Dr Hadi Maljawi

• Life style , leg elevation , exercise , weight loss, avod long standing . • Sclerotherapy . • Surgery : vein stripping or ligation ( best result ) .CI in pateints with history of DVT .

• If no dissection : control the risk factor , treat HTN , stop smoking , B blockers ARB decrease TGFb , prophylactic surgery if > 5.5cm in ascending aorta or > 6.5cm in descending aorta . • If dissection : control BP by esmolol then surgical repair .

• Acute lower limp ischemia : anticoagulation then embolectomy . • Chronic lower limb ischemia : control the risk factor if severe needs bypass graft . • Lerich syndrome : aortoiliac or aortofemoral bypass . • Traumatic vascular injury : surgical repair with venous graft . • AAA : elective repair ( graft repair ) . • Burger disease : stopping the smoking most effective therapy . • Cholesterol embolism : anticoagulation . • Carotid body tumor : surgical in low surgical risk , radio in high surgical risk . • Carotid artery stenosis: antiplatelet and statins , carotid endarterectomy is the best or carotid stent .

      • Esophageal atresia : surgical repair .       • Pyloric stenosis : first correct alkalosis by normal saline then pylorotomy . • Duodenal atresia : duodeno - duodenostomy . • Meckels diverticulum : symptomatic : segmental resection     asymptomatic :   if patient age >50 leave it but age <50 then do diverticulectomy . • Intussusception : emergent reduction by double contrast enema  , but if perforation the do surgery . • Hirschsprung disease : surgery . • Congenital diaphragmatic hernia : stabilize the patient the do surgery repair . • NEC : stop enteral feeding . IV fluid , NG tube , ATB , then ness  surgery  • Abdominal wall defect : surgical closure , if tension then need silastic patch and later closure . • Cryptorchidism : orchidopexy at 1y but if discovered later then need orchidectomy . • Testicular torsion : orchidopexy of both sides . • Biliary atresia : if age <90days need KASAI ope...

  1) statins ( simvastatin ) : used if LDL is elevated   SE: myopathy and rhabdomyolysis  2) fibrates : used if TG is elevated  meme SE  3) cholesteramine  4 ) omega oil fatty acid  5 ) niacin 

Indication :  1) 3 vessels disease 2) occlusion of the  left main coronary artery 3) occlusion of the left proximal anterior descending coronary artery 4) chronic disabling angina vessels used :  1) great saphenous vein  2) internal thoracic artery ( the best )

1) ventricular fibrillation : m.c.c of death in the first hr post MI  2) cardiogenic shock  3) left ventricular failure  4) bradycardia , AV block : inferior  5) ventricular aneurysm : 3-7 d post MI ( persistent ST elevation )  6) ventricular rupture : 1st week  7) mitral regurgitation : more with inferior  8) VSD : anteroseptal , 3-7 d 9) acute cardiac tamponade  10) RV dysfunction : inferior , give dobutamine  11) pericarditis : 2 weeks post MI