Author Archive

ALLOIMMUNE THROMBOCYTOPENIA

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ALLOIMMUNE THROMBOCYTOPENIA

Neonatal alloimmune thrombocytopenia occurs when the mother is homozygous for an uncommon platelet alloantigen, most often PlA2 on gplIla, and the fetus expresses the PlAi haplotype inherited from the father. The pathogenesis of alloimmune thrombocytopenia is analogous to the mechanism by which Rh sensitization induces hemolytic disease of the newborn. The mother is exposed to…

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Evaluation of Leukopenia

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Evaluation of Leukopenia

Neutropenia can reflect decreased production, increased sequestration, or peripheral destruction of neutrophils. Patients should first be evaluated for splenomegaly rule out the possibility of sequestration In patients who are completely asymptomatic and in whom previous studies are unavailable, the possibility of congenital or cyclic neutropenia should be entertained and can be evaluated by serial peripheral…

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Chronic Diarrhea

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Chronic Diarrhea

Clinicians have multiple tests at their disposal when evaluating a patient with chronic diarrhea, and proper judgment should be used in choosing the most appropriate ones. Duration of diarrhea, evidence of systemic involvement, nutritional deficiencies and previous investigations should guide the evaluation of the patient. In contrast to acute diarrhea, infectious etiology is uncommon with…

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Helicobacter pylori

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Helicobacter pylori

H. pylori is a gram-negative curved, flagellated rod found only in gastric epithelium or in gastric metaplastic epithelium. H. pylori clearly causes histologic gastritis and is found in 80% to patients with duodenal ulcers and 70% to 90% of patients with gastric ulcers. However, only a minority of patients with H. pylori gastritis develop peptic…

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CLINICAL MANIFESTATIONS

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CLINICAL MANIFESTATIONS

Classic symptoms of acute pancreatitis include acute abdominal pain, nausea, and vomiting. Physical examination may reveal reduced bowel sounds secondary to ileus, jaundice resulting from gallstones abdominal tenderness, fever, or tachycardia. Acute in to the results in leakage of pancreatic enzymes into the blood stream. This condition is detected as an increase in serum amylase…

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Clinical Presentation Complications

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Clinical Presentation Complications

ARF results in signs and symptoms that reflect loss of the regulatory, excretory, and endocrine functions of the kidney. The loss of excretory ability of the kidney is ressed by a rise in the plasma of specific substances normally excreted by the kidney. The most widely monitored indices are the concentrations of BUN and creatinine…

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Chronic Obstructive Pulmonary Disease

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Chronic Obstructive Pulmonary Disease

Patients with COPD have slowly progressive, irreversible airway obstruction. The course of the disease is punctuated by periodic exacerbations characterized increased dyspnea, increased sputum production, a change in character of the sputum, and occasionally respiratory failure. Exacerbations may result from bacterial respiratory infection, failure, poor compliance with prescribed therapy, or acute bronchospasm. Pulmonary emboli may…

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PATHOPHYSIOLOGY

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PATHOPHYSIOLOGY

A diagnostic approach to hyponatremia is outlined in list. The of hyponatremia show that it can be associated with normal, high, or low total body sodium content. In some hyponatremic disorders, the serum osmolality is elevated; thus, the intracellular wa ter content is not increased, and no risk of brain edema exists. Hyperglycemia and the…

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IMMUNE THROMBOCYTOPENIC PURPURA

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IMMUNE THROMBOCYTOPENIC PURPURA

In children, acute immune thrombocytopenic purpura(ITP) is often preceded by a viral infection, such as varicella. Patients with ITP present with petechial hemorrhage, mucosal bleeding, and thrombocytopenia with counts often lower than 20,000/AL. The peripheral blood smear shows large platelets and no other abnormal cells(such as blasts, which would accompany childhood leukemia); the bone marrow…

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THROMBOCYTOPENIA CAUSED BY SEQUESTRATION

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THROMBOCYTOPENIA CAUSED BY SEQUESTRATION

Up to 30% of circulating platelets are normally contained within the any given time. Conditions that lead to splenomegaly cause increased trapping of in platelets; this platelet sequestration causes thrombocytopenia, often dropping the platelet count into the range of 50,000 to 100,000/uL, but rarely lower. Thrombocytopenia from sequestration is common in advanced liver disease, myeloproliferative…

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