Norman's Medical Review Podcast

Acute bronchitis This should be suspected in patients with an acute onset but persistent cough lasting one to three weeks who do not have clinical findings suggestive of pneumonia. If nasal discharge, sore throat, or ear pain are present, upper respiratory infection is likely.

Community acquire pneumonia is pneumonia occurring outside of the hospital or occurring within 72 hours of admission to the hospital. The most common organism is streptococcus pneumoniae also called pneumococcus. Other organisms include haemophilus influenza, legionella species, staphylococcus aureus and klebsiella. Nosocomial pneumonia is pneumonia acquired after 72 hours of admission. There are...

Gram-positive cocci—ampicillin or amoxicillin/clavulanic acid, ampicillin/ sulbactam, or vancomycin for S. aureus. • Anaerobes—clindamycin or metronidazole. Gram-negative organisms are suspected, add a fluoroquinolone or ceftazidime.

•Bronchophony is normal if the sound of 99 is muffled and indistinct when repeated by the patient during auscultation. •If there is consolidation in the lungs the sound of 99 will be very clear. •Ego-phony is normal if the pronunciation of the letter “e” is muffled. However if the pronunciation of “e” sounds like “a” then there is consolidation in the lungs •Whispered pecto-ri-lo-quy is the whispe...

•A person’s blood type is determined by the antigen on the surface of the RBC •. There are four major ABO blood groups determined by the presence or absence of two red cell antigens (A and B). •People who have neither A nor B antigens are classified as having type O blood. •Those with A antigens are classified as having type A blood; •those with B antigens, as having type B blood; •and those with...

Inherited bleeding disorders. 1. von Willebrand—deficiency or defect in vWF 2 HEMOPHILIA A—factor 8 deficiency,. Its an X-linked recessive disorder that primarily affect only males. 3. HEMOPHILIA B---factor 9 deficiency

•Thrombocytopenia may be due to: •1. drugs such as aspirin,and atorvastatin, •2. heparin . Ten percent of people treated with heparin develop a mild, transient thrombocytopenia within 2 to 5 days of starting the drug. •3. Thrombotic Thrombocytopenic Purpura. •4. immune thrombocytopenic purpura.-Primary ITP is an autoimmune disease in which platelets are directly destroyed or their formation inhibi...

Bleeding because of platelet disorders reflects: A decrease in platelet number because of decreased production, Increased PLATELET destruction, or Impaired function of platelets.

There are 5 types of white blood cells.

THE RATE AT WHICH THE RBCs FALL TO THE BOTTOM OF THE TUBE IS ACCELERATED IN THE PRESENCE OF FIBRINOGEN. FIBRINOGEN IS USUALLY INCREASED DURING INFLAMMATORY DISEASE.

•Primary polycythemia — Primary polycythemia is caused by a mutation in RBC progenitor cells that results in increased RBC mass. •Secondary polycythemia — Secondary polycythemia refers to an increase of RBC mass caused by elevated serum EPO. Most often, this is due to an appropriate physiologic response to tissue hypoxia.

When there is severe bleeding regardless of the cause the clotting factors V and V111 , fibrinogen and platelets migrate to the site to form a plug . Most time these clotting factors are fully consumed with subsequent clot formation. As a result of these clot formation plasmin is released. Plasmin is designed to breakdown fibrinogen and prevent clots. As a result of fibrinogen being broken down by...

Impaired Platelet Function. Impaired function of platelets may be hereditary or acquired. The two most common inherited disorders of bleeding are ; 1.Von Willebrand disease ( v. WF defect) 2.Hemophilia A ( factor V111 deficiency) and B ( factor IX deficiency) ● Von Willebrand Disease. Von Willebrand factor is synthesized by the endothelium and megakaryocytes and is required for the adhesion of pla...

1.This is a reduction in platelet number below 150,000/micro liter 2.Thrombocytopenia may be due to bone marrow dysfunction from radiation and chemotherapy. 3.Thrombocytopenia may be due to increase pooling of platelets in the spleen 4.Thrombocytopenia may be due to antibodies against platelets that facilitate destruction. These antibodies attack the glycoprotein 11b/111a receptors on the surface...

Thrombocytopenia may be due to immune thrombocytopenic purpura( ITP). In this condition antibodies bind to platelets and cause excess destruction. This is an autoimmune disease. Itscalled primary ITP. This affect both genders and all ages. The platelet–antibody complex that is formed exposed the platelets to phagocytosis in the spleen.

This condition is caused by uncontrolled platelet aggregation which is responsible for generalized vascular occlusion and organ failure

Bleeding Relating To Platelets May Be Due To: 1. Decrease in platelet production 2. Increase in platelet destruction 3. Impaired platelet function

Lymph node biopsy has to demonstrate the presence of Reed–Sternberg cells in order to make the diagnosis •Presence of inflammatory cell infiltrates—This distinguishes Hodgkin lymphoma from non-Hodgkin lymphoma (NHL). The inflammatory cells present are reactive to the Reed–Sternberg cells. These include plasma cells, eosinophils, fibroblasts, and T and B lymphocytes.

•Non-Hodgkin lymphomas (NHL) are a group of malignant tumors derived from •B cell progenitors, •T cell progenitors, •mature B cells, •mature T cells, •or (rarely) natural killer cells. •NHL is seen in patients of all ages, races, and socioeconomic status.

1. ALL--most common in children, response best to treatment 2.AML 3. CLL 4. CML

Reticulocyte indices, less than 2% or more than 2%

What is the first thing to do in evaluating a person with low H/H

The most common cause How does it present How is it diagnosed How is it treated.

What is the most common Thalassemia anemia Which Thalassemia requires frequent blood transfusion

When should be transfusion be given