This document discusses common causes of anemia by presenting several case studies and providing conceptual frameworks for evaluating patients. It covers increased red blood cell loss or destruction, decreased red blood cell production, plasma volume expansion, and maldistribution as primary causes. Specific conditions discussed include iron deficiency, hemolytic anemias, myelopathies, chronic kidney disease, and anemia of chronic disease. The importance of considering epidemiology and performing a full blood count with differential to form a differential diagnosis is emphasized.
This document discusses polycythemia, which is defined as an increased number of red blood cells above normal levels. It can be either relative, due to decreased plasma volume, or absolute. Primary absolute polycythemia includes polycythemia vera, a myeloproliferative neoplasm caused by a clonal mutation in hematopoietic stem cells resulting in uncontrolled production of red blood cells, granulocytes, and platelets. Symptoms are related to increased viscosity and include fatigue, headache, difficulty breathing, risk of thrombosis, and organomegaly. The molecular basis involves mutations in JAK2 kinase which lead to constitutive activation of erythropoietin and thrombopoiet
This 20-year old male presented with a history of delayed growth, puberty, fever, severe joint pain and abdominal pain. Examination found pallor, icterus and tenderness. Labs showed anemia, elevated bilirubin and liver enzymes. Peripheral smear showed normocytic normochromic RBCs with some sickle cells. USG found gallstones and spleen not visualized. Hb electrophoresis showed HbS, consistent with sickle cell anemia.
This document provides an overview of pancytopenia, including definitions, common causes, clinical evaluation, and diagnostic approach. Pancytopenia is defined as a reduction in all three blood cell lines. The evaluation involves obtaining a complete blood count with peripheral smear, bone marrow aspiration and biopsy, and specific tests depending on findings. The bone marrow examination can help differentiate causes based on cellularity and features seen in erythropoiesis, myelopoiesis, megakaryopoiesis and other cell types. Common causes include bone marrow failure, infiltrative disorders, infections, immune disorders and nutritional deficiencies. A thorough history, examination and systematic evaluation of the bone marrow are required to identify the underlying cause of pancy
This document summarizes hemoglobinopathies, specifically sickle cell disease. It discusses the genetics, pathophysiology, clinical features including acute complications like vaso-occlusive crises and stroke, and chronic complications affecting organs like the lungs, kidneys, liver, bones and CNS. Key aspects of management include treating acute pain, acute chest syndrome, priapism, stroke prevention through transfusions or hydroxyurea, and addressing end-organ damage.
This document discusses a clinical case of a man with advanced liver disease and sepsis who is experiencing worsening coagulopathy. It then reviews several potential causes of acquired bleeding disorders including liver disease, vitamin K deficiency, disseminated intravascular coagulation (DIC), massive transfusion, uremia, acquired hemophilia, and acquired von Willebrand disease. For this patient, the likely contributing factors are coagulopathy of liver disease, vitamin K deficiency, DIC, and the effects of his low-dose aspirin. The management outlined is vitamin K supplementation, holding blood products unless bleeding occurs, and discontinuing aspirin if possible.
Aging is accompanied by disrupted tissue homeostasis and decreased regenerative capacity. This impacts hematopoiesis through effects on hematopoietic stem cells and their niche. As people age, there is a shift to increased myeloid lineage biased differentiation from HSCs. This leads to outcomes like immunosenescence and an increased risk of hematologic malignancies. Aging also contributes to anemia through several mechanisms, including nutrient deficiencies, chronic kidney disease, chronic inflammation, and changes to erythropoiesis. While aging phenotypes may be partly reversible through interventions like antioxidants and caloric restriction, aging overall remains associated with functional impairments in hematopoiesis.
This document discusses anaemia in elderly patients. It is a common problem associated with increased mortality and reduced quality of life. Causes of anaemia in the elderly include decreased red blood cell production, increased breakdown of red blood cells, blood loss, and anaemia of chronic disease. Diagnostic tests are discussed for different types of anaemia including iron deficiency anaemia, B12 and folate deficiency anaemia, and anaemia of unknown origin. The conclusion emphasizes that anaemia of chronic disease is most common in the elderly, and tests of serum ferritin, methylmalonic acid and homocysteine levels can help diagnose various types of anaemia.
This document discusses a clinical case of acquired bleeding disorder in a 74-year-old man presenting with bruising. Testing revealed von Willebrand disease type 2 and angiodysplasias. The key considerations for this patient include potential medication and liver disease contributions to bleeding, as well as the diagnosis of acquired von Willebrand disease. Treatment focuses on managing the underlying cause of the acquired bleeding disorder.
This document discusses hemolytic and aplastic anemias. It defines them as anemias resulting from increased red blood cell destruction coupled with increased erythropoiesis. Hemolytic anemias are classified as congenital/hereditary or acquired. Aplastic anemia is defined as damage to the bone marrow and hematopoietic stem cells, causing a deficiency of red blood cells, white blood cells, and platelets. Causes can include chemicals, radiation, medications, and unknown etiology. Treatment involves suppression of the immune system through medications or bone marrow transplant.
The document provides an overview of approach to anemia in children. It begins with definitions of anemia and discusses clinical features and etiologies. Common causes of anemia include impaired red blood cell production, increased red blood cell destruction, and blood loss. The document reviews physiological neonatal anemia and pathological neonatal anemia. It outlines the clinical approach including history, physical exam, and initial lab workup. The approach depends on red blood cell indices and reticulocyte count to guide further testing and diagnosis of the underlying cause.
Hemolytic anemia are disorders where red blood cell survival is reduced, either episodically or continuously. The bone marrow can increase red blood cell production up to eight times normal, so anemia only occurs when red blood cell survival is extremely short or the bone marrow's ability to compensate is impaired. Hemolytic anemia can be congenital or acquired. Investigations include blood counts, peripheral smears, reticulocyte counts, and tests of serum LDH, haptoglobin, bilirubin, and urine for hemosiderin and urobilinogen. Management may include folic acid, corticosteroids, IVIG, transfusions, erythropoietin, iron therapy, discontin
This document discusses the diagnosis of hemolytic anemia. It defines hemolytic anemia as anemia caused by the premature destruction of red blood cells. It describes how hemolytic anemia can be categorized based on whether the defect is intrinsic or extrinsic to red blood cells, inherited or acquired, acute or chronic, immune or non-immune mediated, and intravascular or extravascular. The diagnostic approach involves confirming hemolysis through laboratory tests showing increased reticulocytes, high LDH and bilirubin, and low haptoglobin. The cause is then determined through history, exam, blood smear review, and additional specialized tests. Immediate management may be needed to address severe anemia before the specific cause
Aplastic anemia is a bone marrow failure syndrome characterized by pancytopenia and a hypocellular bone marrow. It is diagnosed through a bone marrow biopsy showing fewer than 25% of normal hematopoietic cells. The causes of aplastic anemia include exposure to toxins, certain drugs, viruses, and an immune-mediated process destroying hematopoietic stem cells in the bone marrow. Treatment involves immunosuppressive therapy with antithymocyte globulin and cyclosporine, or allogeneic bone marrow transplantation for severe cases. Long term management focuses on supportive care through blood product transfusions and monitoring for complications.
1. The patient presented with headache and right-sided hemiplegia, consistent with an acute stroke.
2. Strokes in sickle cell disease are most commonly ischemic and occur bimodally, peaking in younger children and those over 30 years old. Hemorrhagic strokes are rarer and peak during the second decade.
3. Diagnostic workup includes blood tests and neuroimaging to determine if the stroke is ischemic or hemorrhagic, as management differs between the two.
The document discusses various drug-induced hematological disorders including thrombocytopenia, thromboembolic diseases, aplastic anemia, hemolytic anemia, neutropenia, and agranulocytosis. It provides information on the mechanisms, risk factors, signs and symptoms, diagnosis, morbidity and mortality, prevention, and management of each condition. Common causative agents are identified for each disorder.
Zola, a 2-year old girl from Southern Africa recently moved to the US and has been experiencing numerous health issues including painful wounds that are slow to heal, swollen fingers and toes, fever, paleness, and pneumonia-like symptoms. An initial diagnosis would be anemia, and blood tests such as hemoglobin electrophoresis would be performed to diagnose sickle-cell anemia, which is caused by a genetic mutation resulting in abnormal sickle-shaped hemoglobin. Treatment options include medications, blood transfusions, and potentially a bone marrow transplant.
This document discusses aplastic anemia, a condition characterized by pancytopenia and bone marrow hypocellularity. It defines aplastic anemia, discusses its causes (acquired from things like radiation, drugs, viruses, immune diseases, or inherited genetic syndromes), epidemiology, pathophysiology, clinical features including symptoms and examination findings, diagnostic testing including blood tests and bone marrow biopsy, and treatment options including hematopoietic stem cell transplantation, immunosuppression, supportive care, and prognosis.
This document discusses thalassemia, a group of inherited blood disorders characterized by reduced or absent hemoglobin production. There are three main types: thalassemia minor causes no symptoms; thalassemia major requires lifelong blood transfusions and causes severe anemia symptoms from infancy; thalassemia intermedia causes variable non-transfusion dependent anemia that can worsen during times of stress. Long term complications of thalassemia include anemia, bone and growth problems, iron overload, and organ damage to the liver, heart, and endocrine system. Treatment focuses on blood transfusions, iron chelation therapy, and managing complications.
The document discusses the main causes of anemia, which are blood loss, increased destruction of red blood cells, and decreased production of red blood cells. Blood loss can be acute from overt bleeding or chronic from sources like the gastrointestinal tract or menstruation. Hemolytic anemia is caused by the increased destruction of red blood cells, which can be due to intrinsic defects in red blood cell production or metabolism, or extrinsic factors like infections, medications, autoimmune disorders, or mechanical damage. Decreased production of red blood cells can result from conditions such as aplastic anemia, iron deficiency, sideroblastic anemia, anemia of chronic disease, megaloblastic anemia, or tumors like leukemia.
Possible causes of anemia in a patient with rheumatoidbizkyflavour
The document discusses possible causes of anemia in patients with rheumatoid arthritis. There are two major categories of causes: non-drug associated and drug associated. Non-drug associated causes include anemia of chronic disease, which is the most common, occurring in up to 77% of cases due to inflammation from RA. Drug associated anemia is not directly from RA but caused by side effects of medications used to treat RA, such as NSAIDs and DMARDs, which can cause iron deficiency anemia through gastrointestinal bleeding or bone marrow suppression. Identifying the specific type of anemia is important for determining the correct treatment approach.
This document provides information about anemia. It begins with an introduction stating that anemia is a major problem in India, affecting many women and contributing to maternal deaths. The objectives of the document are then outlined, including defining anemia, classifying types, and discussing causes, symptoms, investigations, treatment and prevention. Several types of anemia are described such as iron deficiency, megaloblastic, and sickle cell anemia. Risk factors, signs and symptoms, normal values, and investigations like hematocrit and hemoglobin levels are explained. The document concludes with sections on management, treatment recommendations including iron supplementation, and benefits of therapy like improved cognition and survival.
The document discusses anemia, including its definition, causes, types, symptoms, diagnosis, treatment, nursing care, and prevention. It provides details on iron deficiency anemia, anemia of chronic disease, thalassemia, sickle cell anemia, and the nursing process for patients with anemia. The document serves as an overview of anemia and aims to educate on this common blood disorder.
The document discusses different types and causes of anemia. It classifies anemia into etiologic categories including impaired red blood cell production, excessive destruction of RBCs, and blood loss. It further describes morphologic classifications such as macrocytic, microcytic hypochromic, and normocytic normochromic anemia. Specific causes are provided for each category including deficiencies, diseases, and genetic disorders. Hemolytic anemia is discussed in more detail including hereditary and acquired causes. Laboratory findings associated with different types of anemia are also summarized.
The document discusses the importance of peripheral smear examination in diagnosing different types of anemias. It provides examples of various cases where examining peripheral smear clues helped arrive at accurate diagnoses, including thalassemia major, megaloblastic anemia, hemolytic anemias like hereditary spherocytosis, autoimmune hemolytic anemia, thrombotic thrombocytopenic purpura and sickle cell anemia. It emphasizes that describing a smear as hemolytic anemia is incorrect and the cause of hemolysis must be identified. Seeing schistocytes is also highlighted as a critical finding requiring urgent therapy.
Case 1: This 27-year-old female with lupus presents with worsening dyspnea and dark urine, consistent with hemolytic anemia. Labs show hemolytic pattern with elevated bilirubin and reticulocytosis. Her lupus likely exacerbated an underlying hemolytic condition.
Case 2: This 62-year-old male underwent a cardiac workup for angina but had a normal angiogram, yet subsequent labs revealed a microcytic anemia. His symptoms are likely due to an underlying hemolytic anemia rather than cardiac ischemia.
Case 3: This elderly woman admitted for failure to thrive has a norm
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1-Differentiate between the different causes of anemia
2. Discuss the investigations that may clarify the diagnosis
3. Recognize the predisposing factors and consequences of iron deficiency anemia and discuss how to manage it
4. Discuss the hereditary basis and clinical features of sickle cell anemia and thalassemia .
prepared by med_students0
Anemia of chronic disease and chronic kidney disease can have several underlying mechanisms. Hepcidin regulates iron availability and contributes to decreased red blood cell production in chronic inflammatory states. Cytokines like interleukin and tumor necrosis factor can destroy red blood cell precursors. In chronic kidney disease, there is a primary deficiency of erythropoietin production by interstitial fibroblasts in the kidneys, leading to anemia related to residual renal function. Anemia is common in later stages of chronic kidney disease and prevalence increases with age. Evaluation of anemia includes symptoms, physical exam, blood tests of red blood cell indices, peripheral smear, reticulocyte count, and potentially bone marrow biopsy.
This document provides guidance on evaluating and managing anemia in patients. It discusses evaluating the cause of anemia based on history, physical exam, and lab tests. Causes in critically ill patients especially include blood loss from phlebotomy and bleeding, decreased erythropoiesis from inflammation, and nutritional deficiencies. Transfusions are used to manage anemia but have risks, so restrictive protocols targeting Hgb <7g/dL are recommended except for patients with cardiovascular conditions. New blood substitutes are still experimental and have shown adverse effects.
This document provides an overview of anemia, including its definition, cut-off levels used to diagnose it, common causes, classification approaches, and key details about specific types like iron deficiency anemia, megaloblastic anemias, sickle cell disease, and thalassemias. It covers diagnostic testing and clinical manifestations, emphasizing the importance of considering a patient's red blood cell morphology, erythropoiesis, and underlying pathophysiology when evaluating the cause of an anemia.
The document discusses various red blood cell disorders and anemias. It covers the etiology, pathogenesis, clinical features, laboratory evaluation, and management of different types of anemias including aplastic anemia, iron deficiency anemia, megaloblastic anemia, anemia of chronic disease, and hemolytic anemias like sickle cell disease. It provides details on the causes, symptoms, diagnostic criteria and treatment approaches for these conditions.
Haematopathology consists of dysplastic or neoplastic changes to normal blood and bone marrow cells. There are nearly 100 types of hematopoietic disorders categorized into anaemias, myeloid neoplasms, lymphoid neoplasms, and histiocytic/dendritic neoplasms. Advanced digital imaging technologies are used to diagnose these diseases by examining blood smears, bone marrow aspirates, and lymph node biopsies. The three major types of anaemia are those due to blood loss, poor red blood cell production, and red blood cell destruction.
This document provides an overview of hematopoiesis, erythropoiesis, and anemia. It discusses where blood cell formation occurs, the lifespan and production rate of red blood cells, and how hypoxia stimulates erythropoietin production. It defines anemia, lists global and country prevalence data, and compensatory mechanisms. It describes classifications of anemia including morphological and etiological, and covers causes such as blood loss, bone marrow disorders, nutritional deficiencies, and hemolytic anemias. Laboratory evaluation of anemia and peripheral blood smear findings are also summarized.
This document provides information on different types of anemia including iron deficiency anemia, vitamin B12 and folic acid deficiency anemias, sickle cell anemia, thalassemia, acquired hemolytic anemia, glucose-6-phosphate dehydrogenase deficiency anemia, and aplastic anemia. For each type of anemia, the causes, pathophysiology, manifestations, diagnostics, and potential interventions are described.
Anemia is underdiagnosed and its symptoms are often attributed to other diseases. It can be caused by chronic kidney disease, cardiovascular disease, diabetes, cancer, HIV/AIDS, rheumatoid arthritis, inflammatory bowel disease, hepatitis C, and surgery. Anemia affects delivery of oxygen to organs and always negatively impacts quality of life, even when mild. It can cause fatigue, impaired cognitive function, cardiac problems, and decreased treatment efficacy for cancer. Reticulocyte count and other blood tests are used to diagnose and characterize anemia.
Anaemia is defined as a low blood haemoglobin level below the normal range based on age and sex. Common causes include iron, folate or B12 deficiency, bleeding, bone marrow disorders, and haemolysis. Clinical features depend on severity and cause, and may include fatigue, palpitations, and signs of heart failure in severe cases. A combination of blood tests, medical history, and physical examination can help identify the underlying cause.
The document discusses anemias and their classification. It begins by defining anemia and noting that it is a reduction in red blood cells (RBCs) or hemoglobin. Anemias are classified based on RBC size and hemoglobin content as hypochromic microcytic, normocytic, or macrocytic. Causes can include blood loss, decreased production, or increased destruction. A thorough diagnostic approach considers the patient's history, physical exam findings, and lab tests to determine the underlying cause of the anemia. Complete blood count, RBC indices, reticulocyte count, and peripheral smear help characterize the anemia. Identifying associated symptoms and risk factors provides clues to facilitating diagnosis
The document discusses hereditary hemochromatosis, an iron overload disorder caused by a mutation in the HFE gene. It describes the case of a 45-year-old man presenting with fatigue and joint pains whose labs show elevated liver enzymes. Testing for the HFE gene mutation could diagnose hereditary hemochromatosis. The document then covers the genetics, presentation, evaluation, diagnosis and treatment of hemochromatosis with regular phlebotomy to reduce iron levels and prevent complications. Screening recommendations for hemochromatosis in the general population are mixed.
The document discusses red blood cell disorders and anemia. It defines anemia and normal hemoglobin levels. The evaluation of anemia involves history, physical exam, complete blood count, peripheral smear, and further tests depending on results. Anemia is classified morphologically based on red blood cell size and color, and pathogenetically based on the underlying cause such as blood loss, impaired production, or increased destruction. Common types are discussed like iron deficiency anemia, thalassemia, megaloblastic anemia, and hemolytic anemia. A systematic approach is outlined to identify the cause of anemia.
This document provides an overview of hematological disorders and diseases of the blood. It begins with an introduction to blood components and hematopoiesis. It then discusses specific blood disorders like anemia, leukemias, and hemolytic anemias. For each disorder, it covers causes, signs and symptoms, investigations, classifications, and treatment approaches. The document aims to comprehensively describe common blood disorders and diseases at a high level.
The patient presents with fatigue and is found to have anemia. Initial workup reveals a normocytic, hypoproliferative anemia with normal white and platelet counts. Given his risk factors of age and alcohol use, further workup is needed to evaluate for potential causes of blood loss or decreased production such as iron deficiency or occult gastrointestinal bleeding. A colonoscopy should be considered.
1. Anemia is defined as a low hemoglobin level caused by underlying diseases or conditions. It is classified based on red blood cell size, cause, and bone marrow activity.
2. Common causes include blood loss, impaired red blood cell production, and increased red blood cell destruction. Symptoms vary depending on severity and can include fatigue, weakness, and palpitations.
3. Evaluation of anemia involves medical history, physical exam, hematological tests like complete blood count and peripheral smear, and other tests to identify the underlying cause. This helps determine the appropriate treatment.
This document provides information on hematological disorders including anemias, polycythemias, and bleeding disorders. It begins by defining hematological disorders as diseases affecting blood and blood forming tissues. It then discusses different types of anemias classified by cause or cell morphology. Common anemias described include iron deficiency anemia, anemia of chronic disease, and thalassemia. Symptoms, diagnostic tests, and treatment options for anemias are also outlined. The document also introduces polycythemias including definitions and types like primary and secondary polycythemia. Primary polycythemia vera is described in more detail regarding its cause, risk factors, signs and symptoms, and diagnostic evaluation. Finally, bleeding disorders
Fibromyalgia is a chronic pain condition characterized by widespread muscle aches, pain and fatigue. While the exact cause is unknown, it involves dysregulation of the autonomic nervous system and neuroendocrine changes. The American College of Rheumatology diagnostic criteria includes widespread pain for over 3 months and tender points found in 11 of 18 sites. Treatment options with mild to moderate effectiveness include low-dose antidepressants, aerobic exercise and cognitive behavioral therapy, though more research is still needed on alternative therapies.
This document summarizes information about preterm labor prevention and treatment. It defines preterm labor and discusses risk factors like prior preterm birth, infections, and cervical length. Interventions discussed include progesterone supplementation, treating asymptomatic bacteriuria, and cervical cerclage for short cervix. Fetal fibronectin testing and transvaginal ultrasound are presented as tools to assess preterm labor risk based on cervical length and funneling.
The document discusses dementia, including its various types, symptoms, diagnostic criteria, assessment methods, and treatment options. It defines dementia as the loss of cognitive and intellectual function without impairment of perception or consciousness. The five major types of dementia are Alzheimer's disease, cerebrovascular disease, Lewy body disease, frontotemporal dementia, and Parkinson's disease with dementia. Assessment involves interviews, examinations, and tests to evaluate cognition, function, and rule out other conditions. Treatment focuses on enhancing quality of life and includes both non-pharmacological and pharmacological approaches.
This document outlines desirable components and characteristics for developing medical school cases for small group learning. It recommends that cases have clear, measurable learning objectives; content matched to the objectives; effective inserted questions to stimulate discussion; appropriate context and level; authentic problem scenarios; clear organization; appropriate length; high quality exhibits; up-to-date medical information; opportunities to use medical informatics; connections to other course content; and facilitator guides with discussion points. It also stresses obtaining feedback to improve cases.
The Role of Human Papillomavirus (HPV) Infection in Abnormalities of the CervixMedicineAndDermatology
The document discusses the financial burden that prescription drugs place on elderly patients. Only 75% of community dwelling Medicare beneficiaries have prescription drug coverage, and of those only half have continuous coverage over a year. The costs of prescription drugs are expected to reach $1.8 trillion from 2004-2013, far exceeding the allocated federal budget of $400 billion. The financial burden disproportionately impacts low-income elderly patients and can prevent them from affording necessary medications. The document outlines ways physicians can help elderly patients access affordable prescription drugs, such as utilizing patient assistance programs, state and local programs, and Medicare drug discount cards.
This document discusses medical considerations and recommendations for managing diabetes during Ramadan. It notes that fasting is prohibited if it poses health risks. For those with diabetes who choose to fast, risks include hypoglycemia, hyperglycemia, dehydration, and electrolyte abnormalities. It provides guidelines on fasting for those with type 1, type 2, or using insulin based on their risk level and treatment plan. Doctors should discuss concerns with patients and encourage frequent monitoring if fasting.
This document discusses HPV (human papillomavirus), its relationship to cervical cancer, and cervical cancer screening guidelines. It describes the different types of HPV and their risks, how HPV is transmitted, how infections typically progress, and methods of detection. The document also outlines cervical cancer screening guidelines and provides an introduction to colposcopy, using images to illustrate cervical abnormalities.
This document outlines four teaching formats to educate learners about developmental delay, mental retardation, pervasive developmental disorder, and autism:
1. Point of Care provides resources for immediate patient care and self-directed learning.
2. Morning Report discusses case studies highlighting key issues.
3. Noon Conference is a formal lecture presenting evaluation approaches and genetic testing options.
4. Self-Directed Learning is a web-based module teaching the basics through case-based examples. Each format identifies educational materials, pre-reading, teaching approaches, and evaluation methods.
This document discusses incorporating portable ultrasound technology into family medicine clerkship teaching. It describes how a 90-minute hands-on workshop is used to teach students basic ultrasound skills like identifying fetal anatomy and assessing the abdomen. Students practice scanning each other and sometimes make unexpected findings. Portable ultrasound can also be used in community outreach settings. The document provides resources for learning and teaching ultrasound skills pertinent to family medicine.
The USPSTF strongly recommends screening for colorectal cancer in adults aged 50-75 with fecal occult blood testing, sigmoidoscopy, or colonoscopy. It recommends against screening for ovarian and testicular cancer due to lack of evidence that screening improves outcomes and potential for harms from unnecessary procedures. For breast, lung, and prostate cancer, the USPSTF found insufficient evidence to recommend for or against routine screening due to uncertainty around benefits and harms of screening for certain age groups and cancer stages.
This study analyzed blood cultures from neonatal intensive care unit patients from 1997 to 2001 in Tripoli Medical Center, Libya. A total of 1431 blood culture sets from 1092 patients were positive for bacterial growth in 801 sets, representing 648 cases of neonatal bacteraemia. The most common causative agents were members of the Enterobacteriaceae family including Serratia, Klebsiella, and Enterobacter species as well as coagulase-negative and positive Staphylococci. Antibiotic susceptibility testing found high levels of resistance among the most frequent pathogens, though resistance to newer antibiotics like aztreonam and imipenem was less common. Resistance in Staphylococcus to anti-stap
This document outlines four formats for teaching approaches about Alzheimer disease: point of care, morning report, noon conference, and self-directed learning. For point of care, it suggests having web-based resources directly accessible in clinical settings to address common questions. The morning report format suggests discussing case-based materials covering major Alzheimer disease points, potentially using online teaching cases. For self-directed learning, it recommends online videos, comprehensive summaries of Alzheimer disease genetics from GeneReviews, and other resources.
This document provides guidance on screening, diagnosing, and managing hypertension through patient-centered care and therapeutic lifestyle changes. It presents a case study of a 45-year-old man with new onset high blood pressure and discusses further evaluation, initial recommendations, and follow-up based on guideline-recommended treatment goals. The document also addresses how care may differ based on patient characteristics and explores assessing psychosocial factors that could impact treatment.
This document discusses barriers to teaching addiction medicine in residency programs and strategies for overcoming them. It describes how a private foundation called MERF partners with family practice residencies to provide faculty development support through educational conferences and scholarships. This helps improve faculty expertise and attitudes, and allows for better integration of addiction curriculum that increases screening and treatment of substance use disorders. Evaluation found the program successfully increased faculty and resident knowledge and comfort with addiction medicine.
The document discusses community-acquired pneumonia (CAP), including common pathogens, signs and symptoms, diagnosis, and treatment options. The most common pathogens for typical CAP are Streptococcus pneumoniae, while atypical CAP is commonly caused by organisms such as influenza virus, Mycoplasma, and Chlamydia. Signs and symptoms include cough, fever, chills, dyspnea, and fatigue. Diagnosis involves a chest x-ray and labs such as a complete blood count and sputum/blood cultures. Treatment depends on severity and location (outpatient vs inpatient), but generally includes macrolides, fluoroquinolones, or doxycycline.
The document discusses community-acquired pneumonia (CAP), including common pathogens, signs and symptoms, diagnosis, and treatment options. The most common pathogens for typical CAP are Streptococcus pneumoniae, while atypical CAP is commonly caused by organisms such as influenza virus, Mycoplasma, and Chlamydia. Signs and symptoms include cough, fever, chills, dyspnea, and fatigue. Diagnosis involves a chest x-ray and labs such as a complete blood count and sputum/blood cultures. Treatment depends on severity and location (outpatient vs inpatient), but generally includes macrolides, fluoroquinolones, or doxycycline.
1. Multiple Sclerosis (MS) is a disease of the central nervous system that results in demyelination and damage to the protective covering of nerve fibers. It commonly causes visual issues, weakness, sensory problems, and other neurological symptoms.
2. The diagnosis of MS involves demonstrating dissemination of lesions in both time and space, either clinically or radiologically. The McDonald criteria from 2001 provides guidelines for diagnosing MS based on clinical attacks, MRI findings, and cerebrospinal fluid analysis.
3. Common symptoms of MS include visual problems, motor weakness, sensory issues like numbness and tingling, and bladder/bowel dysfunction. Symptoms vary depending on location of lesions in the brain and spinal
1. Multiple Sclerosis (MS) is a disease of the central nervous system that results in demyelination and damage to the protective myelin sheaths surrounding nerve fibers. Common symptoms include visual problems, muscle weakness, sensory issues, and coordination and balance issues.
2. The diagnosis of MS is based on clinical evidence of lesions in the brain and spinal cord disseminated in time and space. MRI and lumbar puncture are important tests to support the diagnosis.
3. There are different clinical courses of MS including relapsing-remitting, secondary-progressive, primary-progressive and progressive-relapsing. The McDonald criteria from 2001 is now commonly used to diagnose MS based on clinical and
This document provides information on smoking cessation and motivational interviewing techniques to help patients quit smoking. It discusses:
- The 5 A's approach to smoking cessation in primary care (Ask, Advise, Assess, Assist, Arrange).
- Stages of change model for behavior change, including precontemplation, contemplation and preparation stages.
- Motivational interviewing techniques like expressing empathy, developing discrepancy, avoiding arguments and rolling with resistance to help move patients through the stages of change.
- Using the 5 R's of relevance, risks, rewards, roadblocks and repetition when motivational interviewing with precontemplative and contemplative patients.
The document discusses sleep, insomnia, and their treatment. It defines insomnia as difficulty initiating or maintaining sleep. Insomnia can be transient, acute, or chronic. Common causes include medical, psychiatric, substance-related, and circadian issues. Treatment involves addressing underlying causes, improving sleep hygiene, cognitive-behavioral therapy including stimulus control and sleep restriction, and may include pharmacotherapy with hypnotics as a short-term option. Multicomponent cognitive behavioral therapy is most effective for insomnia.
Formulation of Buccal Drug Delivery SystemKHimani2
Buccal drug delivery system is an advanced type of drug delivery system where the drug is passed into the specific site without must wastage ! It is a novel drug delivery system where the medicament avoids 1st pass metabolism, which increases its bio availability !
* Types include matrix type and reservoir type in which 2nd type is more advanced and shows quick absorption of the drug .
* I have mentioned it's advantages and disadvantages.
* Factors effecting the drug delivery system
*Formulation of the BDDS
* Evaluation parameters
Factors influencing growth & development:
Growth & development depend upon multiple factors or determinants. They influence directly or indirectly by promoting or hindering the process.
The determinants can be grouped as Heredity & environment..
Heredity or genetic factors are also related to sex, race, & nationality. Environment includes both pre natal & post natal factors.
Osvaldo Bernardo Muchanga- MALE CIRCUMCISION, ITS Vs SOCIOCULTURAL BELIEFS (C...Osvaldo Bernardo Muchanga
MALE CIRCUMCISION consists of the surgical act of removing the foreskin (skin that covers the glans of the penis), leaving the glans more prominent and better cleanable.
MALE CIRCUMCISION itself has medical as well as sociocultural implications, as it has been proven to be an act that can minimize SEXUALLY TRANSMITTED INFECTIONS (STIs), especially HIV, but it also represents the SOCIOCULTURAL IDENTITY of some people, respectively.
Now, in a SERO-EPIDEMIOLOGICAL PROFILE like that of Mozambique where the prevalence of HIV is around 12.5% which corresponds to approximately 2 million people living with HIV, where the province of GAZA is the most seroprevalent with a positivity rate of 21% (INSIDA, 2021), it is extremely necessary to THOROUGHLY scrutinize all possibilities for preventing or minimizing the spread of HIV and other STIs.
These are the class of Drugs that are used to treat and prevent cardiac arrhythmias by blocking ion channels involved in cardiac impulse generation and conduction. Class I drugs like quinidine and procainamide block sodium channels to prolong the action potential duration, while Class IB drugs like lignocaine shorten repolarization. Class III drugs like amiodarone block potassium channels to prolong the action potential. Calcium channel blockers like verapamil inhibit calcium influx. Other drugs include adenosine for paroxysmal supraventricular tachycardia, beta blockers for supraventricular arrhythmias, and atropine for bradycardias. Adverse effects vary between drugs but include arrhythmias, heart block and QT prolong
कायाकल्प क्लिनिक: पटना के अग्रणी सेक्सोलॉजिस्ट और स्किन केयर विशेषज्ञ
पटना का एक शानदार स्वास्थ्य सेवा प्रदाता, कायाकल्प क्लिनिक, आपके स्वास्थ्य और त्वचा की देखभाल में विशेषज्ञता प्रदान करता है। हमारे नवीनतम तकनीकी समाधानों और अनुभवी विशेषज्ञों के साथ, हम पुरुष और महिलाओं के स्वास्थ्य सम्बंधित मुद्दों को हल करते हैं। यहां पर हम प्रदान करते हैं:
Expert Treatment for Sex Issues at Kaya Kalp Clinic in Patna -best sexologist in patna
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Discover the Best Sexologist in Patna: Expert Care at Kayakalp Clinic
Kayakalp Clinic - Best Sexologist in Patna
Kayakalp Clinic - Best Sexologist in Patna
When it comes to sexual health, finding the right expert is essential for effective diagnosis and treatment. At Kayakalp Clinic in Patna, we pride ourselves on providing exceptional care for a wide range of sexual health issues. If you’re searching for the best sexologist in Patna, look no further. Our team of highly skilled professionals is here to help you navigate and resolve your concerns with confidentiality and compassion.
Why Choose Kayakalp Clinic?
1. Experienced Professionals
Our sexologists are highly trained and experienced in dealing with various sexual health issues. They stay updated with the latest advancements in the field to provide the best care possible.
2. Comprehensive Services
At Kayakalp Clinic, we offer a wide range of services, including:
- Treatment for erectile dysfunction
- Solutions for premature ejaculation
- Counseling for low libido
- Infertility treatment
- Management of sexual pain disorders
- STI screening and treatment
- Relationship and intimacy counseling
3. Personalized Treatment Plans
We understand that every individual is unique, and so are their health concerns. Our sexologists take the time to understand your specific needs and create personalized treatment plans to ensure the best outcomes.
Co-Chairs, Stephen Salloway, MD, MS, and Sharon J. Sha, MD, MS, prepared useful Practice Aids pertaining to Alzheimer's disease for this CME/MOC/NCPD/AAPA activity titled “Preparing Your Practice for the New Era of Amyloid-Targeting Therapies in Alzheimer's Disease: Expert Insights on Key Evidence, Administrative and Clinical Considerations, and Best Practices for Individualized, Patient-Centered Care.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA information, and to apply for credit, please visit us at https://bit.ly/3twjpAt. CME/MOC/NCPD/AAPA credit will be available until June 19, 2025.
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn J...rightmanforbloodline
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn Jarvis, All Chapters 1 - 32 Full Complete.pdf
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn Jarvis, All Chapters 1 - 32 Full Complete.pdf
Hemodialysis: Chapter 11, Venous Catheter - Basics, Insertion, Use and Care -...NephroTube - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/QeWTw_fYPlA
- Video recording of this lecture in Arabic language: https://youtu.be/fUWI9boFc7w
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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This document contains an overview of different types of ocular neoplastic disorders or ocular tumors among pediatric patients. you can have a quick basic concept about ocular tumors among children and a basic management strategy. You will have perfect idea about almost 8 ocular tumors among pediatric patients .
Lymphoma Made Easy , New Teaching LecturesMiadAlsulami
This lecture was presented today as part of our local Saudi Fellowship program. After three years of direct interaction with trainees and hematologists, I have started to develop an understanding of what needs to be covered. This lecture might serve as a roadmap for approaching and reporting lymphoma cases.
General Endocrinology and mechanism of action of hormonesMedicoseAcademics
This presentation, given by Dr. Faiza, Assistant Professor of Physiology, delves into the foundational concepts of general endocrinology. It covers the various types of chemical messengers in the body, including neuroendocrine hormones, neurotransmitters, cytokines, and traditional hormones. Dr. Faiza explains how these messengers are secreted and their modes of action, distinguishing between autocrine, paracrine, and endocrine effects.
The presentation provides detailed examples of glands and specialized cells involved in hormone secretion, such as the pituitary gland, pancreas, parathyroid gland, adrenal medulla, thyroid gland, adrenal cortex, ovaries, and testis. It outlines the special features of hormones, differentiating between peptides and proteins based on their amino acid composition.
Key principles of endocrinology are discussed, including hormone secretion in response to stimuli, the duration of hormone action, hormone concentrations in the blood, and secretion rates. Dr. Faiza highlights the importance of feedback control in hormone secretion, the occurrence of hormonal surges due to positive feedback, and the role of the suprachiasmatic nucleus (SCN) of the hypothalamus as the master clock regulating rhythmic patterns in biological clocks of neuroendocrine cells and endocrine glands.
The presentation also addresses the metabolic clearance of hormones from the blood, explaining the mechanisms involved, such as metabolic destruction by tissues, binding with tissues, and excretion by the liver and kidneys. The differences in half-life between hydrophilic and hydrophobic hormones are explored.
The mechanism of hormone action is thoroughly covered, detailing hormone receptors located on the cell membrane, in the cell cytoplasm, and in the cell nucleus. The processes of upregulation and downregulation of receptors are explained, along with various types of hormone receptors, including ligand-gated ion channels, G protein–linked hormone receptors, and enzyme-linked hormone receptors. The presentation elaborates on second messenger systems such as adenylyl cyclase, cell membrane phospholipid systems, and calcium-calmodulin linked systems.
Finally, the methods for measuring hormone concentrations in the blood, such as radioimmunoassay and enzyme-linked immunosorbent assays (ELISA), are discussed, providing a comprehensive understanding of the tools used in endocrinology research and clinical practice.
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The Revolutionary Nature of Needleless Double Transfer Spikes in HealthcareNanchang Kindly Meditech
It's likely that you have witnessed medical personnel using needles to transmit fluids or medicines if you have ever visited a hospital or other healthcare facility. But as technology advances, needleless double transfer spikes are becoming more and more common and revolutionizing the delivery of healthcare.
Introduction of mental health nursing, Perspective of mental health and mental health nursing, Evolution of mental health services, treatment and nursing practices Mental health team, Nature and scope of mental health nursing, Role & function of mental health nurse inn various settings and factors affecting the level of nursing practice, concept of normal and abnormal behavior
2. Anemia Goals Review common causes of anemia Provide conceptual framework for evaluating patients with anemia Show some interesting, gross and unusual pictures
3. Anemia Definition: Age/gender-specific reduction in the circulating red blood cell mass Commonly measured by the hemoglobin or hematocrit
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5. Anemia: Prevalence Approximately 4.7 million Americans 6.6 % of men; 12.4 % of women Increases with age; 44.4 percent in men > 85 “ Although the elderly are more prone to develop anemia, older age is not of itself a cause of the condition.” Brill JR, Baumgardner DJ. Am Fam Physician 2000; 62:2255-63,2264
6. Primary Causes of Anemias Increased red blood cell loss or destruction Decreased red blood cell production Overexpansion of plasma volume Maldistribution
20. Case 3 31 y/o woman 3 day hx severe diarrhea; 2 other family members also effected Now with bloody diarrhea, fever, confusion Hgb 8.5, Hct 26, Plts 23K, WBC 23.6 Creat 4.3
23. Case 4 72 year old woman, new pt DM, HTN. On glipizide, lisinopril, HCTZ, ASA Fatigue, felt 2nd to care of husband with CVA Rectal heme negative Hgb 6.7, Hct 20 Nl WBC, Plts, CMP, TSH No prior CBC available
27. Decreased RBC Production Primary causes Marrow hypoplasia or aplasia Myelopathies Myeloproliferative diseases Pure red blood cell aplasia
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29. Secondary causes Anemia of chronic disease Chronic renal failure Endocrine deficiency states Si deroblastic anemias
30. Iron Deficiency Most common cause of anemia world-wide Low Fe, Ferritin; elevated TIBC, platelets
31. Case 5 63 y/o man Farmer, never came to doctor 8 month hx weight loss, anorexia, fatigue Hgb 7.3, Hct 22 Plts464K, WBC 11.3 MCV 82, RDW 18.5 Ferritin 6 Dark maroon heme +++ stool
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35. Anemia of Chronic Disease Most common cause of anemia in US Increases with age 30% hospitalized patients Malignancies, endocrinopathies, rheumatic disease, hepatic disease Renal disease: not linked to degree of impaired GFR
36. Case 6 67 y/o man DM, HTN, Hyperlipidemia, CAD HgbA1c 9.4, microalbumin high, creat 1.6 Hgb 9.5, Hct 29, nl WBC, Plts, MCV 84 RDW 14 Ferritin 140 Erythropoeitin x 6 weeks, Hgb 11.1
37. Summary Anemia is common Consider epidemiology, history to formulate a differential, directed labs Use whole CBC
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39. References Incidence of anemia in older people: an epidemiologic study in a well defined population . BJ Ania, VJ Suman, VF Fairbanks, DM Rademacher, LJ … - J Am Geriatr Soc, 1997 Advances in the anemia of chronic disease. RT Means Jr - Int J Hematol, 1999 Normocytic anemia. JR Brill, DJ Baumgardner - Am Fam Physician, 2000 Nov 15;62(10):2255-64