Archive For The “Funny” Category

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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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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Vascular Causes of Bleeding

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Vascular Causes of Bleeding

Vascular purpura(bruising) is defined as bleeding as bleeding caused by intrinsic structural abnormalities of blood vessels or by inflammatory infiltration of blood vessels(vasculitis). Although vascular purpura usually causes bleeding in the setting of normal platelet counts and normal coagulation studies, vasculitis and vessel damage may be severe enough to cause secondary consumption of platelets and…

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DIAGNOSIS

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DIAGNOSIS

The diagnosis of GERD is best made by the patient’s history. Objective tests are useful to quantify the severity of disease and to address three questions: Does reflux exist?(2) Is acid reflux responsible for the patient’s symptoms? and(3) Has reflux led to esophageal damage? Reflux may be demonstrated during a barium swallow or by radionuclide…

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NON-HODGKIN’S LYMPHOMAS

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NON-HODGKIN’S LYMPHOMAS

The NHLs comprise a heterogeneous group of lymphoid malignancies that differ with respect to their histologic appearance, cell of origin and immunophenotype molecular clinical features, prognosis, and outcome with therapy. In view of the heterogeneity of NHLs, classification schemes have been devised to identify specific pathologic es that correlate with distinct clinical entities. The most…

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Bleeding Peptic Ulcers

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Bleeding Peptic Ulcers

Peptic ulcer disease is the most common cause of upper gastrointestinal bleeding, which occurs in 15% to 20% of patients.Although bleeding ceases spontaneously in 80%, the mortality of bleeding ulcers is 6% to 7%. The major risk factor for bleeding ulcers is consumption of NSAIDs. Patients with bleeding ulcers present with hematemesis, melena, or hematochezia,…

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Hereditary Elliptocytosis

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Hereditary Elliptocytosis

Hereditary Elliptocytosis is typically caused by dominantly inherited mutations affecting the interaction between membrane proteins with underlying cytoplasmic proteins. The most common abnormalities affect the interaction with spectrin and protein 4.1. This process causes the RBCs to assume an elliptic shape. As in hereditary spherocytosis, patients mall usually have mild hemolysis and splenomegaly. Hereditary pyropoikilocytosis…

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Differential Diagnosis

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Differential Diagnosis

The differential diagnosis of normocytic hypoproductive anemia is long. Most nutritional anemias that classically cause or macrocytosis begin as normocytic anemia. Combined nutritional deficiencies may also cause normalization of the MCV. The measurement of EPO levels may be helpful in the diagnosis of normocytic anemia. In addition to helping in the diagnosis of anemia resulting…

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ADRENAL CAUSES OF HYPERTENSION

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ADRENAL CAUSES OF HYPERTENSION

Hyperaldosteronism: Primary hyperaldosteronism results from the autonomous production of aldosterone from the adrenal gland, independent of renin stimulation. It is a result of a unilateral adrenal adenoma(Conn’s syndrome) in 54% of cases and bilateral adrenal hyperplasia in the majority of the rest. is more common in men, and adenomas are more common in women. The…

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