Archive For The “Funny” Category

Thyrotoxicosis Factitia

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Thyrotoxicosis Factitia

Thyrotoxicosis factitia presents as typical features of thyrotoxicosis from ingestion of excessive amounts of thyroxine, often in an attempt to lose weight. Serum T3 and T4 levels are elevated, and TSH is suppressed, as is the serum thyroglobulin concentration. Radioactive iodine uptake is absent. Patients may require psychotherapy. Struma ovarii occurs when an ovarian teratoma…

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GONADOTROPINS (LH AND FSH)

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GONADOTROPINS (LH AND FSH)

Gonadotroph secretion is regulated by hypothalamic gonadotropin-releasing hormone(GnRH), a 10-amino acid peptide secreted in a pulsatile manner, and feedback inhibition is regulated by gonadal steroids(estrogen and testosterone) and peptides(inhibin and activin) Basal LH and FSH are secreted in a pulsatile manner concordantly with the pulsatile release of GnRH. GnRH release determines the onset of puberty…

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Wilson’s Disease

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Wilson’s Disease

wilson’s disease, or hepatolenticular degeneration, is an autosomal recessive disorder affecting 1 to 3 per 100,000 population. It is caused by defective hepatic excretion of copper. The consequence is copper-induced injury to many organs, particularly the liver and brain. Copper is an essential trace element. Organ meats(particularly liver), nuts, seafood, and seeds are rich dietary…

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DISORDERS MANIFEST IN ADULTHOOD

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DISORDERS MANIFEST IN ADULTHOOD

Both chylomicrons and VLDL are catabolized by lipoprotein lipase, and the enzyme is saturable. The enzyme refers chylomicrons, so VLDL usually accumulate first until TG levels exceed 500 mg/dL. At higher levels, both VLDL and chylomicrons contribute to the hypertriglyceridemia. Testing to resolve the independent contribution of these two lipoproteins is rarely indicate and tests…

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Nutritional Assessment

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Nutritional Assessment

Every hospitalized patient deserves objective consideration of nutritional status. Severely malnourished patients have poorer outcomes, regardless of the disease entity or reason for hospitalization. Types of patients benefiting from nutritional support have been identified. In general, patients who have recently lost 10% of their body weight or more and those 30% or more below ideal…

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Biologic Therapy

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Biologic Therapy

Interferons, interleukin-2(IL 2), and monoclonal antibodies are examples of biologic therapies. Interferons have antiviral, and antiangiogenic effects. First used in the treatment of the rare hematologic malignancy hairy cell leukemia interferons are now used more often in the treatment of chronic myelogenous leukemia(CML). Interferon reduces cellular proliferation and controls the leukocytosis in CML in approximately…

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Hypercoagulability and Platelet Disorders

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Hypercoagulability and Platelet Disorders

Essential thrombocythemia, chronic myelogenous leukemia, and polycythemia vera are clonal myeloproliferative disorders that are wholly(essential thrombocythemia) or partially(chronic myelogenous leukemia, polycythemia vera) characterized by an elevated platelet count, socalled primary thrombocytosis. Platelet aggregometry in these disorders often shows abnormal responses, especially to weak agonists such as epinephrine and ADP however, the abnormal aggregation does not…

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Secondary Prevention

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Secondary Prevention

Secondary prevention of cancer is achieved with screening tests to detect disease in asymptomatic patients with early-stage disease. Examples include mammography to detect breast cancer, Papanicolaou(Pap) to detect cervical cancer, and sigmoidoscopy to detect colon cancer. Screening tests do not prevent disease and are not diagnostic on their own. Instead, they identify patients who need…

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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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