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قناة طبيه تهتم بالكتب الطبيه واي شي۽ متعلق بالطب #BRS #pathoma @Yaqob_alsomaii
about Anemia
Questiones long case
How to take history
HOW TO DO EXAMINATION
EXPLAIN WHY ?
🧑⚕ answer
Site of examination:
1. Inner aspect of lips (pull the lower lip outward
gently)
2. Tongue
3. Skin of the face.
5. Palm creases.
4. Nails. 6. Conjunctiva
👨⚕ can you tell me another causes of pallor rather than anemia ??
Or tell me causes of pallor with normal CBC ?
🧑⚕
Causes of pallor with normal CBC:
• Shock or .J, COP.
• Toxemia e.g. infective endocarditis.
• Edema of the face e.g. nephrotic syndrome.
• Racial pallor (Far East).
• Albinism
• Myxedema
• Lymphedema
👨⚕Why you will examine abdomen in patient with anemia ?
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👨⚕Q. What are the causes of macrocytic anemia?
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👨⚕ Q. What are the causes of microcytic hypochromic anemia?
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👨⚕ Q. What are the causes of normocytic normochromic anemia?
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👨⚕ what is other classification of anemia?
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Cardiovascular System
✓ There is a systolic murmur in the apical area (likely to be flow murmur)
Simply its cause is unknown , but some cases may have underlying cause as multiple sclerosis , tumer in cerebllopontine angle
How to Diagnosis?
Diagnostic criteria:
✓Recurring unilateral face pain✓Pain characteristics:Severe, no more than Two minutes ,
✓ Quality: sharp, shooting, stabbing, or electric shock-like✓Triggered by innocuous stimuli in the area innervated by the affected trigeminal nerve divisions
✓ other diagnosis not explainby symptom
So it's diagnosis is clinically
When i will use MRI ?
Only When i sugges patient has secondary casue as MS , and tumer by their clinical pictures
Treatment :
Carbamazepine " 100 mg PO twice Dailey
For acute exacerbations :
lidocaine infusion : 5 mg/kg IV over 60 minutes
If you don't do mistake here you will do it in your patient 😞
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همُ الأحرارُ ونحنُ الأسرىٰ، همُ الأعزاءُ ونحنُ الأذلَّاء، نحنُ مَن يحتاجُ إلىٰ مِنهاج تربيتِهم ونصرتِهم وعزتِهم وتقواهُم وصبرهِم وبأسِهم وإيمانِهم، نحنُ المَغلوبون العَاجزون المكبَّلون النائِحون، وهمُ المناضِلون الصَّامدون الثابتُون علىٰ الحقِّ والدِّين والأرضِ ولَو تكالبَ العالمُ بأسرهِ عليهِم، إنمَا نحَاول اللحاقَ بركبهِم لعلَّ يصِيبنا مِنهم بَعض الشجاعةِ والعزةِ والمَجد. 🤍
- لِقائله.
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New scenes documenting the massacre of hundreds of martyrs and wounded in the courtyard of the National Arab Hospital in Gaza after the Israeli occupation aircraft bombed the hospital. It is noteworthy that the hospital contained thousands of displaced people after the occupation asked them to evacuate their homes. 🇵🇸... This is the real Holocaust.”
All questions about anemia
/channel/easymedicine7/32
🧑⚕ I will examine abdomen for spleenomegaly which may suggest hemolytic anemia
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🧑⚕
1. Macrocytosis with megaloblastic marrow are found in:
✓ Vitamin B12 deficiency
✓ Folic acid deficiency.
2. Macrocytosis with normoblastic marrow are found in:
✓ Chronic liver disease
✓ Chronic alcoholism
✓ Hypothyroidism
✓ Hemorrhage
✓ Hemolysis
✓ Others—sideroblastic anemia, pure red cell aplasia, azathioprine therapy
🧑⚕ Answer:
✓ Iron deficiency anemia
✓ b-thalassemia major
✓ Sideroblastic anemia
✓ Anemia of chronic disorder (ACD).
🧑⚕ Answer :
✓ Anemia of chronic disorder
✓ Chronic infection (e.g. tuberculosis)
✓ Collagen disease (e.g. SLE, rheumatoid arthritis)
✓ Malignancy
✓ Endocrine disease
✓ Sideroblasitic anemia
Answer :
Morphological (depending on MCV and MCHC):
1. Normocytic normochromic anemia (normal MCV and MCHC).
2. Microcytic hypochromic anemia (low MCV < 76 fl, low MCHC < 30 g/dl).
3. Macrocytic anemia (high MCV > 96 fl).
4. Diamorphic anemia (two cell lines—macrocytes and microcytes)
🧑⚕answer ✓ aetiological classification :
1. Hemorrhagic anemia (due to blood loss)
2. Dyshemopoietic anemia (due to inadequate production of RBC):
✓ Deficiency anemia—Iron, vitamin B12, folate deficiency.
✓ Aplastic anemia (bone marrow failure which may be primary or secondary to some other
diseases or drugs).
✓ Anemia of chronic disorder (ACD)—SLE, rheumatoid arthritis, CRF.
✓ Other Hypothyroidism, sideroblastic anemia, malignancy.
3. Hemolytic anemia:
✓Genetic—Red cell membrane defect (e.g. hereditary spherocytosis, eliptocytosis,
stomatocytosis), hemoglobin abnormality (thalassemia, sickle cell anemia) or enzyme defects
(glucose-6-phosphate dehydrogenase deficiency, pyruvate-kinase deficiency).
✓ Acquired—Autoimmune, toxic, mechanical and infectious causes.
Answer :Anemia is a clinical condition characterized by reduced hemoglobin concentration, which is
usually but not invariably associated with reduced RBC
Name. …, ? years old, work , normotensive, nondiabetic, nonsmoker, hailing from …, presented with severe weakness for … months, which is gradually worsening and now she finds it difficult to perform regular daily activities. For the last … months, she also experiences occasional dizziness, light-headedness, tingling and numbness in both feet and occasional cramps in calf muscles. The patient also complains of palpitation, loss of appetite and weight loss for … months. There is no history of fever, difficulty in swallowing, bleeding from any sites or menorrhagia and bowel or bladder abnormality. The patient was treated by local physicians with iron tablets, multivitamin and ranitidin. There is no family history of similar illness
Examination: as above
Anemia
Chief complaints
✓ Weakness for … months
✓ Occasional dizziness for … months
✓ Tingling and numbness in lower limbs for … months
✓ Anorexia, weight loss and palpitation for … months.
History
History present illness: The patient states that she was alright … months back. Since then, she has
been suffering from severe weakness which is gradually worsening and now she finds it difficult to
perform regular daily activities. For the last … months, she also experiences occasional dizziness,
light-headedness, tingling and numbness in both feet and occasional cramps in calf muscles. The
patient also complains of palpitation, loss of appetite and weight loss for … months. There is no
history of fever, difficulty in swallowing, bleeding from any sites or menorrhagia and bowel or bladder
abnormality.
History of past illness
Family history
Personal history
Menstrual history
Socioeconomic history
Drug history: Mention according to the patient’s statement.
General examination
✓ The patient looks pale
✓ Moderately anemic
✓ No jaundice, clubbing, cyanosis, koilonychia, leukonychia or edema
✓ No lymphadenopathy or thyromegaly
✓ Sternal tenderness: Absent
✓Pulse: 120/min.
✓ BP: 95/65 mm Hg
#long_case
Trigeminal neuralgia more in female old age ,
What is the cause of trigeminal neuralgia ?
How to diagnose?
What is the DD ?
What is the treatment ?
''Making mistakes simply means you are learning faster."
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