the middle to evacuate the bematoma"XHremove the nail"
orb 4 -)* 44-4, *,,-4. |.T 4|*T-44-@Q1H Temperature chart"-H Semen analysis"XH Refer to reproductive clinic"/H rine analysis to detect the ovulation "
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oob34D* **/- .| *.D.+, QH fatal hepatic to[icity "H fatal renal to[icity"Hdys^inesiaHspeechob +,-4*- +T*3*- -. @. )* @. 3** )43 /,3* @. D43/.*T -),- +,-4*-),3 -*T4, 3-,k* .| /)T.4/ 4*33 ). -. ,,k* -)43 +,-4*- Q
H ma^e him go to the home"ob A |*,-T*3 .| -.34,T ,g3/*33 *}/*+- Qdeviation of uvula to aected side:
o8bET*-)*, .D.3 Qpainful red nodules treated with S1./s not steroids
o /)4D 4-) */*, ,T* + )* 43 . 3-*T.4D ,D ),4k 4-/)4k D43-Tg )433**+4kQ,,k**- Q
H ointmentH antihistamine##b0b+T*k,- ,D@ 28 F3 4-) C),@D4, 4|*/-4. QHa\ithromycin B single dose EHerythromycin B this point what . remem,er was not present EH /o[ycyclineH ! points of ! drug of oinolon groupb
1b /.. /,3* .| ,* 4|*T-44-@QHprimary hypogonadisim : ilnfelter syndrome ||||| turner syndrome in female
Hsecondary hypogonadisimHe`aculation o,struction
2b18@*,T3 .D g.@ 4-) g,/F +,4 4*3-4k,-4. -. D. *}/*+- QCC vASRG Hray,one scan
ab 4T. D*B/4*/@ ,*4, QHserum iron
HferritinHT.-X
r b )4/) kT.+ @. 4 D. .*T *D.3/.+@ |.T +,-4*-3 4-) 4T. D*B/4*/@,*4, 4 4-) . g*4k /,3*QHmale all age groupHchildrenHpermanupausal womenHwomen DXP
ob |*,* +,-4*- F. -. @. 34/* a @*,T3 ,k. ),3 S 3)* D4D- ,kT**
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4-) @. ,g.- -),- @. D. , -)* 4*3-4k,-4. .-)4k 3kk*3-4* .-)*T -),-),- 3)* ,- @. -. T*|*T )*T ,- -)43 /,3* ),- @. 4 D.H """"""""""""""you will response to her F refer her to the doctor that he is want "H """""""""""you will response to her F refer her to the doctor that you are want "
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HERE S A R CASE RS
H REA HE EE R H EERACE EC SER
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D}uterine ,roidadenomyosisendometriosis
g*3- 4}QSlaproscopy
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8/10/2019 SLE 2008 -1
13/14
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H ,,k**- Qo[itocin infusionmesoprosto
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}}}"CA/.X11X1/AC"ATCOLLECTED AND TRIED TO BE ANSWERD AND SENT BY
DR.ABULMALIK ALBAKER [email protected]=>? FG J PQ
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mailto:[email protected]:[email protected]