Appraoch to autoimmune diseases.pptx
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This is an approach to the basis of the common antibodies and the associated diseases, called autoimmune diseases.
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pediatric Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and circulating autoantibodies directed against self-antigens. SLE predominantly affects females and can involve many organs systems, leading to a variety of clinical manifestations. Diagnosis is based on meeting 4 out of 11 criteria developed by the Systemic Lupus International Collaborating Clinics, including at least 1 clinical and 1 immunologic criteria. Treatment involves controlling symptoms, preventing organ damage, and immunosuppressive drugs such as corticosteroids and hydroxychloroquine. The course of SLE can be variable with periods of disease exacerbation and remission.
SLE
A 40-year-old woman presented with a butterfly rash on her face, arthralgia, alopecia, and fatigue but no fever. The most likely diagnosis is systemic lupus erythematosus (SLE) given the clinical presentation of rash and joint pain. SLE is an inflammatory autoimmune disorder that can affect multiple organ systems including skin, joints, brain, heart, lungs, liver, and kidneys. Laboratory tests ordered would include CBC, ESR, CRP, autoantibodies such as ANA, anti-dsDNA, and complement levels. Initial treatment would include NSAIDs, antimalarial drugs, and short courses of oral corticosteroids depending on organ involvement
Autoimmune hemolytic anemia HY
Autoimmune hemolytic anemia can be warm or cold agglutinin types. Warm types are caused by drugs, infections, autoimmune diseases, or immunodeficiencies. Symptoms range from asymptomatic to life-threatening anemia. Treatment involves corticosteroids or splenectomy for refractory cases. Cold agglutinin types are caused by infections and present with anemia and skin changes with cold exposure, treating with rituximab or avoidance of cold. Complications of both types include blood clots, gangrene, and risk of lymphoma.
Pediatric systemic lupus erythematosus
1. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of auto-antibodies against components of the cell nucleus.
2. SLE affects multiple organ systems and is more common in females, with a female to male ratio of 9:1 before puberty.
3. Diagnosis of SLE requires meeting 4 out of 11 American College of Rheumatology diagnostic criteria, including at least 1 clinical and 1 immunological criterion. Common clinical manifestations include malar rash, arthritis, renal disease, and hematological abnormalities.
Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs in the body. It is more common in women, especially of childbearing age, and in African Americans. The disease is characterized by autoantibody production and tissue damage caused by immune complexes. Diagnosis is based on meeting criteria from the SLICC classification system, which improved upon previous criteria. Organ manifestations include renal, neurological, cardiac, pulmonary, hematological and cutaneous involvement. Management aims to suppress symptoms and prevent organ damage through medications like glucocorticoids, antimalarials, immunosuppressants and biologics. The goal is complete remission though sustained remission is rare
MCTD by Dr Zohaib.pptx
Mixed Connective Tissue Disease (MCTD) is an autoimmune disease with features of systemic lupus erythematosus (SLE), scleroderma, polymyositis, and rheumatoid arthritis. It is characterized by the presence of anti-U1 RNP antibodies. Common manifestations include Raynaud's phenomenon, arthritis, myositis, and lung or kidney involvement. Treatment focuses on symptoms and may include corticosteroids, immunosuppressants, and vasodilators. Prognosis is generally good, but pulmonary hypertension and interstitial lung disease can be serious complications.
4 Sle2009
A 22-year-old college student presents with symptoms including a malar rash, photosensitivity, arthritis, fatigue, and hair loss. Laboratory tests show a positive ANA, positive anti-Smith antibody, and low white blood cell and platelet counts. This constellation of clinical features and laboratory results makes systemic lupus erythematosus the most likely diagnosis for the patient.
Mixed connective tissue disease
Mixed connective tissue disease (MCTD) is a rare autoimmune disorder with features of lupus, scleroderma, rheumatoid arthritis, and polymyositis. It is characterized by high levels of antibodies against ribonucleic proteins. Diagnostic criteria require at least 3 of 5 clinical features plus positive serology. Over time, many patients evolve features meeting criteria for other connective tissue diseases. Common clinical manifestations include Raynaud's phenomenon, arthritis, swollen hands, and lung and heart involvement. Prognosis depends on degree of organ involvement, with 5-year cumulative risks including pulmonary dysfunction in 66% and pericardial disease in 30% of patients.
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pediatric Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and circulating autoantibodies directed against self-antigens. SLE predominantly affects females and can involve many organs systems, leading to a variety of clinical manifestations. Diagnosis is based on meeting 4 out of 11 criteria developed by the Systemic Lupus International Collaborating Clinics, including at least 1 clinical and 1 immunologic criteria. Treatment involves controlling symptoms, preventing organ damage, and immunosuppressive drugs such as corticosteroids and hydroxychloroquine. The course of SLE can be variable with periods of disease exacerbation and remission.
SLE
A 40-year-old woman presented with a butterfly rash on her face, arthralgia, alopecia, and fatigue but no fever. The most likely diagnosis is systemic lupus erythematosus (SLE) given the clinical presentation of rash and joint pain. SLE is an inflammatory autoimmune disorder that can affect multiple organ systems including skin, joints, brain, heart, lungs, liver, and kidneys. Laboratory tests ordered would include CBC, ESR, CRP, autoantibodies such as ANA, anti-dsDNA, and complement levels. Initial treatment would include NSAIDs, antimalarial drugs, and short courses of oral corticosteroids depending on organ involvement
Autoimmune hemolytic anemia HY
Autoimmune hemolytic anemia can be warm or cold agglutinin types. Warm types are caused by drugs, infections, autoimmune diseases, or immunodeficiencies. Symptoms range from asymptomatic to life-threatening anemia. Treatment involves corticosteroids or splenectomy for refractory cases. Cold agglutinin types are caused by infections and present with anemia and skin changes with cold exposure, treating with rituximab or avoidance of cold. Complications of both types include blood clots, gangrene, and risk of lymphoma.
Pediatric systemic lupus erythematosus
1. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of auto-antibodies against components of the cell nucleus.
2. SLE affects multiple organ systems and is more common in females, with a female to male ratio of 9:1 before puberty.
3. Diagnosis of SLE requires meeting 4 out of 11 American College of Rheumatology diagnostic criteria, including at least 1 clinical and 1 immunological criterion. Common clinical manifestations include malar rash, arthritis, renal disease, and hematological abnormalities.
Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs in the body. It is more common in women, especially of childbearing age, and in African Americans. The disease is characterized by autoantibody production and tissue damage caused by immune complexes. Diagnosis is based on meeting criteria from the SLICC classification system, which improved upon previous criteria. Organ manifestations include renal, neurological, cardiac, pulmonary, hematological and cutaneous involvement. Management aims to suppress symptoms and prevent organ damage through medications like glucocorticoids, antimalarials, immunosuppressants and biologics. The goal is complete remission though sustained remission is rare
MCTD by Dr Zohaib.pptx
Mixed Connective Tissue Disease (MCTD) is an autoimmune disease with features of systemic lupus erythematosus (SLE), scleroderma, polymyositis, and rheumatoid arthritis. It is characterized by the presence of anti-U1 RNP antibodies. Common manifestations include Raynaud's phenomenon, arthritis, myositis, and lung or kidney involvement. Treatment focuses on symptoms and may include corticosteroids, immunosuppressants, and vasodilators. Prognosis is generally good, but pulmonary hypertension and interstitial lung disease can be serious complications.
4 Sle2009
A 22-year-old college student presents with symptoms including a malar rash, photosensitivity, arthritis, fatigue, and hair loss. Laboratory tests show a positive ANA, positive anti-Smith antibody, and low white blood cell and platelet counts. This constellation of clinical features and laboratory results makes systemic lupus erythematosus the most likely diagnosis for the patient.
Mixed connective tissue disease
Mixed connective tissue disease (MCTD) is a rare autoimmune disorder with features of lupus, scleroderma, rheumatoid arthritis, and polymyositis. It is characterized by high levels of antibodies against ribonucleic proteins. Diagnostic criteria require at least 3 of 5 clinical features plus positive serology. Over time, many patients evolve features meeting criteria for other connective tissue diseases. Common clinical manifestations include Raynaud's phenomenon, arthritis, swollen hands, and lung and heart involvement. Prognosis depends on degree of organ involvement, with 5-year cumulative risks including pulmonary dysfunction in 66% and pericardial disease in 30% of patients.
Mixed connective tissue disease
Mixed connective tissue disease (MCTD) is a rare autoimmune disorder with features of lupus, scleroderma, rheumatoid arthritis, and polymyositis. It is characterized by high levels of antibodies against ribonucleic proteins. Diagnostic criteria require 3 of 5 clinical features plus positive serology. Over time, many patients evolve symptoms meeting criteria for other connective tissue diseases. Pulmonary, renal, and cardiac involvement are common complications. Prognosis depends on degree of organ involvement, with 5-year mortality of 8-19% reported.
Sle
This document provides an overview of systemic lupus erythematosus (SLE). It discusses the definition, epidemiology, pathogenesis, diagnosis, clinical manifestations, management, and complications of SLE. The pathogenesis involves genetic susceptibility and environmental triggers leading to abnormal immune responses and autoantibody production. Diagnosis is based on the SLICC classification criteria. Management involves controlling symptoms, preventing organ damage, and treating flares and complications using medications like glucocorticoids, antimalarials, immunosuppressants, and biologics. Life-threatening complications can include renal disease, neurological involvement, hematological abnormalities and vasculitis.
Approach to sle
SLE, the disease that's most common among us, young females. In my presentation I discuss 1 case then elaborate on the subject.
SYSTEMIC LUPUS ERYTHEMATOSUS.pptx
This patient has a history of recurrent deep vein thrombosis and pregnancy losses. She presents with right calf swelling and tenderness and is found to have thrombocytopenia and a prolonged PTT. Testing reveals a positive lupus anticoagulant on two occasions more than 12 weeks apart, meeting criteria for antiphospholipid syndrome which can present as recurrent thrombosis.
Systemic lupus erythmatosus
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs in the body. Common symptoms include fatigue, joint pain, rashes, and kidney problems. It is caused by genetic and environmental factors that lead to abnormal immune responses against the body's own tissues. Diagnosis involves evaluating clinical features along with blood tests to detect autoantibodies. Treatment depends on the specific organs involved but may include medications to suppress the immune system.
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Autoimmune diseas in pregnancy 김윤영
The document discusses autoimmune disease in pregnancy. It notes that autoimmune diseases involve the immune system attacking the body's own tissues. When autoimmune diseases occur during pregnancy, careful monitoring is needed as disease activity may be exacerbated or confused with normal pregnancy symptoms. For lupus specifically, outcomes are best if the disease is inactive prior to conception and complications like preeclampsia are avoided. Active management includes monitoring for signs of lupus flares or preeclampsia through laboratory tests and urine analysis.
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This document discusses ANA profiles in connective tissue diseases. Some key points:
1. ANAs are autoantibodies that bind to nuclear structures and are seen at higher levels in patients with CTDs compared to normal individuals. Their detection is important for CTD diagnosis and treatment monitoring.
2. Historical studies first described CTDs like SLE and identified LE cells containing nuclear material, suggesting the presence of an anti-nuclear antibody.
3. Common ANA patterns include homogeneous, speckled, peripheral and nucleolar and are associated with CTDs like SLE, Sjogren's syndrome and scleroderma. Specific ANAs like anti-dsDNA and anti-Sm are highly
Scleroderma
Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis of the skin and internal organs. It results from autoimmune dysfunction leading to accumulation of T cells and cytokines in the skin that stimulate collagen deposition by fibroblasts. There are two main types: limited cutaneous SSc affects only the hands and forearms, while diffuse cutaneous SSc affects the skin over much of the body. SSc most commonly affects women ages 30-50 and can involve serious complications like scleroderma renal crisis resulting in high blood pressure, kidney damage, and other symptoms. Diagnosis involves clinical signs and presence of autoantibodies, and treatment depends on complications but may include ACE inhibitors for renal problems. Mixed connect
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1. Vacuolar myelopathy, a rare condition since ART that causes slowly progressive weakness.
2. Distal sensory polyneuropathy (DSP), the most common neuropathy affecting 30-50% of HIV patients, presenting as numbness and tingling.
3. Inflammatory demyelinating polyradiculoneuropathies like AIDP and CIDP, which develop during early infection and present with weakness.
4. Other rare conditions like lumbosacral polyradiculo
Mctd final
Mixed connective tissue disease (MCTD) is characterized by features of systemic lupus erythematosus, systemic sclerosis, polymyositis, and rheumatoid arthritis. It is defined by very high levels of anti-U1RNP antibodies. Clinical features include Raynaud's phenomenon, joint and muscle involvement, lung and heart disease, gastrointestinal issues, and kidney disease. Diagnosis requires clinical and serological criteria including high titers of anti-U1RNP antibodies. Treatment depends on organ system involvement but may include analgesics, steroids, immunosuppressants, and calcium channel blockers. Prognosis is variable depending on degree of organ involvement.
Sle diagnosis & treatment
Systemic Lupus Erythematosus (SLE) is a multi-gene autoimmune disease caused by a combination of genetic and environmental factors. It is characterized by abnormal immune responses that result in inflammation and damage to various organs. Diagnosis requires meeting 4 out of 11 classification criteria relating to clinical symptoms and blood markers. Management aims to induce remission of acute flares, maintain improvements to suppress symptoms, and prevent organ damage. Treatment choices depend on the severity and potential reversibility of manifestations. The goal is controlling symptoms without cure since complete sustained remission is rare.
Sjogren's syndrome
This document discusses Sjogren's syndrome, an autoimmune disorder characterized by lymphocytic infiltration of exocrine glands causing dry eyes and mouth. It covers diagnostic criteria including symptoms, objective signs of dryness, autoimmune involvement and biopsy findings. Treatment focuses on managing sicca symptoms through salivary stimulation and substitutes. Rituximab has shown promise in improving dryness symptoms and systemic manifestations in early studies. The risk of lymphoma is higher in Sjogren's patients, especially those with prognostic factors like low C4 levels or purpura.
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Connective tissue diseases
Connective tissue diseases share features of immune dysregulation and autoantibody production directed at nuclear components, causing widespread tissue damage. Systemic lupus erythematosus is characterized by arthritis, rashes, kidney involvement and positive ANA and anti-dsDNA antibodies. Systemic sclerosis involves skin thickening from fibrosis, Raynaud's phenomenon, and autoantibodies like anti-Scl-70. Polymyositis and dermatomyositis cause proximal muscle weakness and inflammation with skin lesions in dermatomyositis.
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2. Key questions to ask patients around joint involvement, morning stiffness, pain with activity, and constitutional symptoms.
3. Common patterns seen in different diseases like rheumatoid arthritis, spondyloarthropathies, and osteoarthritis.
4. The role of various laboratory tests like ESR, CRP, rheumatoid factor, anti-CCP, ANA, and ANCA in evaluating patients and supporting diagnoses.
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SLE is a multisystem autoimmune disease that predominantly affects women of childbearing age and is the most common form of lupus.
The exact cause is still unknown.
For more informations you can read the following file.
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This document summarizes several neurological conditions associated with HIV, including:
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2. Aseptic meningitis, cryptococcal meningitis, toxoplasmosis, progressive multifocal leukoencephalopathy (PML), and spinal cord diseases like vacuolar myelopathy are also discussed.
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- Diagnosis is made through ultrasound showing cystic spaces and very high HCG levels. Management involves surgical evacuation followed by monitoring of HCG levels to detect malignant changes, as 20% of complete moles may develop into gestational trophoblastic neoplasia.
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Mixed connective tissue disease (MCTD) is a rare autoimmune disorder with features of lupus, scleroderma, rheumatoid arthritis, and polymyositis. It is characterized by high levels of antibodies against ribonucleic proteins. Diagnostic criteria require 3 of 5 clinical features plus positive serology. Over time, many patients evolve symptoms meeting criteria for other connective tissue diseases. Pulmonary, renal, and cardiac involvement are common complications. Prognosis depends on degree of organ involvement, with 5-year mortality of 8-19% reported.
Sle
This document provides an overview of systemic lupus erythematosus (SLE). It discusses the definition, epidemiology, pathogenesis, diagnosis, clinical manifestations, management, and complications of SLE. The pathogenesis involves genetic susceptibility and environmental triggers leading to abnormal immune responses and autoantibody production. Diagnosis is based on the SLICC classification criteria. Management involves controlling symptoms, preventing organ damage, and treating flares and complications using medications like glucocorticoids, antimalarials, immunosuppressants, and biologics. Life-threatening complications can include renal disease, neurological involvement, hematological abnormalities and vasculitis.
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SLE, the disease that's most common among us, young females. In my presentation I discuss 1 case then elaborate on the subject.
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This patient has a history of recurrent deep vein thrombosis and pregnancy losses. She presents with right calf swelling and tenderness and is found to have thrombocytopenia and a prolonged PTT. Testing reveals a positive lupus anticoagulant on two occasions more than 12 weeks apart, meeting criteria for antiphospholipid syndrome which can present as recurrent thrombosis.
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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs in the body. Common symptoms include fatigue, joint pain, rashes, and kidney problems. It is caused by genetic and environmental factors that lead to abnormal immune responses against the body's own tissues. Diagnosis involves evaluating clinical features along with blood tests to detect autoantibodies. Treatment depends on the specific organs involved but may include medications to suppress the immune system.
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The document discusses autoimmune disease in pregnancy. It notes that autoimmune diseases involve the immune system attacking the body's own tissues. When autoimmune diseases occur during pregnancy, careful monitoring is needed as disease activity may be exacerbated or confused with normal pregnancy symptoms. For lupus specifically, outcomes are best if the disease is inactive prior to conception and complications like preeclampsia are avoided. Active management includes monitoring for signs of lupus flares or preeclampsia through laboratory tests and urine analysis.
Ana profile in cvd
This document discusses ANA profiles in connective tissue diseases. Some key points:
1. ANAs are autoantibodies that bind to nuclear structures and are seen at higher levels in patients with CTDs compared to normal individuals. Their detection is important for CTD diagnosis and treatment monitoring.
2. Historical studies first described CTDs like SLE and identified LE cells containing nuclear material, suggesting the presence of an anti-nuclear antibody.
3. Common ANA patterns include homogeneous, speckled, peripheral and nucleolar and are associated with CTDs like SLE, Sjogren's syndrome and scleroderma. Specific ANAs like anti-dsDNA and anti-Sm are highly
Scleroderma
Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis of the skin and internal organs. It results from autoimmune dysfunction leading to accumulation of T cells and cytokines in the skin that stimulate collagen deposition by fibroblasts. There are two main types: limited cutaneous SSc affects only the hands and forearms, while diffuse cutaneous SSc affects the skin over much of the body. SSc most commonly affects women ages 30-50 and can involve serious complications like scleroderma renal crisis resulting in high blood pressure, kidney damage, and other symptoms. Diagnosis involves clinical signs and presence of autoantibodies, and treatment depends on complications but may include ACE inhibitors for renal problems. Mixed connect
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This document summarizes HIV-associated neurological complications. It discusses several conditions that can affect the spinal cord, peripheral nervous system, and muscles in patients with HIV/AIDS, including:
1. Vacuolar myelopathy, a rare condition since ART that causes slowly progressive weakness.
2. Distal sensory polyneuropathy (DSP), the most common neuropathy affecting 30-50% of HIV patients, presenting as numbness and tingling.
3. Inflammatory demyelinating polyradiculoneuropathies like AIDP and CIDP, which develop during early infection and present with weakness.
4. Other rare conditions like lumbosacral polyradiculo
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Mixed connective tissue disease (MCTD) is characterized by features of systemic lupus erythematosus, systemic sclerosis, polymyositis, and rheumatoid arthritis. It is defined by very high levels of anti-U1RNP antibodies. Clinical features include Raynaud's phenomenon, joint and muscle involvement, lung and heart disease, gastrointestinal issues, and kidney disease. Diagnosis requires clinical and serological criteria including high titers of anti-U1RNP antibodies. Treatment depends on organ system involvement but may include analgesics, steroids, immunosuppressants, and calcium channel blockers. Prognosis is variable depending on degree of organ involvement.
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Systemic Lupus Erythematosus (SLE) is a multi-gene autoimmune disease caused by a combination of genetic and environmental factors. It is characterized by abnormal immune responses that result in inflammation and damage to various organs. Diagnosis requires meeting 4 out of 11 classification criteria relating to clinical symptoms and blood markers. Management aims to induce remission of acute flares, maintain improvements to suppress symptoms, and prevent organ damage. Treatment choices depend on the severity and potential reversibility of manifestations. The goal is controlling symptoms without cure since complete sustained remission is rare.
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This document discusses Sjogren's syndrome, an autoimmune disorder characterized by lymphocytic infiltration of exocrine glands causing dry eyes and mouth. It covers diagnostic criteria including symptoms, objective signs of dryness, autoimmune involvement and biopsy findings. Treatment focuses on managing sicca symptoms through salivary stimulation and substitutes. Rituximab has shown promise in improving dryness symptoms and systemic manifestations in early studies. The risk of lymphoma is higher in Sjogren's patients, especially those with prognostic factors like low C4 levels or purpura.
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This document provides an approach to evaluating and diagnosing neurodegenerative disorders in children. It begins by defining neurodegenerative diseases as those causing progressive neurological deterioration. The approach involves taking a detailed history and physical exam, looking for clues about whether gray or white matter is predominantly affected. A variety of investigations can then help identify specific conditions, such as enzyme analysis for lysosomal storage diseases or brain imaging. Management is directed at underlying causes, complications, and supportive care, with some conditions having specific treatments like bone marrow transplantation or enzyme replacement therapy.
Connective tissue diseases
Connective tissue diseases share features of immune dysregulation and autoantibody production directed at nuclear components, causing widespread tissue damage. Systemic lupus erythematosus is characterized by arthritis, rashes, kidney involvement and positive ANA and anti-dsDNA antibodies. Systemic sclerosis involves skin thickening from fibrosis, Raynaud's phenomenon, and autoantibodies like anti-Scl-70. Polymyositis and dermatomyositis cause proximal muscle weakness and inflammation with skin lesions in dermatomyositis.
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This document provides an overview of how to approach connective tissue disorders. It discusses:
1. The importance of taking a thorough history and physical exam to determine if the condition is articular or non-articular, acute or chronic, and which joints are involved.
2. Key questions to ask patients around joint involvement, morning stiffness, pain with activity, and constitutional symptoms.
3. Common patterns seen in different diseases like rheumatoid arthritis, spondyloarthropathies, and osteoarthritis.
4. The role of various laboratory tests like ESR, CRP, rheumatoid factor, anti-CCP, ANA, and ANCA in evaluating patients and supporting diagnoses.
Systemic lupus erythematosus.pptx
SLE is a multisystem autoimmune disease that predominantly affects women of childbearing age and is the most common form of lupus.
The exact cause is still unknown.
For more informations you can read the following file.
White blood cell disorders
White Blood Cell Disorders can affect neutrophils, eosinophils, basophils and mast cells. Neutropenia is classified by severity based on absolute neutrophil count and risk of infection. Causes include acquired conditions like drugs/infections or congenital disorders. Hypereosinophilic syndrome is a broad condition caused by primary or secondary eosinophilia leading to tissue damage. Diagnosis involves ruling out secondary causes and identifying organ involvement. Treatment depends on etiology and includes steroids, hydroxyurea, interferon-alpha, imatinib or anti-IL-5 antibodies.
approach to MPN
This document discusses the diagnostic approach and classification of myeloproliferative neoplasms according to the 2008 WHO criteria. It describes the differential diagnosis and clinical features of polycythemia vera, essential thrombocythemia, and primary myelofibrosis. It discusses diagnostic criteria, disease course, prognosis, and treatment approaches for these chronic myeloproliferative disorders.
Hiv in neurology
This document summarizes several neurological conditions associated with HIV, including:
1. HIV-associated neurocognitive disorder (HAND), which has three stages from asymptomatic to HIV-associated dementia.
2. Aseptic meningitis, cryptococcal meningitis, toxoplasmosis, progressive multifocal leukoencephalopathy (PML), and spinal cord diseases like vacuolar myelopathy are also discussed.
3. Peripheral neuropathies are common, especially a painful sensory neuropathy, as well as myopathies related to HIV or antiretroviral medications.
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JVP - A SHORT REVIEW
The jugular venous pulse reflects right atrial pressure and is best examined in the right internal jugular vein. It normally displays three positive waves and two negative troughs related to atrial filling and emptying. Abnormalities can indicate conditions that elevate or lower right atrial pressure such as heart failure, tamponade, constriction. Specific wave changes suggest problems like tricuspid regurgitation or stenosis. The jugular venous pulse is a useful physical exam finding for cardiovascular assessment.
HEART MURMURS
Heart murmurs can be produced by turbulence in blood flow caused by abnormalities in heart valves or structures. A murmur is described by its timing in the cardiac cycle, location, intensity, quality, and radiation pattern.
A mid-systolic murmur is the most common murmur and can be caused by ventricular outflow obstructions like aortic stenosis, dilation of the aorta/pulmonary trunk, accelerated flow, or innocent murmurs from normal anatomical variations. Diastolic murmurs include early diastolic murmurs like aortic regurgitation and high-pressure pulmonary regurgitation, and mid-diastolic murmurs caused by stenosis of the mitral or tricuspid valves. Flow murmurs
Development of male and female reproductive system
The document describes the development of the male and female reproductive systems from the indifferent stage through sexual differentiation. It covers the development of the gonads (testes and ovaries), genital ducts, and external genitalia. Some key points include:
- The gonads initially develop as indifferent gonads before differentiating into testes or ovaries depending on the presence of the SRY gene on the Y chromosome.
- The genital ducts also initially develop in an indifferent stage before the mesonephric ducts develop into male structures like the epididymis and vas deferens, while the paramesonephric ducts develop into female structures like the uterus and fallopian tubes.
- External
Chronic Osteomyelitis
This document discusses chronic osteomyelitis, including its causes, pathology, presentations, examinations, investigations, differential diagnoses, and treatments. It can develop following acute osteomyelitis or be caused by tuberculosis or fungi. Pathology involves spread of pus within bone leading to bone death and cavities. Presentations include discharging sinuses and bone fragments. Investigations include x-rays showing bone changes and cultures of pus. Surgical treatments aim to remove dead bone and tissue. Complications include exacerbations, growth abnormalities, and fractures. It also discusses Garre's osteomyelitis and Brodie's abscess as specific types.
Forceps delivery and vacuum extraction
Forceps delivery is an operative vaginal delivery procedure that uses obstetric forceps to assist in the extraction of the fetal head. Forceps have curved blades that fit around the fetal head to allow the operator to apply gentle traction. Forceps delivery is indicated when there are signs of fetal distress, prolonged second stage of labor, or maternal medical complications. Risks include laceration, hemorrhage, and injuries to the mother or baby. Proper technique and only performing the procedure when fully trained can help minimize risks.
Face Presentation
This document provides information on face presentation during childbirth. It defines face presentation as a cephalic presentation with the fetus in a complete extended attitude and the presenting part being the face. The two types of face presentation are primary (presenting before labor) and secondary (caused by extension during labor). The main positions are left and right mentoanterior and mentoposterior. Face presentation has a higher risk of complications compared to vertex presentation such as prolonged labor and increased need for operative delivery. The management involves allowing labor to progress for mentoanterior positions but cesarean section is usually needed for persistent mentoposterior.
E coli - Microbiology
E. coli is a normal flora in the gut but can cause several infections. It is the most common cause of urinary tract infections and can lead to different types of gastroenteritis depending on the strain. Some strains like EHEC O157:H7 can cause hemorrhagic colitis and potentially fatal hemolytic uremic syndrome in young children and the elderly. E. coli is also known to cause neonatal meningitis, wound infections after surgeries, and sepsis.
Blood supply of brain
The brain receives a high blood supply to meet its metabolic demands. Arterial blood reaches the brain through the internal carotid and vertebral arteries, forming the circle of Willis at the base of the brain before branching into smaller vessels. Venous blood drains from the brain into internal jugular veins. Disruption of blood flow to the brain through cerebrovascular accidents like stroke can cause rapid loss of consciousness or permanent brain damage. Cerebrospinal fluid produced by choroid plexuses circulates within ventricles and around the brain and spinal cord, carrying nutrients and waste products.
Comprehensive Overview of Medical Genetics
This document discusses genetic diseases and abnormal fetal development. It begins with definitions of genetic terms like genetic code, chromosomes, genes, and cell division. It then discusses abnormal fetal development including malformations, deformations, and disruptions caused by chromosomal abnormalities, genetic defects, and environmental factors. The document ends by covering perinatal pathology including birth defects and metabolic disorders.
Short Review of Thalassemias
This document provides information on thalassemia, a group of genetic disorders that result in reduced hemoglobin production and anemia. It discusses the different types of thalassemia including alpha and beta thalassemia. Alpha thalassemia is caused by genetic deletions of the alpha globin genes and has varying severity from silent carrier to Hemoglobin H Disease to Bart's Hydrops Fetalis Syndrome. Beta thalassemia results from mutations in the beta globin genes and includes forms ranging from silent carrier to beta thalassemia minor to intermedia to major. Laboratory tests outlined can help diagnose and differentiate types of thalassemia based on red blood cell morphology, hemoglobin analysis and iron studies.
Localising the lesion of the CNS
This document provides an overview of localizing neurological lesions, including definitions of key terms like the central nervous system and peripheral nervous system. It describes various motor and sensory pathways in the brain and spinal cord. Conditions covered include the corticospinal system, stroke syndromes, multiple sclerosis, cerebellar syndrome, and motor neuron disease. For each, the causes, signs, investigations, and management are summarized. Clinical case scenarios are also provided to help localize neurological lesions.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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The Electrocardiogram - Physiologic Principles
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Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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- 1. Approach to connective tissue disease
- 2. • Prototype is SLE • Overlap of symptoms and signs occur • Labs are not always conclusive
- 3. Approach • Labs cant diagnose certainly • Clue to disease ANA- nucleotides and nucleoproteins • Used to screen CTD • Except Rheumatic Arthritis – high sensitivity but low specificity
- 4. Positive ANA without CTD • Aging , HIV , viral hepatitis, ILD, Tuberculosis • Malignancies – B cell lymphomas • If negative ANA- chance of CTD is very low except rheumatoid arthritis
- 5. Specific antibodies Antids DNA Against double stranded DNA Specific for SLE especially lupus nephritis Titres for monitoring process of damage
- 6. SSA/Ro • Sjogrens syndrome • SLE associated with photosensitivity • Neonatal lupus • Fetal congenital heart block in mothers with SLE
- 7. SSB/La • Also seen in Sjogren’s syndrome • SSA/Ro + SSB/La- definitive diagnosis of the Sjogrens syndrome
- 8. RNP-U1 • Ribonucleoprotein U1 • Seen in mixed connective tissue disease(MCTD) • Lupus , scleroderma and myositis
- 9. AntiScl 70 • Scleroderma 70 ( antitopoisomerase 1 ) • Seen in systemic sclerosis • Increased risk of ILD in systemic sclerosis patients with AntiScl 70
- 10. Anticentromere antibodies CREST syndrome - Calcinosis cutis - Raynaud’s syndroome - Esophageal dysmotility - Sclerodactily - Telengectasia
- 11. Antihistone antibodies • It is a ribonucleoprotein • Drug induced SLE - Procanamide - INH - Hydralazine - Quinidine --------moderate risk
- 12. Anti-Jo 1 antibody • Seen in antisynthetase syndrome (Polmyositis and ILD)
- 13. Rheumatoid factor(RF) • Seen in RA and Hep C • IgM against Fc portion of IgG
- 14. Anti-CCP antibody • Cyclic citrulinated antibody • Derivative of arginine • Seen in rheumatoid arthritis
- 15. CRP • Non specific for inflammation • Acute phase reactant from liver • Varies with level of inflammation • Produced on the signal of IL-6
- 16. ESR • Proportional to inflammation • False elevation can occur • Not specific
- 17. Thank you