Miliary tuberculosis is a rare form of tuberculosis characterized by the widespread dissemination of tuberculosis bacteria through the bloodstream, forming small nodules throughout the body. It represents 1-3% of tuberculosis cases. Risk factors include age, immunosuppression, cancer, HIV, malnutrition, and diabetes. The bacteria spread from the lungs into the bloodstream and infect multiple organs. Symptoms are nonspecific and include weakness, fever, weight loss, and cough. Diagnosis involves imaging tests to identify the small nodules and laboratory tests such as sputum cultures. Treatment requires a multi-drug regimen for 6-9 months.
This document provides an outline and overview of fever and malaria. It defines normal body temperature and fever, and distinguishes fever from hyperthermia. The pathogenesis of fever is described. Acute febrile infections are discussed as common causes of fever in certain settings, including malaria, typhoid, ricketssial diseases, relapsing fever, and CNS infections. Malaria in Ethiopia is then described in more detail, including the life cycle of malaria parasites, epidemiology, geographic distribution, clinical features of uncomplicated and complicated malaria, investigations, and treatment approaches.
The uterus is supported by both primary and secondary structures to prevent prolapse. The primary supports include the pelvic diaphragm, perineal body, urogenital diaphragm, urinary bladder, vagina, and uterine ligaments. Secondary supports are provided by peritoneal folds like the broad ligaments and pelvic cellular tissue that fill dead space. Together these structures help maintain the position of the uterus within the pelvis.
This document outlines various complications that can arise from pulmonary tuberculosis, including hemoptysis, pleurisy, pleural effusion, empyema, pneumothorax, aspergilloma, endobronchitis, bronchiectasis, laryngitis, cor pulmonale, carcinoma of the bronchus, tuberculous enteritis, and miliary tuberculosis. It describes the mechanisms, symptoms, diagnostic approach, and treatment for each complication.
Miliary tuberculosis is a rare form of tuberculosis characterized by the widespread dissemination of tuberculosis bacteria through the bloodstream, forming small nodules throughout the body. It represents 1-3% of tuberculosis cases. Risk factors include age, immunosuppression, cancer, HIV, malnutrition, and diabetes. The bacteria spread from the lungs into the bloodstream and infect multiple organs. Symptoms are nonspecific and include weakness, fever, weight loss, and cough. Diagnosis involves imaging tests to identify the small nodules and laboratory tests such as sputum cultures. Treatment requires a multi-drug regimen for 6-9 months.
This document provides an outline and overview of fever and malaria. It defines normal body temperature and fever, and distinguishes fever from hyperthermia. The pathogenesis of fever is described. Acute febrile infections are discussed as common causes of fever in certain settings, including malaria, typhoid, ricketssial diseases, relapsing fever, and CNS infections. Malaria in Ethiopia is then described in more detail, including the life cycle of malaria parasites, epidemiology, geographic distribution, clinical features of uncomplicated and complicated malaria, investigations, and treatment approaches.
The uterus is supported by both primary and secondary structures to prevent prolapse. The primary supports include the pelvic diaphragm, perineal body, urogenital diaphragm, urinary bladder, vagina, and uterine ligaments. Secondary supports are provided by peritoneal folds like the broad ligaments and pelvic cellular tissue that fill dead space. Together these structures help maintain the position of the uterus within the pelvis.
This document outlines various complications that can arise from pulmonary tuberculosis, including hemoptysis, pleurisy, pleural effusion, empyema, pneumothorax, aspergilloma, endobronchitis, bronchiectasis, laryngitis, cor pulmonale, carcinoma of the bronchus, tuberculous enteritis, and miliary tuberculosis. It describes the mechanisms, symptoms, diagnostic approach, and treatment for each complication.
Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called ORIENTIA TSUTSUGAMUSHI.
Scrub typhus is spread to people through bites of infected chiggers (larval mites).
Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or travelling to areas where scrub typhus is found could get infected
Scrub typhus is not transmitted directly from person to person; it is only transmitted by the bites of vectors
Chiggers are abundant in locales with high relative humidity (60%–85%), low temperature (20°C–30°C), low incidence of sunlight, and a dense substrate-vegetative canopy.
Occupational risk is higher in farmers (aged 50–69 years), females.
lupus nephritis is a autoimmune disease, commonly seen in adult and child and the medical or nursing care is also very important for this type of disease condition.
Fibroadenomas are the most common benign breast tumors, occurring most frequently in young females between 15-25 years old. They represent a hyperplastic growth of the terminal ductal lobular unit and their cause is unknown. Most fibroadenomas stop growing at 2-3 cm and involute after menopause. They present as a painless, movable breast lump that can be detected on mammogram, ultrasound or biopsy. Treatment involves surgical excision of the lump, with periareolar or submammary incisions depending on the tumor type. Rarely, fibroadenomas can undergo sarcomatous change.
Fever is an elevation of body temperature regulated by the hypothalamus in response to pyrogens. It is a common symptom of infection or inflammation. Fever has various stages as temperature rises and falls, and can be classified by pattern of temperature changes. Fever benefits the immune response by enhancing immune cell activity and inhibiting microbial growth at higher temperatures. Management involves identifying and treating the underlying cause while controlling temperature.
This document provides information on the bacterial infections diphtheria and pertussis. It describes diphtheria as an acute infection caused by Corynebacterium diphtheriae that produces a potent exotoxin. Clinical features include a thick gray membrane in the throat and complications affecting the heart, kidneys and nerves. Pertussis is caused by Bordetella pertussis and is characterized by paroxysmal coughing fits ending in a distinctive whoop. Both are highly contagious and can be prevented by vaccination.
This document discusses opportunistic infections (OIs) that occur in patients with AIDS. It defines AIDS according to CDC and NACO criteria involving OIs or low CD4 counts. Common OIs seen in India are described such as tuberculosis, candidiasis, cryptosporidiosis, herpes zoster, toxoplasmosis, and Pneumocystis pneumonia. Symptoms, diagnosis, and treatment of these OIs are outlined. The role of patient education in prevention and treatment adherence is also discussed.
Gas gangrene is caused by gas-producing bacteria such as Clostridium perfringens infecting crushed or puncture wounds in an anaerobic environment. It leads to localized muscle death and tissue necrosis. Symptoms include pain, fever, and swelling at the wound site with a foul odor. The infection can spread rapidly without prompt treatment which includes intravenous antibiotics, debridement of dead tissue, and possibly amputation of an affected limb. Untreated gas gangrene has high mortality rates due to sepsis and organ failure.
Mumps is a contagious viral disease that is spread through saliva and respiratory droplets from infected individuals. It causes painful swelling of the salivary glands. While most cases are mild, complications can include infection of the central nervous system, testicles, or pancreas in some cases. Vaccination has significantly reduced rates of mumps infection, though outbreaks can still occasionally occur.
Cerebral malaria is a serious neurological complication caused by Plasmodium falciparum infection that can lead to coma and death. It accounts for approximately 20% of adult and 15% of childhood malaria deaths globally each year. The document discusses the epidemiology, transmission, clinical manifestations including retinopathy-specific signs, diagnosis, treatment and management of cerebral malaria. Pathophysiological mechanisms contributing to cerebral malaria are still being investigated.
Approach to history taking in a patient with feverReina Ramesh
The document provides an overview of fever (pyrexia), including its definition, pathophysiology, types, and differential diagnosis. It discusses how fever is regulated by the hypothalamus and the role of pyrogens and cytokines in initiating the febrile response. Common causes of fever are described, such as infections, malignancies, and autoimmune conditions. Different patterns of fever are also outlined, including continuous, intermittent, and remittent fever. The evaluation of pyrexia of unknown origin is summarized. Factitious fever is defined as fever intentionally fabricated by the patient. The importance of a thorough history is emphasized when evaluating a febrile patient.
This document discusses the pharmacotherapy of acute bronchitis. It begins by defining acute bronchitis as a cough lasting less than 3 weeks, which is usually viral in origin. The goals of therapy are to rule out serious illness, minimize symptoms, and limit unnecessary antibiotic use. Treatment is primarily supportive and includes analgesics, antitussives, and bronchodilators only for those with wheezing. Antibiotics are not routinely recommended as they do not impact illness duration or severity. Education of patients about the typical self-limiting course of acute bronchitis is important.
This document discusses body temperature regulation and fevers. It defines key terms like core temperature, surface temperature, and fever. Fever is caused by the hypothalamus setting a higher temperature set point in response to infections or other stimuli. Types of fevers include intermittent, remittent, sustained, and relapsing. Treatment involves antipyretics and addressing the underlying cause. Hyperthermia is an unintentional elevated temperature while hypothermia is a subnormal temperature. Frostbite results from freezing of tissues, especially the extremities. Proper first aid involves slowly rewarming while avoiding further injury.
The document outlines septic shock, including its definition, classification, epidemiology, pathogenesis, clinical features, investigation, treatment, complications, prognosis and prevention. Septic shock results from a systemic inflammatory response due to infection and can lead to multiple organ dysfunction. Prompt resuscitation, antibiotics, source control and organ support are crucial for treatment, but mortality remains high, especially in patients with multiple organ dysfunction or failure to respond to therapy. Early recognition and treatment of infection helps reduce risks of septic shock.
This document discusses a case of Kawasaki disease in a 2-year-old boy presenting with fever and limp. It then provides details on Kawasaki disease including that it is the most common cause of acquired heart disease in children, characterized by inflammation of blood vessels. Signs and symptoms, diagnostic criteria, differential diagnosis, cardiovascular manifestations, and management are described. The importance of early diagnosis and treatment to prevent cardiac complications is emphasized.
This document discusses pyrexia of unknown origin (PUO), defined as a fever over 101°F persisting for more than 3 weeks without a confirmed diagnosis. It outlines the approach to evaluating a patient with PUO, including a thorough medical history and physical examination. Potential causes of PUO are grouped into infections, neoplastic diseases, autoimmune diseases, hereditary diseases, granulomatous diseases, and drug reactions. Common infectious causes include viral infections, tuberculosis, and bacterial infections like endocarditis.
This document discusses potassium homeostasis and hyperkalemia. It notes that potassium is mainly intracellular and its serum level is tightly regulated between 3.5-5 mEq/L. Mechanisms involve sodium-potassium pumps and renal excretion. Causes of hyperkalemia include reduced renal excretion, intracellular shifts, and inadequate aldosterone levels. Symptoms range from none to muscle weakness to arrhythmias. Treatment focuses on antagonizing cardiac effects, driving potassium intracellularly, and removing excess potassium.
The document discusses pulmonary eosinophilias, which are a heterogeneous group of disorders characterized by varying degrees of pulmonary or blood eosinophilia. It classifies the main types as Loeffler's syndrome, drug and toxin induced eosinophilic pneumonia, tropical pulmonary eosinophilia, and allergic bronchopulmonary aspergillosis. Loeffler's syndrome is characterized by transient pulmonary infiltrates associated with eosinophilia caused by parasites. Tropical pulmonary eosinophilia is caused by a hypersensitivity reaction to filarial parasites. Allergic bronchopulmonary aspergillosis involves a hypersensitivity response to inhaled fungal antigens like Aspergillus.
Pertussis : Highly contagious respiratory infection caused by Bordetella pertussis
Outbreaks first described in 16th century
Bordetella pertussis isolated in 1906
Estimated >300,000 deaths annually worldwide
Before the availability of pertussis vaccine in the 1940s, public health experts reported more than 200,000 cases of pertussis annually.
Since widespread use of the vaccine began, incidence has decreased more than 75% compared with the pre-vaccine era.
In 2012, the last peak year, CDC reported 48,277 cases of pertussis.
Extremely contagious-attack rate 100%
Immunity is never complete
Protection begins to wane in 3-5 yrs after vaccination
Dengue virus rarely causes death. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Symptoms of dengue hemorrhagic fever include: bleeding under the skin. frequent vomiting.
The document discusses women empowerment in India. It defines empowerment as increasing individual and collective authority to identify and overcome discrimination. Population control can be achieved by overall development of women through social, economic and educational empowerment so they can make informed choices about family size. Legislative measures like the equal remuneration act and raising the marriage age aim to empower women socially and economically. National policies also aim to promote gender equality and women's participation in governance.
Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called ORIENTIA TSUTSUGAMUSHI.
Scrub typhus is spread to people through bites of infected chiggers (larval mites).
Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or travelling to areas where scrub typhus is found could get infected
Scrub typhus is not transmitted directly from person to person; it is only transmitted by the bites of vectors
Chiggers are abundant in locales with high relative humidity (60%–85%), low temperature (20°C–30°C), low incidence of sunlight, and a dense substrate-vegetative canopy.
Occupational risk is higher in farmers (aged 50–69 years), females.
lupus nephritis is a autoimmune disease, commonly seen in adult and child and the medical or nursing care is also very important for this type of disease condition.
Fibroadenomas are the most common benign breast tumors, occurring most frequently in young females between 15-25 years old. They represent a hyperplastic growth of the terminal ductal lobular unit and their cause is unknown. Most fibroadenomas stop growing at 2-3 cm and involute after menopause. They present as a painless, movable breast lump that can be detected on mammogram, ultrasound or biopsy. Treatment involves surgical excision of the lump, with periareolar or submammary incisions depending on the tumor type. Rarely, fibroadenomas can undergo sarcomatous change.
Fever is an elevation of body temperature regulated by the hypothalamus in response to pyrogens. It is a common symptom of infection or inflammation. Fever has various stages as temperature rises and falls, and can be classified by pattern of temperature changes. Fever benefits the immune response by enhancing immune cell activity and inhibiting microbial growth at higher temperatures. Management involves identifying and treating the underlying cause while controlling temperature.
This document provides information on the bacterial infections diphtheria and pertussis. It describes diphtheria as an acute infection caused by Corynebacterium diphtheriae that produces a potent exotoxin. Clinical features include a thick gray membrane in the throat and complications affecting the heart, kidneys and nerves. Pertussis is caused by Bordetella pertussis and is characterized by paroxysmal coughing fits ending in a distinctive whoop. Both are highly contagious and can be prevented by vaccination.
This document discusses opportunistic infections (OIs) that occur in patients with AIDS. It defines AIDS according to CDC and NACO criteria involving OIs or low CD4 counts. Common OIs seen in India are described such as tuberculosis, candidiasis, cryptosporidiosis, herpes zoster, toxoplasmosis, and Pneumocystis pneumonia. Symptoms, diagnosis, and treatment of these OIs are outlined. The role of patient education in prevention and treatment adherence is also discussed.
Gas gangrene is caused by gas-producing bacteria such as Clostridium perfringens infecting crushed or puncture wounds in an anaerobic environment. It leads to localized muscle death and tissue necrosis. Symptoms include pain, fever, and swelling at the wound site with a foul odor. The infection can spread rapidly without prompt treatment which includes intravenous antibiotics, debridement of dead tissue, and possibly amputation of an affected limb. Untreated gas gangrene has high mortality rates due to sepsis and organ failure.
Mumps is a contagious viral disease that is spread through saliva and respiratory droplets from infected individuals. It causes painful swelling of the salivary glands. While most cases are mild, complications can include infection of the central nervous system, testicles, or pancreas in some cases. Vaccination has significantly reduced rates of mumps infection, though outbreaks can still occasionally occur.
Cerebral malaria is a serious neurological complication caused by Plasmodium falciparum infection that can lead to coma and death. It accounts for approximately 20% of adult and 15% of childhood malaria deaths globally each year. The document discusses the epidemiology, transmission, clinical manifestations including retinopathy-specific signs, diagnosis, treatment and management of cerebral malaria. Pathophysiological mechanisms contributing to cerebral malaria are still being investigated.
Approach to history taking in a patient with feverReina Ramesh
The document provides an overview of fever (pyrexia), including its definition, pathophysiology, types, and differential diagnosis. It discusses how fever is regulated by the hypothalamus and the role of pyrogens and cytokines in initiating the febrile response. Common causes of fever are described, such as infections, malignancies, and autoimmune conditions. Different patterns of fever are also outlined, including continuous, intermittent, and remittent fever. The evaluation of pyrexia of unknown origin is summarized. Factitious fever is defined as fever intentionally fabricated by the patient. The importance of a thorough history is emphasized when evaluating a febrile patient.
This document discusses the pharmacotherapy of acute bronchitis. It begins by defining acute bronchitis as a cough lasting less than 3 weeks, which is usually viral in origin. The goals of therapy are to rule out serious illness, minimize symptoms, and limit unnecessary antibiotic use. Treatment is primarily supportive and includes analgesics, antitussives, and bronchodilators only for those with wheezing. Antibiotics are not routinely recommended as they do not impact illness duration or severity. Education of patients about the typical self-limiting course of acute bronchitis is important.
This document discusses body temperature regulation and fevers. It defines key terms like core temperature, surface temperature, and fever. Fever is caused by the hypothalamus setting a higher temperature set point in response to infections or other stimuli. Types of fevers include intermittent, remittent, sustained, and relapsing. Treatment involves antipyretics and addressing the underlying cause. Hyperthermia is an unintentional elevated temperature while hypothermia is a subnormal temperature. Frostbite results from freezing of tissues, especially the extremities. Proper first aid involves slowly rewarming while avoiding further injury.
The document outlines septic shock, including its definition, classification, epidemiology, pathogenesis, clinical features, investigation, treatment, complications, prognosis and prevention. Septic shock results from a systemic inflammatory response due to infection and can lead to multiple organ dysfunction. Prompt resuscitation, antibiotics, source control and organ support are crucial for treatment, but mortality remains high, especially in patients with multiple organ dysfunction or failure to respond to therapy. Early recognition and treatment of infection helps reduce risks of septic shock.
This document discusses a case of Kawasaki disease in a 2-year-old boy presenting with fever and limp. It then provides details on Kawasaki disease including that it is the most common cause of acquired heart disease in children, characterized by inflammation of blood vessels. Signs and symptoms, diagnostic criteria, differential diagnosis, cardiovascular manifestations, and management are described. The importance of early diagnosis and treatment to prevent cardiac complications is emphasized.
This document discusses pyrexia of unknown origin (PUO), defined as a fever over 101°F persisting for more than 3 weeks without a confirmed diagnosis. It outlines the approach to evaluating a patient with PUO, including a thorough medical history and physical examination. Potential causes of PUO are grouped into infections, neoplastic diseases, autoimmune diseases, hereditary diseases, granulomatous diseases, and drug reactions. Common infectious causes include viral infections, tuberculosis, and bacterial infections like endocarditis.
This document discusses potassium homeostasis and hyperkalemia. It notes that potassium is mainly intracellular and its serum level is tightly regulated between 3.5-5 mEq/L. Mechanisms involve sodium-potassium pumps and renal excretion. Causes of hyperkalemia include reduced renal excretion, intracellular shifts, and inadequate aldosterone levels. Symptoms range from none to muscle weakness to arrhythmias. Treatment focuses on antagonizing cardiac effects, driving potassium intracellularly, and removing excess potassium.
The document discusses pulmonary eosinophilias, which are a heterogeneous group of disorders characterized by varying degrees of pulmonary or blood eosinophilia. It classifies the main types as Loeffler's syndrome, drug and toxin induced eosinophilic pneumonia, tropical pulmonary eosinophilia, and allergic bronchopulmonary aspergillosis. Loeffler's syndrome is characterized by transient pulmonary infiltrates associated with eosinophilia caused by parasites. Tropical pulmonary eosinophilia is caused by a hypersensitivity reaction to filarial parasites. Allergic bronchopulmonary aspergillosis involves a hypersensitivity response to inhaled fungal antigens like Aspergillus.
Pertussis : Highly contagious respiratory infection caused by Bordetella pertussis
Outbreaks first described in 16th century
Bordetella pertussis isolated in 1906
Estimated >300,000 deaths annually worldwide
Before the availability of pertussis vaccine in the 1940s, public health experts reported more than 200,000 cases of pertussis annually.
Since widespread use of the vaccine began, incidence has decreased more than 75% compared with the pre-vaccine era.
In 2012, the last peak year, CDC reported 48,277 cases of pertussis.
Extremely contagious-attack rate 100%
Immunity is never complete
Protection begins to wane in 3-5 yrs after vaccination
Dengue virus rarely causes death. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Symptoms of dengue hemorrhagic fever include: bleeding under the skin. frequent vomiting.
The document discusses women empowerment in India. It defines empowerment as increasing individual and collective authority to identify and overcome discrimination. Population control can be achieved by overall development of women through social, economic and educational empowerment so they can make informed choices about family size. Legislative measures like the equal remuneration act and raising the marriage age aim to empower women socially and economically. National policies also aim to promote gender equality and women's participation in governance.
PSYCHOLOGICAL COMPLICATION DURING PREGNANCY.pdfNANCY MAURYA
The document discusses psychological complications that can occur during pregnancy, including maternity blues, postpartum depression, and postpartum psychosis. Maternity blues occurs in about 50% of women 4-5 days after delivery and involves mood lability, tearfulness, anxiety, and sleep/appetite disturbances. Postpartum depression occurs in 10-20% of mothers within the first 4-6 months after delivery and is associated with psychiatric, obstetric, and psychosocial risk factors. Postpartum psychosis is a psychiatric emergency that occurs in 1-2% of women and requires hospitalization due to symptoms like delusions, hallucinations, and disorientation. Prevention focuses on identifying at-risk women through
This document provides information on several emergency drugs that ICU nurses must know, including:
Adrenaline, used to treat severe allergic reactions and anaphylactic shock. Atropine is used to treat low heart rate, reduce salivation before surgery, and as a poison antidote. Adenosine is used to treat irregular heartbeats and for stress testing. Amiodarone is used to treat serious irregular heartbeats and restore normal rhythm. Verapamil is used to treat high blood pressure, chest pain, and heart rhythm disorders. Digoxin is used to treat heart failure and certain irregular heartbeats. Other drugs discussed include dopamine, dobutamine, calcium gluconate,
Sikkim is a small, mountainous state located in northeastern India. It borders Nepal, China, and Bhutan. The population of Sikkim is around 600,000 people, comprised of several ethnic groups including Lepchas, Bhutias, Nepalese, and others. As the least populous state in India, Sikkim is also a popular tourist destination known for its Himalayan scenery and biodiversity. Some notable features of Sikkim include Kangchenjunga, the third highest mountain in the world on its border with Nepal, and its unique blend of Tibetan Buddhist, Hindu, and indigenous traditions among its diverse ethnicities.
This document provides an overview of defense mechanisms, which are unconscious psychological strategies used to manage anxiety and protect the ego. It categorizes defenses as primitive, less primitive, or mature. Primitive defenses include denial, regression, acting out, dissociation, compartmentalization, projection, and reaction formation. Less primitive defenses involve repression, displacement, intellectualization, rationalization, and undoing. Mature defenses include sublimation, compensation, affiliation, self-assertion, altruism, and anticipation. Examples are given for each defense mechanism.
Rheumatic heart disease is caused by untreated strep throat infections which can cause inflammation and damage to heart valves. It most commonly affects children aged 10 years in developing countries. Symptoms include heart valve problems, joint pain, involuntary movements, and skin rashes. Treatment involves antibiotics to prevent future infections, medications and surgery to repair or replace damaged valves, and therapies for pain and anxiety relief. Nursing care focuses on monitoring for heart failure, managing joint pain and anxiety, and providing health education.
2. LIVE ATTENUTED VACCINE
• MNEMONIC: BOY Love The CRIME.
• B - BCG
• O - OPV ( sabin)
• Y - YELLOW FEVER
• The - TYPHOID
• C - CHICKEN POX
• R - RUBELLA
• I - INFLUENZA
• M - MUMP, MEASELS
• E - EPIDEMIC TYPHUS