Pediatrics OSCE: History and Examination |PED2|

インデックス作成: 2026-05-22

[00:00:00]Peace, mercy, and blessings of God be upon you.

[00:00:03]Today, doctors of pediatrics, we will be discussing the two OSCEs. Listen, my friend, you have two branches here. First, the abdominal branch, which is part of hematology (blood). Second, the neurology branch, which is the brain and nervous system. What are the common conditions you might see in the exam? Under hematology, there are three: beta-amyotrophic lateral sclerosis (BAS), hemophilia (type X), and the one marked with an X because it's less rare. As for neurology, you have hydrocephalus, cerebral palsy, and the third one, also marked with an X, is Duchenne muscular dystrophy, which is the least rare in your university section. The first thing you need to know is, please review my theory regarding these four topics specifically. Look at the checklist, God willing, and I'll also leave it where in the video description or comments, or something like that.

[00:00:56]Anyway, if you come and look with me in the discussion section... You'll find "Investigation and Treatment" written for the four cases I just mentioned. So, like a good person, first go to the hematology file and look for your two topics: thalassemia, which was a microcytic hypochromic anemia, and hereditary spherocytosis, which was a hemolytic anemia with higher reticulocyte counts because it's a normochromic anemia where the red blood cells break down, and their reaction is to increase reticulocyte counts. You'll find these two topics, and as I explained them in detail in the theory videos, you'll find them in the playlist, God willing. Just like that, like a good person, start reading it.

[00:01:38]Read it all at once: Clinical Picture, Complexity, Investigation, Treatment, and so on.

[00:01:42]Focus especially on the Investigation and Treatment sections. Okay? I can leave you three seconds here with thalassemia if you want to stop and zoom in. And God willing... It appears, meaning you read the text you have. Okay, you have three seconds. 3, 1.

[00:01:57]Then, with Heridiasis (respiratory syndrome), the same thing applies.

[00:02:09]You have three seconds. Now, stop, zoom in, and read the text at your leisure. 3, 1. And the same thing applies to the Neurology file. God willing, we have Serral Policy. You have three seconds. 3, 1. Continue with Serral Policy. Stop and read the text. You have three seconds. 3, 1. And the last case we have is Hydrocephalus. God willing, this is the first part of it. Then, the second part of Hydrocephalus. You have three seconds. 3, 2, 1. Genius, sir! A second round of applause for you because, thank God, you were able to review the four topics theoretically. So, you are now ready for us to delve into the OSCE content. Great, initially, sir, for each of these branches, either Hematology or Neurology, we will study normally as we are accustomed to in the OSCE: History, and then Assumption.

[00:02:48]Assumption is general. Azmasion and Lock Azmasion, initially the history and generation, do you already have a background in that? If we go to the Yamnout channel and then to the playlist, and scroll down, God willing, until we find the Pediatrics One Playlist, and scroll down again, we kept looking for the video you see here, titled "Pediatric History Teach." At the end of that video, I told you, my friend, that you'll need it in the second semester for Pediatrics 2, and to listen to me and study it well. But you didn't listen to me properly, but it's okay. We also made a video for Pediatric Examination there; you don't need to worry about that at all. Anyway, I'm telling you that you have an idea about it, so it won't be difficult. That doesn't mean we won't review it; we'll review it, go over it, and explain it normally. Because there are differences, for example, in the Present History section here, and there are some additions in the General Examination section, and so on. We'll go over it, don't worry about it. Anyway, the last section is the Local Examination, and this, my friend, is actually It's explained in the abdominal exam, and then you'll be tested on it here in pediatrics. So, we went to Yamnos's channel and scrolled down, looking for the Medicine Introduction video series.

[00:03:58]Okay, what did I do for you? I mean, an introduction to all the practical branches of the abdominal exam, including neurology examination and abdominal examination.

[00:04:08]But that was the basic introduction, and it's completely enough for you to be tested on in the pediatrics section. It's enough; you don't necessarily need their advanced clinical examination. I made a video for chest and cardiology, and I'll make an advanced version for those too, but the basics aren't enough for you to be tested on. We might review the contents at the very end of this video, but the main explanation is there. So, in this video, our main focus will be on history and general examination, and maybe... Now let's move on to reading the local assessment, investigation, and treatment for each case. Okay, listen, before we start our video, these are the medical tools you should bring to the exam. Please pay close attention.

[00:04:53]Most of them are new things, like cotton buds and toothpicks. These are for sensory systemology light, and ton forks are for keratin nerve function. This one is for light reflexes, this one for facial aspirates, and the reflex meter is for motor systems reflexes, and so on.

[00:05:13]Okay? Then we have some general things like mechanoreceptors to measure, for example, the circulatory system. I do n't know if they work in all cases, and you put them on your growth chart. You could also bring one for elevated circulatory system reflexes, and so on. And don't forget your lab coat, please. It should be a good quality coat, or whatever you prefer.

[00:05:33]As you wish, and the last thing we have, of course, is the stethoscope. But why didn't I include it in the pictures? I wrote on the side, "Keep the stethoscope in your pocket." Because if you, a respectable doctor, come in and put it in like that, the abdominal doctor will say, "Oh, you brought your stethoscope? Well, do a scaling for me, sir." You'll say, "But I'm not trained in cases." I won't tell you to keep the stethoscope with you, but put it in your pocket, put it in your bag, like that. Excuse me. Okay, okay, sir. That was our introduction. God willing, I'll leave these files in the video description. And we put our trust in God.

[00:06:09]They said, "Glory be to You! We have no knowledge except what You have taught us. Indeed, You are the All-Knowing, the All- Wise." In the name of God, the Most Gracious, the Most Merciful. Let's begin. The first thing we have is history. Look, sir, of course, you already know and have studied the history items. I studied and explained this to you before, so let's just go through it briefly, God willing. First, what does "personal history" mean? It means we'll take the patient's personal medical record. These are people who read, not people who give orders like with adults. You're dealing with a pediatrician who is under 18 years old and not yet fully responsible for themselves. They might even be two or three months old. You're working with people who are close to you.

[00:07:00]First, you'll ask the mother or the accompanying person what their name is and how old they are. Let's take these in English first: Name (what is their name?), Age (how old?), Sex (female or male).

[00:07:11]If their characteristics are clear, you don't ask. For example, if someone is two or three months old and covered with a sheet, it won't be obvious, so you ask the mother. Otherwise, you don't ask because it's not effective. Order of birth (what is their birth order among their siblings?), residence (where they live), and information (what is your relationship to them?). Okay?

[00:07:31]For example, after You haven't gathered all the information and you want to tell it to the doctor supervising you. You'll say, " Maryam, okay, Maryam, fine." Now, regarding this, of course, where did you study it? And something like, for example, how is he doing in school? Or you could mention it, for example, in the functional history with mental development, or something like that, but that's not the topic here. And it also depends on the school you're following. Okay, we've finished the first item, which is the personal history, and the same thing is written in Arabic in front of you. If you want to stop and read it, just follow the reading I told you, and don't leave the conjunctions here unless the doctor taught them to you in the section. Don't show up and ask about the conjunctions now, not with the family history, because it's different. The second item we have, sir, is the complement, sir, or, respected mother, what is the main complaint that you brought your child to the hospital with? What is the main or primary complaint?

[00:08:40]Okay, and you tell it to the doctor.

[00:08:44]I mean, you're not going to turn it into scientific terms.

[00:08:47]He told you in Difficulty breathing remains a concern. You wouldn't say "disinosis," for example. Hematology, for instance, herpesviruses, cerebral hemorrhage, osmia.

[00:08:57]What might the patient complain of? The mother might say, " This is biliary, this is phlegm, this is sudden pallor, and his urine was very dark, whether it was very dark yellow or very dark brown. The important thing is fainting, or his abdomen gradually enlarges. Is this due to spleen formation?

[00:09:16]Because this is anemia. Anemia causes the cerebrum to break down. Where does it break down? In the cerebrum. So, to increase the breakdown, the cerebrum enlarges."

[00:09:25]And so on. As an example from neurology, for instance, a hydrocephalus patient might say, "This is an enlarged head, its shape is abnormal, it keeps getting bigger."

[00:09:36]We'll tell the doctor the complete list, and then we'll move on to the next item, which is the history.

[00:09:44]This information, of course, needs to be memorized. The easiest and best way is for you to come to us first. What you heard from him is fine. Now we want to start analyzing it. Remove the points we are used to, which is ODA, increase, decrease, last attack, treatment effect, right? That is the last. Did the issue start suddenly or gradually? Okay, does the course increase or decrease? How long has the dehydration been going on? How much association is there? Is there anything else accompanying it? What increase? Is there anything that increases it? What decrease? Is there anything that reduces it?

[00:10:33]When did he last experience this complementary treatment effect? ​​What treatment did he take?

[00:10:39]What was its effect? For example, let's say the mother complained to you that her child's skin color suddenly changed, so she brought him to the hospital. You ask her these eight questions, and she tells you, "This started gradually, Doctor, but it's progressive. The pale color gets paler, further away from the natural red color or his natural color, regardless of what his natural color is. Of course, we have different colors, praise be to God, that's a sign. This started three months ago. He also had yellow eyes, dizziness, and fatigue. It increases when he gets an infection or when he moves or exerts himself. It decreases when he rests or when he receives a blood transfusion.

[00:11:20]Doctor, the last attack was this morning, so I brought him to you right now." Of course, the patient you'll see in the OSCE exam will likely be a chronic patient, someone who is being monitored in the hematology clinic or something similar. So you'll tell the doctor, "No, he's being monitored in the hematology clinic." Because he has such-and-such condition, and she was writing, writing, and telling her, or telling the doctor any information you heard about my treatment effect, for example, when the blood takes on a pale color, it gets fixed again, but only temporarily, based on the fact that the spleen breaks it down again, and so on, and new, clean blood isn't formed. Okay, we did the analysis, the complete one, and I sent you examples of the system. No, of course, you have hematology, agreed? Hematology, here are the patients: beta-associated otitis, or, sir, neurology. Neurology, of course, which is the patients: hydrocephalus or cerebral policing. Okay, of course, the patient in front of you, as long as you haven't heard from one of your friends or from the supervising intern outside, what he is like, then you will go in and ask him both.

[00:12:18]You will ask about hematology and you will ask about neurology, and so on. And take the middle path and keep asking, asking until the doctor... Okay, sir, the history We're done with that. Now move on to the next points. Thanks from Uncle Hematology, sir. Hematology, of course, has a lot of questions, and I could fill this sheet with them, but the point is that you need to be able to memorize them. So, to memorize them, you need a system. How do I memorize it?

[00:12:39]Hematology of blood. So, what are the components of blood?

[00:12:41]Well, RBCs, lymphocytes, plasma, and the others. These are four components, sir.

[00:12:45]Reduce one of each one for me, and start deducing the questions based on that. Okay, reduce the RBCs for anemia. We'll ask about the symptoms of anemia. You studied them in the theory, for example. Did he, for instance, focus with me? Does he look pale? Does he get tired? Does he have a swollen throat? Does he feel his heartbeat? Does he have difficulty breathing? Does he have dyspnea? Does he have dizziness? Does he have blurred vision? And so on. Well, a deficiency of lipids comes in the form of an infection, so we'll ask about the infection. For example, the throat. His condition, for example, was he swollen, did his temperature rise, what about the infection? I'm giving you the headings, and I know that once I've structured the topic for you, you can add much more, depending on your creativity. Okay? A decrease in platelets will lead to bleeding, so ask, for example, about body orifices and bleeding from them. Was he bleeding from his nose and from his anus? Was he bleeding from urine (hematuria)? Was he bleeding with his stool ( hematekysia)? And list all the body orifices, okay? A decrease in plasma increases succulency, so ask about thrombotic manifestations, like a decrease in blood pressure, okay? Or even a decrease in plasma can cause symptoms of hypovolemic shock, so ask if his blood pressure is low, and so on. Okay? I'm structuring the topic for you in a way that, when you study hematology as an abdominal condition, you'll thank me because, God willing, I will explain hematology in the abdomen to you, and I will explain the exact same thing to you.

[00:14:08]History is asked in this way, and the topic You memorized the titles, you genius! Why? Because I'll keep giving you much more and I'll sort things out for you, God willing.

[00:14:17]If God wills it, we'll still be content. Okay, so that's hematology. And neurology too? Listen, in neurology we ask about three things: osmosis, motor system, center system, and cerebral nerves. Motor system: involuntariness movement.

[00:14:33]For example, did he have tremors, a tremor in his hand, spasms, sudden body spasms, convulsions, tremors, or spasms? Spontaneous control: does he wet himself? This information is in the checklist, pay attention. Voluntariness movement: for example, when he moves his hands, when you say, for example, "Hold something," does he have a defect? ​​Does he hold an object and fall while walking? Does he have frequencies? Is his body weak and wiggling? And so on. These are all examples, and with practice, the material will be memorized, God willing, as a center.

[00:15:00]System, substantia [ __ ], pulsation, burning sensation, deep sensation. You'll ask about the ataxia: is it moving, staggering, sitting down, unable to maintain balance? Okay, the cranial nerves—you should know them. I've already written this down for you; I explained this model in several videos before, the 12 cranial nerve functions. They're simple, and I know you've studied them and I've explained them to you several times, so we won't waste time on them. For example, the olfactory nerve: can it smell? You'll remember the cranial nerve name and its function and ask about it. You don't write this down at the end; I'll leave this information at the end of the video, so don't worry. Okay, the optic nerve: can it see? Keep it simple. Okay, what does it see? Good? I don't know what? That's it.

[00:15:46]We're not going to... In Ophthalmologie, we explained this in detail, but the idea is that we are superficial and we are trying to cover all the different points. Okay, this is a trick here in medicine. Okay, the OK motor, the trochlear motor, and the epidusence. These three, four, and six are responsible for eye movement. So you will ask, does he know how to move his eyes properly? Oh, okay, no, he has a squat, I don't know what it is, the trigeminal is responsible, for example, for the movement of his facial sensations, the trigeminal, the triad, one, two, three, from top to bottom, three places, and so on, okay, and some muscles, but the important thing is, you might ask, for example, does he feel his face well?

[00:16:28]This strange question, we will do these things as an examination, God willing.

[00:16:29]Okay, the facial is responsible for the facial muscles, does he move his facial expression well? He closes his eyes, opens his mouth, and so on. The vestibular plexus, as its name suggests, is responsible for hearing. He heard well. Next, we have the bulbar nerves, which are the globus plexus, phlegmon, and hypoglossal plexus 9, 10, and 1. Does he swallow well? Does he have difficulty swallowing? The accessory nerve is responsible for neck movement. He can look right and left and move his neck properly.

[00:16:59]The trick here is to organize your answers in this order, each corneal nerve name and its corresponding function. You then focus on the function in a specific way, like this: grossly, and that's it. Okay, so far.

[00:17:08]By the way, and I noticed we asked more than 40 questions. So, when you organized and arranged these questions, the doctor will say you're a genius. So, we're done.

[00:17:20]Oh, the rest of the analysis of these systems... I haven't written details about that yet. If I remember anything, I'll tell you. Other than that, it's less important. Why are these questions enough? They'll be on your exam here.

[00:17:30]Pediatrics means other systems. I remembered, for example, the CNS. If you connect the two, which we said is, if there are two in the CNS, there will be intracranial hemorrhage. Did he have any bleeding in the brain? So, I've given you a side example so we can disagree on it. Hematology and neurology are enough. Okay, past history is specialized, written with letters: Dodd-Drugs, have you taken any medications before?

[00:17:50]We can include vaccinations, for example.

[00:17:53]Vaccinations aren't just medications, but as a way to remember them.

[00:17:56]Operations, have you had any surgeries before? For example, did you have a splenectomy? The disease is coming. Has he had any diseases before? Any other diseases besides what you told me? Okay, and don't forget to ask these three questions, they're very important: vaccinations, splenectomy.

[00:18:11]Why splenectomy? Because they're on the checklist. Okay, family history. Family history.

[00:18:16]History two, starting with the letter "S," similar condition: does he or she have the same disease, or does anyone in the family have it?

[00:18:22]Consecutiveness: are you and your husband related? Okay? Then we have the flow-based history, which we also divide into motor and mental. We go back to the motor and mental questions, meaning the same thing we explained in Pediatrics 1. Okay? These are detrimental in neurological cases like cerebral palsy and hydrocephalus, and normal in hematological cases like thalassemia. By the way, just between you and me, if you rarely see a case of heterozygous spherocytosis, it's usually a patient representing heterozygous spherocytosis. Okay? And I didn't see any heterozygous spherocytosis in the sections, but generally, these will be detrimental in neurology and normal in hematology. Okay? And this is another way to differentiate between them, besides the external.

[00:19:08]Features vary, meaning if you find a baby with a large head and a hydrocephalus character, then it's hydrocephalus, and so on. The important thing is the language itself: when did the baby's head stabilize? When did the baby sit up? When did the baby crawl and stand up? When did the baby walk?

[00:19:25]Their corresponding numbers are multiples of three: 6 months, 9 months, 11 months. These are the normal numbers to keep in mind so that when she answers you, you can compare them. Is there a delay? For example, if the baby's head is at, say, six months, that's delayed. Or mentally, they'll be the same.

[00:19:43]When did the baby start smiling? When did the baby start recognizing "when"? When did the baby start saying " dada" and "mama"? The normal range is 6 months, 6 months, 9 months, and so on.

[00:19:56]Memorize these things, okay? And then we have the net channel history. And what we memorize with the letters B and B, we'll ask about: Where is the breast? Was it breastfed on both breasts? When was it weaned and what was it weaned on? For each of these branches, I can include more than one question, it's up to you. But what are you basing your memorization on? Okay, what is it eating now? Food frequency, meaning approximately how many times a day? Appetite, what is its appetite like?

[00:20:26]Okay, the important thing is that you ask, regardless of the answer. The important thing is that you ask, and there's no need to sum it up and tell the doctor unless you're in an equivalency exam and writing down the points with answers after them.

[00:20:36]Okay, the last thing we have is the prenatal history. Prenatal means around birth, meaning prenatal before birth. We'll ask the mother questions, and during birth we'll talk about the delivery. The postnatal postpartum we'll ask about the baby. Okay, before birth we'll see if the mother was exposed to anything, and if so, what was she exposed to? The mother had a rash, then got diabetes, and so on, things like preeclampsia and stuff like that, high blood pressure, I don't know what else. Look for any illness you can think of for the mother, anything. During childbirth, did she have a natural birth? When the baby was born, how old was he, what was his weight, and how long was he? What were his majors right after birth?

[00:21:15]After he was born, did he turn blue, cry, have a seizure, and so on? And if you want, sir, questions on neonatal history, you can stop and read the things in front of you. But for me, what I gave you were hints, just enough to memorize. Because if you go overboard, you'll get confused and forget the important items in the exam. Okay, okay. If you want to stop and read this, go ahead, you have three seconds. Okay, one. Great, sir. All we've done so far is that I've told you the history, that I've organized it for you respectfully, and that I've told you how Your role now is to memorize it completely. After you memorize it, you'll practice on your friend, for example, by asking him questions, or by asking him questions like, "Hey, someone's asking you questions, patient, your name is Cerebral Polis, I don't know what it is." I'll practice on you now. I'll ask you questions, please answer me in Egyptian Arabic or Arabic, whatever you like. Okay? I understand something about history: don't forget the point. You need to cover all the points, not go into too much detail. You know, if you practice, you'll be able to go into too much detail.

[00:22:17]These things expand. I'm giving you the trunk of the tree, and I can give you many, many, many branches, but I'll confuse you. My role now, as someone explaining to you, is to give you the trunk of the tree and tell you how to grow branches from it. Okay, with practice, the branches will grow and appear. Okay? Are there any additions? Yes, there are additions. Look, in history, for example, the history of hereditary trisosis, we talked about personal history and on The complete course, the present history, the family history, the print history, the past history, and so on. Okay, inside the present history, what varies from patient to patient.

[00:22:52]For example, we talked about the anemia manifest, but did we mention hemolysis and gallstones? No, because the doctor doesn't ask too many questions.

[00:23:02]I'll tell you, "Okay, you've memorized it well, so he'll let it slide."

[00:23:04]Otherwise, you can find out about them if I didn't write them in the summer, for example, about a fever, jaundice, or dark urine. And if you noticed, we asked about them indirectly too, but it didn't differ. A patient with hemolytic anemia or thalassemia—well, that's hemolytic anemia—so you ask about the anemia itself, the type of anemia ( hemolysis), and the complications of the anemia (gallstones).

[00:23:24]Okay, when When the bilirubin conjugates with gallstones, it doesn't go to the staphylococcal globulin, so the staphylococcal globulin becomes pale because there's low estrogen. Then it returns to the bloodstream and goes to the urine, so the urine becomes urobilinogen. Okay, okay, we'll talk about the investigations later, God willing, with the treatment and all that.

[00:23:53]Because this isn't actually a question you ask the patient. The patient won't know what bilirubin is, or serum iron or osmotic pressure. She won't know these things.

[00:24:02]This is a theoretical question the doctor asks you, written down at the end with the discussion. Okay, okay. And if we move on to the patient's neurology history, we'll find that we've covered all the points, God willing: present history, complementary history, present stores, everything.

[00:24:17]But I'm focusing here; it's important because you're asking about the causative agent.

[00:24:24]For example, the causative agent is the one for the substantia [ __ ], and so on. Okay?

[00:24:27]Okay, sir, excellent, very, very, very good. For example, it says "Nutritional History" here, but it's not written with "Hematology," so we've put it all together on one page. Here it is for any patient.

[00:24:36]I have this page memorized, and I'll recite it to you, sir. Good, sir. One more thing I want to explain before we get into the examination, before we get into the general examination. We have a series, sir. You start with this series with every patient in your life. I taught you this from the moment you entered medical school. Whether you're going to take a history, do a general examination, or do a local examination, you must start with a series, which is the "S" stand.

[00:24:56]Who will you stop at? What introduction? You'll introduce yourself: "My name is Youssef, a medical student. I'm here to do this and that," or "I have a request. I'm here to ask you something, but I'll just examine it." I'll ask you a few questions, like... Okay, explain this. There are points for this. Don't worry, I've written everything down on this page for you to memorize. Just focus on it and practice before we move on to the general examination. There's something else you can ask about, which is the topic of blood transfusions with hematology patients and the topic of meningitis with neurology patients. Regarding blood transfusions, you can elaborate on that, for example, if the transfusion was before six months, it could cause rheumatic fever, and if it was after six months, it could cause dialasmia or sickle cell anemia. We won't disagree on that point. Also, regarding vaccinations, we need to know about the vaccinations given before epilepsy, which are pneumococcal, meningococcal, and Haemophilus influenzae type B. Regarding meningitis, you have it in front of you.

[00:25:47]Did the patient you have, for example, your septicemia patient, develop postmeningitis after the meningitis, or not? We ask, for example, if they were vomiting—any signs of infection.

[00:25:58]Okay? She was crying a lot, for example, because of the pain. She had light sensitivity and any other symptoms.

[00:26:03]Meningitis is less important, but what I'm telling you is that if you want to add a certain point, go ahead. Otherwise, congratulations, we've finished the history test. God willing, now for the general examination. Why is it in a separate box in the checklist? Because it's important. Okay, let's leave that aside. Of course, the same applies to all patients. This is a trick here for organizing the information. Look, first, BCD. The same thing we take in class. The abbreviations I told you to memorize will make it easier for you now and in the future. The abbreviations for vital signs numbers are: B, B, C, Complex, D, D, Extremities. Don't forget Mental Health and Majors. Okay, first, the vital signs numbers. Of course, you know vital signs, which are: PPTR, PT, PT, and NONEX. What I'm saying is that these are things that are repeated a trillion times, so you have to put them together in nemonics, okay? So it's not over- nemonic or anything, it's just one big summer thing, God willing. Anyway, we'll measure blood pressure and temperature, of course. We tell the doctor we need to measure the blood pressure with a blood pressure monitor and the temperature with a thermometer, which probably won't be on the exam, but you just need to mention them, that's all. Okay, now for the pluses. The pluses are what we're focused on, and this is the most important thing in the vital file numbers. Usually, I was telling you the pluses are seven criteria that describe the bulk, two of which start with the letter R: rate and rhythm, and two with the letter V: volume and physiological wall.

[00:27:34]We also have the quantity and special characteristics, like the hammer, water hammer, and preference per session. Things like that that you memorize, right? Now, with pediatrics, please don't mention the physiological wall, if you don't mind, because it's usually normal. Anyway You'll stand next to the patient and start checking. You'll place three fingers, or whatever you're used to, on the radial artery. Once you've placed the three fingers, you'll say, "Regular Rhythm," for example, " Normal Volume."

[00:28:02]Of course, you calculate it with a clock or something; you can calculate it in 15 seconds and multiply by four, no problem. But when you get a number, if you're unsure and nervous, say, for example, 90. Keep it a little high because the normal range for beta-lactams is a bit high, not to mention labial corticosteroids and such.

[00:28:18]The important thing is that the patient is scared because you're a doctor and they want to see you looking at the clock. Okay, we won't disagree. Then you'll start checking the positive values ​​on both sides to compare the quality. It's a quick movement, don't rush it, whether the patient is co-operative or not. Be quick. You say "Equal in both sides," and then you go down. Your hand is underneath, and you start lifting it like this, feeling the tendon. This is basic abdominal medicine; it's a shame not to know it. You won't waste time on it.

[00:28:45]For example, you might say "normal" or "vascar wall," but no, I told you to avoid it in pediatrics. Listen to me, my advice is sound. Some doctors don't like it.

[00:28:54]Radiofemoral is less important; you compare the female artery to the radiofemoral pulse and see if there's a difference: one pumped before the other, or if the pulse reached the patient before the other. You also check the preference in the session, which is, for example, Dorsal Speeds and Post-Eptophal Artrizolam preference. These are basic things; everyone knows them. Your comment on the pulse will be " normal, normal, normal," unless you encounter an anemic and controlled patient. Then it will be hyperdynamic circulation, and they might have symptoms like shock, hypotension, hypothermia, tachycardia, and other symptoms. All these pulses can change; they might be He has a hamstring.

[00:29:32]You can lower his hand slightly as you shake his hand, and with your other hand, you'll feel a strong hamstring after he raises his hand.

[00:29:40]This is definitely something you need to feel on the ground and pick up.

[00:29:42]The letter "B" (or "Bel") is what you'll say. You'll say "Average Belt," things you hear. So, his build is average compared to people his age. You wo n't say "Short Stitch" because you need to see the height and put it on the growth chart. It will most likely be "Short Stitch" because of the imbalance in the complex. You'll comment on the colors: paleness with anemia patients, darker with hemolytic anemia patients, and cyanosis with a bluish tint.

[00:30:09]You'll say, "No paleness, no darkness, no cyanosis." After looking at the places you're used to, you'll hold the lips and lower them, then look under the lips.

[00:30:18]You look at the nails and the eyes; these three places are for the three colors. Is there jaundice? Is there, for example, jaundice? Is there, for example, sinusitis? Or not? The three places for the eyes will say no, okay, okay, or even bronze discrepancy. Okay, then, sir, the letter D. Descriptors, the patient's position. You'll say normal position, that line flat, for example, he's lying down, or that's down. You 'll describe how he's sitting because there are abnormal positions, for example, orthopedic, meaning he can't sleep flat because, for example, he has pneumonia or something, fluids, or something in the chest. We also explained this in respiration. In respiration, okay, you'll say normal descriptors, and that's it. After that, the extremities. The extremities of the body. What are they? They are the head and neck. This is the first extremity. And then the upper limb and its skin. Okay, and then... For example, the lower lip and all that stuff is well-studied, my friend, before it's written for you, and it's from very senior doctors who are deeply involved in clinical assessment. So memorize these diagrams I'm writing for you; they'll be useful later. Listen to me carefully. I know I'm not just saying this nonsense. So, how will you comment on the upper limb, head, and neck? Of course, there are a lot of abnormalities, but what concerns us here is, for example, hematology or neurology. In hematology, for example, you might say, "No continuity of the face." Then you'll start negating these things in front of you: no continuity of the face, and for example, there's a mongolide fish. Put three stars on these because if you don't mention them, you'll be asked about them, especially with patients with alasma. To explain mongolide fishes, you need to remember the bones of the sclera. The bone in front is called the frontal bone, okay? And there's the bone at the This is called the temporal bone, and the upper jaw is called the maxilla.

[00:32:04]We have two maxillae, and the one in the cheek is called the zygoma.

[00:32:09]We also have two zygomas, just like two temporal bones, and so on. Okay, the frontal bone is the only one. The important thing now is that a thalassemia patient has what? Well, they have hyperhemolytic anemia, meaning their blood is breaking down. Okay, so the body's reaction is for the bone marrow to hyperplasia, to start enlarging. The bone marrow of the sclera will then hyperplasia and expand. The sclera bones I mentioned to you will start to enlarge and become more prominent. Okay, prominent temporal bone, prominent zygoma, okay, prominent magsilla. Okay, the magsilla will protrude forward, so there will be a separation of the sclera.

[00:32:47]Okay, and the nose will also appear. Okay, so it will start to widen or shape You have a question called " fish" (or "pouch"). You put the word "proteus" next to your questions. If you see this scenario, you'll say "face" (or " no"). Okay, for the upper limb and the skin, you'll say, for example, "no colitis" (meaning the nail is inverted). Okay, "no hyperpigmentation" (meaning the skin isn't pigmented). Okay, for the lower limb, you'll say "no lower limb edema." And of course, you're not randomly selecting specific things; you know what the patient has and you're saying "no." You'll start by saying "no" or "no abnormalities."

[00:33:30]But you'll mention what things are related to the topic you have, which is neurology or hematology, especially hematology here. Anyway, we've finished ABCD A+. Mentality and majors are very important. Mentality is related to the PTT, which is what is Persontime.

[00:33:51]And the measurement means, okay, never mind, they're TPP, the important thing is, TPP, you'll ask the patient, "What's my name?" They'll tell you, "You're the doctor." "So, where are we? Daytime or nighttime?" "Daytime, okay." "So, where are we in the hospital?" "Oh, I know." So, this is the measurement of place time inverse. The measuring tapes are great. You'll start telling the doctor, " We need to do some measuring tapes."

[00:34:13]With my measuring tape, the most important thing is the scale circumference, specifically a specific one, meaning the hydrocephalus. The scales are large, and you absolutely must get used to and learn how to measure scale circumference. You'll measure the scale, as we see, from the beginning of the supraorbital ridge, meaning from above, like the eyebrows, okay? It's called the supraorbital ridge, meaning above the eye, okay? To the oxyseptal ridge, meaning a prominent area, meaning the two most prominent areas, meaning from the scale, like this, okay? The exciter, which is the bony part behind it. You'll count it like this and see what number appears. Here, see what number appears. Okay, let's say it's 42, then 50. Around this range, you'll start looking at, for example, if he's eight years old and the number is, say, 54.

[00:34:52]You'll connect them. What's this? This is above 97. 9, so this is macrocephaly. Okay, and your patient, when he's normal, will be macrocephaly, or macrocephaly. "Cephaly" doesn't mean "cephaly."

[00:35:05]I don't know why they say "cephaly." The letter "C" is pronounced as "C" if followed by "A" or "A" or "A", but if followed by "A" or other letters, it's pronounced as "K," like "macro" followed by "R," something other than "C," "A," or " Y." Okay, anyway, I won't disagree.

[00:35:18]This is our picture. Examples of decubits or the patient's position: it could be cerebral if he has hypertonia, or it could be a ferrugineal position if he has hypotonia. This is with Duchenne, this is with serotonin, the type. The hypertensive thing is less important, and you won't see this in the exam. You'll say normal qubits, okay? That's most likely, God willing. Good. You mean it has pure questions.

[00:35:42]What are we going to do again, sir? In the junctions, we didn't build anything else. We made a cover for all the points. I told you the simplest and fastest way to memorize and study.

[00:35:49]Okay, how do you memorize them? ABC, CD, A+, Mental Health, and don't forget Mental Health and Majors. What are the numbers for Fatal Science, Biologics, Psychocomplication, DEXT, and EXTEMS? And then Mental Health and Majors. Okay? If you're confused about something, you'll say "normal," you'll say "no," you'll negate. You have to negate. If, for example, the blood pressure monitor isn't there, then we'll say we need to do this, but the monitor is n't there, like this, for example. Okay? Or, you won't say to the store, "The monitor isn't working, we just need to measure the blood pressure with the blood pressure monitor," and so on. And what will you do? You'll skip over the point so that you don't Don't tell the doctor, "Why didn't you bring your equipment, sir?" Don't say that.

[00:36:21]You're not required to bring a blood pressure monitor for the exam. The eight items that come with the stethoscope aren't required, of course. We wouldn't bring a blood pressure monitor unless we were in Egypt.

[00:36:31]God forgive me, it happens in the internships.

[00:36:33]They pool their money and buy a blood pressure monitor. They buy, they buy, they buy! I don't know why this happens. I don't know why people... The administration is supposed to pay for and get the equipment for the patients, but they're the ones who take the money from them. Okay, before we skip to the general examination, let's look at it. Look, for example, at the general examination of [name omitted].

[00:36:50]Okay, I told you, with any patient, whatever you do with them, you have to start with the letters [of the alphabet], as we agreed.

[00:36:56]Okay, which are [name omitted], [name omitted], [name omitted], [name omitted], [name omitted], [name omitted], [name omitted], you get the marks for them, God willing. Okay, the important thing is that things are n't arranged in a specific system. We We memorized it by ABCDE, plus it's special, but it's exactly the same thing: General Appearance, Vital Science, and we also have the orthopedic surgery.

[00:37:15]Okay, comments on the head, comments on the neck, comments on the skin, comments on the scrotum, the hans, the femoral lesions, and so on. Okay, the epistaxis, the live numbing, and the canine hans. I didn't write these in the exam, but keep them in mind. Mentioning things in the exam is enough, so it's all very good. And don't forget, don't forget, don't forget the special character.

[00:37:36]This is very, very, very important, especially with the two eyes of anemia, like the water hammer pulse, for example, or radiofrequency delay. There are many, many special characters, but you'll focus on these two. So, when you're examining the patient, you'll do the water hammer pulse.

[00:37:48]If you're in the general examination with, for example, neurology, hydrocephalus, and so on, you'll find the same thing, exactly. Okay, in addition to that, we will synchronize the back, because if he has a meningocele or Okay, we'll keep that in mind, but otherwise, everything else is the same, God willing. The topic of sun appearance and squint, we'll mention that, God willing, with the hydrocephalus. I'll show you a picture of the hydrocephalus at the very end, with the discussion. Or, let's look at some patients, my friend. I wo n't upset you. The one in front of you has patients, meaning he has prominence, which is the mental bulges we just mentioned. This patient, for example, has what? He has hydrocephalus, as we can see. He has macrocephaly, a large head, and his eyes are looking down, which is sun appearance. This is theoretical, as you know. And the patient in front of you has cerebral bulge, meaning he has clear mental retardation. You might also find, for example, that he has a [ __ ] body or something like that. Okay? But what I'm trying to tell you is, if you notice anything, say it, don't hide it. And that's it, my friend, we've finished the general topic. Examination, God willing, along with the content of this entire page, which includes the history and general examination of patients in general, is fine. You can apply it, God willing, to every patient you have. God willing, I will leave these two pages in the video description. So, what's left for us now is local examination, investigation, and treatment. For local examination, as I told you, go to YouTube, reach the playlist, scroll down, and look for the Medicine Playlist. Okay, there's the Medicine Introduction. Then look for the video on neurology and the one on the abdomen. They are short, 18 minutes and 16 minutes respectively, but they are well- organized. The videos are about two years old, but what you will find, God willing, is that the language is appropriate and explained in a beautiful and simple way. In addition, you will go to the original video compiling all the examinations and general examinations.

[00:39:39]Come on. We'll open it together, okay? It opens, as you can see in the video. You'll click on "More" and see, you'll find, God willing, the file. It's in the video description. What file is it? Let's open it. It's okay, as we can see, it's opening. Let's wait until Google Drive loads. It's opening now, okay? Just wait a bit, it's loading. We can do a download, for example. If you click this button, it will download, as we can see, the file is downloaded. No problem, the file has opened, God willing. We focused entirely on neurology and the abdomen, okay? Okay, let's talk about the abdomen.

[00:40:22]You'll do an inspection and then, for example, the patient. Okay, inspection and patient first. So, inspection, agreed? For contour, you'll say, for example, flat, or you can say the medial contour. You'll comment on the four, agreed on them, good. And then the pelvic floor, the superficial patient for tenderness and subcutaneous masses. Of course, you'll get the liver with percussion, as we did on a patient in the video. There's the upper border and the lower border. The upper border With the percussion of the lower border, using the flexor, you do this on his abdomen, applying pressure. You'll get the right lateral lobes, left lobes, and the asplens too. Okay, we go from the right yak region to the left hypochondria in this direction. That's good and very nice. And of course, you do the ascites. We explained the ascites with the shift; this is the most important thing for us. Okay, sir. Also, regarding the neurology of tone, you'll do two checks. Be careful, there's a patient I heard about who, when you do a two-joint check, is hypotonic, and then you go back to the other joints, you'll find he's hypertonic. What is this?

[00:41:27]This is seribolus, but in the extremities. So you look at the major joints, meaning extension and rex, along with the sternal brace, sternal limb, plantar, ankle, and cranial nerves.

[00:41:43]We've already talked about them. And the cranial nerves, sir, are usually in pediatrics. Here, you just need to check the patient; he 'll be incompetent. You're just going back and forth with the doctor, nothing more. We'll do this, we'll do that, we'll do this, okay, okay. Of course, the rest of the file is less important for you, so leave it aside. But please, please, you need to watch the other videos. I explained them to you in a way that's very suitable for pediatrics. I mean, not like a fourth or fifth-grade abdominal exam, no, it was a third-grade or something like that, so it's a simple topic, okay? I mean, inspection is the same thing we've repeated, and palpation is exactly the same, and the diaphragm is less important, don't worry.

[00:42:25]Except for the palpation, it's also clear, like the abdomen percussion, you'd say shift dance, and the section is less important, less important, you won't find anything, okay? Except if you put the stethoscope on the patient's abdomen, that's more than enough. Okay, let me show you assimilation, the same thing, the most important thing is that tone and reflexes are the two most important things.

[00:42:39]The rest will mostly be incompatible, you can do anything, okay? And you'll comment as you We said there exactly the keratin nerves, a very simple topic, and so on until he tells you what the touch linings in the Pesh in Cooperative are the two most important things, but the tone and reflex are good, boss. The investigation and treatment are theoretical talk and we explained it in the theory and I told you at the beginning of the video, please stop and read the words and study the investigation well, right? But a few hints like that too, so that you can give me background. The most important things in hydrocephalus are that it has microcephaly and that it has a sunset aperture. Okay, how will you treat it? Well, you can install Ventriculo Protonial bags, any bags from the three bases we agreed on. Don't forget the bag assay, because if he has meningitis or something, that's part of the general assay. I planned it for you in the checklist. I told you I didn't write it about the entire Seroboli system, sir.

[00:43:26]Review its theory, please, and the theory of hemodialysis (spherocytosis) well, sir.

[00:43:31]Why? Because you won't see this patient, so there will be a discussion in the theory, meaning investigation and treatment. Okay, investigation, and treatment. If the topic has completely overwhelmed you and you don't even want to read the book and you're bored with it, here's the investigation for hemodialysis. You have three seconds to stop and read the words yourself.

[00:43:51]3, no, one. And the most important thing for us, of course, is the osmotic ferruginivity test, sir. Okay, investigation, meaning, what treatment do you have?

[00:44:00]Treatment is very different, but it's actually a genetic disease, so without risk, I don't know, and treat the complications, and so on. You have three seconds.

[00:44:08]If you want to stop and read, go ahead. The most important thing for us is, of course, hemoglobin electrophoresis. We'll find hemoglobin F is elevated, and the rest of the investigations are there. Okay, if you want to stop and read, you have three seconds. Here we have the treatment for thalassemia. If you want to stop and read, go ahead. You can, for example, perform an aspirate and give iron, kidney agents, and things like that. Okay, because of the hemolytic anemia I have. So, the information I'm trying to convey to you before I close is that this isn't a practical video. We already mentioned neurology and the abdominal OSCE. Do you want to see these two?

[00:44:46]Or is it, my friend, a theoretical video? If we go to pediatrics, to playlist You'll find what I explained, God willing. Look in the playlist; you'll find what I explained.

[00:44:54]For example, I explained hydrocephalus, and if you go to the hematology videos, you'll find it in the anemia section. You'll even find a picture of Limonoglyphic Fischer's cerebral plexus.

[00:45:02]We explained the concepts there, including the cerebral policy in detail, and the theoretical stuff. So please review it. Also, for the sake of discussion, you know, the information is scattered and fragmented; you need to gather it yourself. The microphone cut out for a moment, doctors. I was telling you... I don't know exactly what I missed or what I was saying, but God willing, I'll leave these files in the video description. The information is scattered and varied; you need to gather the theoretical material and watch the neurology videos about the abdomen and the abdominal muscles, and the theory about hydrocephalus. These are the four topics we covered, so you can review them or study them on your own from the book. Take your time. Some patients I've heard are present, and so on. For example, there are patients with thalassemia, whether male or female. They might be carrying the insulin, or they might not. So, keep in mind that a hydrocephalus patient might have cerebral pulsation, meaning they might have upper motor neuron ligands, or they might have a mongoose, meaning they might have lower motor neuron ligands. So, be careful not to assume every hydrocephalus patient will have upper or lower motor neuron ligands. You'll find out during the examination.

[00:46:07]Cerebral pulsation can be [ __ ] capricious or it can be atonic, meaning hypotonia, but with hyperreflexia. Be aware that they might present with quadriplegia, hempellegia, or parpellegia. They might also present with dysplasia. You can understand the difference between these terms. They might have metritis, hergloss, and visual loss. These are all symptoms. Cerebral pulsation can also present with Class Benigh. All these cases were present this year. So I said, "Yes, I'll remember it, God willing. That's all, doctors. We're done. We ask God for His mercy and guidance.

[00:46:35]Memorize well, that's the most important thing, and understand, and try to put your trust in God Almighty. God is kind to His servants. Trust in Him, for He is the Almighty. Our final supplication is, 'Praise be to God, Lord of the Worlds.'

[00:46:44]And their final supplication is, 'Praise be to God, Lord of the Worlds.'

[00:46:50]Amen."