Archive For The “CCTV” Category

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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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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Neoplasia of Lymphoid Origin

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Neoplasia of Lymphoid Origin

Malignant transformation of lymphocytes can lead to a diverse array of neoplasia of lymphoid origin, including tumors that arise from T cells or B cells and tumors At at represent different stages of lymphocyte development. Lymphoid malignancies usually involve lymphoid T tissues. but they can arise in or spread to any site. The major clinical…

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Iron Deficiency Anemia

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Iron Deficiency Anemia

Iron deficiency is the leading cause of anemia worldwide. Although classic iron deficiency anemia presents bo as microcytic anemia, early iron deficiency is associated with normocytic anemia. Consequently, iron should be considered in all anemic patients, and iron set indices should be a part of the evaluation of any patient with hypoproductive anemia, regardless of…

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Adaptation to Nephron Loss

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Adaptation to Nephron Loss

To ensure adequate solute, water, and acid-base balance, the surviving nephrons in the diseased kidney must adjust by increasing their filtration and excretion rates. Without such adjustments, patients with chronic renal failure are vulnerable to edema formation and severe volume overload, hyperkalemia, hyponatremia, and azotemia. Thus, during progressive renal disease, sodium balance is maintained by…

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NORMAL VOLUME HOMEOSTASIS

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NORMAL VOLUME HOMEOSTASIS

Protection of extracellular fluid volume is a fundamental characteristic of fluid and electrolyte homeostasis. The homeostatic mechanisms sense changes in the effective circulating volume(ECV). ECV is difficult to define because it is not a measurable and distinct body fluid compartment. ECV relates to the”fullness” and pressure within the arterial tree. Because only 15% of total…

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THE DISTAL NEPHRON

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THE DISTAL NEPHRON

The distal convoluted tubule is a water-impermeable segment of the nephron that continues the dilution of luminal fluid through active sodium chloride absorption. Sodium absorption in the distal nephron occurs primarily by a thiazide diuretic-sensitive, chloride-coupled transport process. The cortical collecting duct reabsorbs sodium by a mineralocorticoid-sensitive process. In states of volume depletion and maximal…

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Common Presenting Complaints

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Common Presenting Complaints

Dyspnea(shortness of breath) is a common complaint of patients with pulmonary disease. Timing and acuity of onset, exacerbating and alleviating factors, and degree of functional impairment are key elements of the history Associated symptoms such as cough, hemoptysis, chest pain, wheezing, orthopnea, and paroxysmal nocturnal dyspnea, as well as environmental triggers, should be elicited and…

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PHYSIOLOGY OF PULMONARY HYPERTENSION

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PHYSIOLOGY OF PULMONARY HYPERTENSION

The pulmonary vasculature is a high-capacity, low-resis-tance system, and it functions under relatively low pressure. The normal pulmonary arterial systolic and mean pressures are less than 30 mm Hg and less than 20 mm Hg, respectively. Diseases of this sys-tem impair gas exchange across the pulmonary alveoli and result in an increase in pulmonary arterial…

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AORTIC DISSECTION

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AORTIC DISSECTION

An aortic dissection is a tear in the aortic intima through which blood enters and subsequently dissects distally along the plane between the intima and media of the vessel, creating a true and false lumen in the aorta. Hypertension and Marian’s syndrome are the most common predisposing factors. Type A disections originate in the ascending…

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