Myeloproliferative disorders PV and ET
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he term myeloproliferative neoplasms (MPN) describes a group of conditions arising from marrow stem cells and characterized by clonal proliferation of one or more haemopoietic components in the bone marrow and, in many cases, the liver and spleen. They are often called the myeloproliferative diseases. The three major non‐leukaemic disorders included in this classification are: 1 Polycythaemia vera (PV); 2 Essential thrombocythaemia (ET); and 3 Primary myelofibrosis.
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This document discusses myeloproliferative neoplasms (MPNs), which are clonal stem cell disorders characterized by excessive proliferation of one or more myeloid cell lines in the bone marrow and peripheral blood. MPNs include chronic myeloid leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). CML is driven by the Philadelphia chromosome and BCR-ABL fusion gene. PV, ET and PMF are typically caused by a mutation in the JAK2 gene known as JAK2 V617F. The clinical features, diagnostic criteria, complications and treatment approaches for each MPN subtype are described.
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- Chronic myeloid leukemia (CML) is characterized by the Philadelphia chromosome and progresses through chronic, accelerated, and blast crisis phases without treatment.
- Chronic lymphocytic leukemia (CLL) involves the accumulation of abnormal B lymphocytes. It typically affects older adults and can cause infections, anemia, and lymph node enlargement.
polycythemia
This document discusses polycythemia, which is characterized by an increased red blood cell mass. It can be absolute, due to increased red cell volume, or relative, due to decreased plasma volume. Causes of absolute polycythemia include primary polycythemia vera, which results from a clonal stem cell mutation, and secondary polycythemia, which is usually appropriate and resolves when the underlying cause is treated. Clinical findings of polycythemia vera include reddening of the skin and risk of blood clots. Treatment aims to maintain a normal blood count through phlebotomy, medications, or splenectomy.
PSH. usman.pptx
This document presents the case of a 36-year-old male with a 7-month history of weakness, pallor, jaundice, and fever. Laboratory tests revealed anemia, thrombocytopenia, and blasts in the blood and bone marrow. Bone marrow aspiration showed erythroid hyperplasia, dysplastic changes, and 40% blasts. The patient was diagnosed with acute erythroid leukemia (erythroid/myeloid subtype) based on over 50% erythroid precursors and over 20% myeloblasts in the bone marrow. Standard treatment involves chemotherapy with cytarabine and an anthracycline such as daunorubicin or idarubicin. Acute
Haematological tests (Common Blood Tests) and significance
Here I describe the common blood tests that are performed for diagnosing disease. It includes only the routine blood count analysis,
Myeloid disorders
This document summarizes several myeloid disorders including myelodysplastic syndrome (MDS), chronic myeloid leukemia (CML), polycythemia vera (PV), and essential thrombocythemia (ET). MDS is a heterogeneous group of malignant stem cell disorders characterized by dysplastic and ineffective blood cell production with a risk of progressing to acute myeloid leukemia. CML is caused by the Philadelphia chromosome and results in excessive granulocyte production. PV is characterized by an elevated red blood cell mass and is caused by a JAK2 mutation. ET involves a sustained increased in platelet count due to megakaryocyte proliferation. These conditions are diagnosed based on blood tests, bone marrow biopsy, and genetic
atherosclerosisA new.pptx
Atherosclerosis is a disease characterized by the buildup of plaque in arteries. It is caused by a combination of genetic and environmental factors that damage the endothelium and allow lipids and inflammatory cells to accumulate. Over time, plaques grow and can rupture, leading to thrombosis and blockage of blood vessels. This causes cardiovascular diseases like heart attacks and strokes. The major modifiable risk factors are hyperlipidemia, hypertension, smoking, and diabetes.
Leukemia slides
This document provides an overview of leukemia, including:
- Leukemia is a group of cancers that affect the blood and bone marrow, resulting in excess dysfunctional blood cells. It can be fatal if untreated.
- There are several types classified by cell maturity and type of white blood cell affected, including acute myelogenous leukemia, acute lymphocytic leukemia, chronic myelogenous leukemia, and chronic lymphocytic leukemia.
- Causes are often a combination of genetic and environmental factors. Treatment involves chemotherapy and may include bone marrow transplantation to eliminate leukemic cells from the body. Nursing care focuses on managing side effects, educating patients, and providing psychosocial support.
Approach to a patient of anemia1 copy
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
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Essential thrombocythemia (2019) by Dr Shami Bhagat SKIMS
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Haematological tests (Common Blood Tests) and significance
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Late pregnancy bleeding Ver2
Late pregnancy bleeding can occur after 20 weeks of gestation and has several potential causes. Placental abruption occurs when the placenta separates from the uterine wall before delivery, presenting with abdominal pain, vaginal bleeding, and contractions. Uterine rupture is a complete separation of the uterine wall that endangers the mother and fetus, often occurring in those with prior uterine surgery. Placenta previa is when the placenta implants in the lower uterine segment, presenting with painless vaginal bleeding. Vasa previa occurs when fetal vessels traverse the membranes over the cervical os, presenting with bleeding upon rupture of membranes or contractions and fetal bradycardia. Abnormal placenta attachment like accreta,
Late pregnancy bleeding
Definition of LPB
Abruptio placentae
Placenta previa
Vasa previa
Uterine Ruptuer
placenta accreta
Obstetric history & examination
To understand the principles of taking an obstetric history.
To understand the key components of an obstetric examination
The patient is normally a healthy woman undergoing a normal life event.
The type of questions asked during the history change with gestation, as does the purpose and nature of the examination.
The history will often cover physiology, pathology and psychology
Cervical neoplasia 2021
Globally, over 600,000 new cases and 300,000 deaths were estimated for cervical cancer in 2020 .
Third most common gynecological cancer in Palestine.
Palestine has a higher age-standardized mortality rate than other countries in the region
Obesity
A 5-year-old boy has moved from the 50th percentile for both weight and height to the 95th percentile for weight and 50th percentile for height, indicating he is now obese. When counseling the family, the doctor should discuss the health consequences of childhood obesity, including increased risk of diseases like diabetes and cardiovascular disease later in life. Obesity in children can also negatively impact psychological health and quality of life.
Obesity in pediatric - case presentation
A 5-year-old boy has moved from the 50th percentile for both weight and height to the 95th percentile for weight and 50th percentile for height, indicating he is now obese. When counseling the family, the doctor should discuss the health consequences of childhood obesity like increased risk of diseases such as diabetes, cardiovascular disease, and psychosocial issues. Obesity in children can lead to obesity in adults and is one of the most common chronic illnesses among adolescents.
Creutzfeldt jakob disease (cjd)
This document provides an outline and overview of Creutzfeldt-Jakob disease (CJD). It begins with a case presentation of a 42-year-old woman exhibiting symptoms of gait and stance issues, tremors, and cognitive decline. It then defines CJD as a fatal neurodegenerative disorder caused by prions, an abnormal form of a protein normally found in the brain. The document discusses the etiology, modes of transmission including genetic and acquired forms, epidemiology including mortality rates varying by region, pathogenesis involving prion protein conversion and neuronal death, clinical diagnosis challenges, lack of treatment options, and infection control recommendations.
Newborn hyperbilirubinemia
Breast milk jaundice.
The key features that point to breast milk jaundice in this case are:
- Jaundice onset after the first week of life
- Progressive deepening of jaundice over 1 week
- Exclusively breastfed
- Pale/gray stool color indicating reduced bilirubin conjugation
Breast milk jaundice results from high levels of beta-glucuronidase in breast milk interfering with bilirubin conjugation in the infant's liver and gut. It typically presents after the first week of life and can persist for several weeks if breastfeeding continues.
Non hodgkin lymphoma
Non-Hodgkin lymphoma is a large group of cancers that develop from lymphocytes, with around 85% originating from B cells and 15% from T or NK cells. T-cell lymphomas presenting with lymphadenopathy rather than outside the lymph nodes are a rare and heterogeneous group of tumors that are usually of the CD4+ phenotype.
Brucellosis a glance on Palestine
Malta Fever , Brucellosis , is one of the most prevalent zoonotic infection globally. It’s a
bacterial infection caused by Brucella , a Gram-Negative bacteria1
. Brucella melitensis
(transmitted from sheep and goats), B. abortus (transmitted from cattle and bovina), and B.
suis (transmitted to humans from pigs) are the most common species causing human
brucellosis
Gastroparesis high yield points
Gastroparesis is a syndrome of objectively delayed gastric emptying in the absence of a mechanical obstruction and cardinal symptoms of nausea, vomiting, early satiety, bloating, and/or upper abdominal pain
Nephrolithiasis - urinary stones
Common disorder with an annual incidence of 0.1% to 0.5%.
The peak age at onset is 20 to 30 years
Men > Women ( until 50s )
Wide geographic variations exist, due to differences in diet and water composition, as well as ambient and sunlight exposure. 5-9% in Europe 20% in Saudi Arabia
Otitis media ENT
It is an inflammation of the middle ear cleft (( not middle ear cavity)).
Account for almost 1/3 of the office visit to pediatricians
Peak incidence 6-24 month of life
More common in boys and in low socioeconomic persons
Incidence increased in children with: HIV , cleft palate, trisomy 21
Oral manf of systemic disease
Many systemic diseases are reflected in the oral mucosa, maxilla, and mandible.
Mucosal changes may include ulceration or mucosal bleeding.
Immunodeficiency can lead to opportunistic diseases such as infection and neoplasia.
Bone disease can affect the maxilla and mandible.
Systemic disease can cause dental and periodontal changes.
Drugs prescribed for a systemic disease can affect oral tissue.
Trotter's Triad
Trotter's triad is a set of three symptoms seen in nasopharyngeal carcinoma patients: middle ear effusion, palatal asymmetry, and a nasopharyngeal tumor. An example case showed a patient with left-sided middle ear effusion, palatal asymmetry, and a nasopharyngeal tumor that had extended intracranially through the foramen ovale and invaded the pterygoid muscles.
Facial nerve and palsy
The facial nerve emerges from the brainstem and has both motor and sensory functions. It innervates the muscles of facial expression and provides parasympathetic innervation to glands. Facial paralysis can result from lesions to the facial nerve. Bell's palsy is the most common cause of unilateral facial paralysis and usually resolves over time with treatment like corticosteroids. Grading systems like the House-Brackmann scale are used to assess facial nerve function.
Disorders of Pancreas
this ppt presents pancreatitis and tumors of the pancreas
The fourth leading cause of cancer-related death in the United States and has a mean age of 55 at diagnosis.
I GET SMASHED
Phoniatrics musa
Phoniatrics is the branch of medicine concerned with communication disorders related to phonation, speech, and language. It deals with the science of voice production, speech articulation using the mouth, tongue, and lips, and the four modalities of human language: comprehension, speaking, reading, and writing. Communication disorders can involve defects in phonation (voice), resonance (in the pharynx, mouth, and nose), speech articulation, or language development and use. Phoniatrists work to diagnose and treat these disorders through medical treatment, surgery, voice therapy and other methods.
Acute brain
The document provides an overview of brain anatomy and various types of head injuries and brain hemorrhages that can be seen on CT imaging. It begins with a brief description of brain anatomy including skull bones, meninges, ventricles, and cortical structures. It then discusses different types of head trauma such as skull fractures, depressed fractures, and basilar fractures. Finally, it covers brain hemorrhages including extra-axial hemorrhages like epidural hematomas and subdural hematomas, as well as subarachnoid hemorrhage and intra-axial bleeding.
Septic arthritis
The document discusses septic arthritis, an inflammatory joint condition caused by bacterial infection. It notes that septic arthritis most commonly affects the knee, with Staphylococcus aureus now the most common pathogen in most patients. Risk factors include advanced age, medical conditions like diabetes, joint surgery, IV drug use, and recent bacteremia. Symptoms include joint pain, swelling, warmth, and fever. Diagnosis involves joint aspiration and fluid analysis, along with blood tests. Treatment requires antibiotics and sometimes surgical drainage, while complications can include permanent joint damage if not addressed promptly.
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Myeloproliferative disorders PV and ET
- 3. MyeloproliferativeDisorders • A group of conditions arising from marrow stem cells and characterized by clonal proliferation of one or more haemopoietic components in the bone marrow and, in many cases, the liver and spleen Mikael Häggström/Wikipedia • The three major non‐leukaemic disorders included in this classification are: 1 Polycythaemia vera (PV); 2 Essential thrombocythaemia (ET); and 3 Primary myelofibrosis.
- 5. Polycythemia Relative Absolute Red cell volume is normal but the plasma volume is reduced Primary Secondary
- 6. Polycythemia vera • Polycythaemia is defined as an increase in the haemoglobin concentration above the upper limit of normal for the patient’s age and sex. Databese Center forLife Science(DBCLS)
- 7. Polycythemia Vera • The disease results from somatic mutation of a single haemopoietic stem cell which gives its progeny a proliferative advantage. Databese Center forLife Science(DBCLS)
- 8. PolycythemiaVera Clinical Features result from hyperviscosity, hypervolaemia, hypermetabolism or thrombosis Shutterstoc k Aquagenic pruritus
- 10. PolycythemiaVera
- 13. Treatment : The haematocrit should be maintained at around 0.45 and the platelet count below 400 ×10^9/L • Phlebotomy • GoalHct< 45% • Low-dose aspirin • Thrombosis prevention • Hydroxyurea • used if there is poor control or intolerance of Phlebotomy, or symptomatic or progressive splenomegaly, thrombocytosis, weight loss or night sweats • Ruxolitinib • JAKinhibitor • Used in refractory cases only
- 14. Essentialthrombocytosis • A sustained increase in the platelet count due to megakaryocyte proliferation and overproduction of platelets. Shutterstoc k • The bone marrow shows no collagen fibrosis. • A persisting platelet count of greater than 450×10^9/L is the central diagnostic feature, but other causes of a raised platelet count (particularly iron deficiency, inflammatory or malignant disorder and myelodysplasia) need to be fully excluded before the diagnosis can be made.
- 16. Shutterstoc k
- 17. Shutterstoc k Essentialthrombocytosis Clinicalfeatures • Often incidental finding of increased platelets ASX • Vasomotor symptoms – microvascular dysfunction • Headache • Dizziness orsyncope • Erythromelalgia • Visualdisturbances • Thrombosis • Bleeding - abnormal platelet function • Pruritus rare
- 18. Shutterstoc k
- 19. Shutterstoc k The goal is to reduce the risk of the major clinical problems of thrombosis or hemorrhage Standard cardiovascular risk factors, such as cholesterol, smoking, diabetes, obesity and hypertension, should be identified and treated. Low‐dose aspirin at 75mg/day is generally recommended in all cases
- 20. Shutterstoc k High Risk group : • over 60 years of age • and/or with previous thrombosis • and/or with platelet count over 1500 ×10^9/L • hydroxycarbamide to reduce the platelets count Low‐risk patients are those aged below 40 years and here aspirin alone is sufficient Optimum control of the medium‐risk group (age 40–60 years) is uncertain.
- 21. Summary
- 22. Summary