A Brief Note On Coagulation And Clotting Factors Essay

A Brief Note On Coagulation And Clotting Factors Essay
Introduction
Disseminated intravascular coagulation is a condition that involves clotting factors. In this case, clotting factors have been interrupted in a way that
causes them to overreact and sometimes become unavailable for normal clotting mechanisms. It is considered a secondary diagnosis because the
complication is created by a preexisting condition. A preexisting condition introduces a procoagulant into the bloodstream and causes theblood to
coagulate excessively. Coagulation is the process of clot formation. Systemic coagulation produces excessive blood clots in the blood stream. When
blood clots are formed in the vascular system, they can travel throughout the body via the circulatory system and minimize circulation to organs.
Thromboses can also be lodged inside of blood vessels, travel to the lungs, extremities or even to the brain.
When the body manifests disseminated intravascular coagulation rapidly it can cause severe bleeding. The hemorrhaging may be internal or from a
small wound that normally would not bleed as much. This is because when coagulation occurs acutely the normal compensatory mechanisms of
homeostasis are quickly overwhelmed and the inability to clot, coagulopathy, becomes a new concern. Clotting factors are essentially "tied up",
causing excessive bleeding and an ironic change in the blood's ability to clot. This is a life–threatening condition which could lead to bleeding into the
organs. When disseminated intravascular coagulation occurs
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Treatment Of A Transfusion Reaction
A transfusion reaction is the body's systemic response to the administration of blood. Causes for transfusion reactions can include red cell
incompatibility, allergic response due to leukocytes, platelets, plasma protein components of transfused blood, or the anticoagulant (potassium or
citrate preservatives) used to store the blood, just to name a few. Symptoms, prevention, and treatment will be discussed for the following transfusion
reactions: Transfusion Associated Circulatory Overload (TACO), Transfusion
–Related Acute Long Injury (TRALI), Hemolytic Transfusion Reactions,
Anaphylaxis and Allergic Transfusion Reactions, and Febrile Transfusion Reactions.
Transfusion–Associated Circulatory Overload (TACO) is a reaction that can happen ... Show more content on Helpwriting.net ...
For treatment, the excess volume must be removed, clinically, by diuresis. Oxygen therapy and intravenous diuretics should be use appropriately.
Transfusion–Related Acute Lung Injury (TRALI) is a reaction, generally presenting during or within 1–2 hours of a transfusion. It is the leading cause
of transfusion–related mortality based on 2011 FDA data. Symptoms are a sudden onset of respiratory distress and hypoxemia which may be
accompanied by fever, tachycardia, tachypnea and sometimes hypotension. Most instances of TRALI are believed to be caused by anti–leukocyte
antibodies present in a donor's plasma. These antibodies are directed against HLA or neutrophil antigens present on the blood recipient's white blood
cells. This reaction is believed to start in the small microvasculature of the lung. This causes a series of events resulting in damage to alveolar
capillaries and leakage of fluid leading to pulmonary edema. There is no specific way to prevent TRALI except by minimizing the number of
transfusions administered. Since blood component collections centers (ex. Red Cross) have implemented policies to restrict plasma donation by female
donors, this reduces the incidence of anti–leukocyte antibodies which can trigger TRALI. Aggressive supportive care is required over several days.
This aggressive supportive care most likely includes adequate respiratory and

Childhood Cancer Prevention Case Study
The two primary roles for health professionals and cancer prevention are first, preventing adult type of cancers by educating parents and children about
the hazards of known carcinogens particularly the effects of cigarette smoking and excessive exposure to sunlight also to provide early detection of
other types of cancer and informing young males to learn testicular self–examination and teaching female adolescence about self–breast examinations
with periodic health exams including pap smears and the second role is the need to be aware of cardinal symptoms of childhood cancer
2. The cardinal symptoms of cancer in children are unfortunately the same manifestations of children common disorders including fever and pain and
these two symptoms ... Show more content on Helpwriting.net ...
Third complication is superior vena cava syndrome with this disorder obstruction may create oncologic emergency for a child with cancer the space
occupied consist of lesions located in the chest especially from Hodgkin's Disease and Non–Hodgkin's lymphoma These malignancies cause superior
vena cava syndrome that triggers the airway to be compromised and produces potential respiratory failure this disorder is common with implantable
intravenous devices related to a thrombus formation or a fibrotic reaction children are observed with cyanosis of the face neck and upper chest; facial
and upper extremity edema and distended neck and chest veins the child also show signs of anxiousness dyspnea wheezing or frequent coughing from
airway obstruction management consist of airway protection and alleviation of respiratory distress rapid treatment is initiated and symptoms typically
improve as the disease is effectively

Osmotic Fragility Test Lab Report
An Osmotic fragility test can be performed on a blood sample to confirm the presence of spherocytes (Hoffbrand, Moss and Pettit, 2006). Figure3:
Spherocytes in the blood smear Available at: http://jwilliamcupp.name/Things/Blood/Spherocyte.htm
Urine samples could be requested to test for blood in the urine and haemosiderin levels (Hoffbrand, Moss and Pettit, 2006). If these are increased, it
supports the laboratory findings of HUS. A prothrombin time test and a partial prothrombin time test are performed to analyse the time it takes blood to
clot and is useful in the diagnosis of Disseminated Intravascular Coagulation (Kumar, Aster and Robbins, 2012).
3.5.1
RBCs have a shorter lifespan as they are destroyed long before they should be and the bone marrow cannot keep up with the demand to produce more,
even though they are being produced at a faster rate; thus disrupting the haemostasis. This faster rate of production could lead to the RBCs having less
haemoglobin than normal (hypochromasia), thus resulting in anaemia and seeing immature RBCs in the peripheral blood (Hoffbrand, Moss and Pettit,
2006).
3.5.2
Disseminated Intravascular Coagulation is an acquired coagulant disorder, where there is a disruption on the haemostasis, consecutive incidence of
consumption of coagulation factors, activation of ... Show more content on Helpwriting.net ...
Haemolytic anaemia has multiple causes and the clinical presentation is based on the cause. This type of anaemia occurs when there is either a
reduction in the life span or increased red cells destruction and the bone is unable to compensate. In this case this can be confirmed by the increased
retic count, presence of Heinz bodies, spherocytes and sickle cells. Red cells can either be destroyed outside the circulation in the spleen, liver and bone
marrow (extravascular haemolysis) or within the circulation, where globin chains bind haptoglobin. (Orf&Cunnington,

Taking a Look at N. Meningitidis
N. meningitidis and the diseases that it is responsible for are diagnosed by blood samples or a spinal tap to retrieve cerebrospinal fluid samples. Since
the bacteria grows fastidious and is oxidase positive, it is preferred to grow it on a blood agar plate or a chocolate agar plate at temperatures ranging
from 35–37 degrees Celsius. It can be identified using the Kovac's oxidase test and if a positive result is found it should be followed with a
carbohydrate utilization test. If this too shows N.meningitidis then a serological test should be performed to determine which strain is present. The
strains of A, B, C, Y and W135 are the only known associated with humans and disease. Strain B is a weaker form and does not generate an adequate
immune response therefore natural infection is capable of generating some immunity. It is also important in the lab testing of N. meningitidis to
remember that the bacteria is capable of fermenting maltose in cultures which would set it apart from N. gonorrhoeae. It is imperative to utilize the
Biosafety Level 2 to prevent contamination in lab workers. Most strains and diseases caused by N. meningitidis are treated with the administration of
intravenous penicillin in a natural form. Ceftriaxone, ciprofloxacin or rifampin as well as Chloramphenicol in children are used in treatment. It is also
advised that anyone who may be exposed to the disease be treated with prophylactic treatment in order to prevent secondary infections. The treatment

Disseminated Intervascular Coagulation
Disseminated Intervascular Coagulation (DIC) is a clinicopathologic syndrome characterized by widespread intravascular fibrin formation in response
to excessive blood protease activity that overcomes the natural anticoagulant mechanisms (Harrison, T. 1974).The mechanism of DIC is a generation of
thrombin that is uncontrolled from exposure of blood to levels of tissue factors pathologically. Two factors that add to the deposition of fibrin in small
and midsize vessels and also speed up the process are, simultaneous suppression of physiologic anticoagulant mechanisms and abnormal fibrinolysis
(Harrison, T. 1974). Fibrin deposition can interfere with the blood supply of many major organs such as the lung, kidney, liver, and brain, all causing...
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2015). These blood test can show the number of platelets in the blood sample has dropped and that the blood is taking a long time to clot. The
diagnosis of DIC is confirmed if test results show large amounts of plasma d–dimer and often a low or decreasing level of fibrogen. The d–dimer
indicates more clots are being produces and broken down than usual (Sharp, M. 2015).

Essay On Pre Eclampsia
1.Title of Project: Incidence and Progression of Lab Values in a Cohort of Patients with Pre–Eclampsia
2.Aims: Establish the frequency of abnormal lab values in patients with pre–eclampsia and analyze the progression of these values.
3.Background and Rationale:
Pre–eclampsia is the development of hypertension and proteinuria after 20 weeks gestational age (1). While the multi–system etiology of the disorder
remains unknown, (2) endothelial dysfunction plays a role in the clinical signs (1). Pre–eclampsia is far from a benign condition as severe
pre–eclampsia may include maternal cerebral disturbances, intrauterine growth restrictions, and impaired liver function (3). Approximately 20% of
women with severe pre–eclampsia will develop disseminated intravascular coagulation, which has poor maternal–fetal outcomes (4). Overall,
pre–eclampsia is a major cause of maternal morality, as it accounts for approximately 18% of maternal deaths (3). ... Show more content on
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Liver enzymes, platelets, creatinine, lactate dehydrogenase and total bilirubin are monitored for the progression of pre–eclampsia, reflecting the
systemic nature of the disease. Severe pre–eclampsia, which may progress to HELLP syndrome, places the patient at risk for end organ damage (5).
Progression to severe pre–eclampsia may occur suddenly or gradually – so close maternal and fetal monitoring is required (6). Current
recommendations suggest that all lab tests should be repeated weekly if progression is not suspected, and more frequently with suspicion of progression

Abdominal Pain Research Paper
The possible causes of abdominal pain are multiple. It is important to differentiate because some causes can quickly become life threatening. Yet not
only are there many, many causes of abdominal pain in the abdomen; in addition, there are abdominal problems that cause referred pain elsewhere in
the body (commonly colic; and blood or infection irritating the diaphragm commonly causes shoulder pain), and there are problems elsewhere in the
body that cause pain in the abdomen. While a 20–year–old man is more likely to have an acute condition (such as infection) causing abdominal pain
and a 50–year–old man is more likely to have a chronic condition (such as IBD) causing his abdominal pain, we cannot have a hard and fast rule
because of age. ... Show more content on Helpwriting.net ...
Peritonitis (inflammation of the peritoneum) can result from many causes, but itself causes the influx of fluid into the peritoneum, resulting in severe
dehydration and electrolyte imbalances, leading to respiratory distress, kidney failure, liver failure, disseminated intravascular coagulation, and death
within days of onset. Laboratory and imaging tests are often not helpful, so can be done last, to make the final differential diagnosis from the
limited set of possibilities we are able to determine after a complete history and physical. Normal lab results can occur even with significant
disease, and abnormal lab results can occur even with mild disease and may not be specific enough to be diagnostic. An exception would be serum
lipase, which would indicate acute pancreatitis. CT scans are usually the most useful when there is significant abdominal pain, but in emergency
cases, the patient should probably proceed to surgery rather than wait for imaging results. The high number of diagnoses to be ruled out in a patient
presenting with abdominal pain make them impossible to cover in a short paper. The reader is encouraged to refer to the figure in the reference
below regarding differential diagnoses based on the location of the pain, a copy of which could be printed out and kept on hand as a diagnostic aid in
the clinical

Case Report On Factor X Deficiency
Case Report
Factor X Deficiency
Name of authors in sequence of authorship
Departments
Name of corresponding author
Phone no.
Mailing address
INTRODUCTION
Factor X is a vitamin K–dependent, liver produced serine protease that serves a pivotal role in coagulation as the first enzyme in the common pathway
to fibrin formation. . Factor X deficiency is a rare heritable bleeding disorder with autosomal recessive inheritance pattern. General population
prevalence is estimated to be 1:1000000 with up to 1:500 carriers1. Till now 50 cases of factor X deficiency have been reported in medical
literature2,3,4. Inherited FX deficiency was identified by two independent groups. In 1956, Telfer and co–workers described a 22 years old woman
named Miss Prower with a bleeding diathesis, she had an abnormal thromboplastin generation test result and a prolonged prothrombin time that was
corrected with the addition of plasma from two patients taking coumarin analogues. In 1957, Hougie and co–workers described a 36 years old man
named Mr. Stuart thought to have FVII deficiency until it was found that his plasma could correct the prolonged prothrombin time of another
FVII–deficient patient. FX became known as the Stuart–Prower factor until it was given its official nomenclature ... Show more content on
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Factor X is activated by other coagulation factors (XII becomes XIIa, XI – XIa, IX– IXa, VIII and lastly, X). Factor IXa normally activates factor X to
factor Xa. Then Factor Xa activates other blood proteins, including factor V, and factor II (prothrombin) which is converted to thrombin. This chain
reaction allows the coagulation process to continue. If one of the coagulation factors is absent or deficient, the chain reaction is broken, and the
bleeding is not

The Cause Of Alzheimer's Disease
The cause of this illness is a microscopic unicellular eukaryote organism moving by minute contractions of small contractile fibrils organelles unlike
many other Protozoa moving by locomotion.
The disease occurs primarily in animals; however, in rare cases, the infection may occur in humans when the nymph black–legged tick (Ixodes
scapularis) attach to a person from vegetation close to ground level and climb up on the host to find a place to bite. In addition to that, the vector
needs to be attached to the host for at least 24 hours to transmit the disease. This tiny parasite infects red blood cells in humans and can cause the blood
cells to burst. Even though it is a rare occurrence, but it is more common to be transmitted between humans via

Gel Testing Lab Report
Laboratory Medicine
Implementation of Gel Testing for Antibody Screening and Identification in a Community Hospital, a 3–Year Experience
Eduardo Delaflor–Weiss, MD, FASCP; Vladislav Chizhevsky, MD
Disclosures
Lab Med. 2005;36(8):489–492.
Comment
Print
Abstract and Introduction Material and Methods Results Discussion and Conclusions
References
Abstract and Introduction
Abstract
Gel technology is based on the principle of controlled centrifugation of red cells through a dextran–acrylamide–gel. One obvious advantage of the gel
microtubes is they can be saved for later supervisory or peer review, for quality assurance, as well as for assistance in any difficult interpretations, since
the reaction is stable ... Show more content on Helpwriting.net ...
The gel test (ID MTS) was released in Europe in 1988 and became available in the United States in 1995 by Microtyping Systems.[1,2] Instead of
the test tube, the reaction occurs in a microtube consisting of a reaction chamber that narrows to become a column about 15 mm long and 4 mm
wide. The use of gel methods for red cell antibody detection and compatibility testing has generally improved since its introduction to become a
mature and well understood technology. Applicable to most of the tests performed in blood group serology, it is standardized and relatively easy to
perform, and it provides clear and stable reactions that improve interpretation of results as compared to tube methods. Microtubes are filled with a

mixture of gel, buffer, and reagent (Figure 1). Depending on the test to be carried out, either a neutral gel containing no reagents (reagents are added to
the top of the gel) or specific gel containing reagents (eg, antiglobulin or anti–A, B, D, etc) may be used. At the top of the gel the suspension of patient
red cells (for typing or direct antiglobulin test) or a mixture of patient or commercial red cells with patient or reagent serum (for reverse ABO typing or
antibody screening/identification) is added, followed by centrifugation through the gel under precise conditions. In negative reactions, there will be no
attachment of antibodies to red

Pathophysiology: Disseminated Intravascular Coagulation (T
Disseminated intravascular coagulation
Pathophysiology
Disseminated intravascular coagulation (DIC) is an acquired syndrome that occurs when a stimulus pathologically activates intravascular coagulation
and fibrinolysis resulting in an unbalanced hemostasis (Cunningham, 1999; Huether & McCance, 2008; Wada, 2008). The initiation of DIC starts with
the release of tissue factor (TF) by the endothelial cells or white blood cells (WBCs). TF are present on many different cell types including lungs, brain,
and placenta. The release of TF is subsequent to a variety of causes including trauma, ischemia, excessive metabolic stress, tumors, infectious
organisms, exposure to cytokines and endotoxins (Baglin, 1996; Vinay, Abul, Nelson, & Richard, 2007). The release of endotoxin is the means by which
... Show more content on Helpwriting.net ...
In this specific patient with gram–negative sepsis leading to DIC may present with spontaneous bruising, prolonged bleeding from venipuncture sites,
and bleeding from three different sites. There are also many other possible sites including the nose, gums, mucosa, eyes, arterial lines, or surgical
wounds (Bliss & Wallace–Jonathan, 2008; Wada, 2008). Depending on where the fibrin clots have deposited, other symptoms may manifest as
ischemia or organ failure occurs such as in the kidneys, heart, lungs, or in the brain. There is a possibility of hemorrhaging into a closed compartment,
which may lead to shock (Huether & McCance, 2008).
Lab values during DIC are also of great importance. There is no specific test for DIC but a combination of PT (prothrombin time), aPTT (activated
partial thromboplastin time), fibrinogen, platelet count and d–dimmer are used to assist in the diagnosis of DIC (Cunningham, 1999). Since many
disorders can cause an increase of each of these lab values, it is important to use the whole picture to make the diagnosis.

Endothelial Cell Injury Essay
Thrombomodulin release and endothelial cell injury in Systemic lupus erythematosus
SLE is an autoimmune disease characterized by the formation of immune complexes (ICs), which contain a complex mixture of autoantigens nucleic
acids, nucleic acids–associated proteins and corresponding autoantibodies (Sun et al., 2013) .
In SLE, the circulating ICs are deposited in the vascular walls of multiple organs and activate the complement pathways. The resulting complement
products stimulate leucocytes to injure the vascular endothelium, leading to blood vessel destruction and organ injury (e.g. glomerulonephritis and
vasculitis). It has been suggested that expression of adhesion molecules primes the vascular endothelium for subsequent injury that increase the release
of TM into the circulation (HO et al., 2003).
Soluble TM is an endothelial marker presents in large quantities on the surface of the endothelium, particularly in the ... Show more content on
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So increase levels of sTM in serum after endothelial injury has been reported as an evidence for a pro–thrombotic state in SLE (Chan et al., 2006) .
It also has been used as a marker of microvascular endothelial injury and thrombotic events in various diseases, such as disseminated intravascular
coagulation, multiple sclerosis and rheumatic diseases. Previous studies have reported that elevated sTM is associated with the disease activity of
SLE, nephritis and vasculitis. So, it is an established marker of endothelial cell damage (HO et al., 2003) sTM which is normally a component of
vascular EC membrane easily released to plasma in patients with active SLE due to persisting EC detachment in active SLE patients. It was suggested
that elevated sTM levels reflect EC damage rather than activation, because EC–leucocyte adhesion and interaction after the activation of inflammatory
cytokines might result in the release of TM from the EC surface (Fiedler and Augustin,

Treatment Options For Acute Fatty Liver Of Pregnancy
TREATMENT OPTIONS
Once the mother is stabilized safe delivery is the key to recovery 6, 1
Vaginal birth is best if possible
Caesarean birth is performed if the mother's condition is deteriorating
During the postpartum period, patients are at high risk of bleeding and coagulopathy
в—‹ Transfusion of blood products may be needed
в—‹ Patients may be at risk for pancreatitis
– Screening serum lipase and amylase will be needed for several days
в—‹ In majority of cases delivery of the infant with supportive care allows the recovery of the mother from liver failure
в—‹ Symptoms may resolve naturally in 3–4 days 10
в—‹ In some women there may be a long cholestatic phase, requiring approximately 4 weeks for recovery 6
в—‹ Liver ... Show more content on Helpwriting.net ...
acute lung injury and adult respiratory distress syndrome
в—‹ Symptomatic cardiovascular support
– Maintain mean arterial pressure >75 mm Hg
– Monitor volume replacement, norepinephrine infusion, hydrocortisone, and possibly, vasopressin
в—‹ Treatment of coagulopathy
– Intravenous vitamin K
– Multiple transfusions of blood products, cryoprecipitate, fibrinogen, and platelets may be required
– Intravenous bolus of recombinant activated factor VIIa may be helpful
в—‹ Electrolytes, blood sugar
– Monitor of serum electrolytes once or twice daily and supplement as needed to avoid hyponatremia
– Frequent monitoring of serum blood glucose
– Parenteral fluids containing 5% glucose for several days
в—‹ Continuous hemodialysis
– To prevent intracranial pressure especially in hemodynamically unstable patients
Comorbidities

в—‹ Chronic hypertension prior to pregnancy or during the first 20 weeks 15
– Monitor the occurrence of preeclampsia, intrauterine growth restriction and placental abruption
– Women in active labor with uncontrolled severe chronic hypertension require treatment with intravenous labetalol or hydralazine
в—‹ Gestational hypertension
– Pregnant women who develop hypertension after 20 weeks and do not have significant proteinuria
– Some of these women may develop proteinuria and thus preeclampsia
– Severe intrapartum or postpartum hypertension
– Systolic blood pressure is greater than or equal to 160 mm Hg or if diastolic measurement is

Nt1310 Unit 6
Ebony Brown
Unit 6
Cancer Paper
Discuss two primary roles for health professionals in cancer prevention. Two types of primary roles for healthcare workers is one prevention and the
second one being the need to be aware of the cardinal symptoms of cancer in children. Prevention begins with teaching and educating the parents and
children about the different hazard of known carcinogens, such as cigarette smoking and the effects of it and being exposed to sunlight in an excessive
manner. Children that have light colored eyes, skin tone(fair–skinned) and hair are at a higher risk for skin cancer. Children that have freckles are
known to get sunburn quicker than others. All children should avoid excessive sun exposure. Various testing... Show more content on Helpwriting.net ...
Two of the most common clinical symptoms in childhood disorders is fever and pain . At times when parents present with their children and the
different concerns that they have noticed, we as healthcare providers must take them serious and evaluate and investigate each individual circumstance.
Identify the cardinal symptoms of cancer in children.
As listed in Wong the "cardinal symptoms of cancer in children are unusual mass or swelling, unexplained paleness and loss of energy, sudden
tendency to bruise, persistent, localized pain or limping, prolonged, unexplained fever or illness, frequent headaches often with vomiting, sudden eye
or vision changes and excessive, rapid weight loss." When completing an assessment of the child the healthcare work should be able to incorporate
these signs to help them complete the necessary physical assessment and also lab or diagnostic testing.
Discuss the following life–threatening oncologic emergencies that may develop in children with cancer as a result of malignancy and/or aggressive
treatment of the malignancy: tumor lysis syndrome, hyperleukocytosis, superior vena cava syndrome, spinal cord compression, and disseminated
intravascular coagulation. Pg.

Disseminated Intravascular Coagulation Essay
What is it?
Disseminated intravascular coagulation is a systemic activation of blood coagulation in which the nature of fibrin changes. (Nhlbi.nih.gov, 2017) It can
lead to multiple organ dysfunction syndromes. Disseminated intravascular coagulation could lead to severe bleeding. DIC can show it show it self as
simultaneously occurring thrombotic and bleeding problem which could difficult proper treatment. (Nhlbi.nih.gov, 2017) Disseminated intravascular
coagulation isn't an illness by it self.
How does it affect the blood does this disorder have repercussion to the rest of the body?
DIC creates small blood clots in the small blood vessels in the body. (Nhlbi.nih.gov, 2017) This can be anywhere in the body and can have very harsh
repercussions. The body's organs can be affected and may even shut down, leading to death in extreme cases. (Nhlbi.nih.gov, 2017) If organs begin to
fail the normal bodily functions will not be performed affecting the entire body.
What are the signs and symptoms?
The signs and symptoms of disseminated intravascular coagulation is dependent on if its acute or chronic. (Nhlbi.nih.gov, 2017)Acute DIC could be
fatal and develops very quickly over a couple of hours or days. Chronic develops over ... Show more content on Helpwriting.net ...
The doctor will first ask for the patient's medical history to see if theres any history of blood disorders. Next the symptoms the patient is
experiencing will be discussed. (Cancer network, 2017) If the doctor believes the patient could possibly have DIC a blood test will be done to
determine it. A complete blood count will be done to account for the amount of red blood cells, white blood cells, and platelets in the blood. The
amount of platelets could show signs of a clotting issue. (Cancer network, 2017) There are also tests to determine the proteins used in the blood
clotting process and how long it takes for them to form. (Cancer network,

Pediatric Exanthems Research Paper
Pediatric Exanthems An exanthem is a skin manifestation or rash caused by an underlying infectious process. When children present with a skin rash,
and/ or fever, it is important to differentiate a common viral or bacterial exanthem, from a serious, life–threatening illness that may require immediate
management. The particular form or shape of an exanthem may provide clues of the underlying illness. Some helpful resources that explain the
characteristics of pediatric exanthems include: https://www.aad.org/File%20Library/.../viral–exanthems–module.ppsx https://childrensnational.org
/choose–childrens/conditions–and–treatments/skin–disorders/viral–exanthems–rashes http://www.physicianspractice.com/articles
/rashes–and–fever–children–sorting–out–potentially–dangerous–part–2 http://www.mdedge.com/clinicianreviews/article/102955/dermatology
/classic–childhood–exanthems/page/0/1... Show more content on Helpwriting.net ...
GAS produces an erythrogenic toxin that damages capillaries and produces an erythematous macular rash with sandpaperlike texture (Dhar, 2015). I
see more cases of scarlet fever during the spring season, typically in children attending to daycare. Besides the characteristic, blanching, orange–red skin
eruption that feels like sandpaper, the red–strawberry tongue presentation is very common. In scarlet fever, a flushed face with circumoral pallor helps
me differentiate this medical condition from the representative hyperemic cracked lips seen in Kawasaki disease (Bryant & Lester,

Intracervical Assessment System
–It is recommended to check bishop score before doing the induction of labour, with monitoring of fetal heart rate pattern. This should be confirmed
by using electronic fetal monitoring {{303 Laughon,S.K. 2011}}. Bishop score is defined as the cervical assessment system most commonly used in
clinical practice. This system formulates a score based upon the station of the presenting part and four characteristics of the cervix including
dilatation, effacement, consistency, and position. If the bishop score is high, the possibility of vaginal delivery is similar whether labor is induced or
spontaneous. Whereas a low bishop score increases the possibility of failed induction to result in vaginal delivery. The thresholds for low and high
bishop scores vary among trials, but in general, a score of в‰¤6... Show more content on Helpwriting.net ...
Extra–amniotic prostaglandins: do not have sufficient evidence to support their use for labour induction as well. Intracervical prostaglandins: it should
not also be used for labour induction. Vaginal PGE2 sometimes fails to induce labour; due to inconsistent guidelines to explain the best way to apply
these agents with regards to dosage and timing, although many studies carried out to settle on the most effective ways of using these agents to induce
labour. 1.7.1.2PGE2 side effects: PGE2 may cause a variety of general side–effects with unknown frequency, such as: backache, cardiac arrest; abruptio
placenta; amniotic fluid embolism; bronchospasm; pulmonary embolism; nausea; diarrhea; vomiting; disseminated intravascular coagulation; fetal
distress; stillbirth or neonatal death; fever; low Apgar scores; maternal hypertension; rapid cervical dilation; severe uterine contractions; uterine
hypercontractility with or without fetal bradycardia; uterine hypertonus; uterine rupture; vaginal symptoms (warmth, irritation,

Case Study Of Anemia And Bleeding Disorders
Module 5 Assignment: Case Studies Anemia and bleeding disorders are common conditions that affect the human blood. Anemia involves a decrease
in both hemoglobin concentration and the number of erythrocytes in the blood. As a result, the condition causes a decrease in the blood's oxygen
carrying capacity. On the other hand, bleeding disorders involve heavy and continuous loss of blood. They are often classified into coagulation disorders
and platelet disorders. In the current study, two different cases of anemia and bleeding disorder were investigated.
Anemia
In a case of anemia, a 47–year–old male patient presented with several symptoms. The patient was asked whether he was experiencing dyspnea on
exertion, as well as fatigue and general ... Show more content on Helpwriting.net ...
Moreover, bone marrow biopsy revealed low iron stores and megaloblastic changes. The results also showed normal levels of B12 but low levels of
red cell folate and serum folate. The patient, therefore, demonstrated an overall lack of iron in his blood, which suggested the presence of anemia
involving iron deficiency. Basically, iron deficiency decreases ferritin and decreases iron stores in the bone marrow, which in turn causes the production
of abnormal erythrocytes (Yadav et al., 2016). Therefore, further assessment of the patient requires the identification of brittle nails, angular cheilitis,
and glossitis, which are associated with iron deficiency. Based on the laboratory findings, the most likely diagnosis of the patient's condition is iron
deficiency anemia. Accordingly, the patient can be managed in several ways. First, the patient should be advised to discontinue alcohol intake. Iron
deficiency in the patient should be evaluated further, particularly by performing a thorough gastrointestinal examination. Moreover, sixty mg of iron
should be administered three times every day to promote the normalization of Hct. In the case of unresponsiveness or intolerance to the dose,
alternative therapies like the use of iron sucrose and ferric gluconate are indicated. Suitable antibiotic combinations have also been shown to reverse
iron deficiency in patients suffering from atrophic gastritis that is associated with Helicobacter pylori (Miernyk et al.,

Analysis of Synergy Model in Obstetric Nursing Practice Essay
The purpose of this paper is to analyze a specific case study in this Troy University School of Nursing student's clinical experience with the
application of the Synergy Model. Both patient characteristics exhibited and nursing characteristics necessary for optimal care and synergy to occur
in this specific case study will be discussed. This particular case study involves a 29 year old obstetric patient who presented to the labor and
delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal
movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks...
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Intravenous (IV) fluids were bolusing; however, when blood pressure was only obtainable manually and revealed that her blood pressure was 74/34,
the decision was made to send the patient to the intensive care unit (ICU). There, coagulation studies revealed an elevated PT, PTT, D–dimer, and a
decreased fibrinogen count. She received a peripherally inserted central catheter (PICC), a transfusion of two units of packed red blood cells (PRBCs),
as well as cryoprecipitate therapy during her treatment in the ICU. Patient Characteristics The Synergy Model defines eight patient characteristics that
nurses must understand in order to facilitate optimal clinical outcomes. All eight patient characteristics will be discussed as they relate to this particular
case study. Resiliency Resiliency describes a patient's ability to return to base–line level of functioning after an illness or injury through use of
compensatory and coping mechanisms (Lindell, Reimer, Swickard, Swickard, and Winkelman, 2014). This patient suffered the psychological trauma
of losing her unborn baby as well as the physical threat to her own life all at the same time. She demonstrated admirable resiliency as she faced such
unfathomable events. After two days of care and observation in the ICU, she was able to be discharged to home. It would certainly take time to
experience the different stages of grief; however, she possessed an admirable faith that she, her husband, and their

Hyperleukocytosis
chemotherapy, or have a rapid proliferative rate. The signs and symptoms to look for include hyperuricemia, hypocalcemia, hyperphosphatemia, and
hyperkalemia and with children flank pain, lethargy, nausea, vomiting, muscle cramps, pruritus, tetany, and seizures . With hyperuricemia more
complications can occur such as the crystallization of uric acid which can cause obstructive nephropathy, tubular injury, acute renal failure and death.
Because tumor lysis syndrome can be lethal the important teaching for management of it would be prevention measures, early identification, and
putting in place interventions early on.
Hyperleukocytosis is considered a pediatric oncologic emergency when the WBC is more than 100,000/mm3, which then can cause capillary
obstruction, microinfarction and organ dysfunction. Two things that they often experience are respiratory distress and cyanosis. A variety of
neurologic changes may take place such as change in loc, problems, agitation, confusion, ataxia, and delirium. Care for hyperleukocytosis would consist
of rapid cytoreduction done through chemotherapy, hydration, alkalinization of the urine and medication(allopurinol). Depending on the circumstance
it may be necessary to use leukophoresis ... Show more content on Helpwriting.net ...
SVCS can cause airway compromise and potentially respiratory failure. The child presents with anxiety, dyspnea, wheezing and coughing frequently
from airway obstruction. They also will have cyanosis of the face, neck, and upper chest area. Swelling can be noted in the face and upper extremities,
along with distended neck and chest veins. Treatment should be started rapidly to protect the airway and relieve respiratory distress. Once treatment
has begun the symptoms will also start to improve as the disease is being

Transfusion Reaction Essay
Transfusion Reactions
A transfusion reaction is the body's systemic response to the administration of blood. Causes for transfusion reactions can include red cell
incompatibility; allergic response due to leukocytes, platelets, plasma protein components of transfused blood, or the anticoagulant (potassium or
citrate preservatives) used to store the blood, just to name a few. Symptoms, prevention, and treatment will be discussed for the following transfusion
reactions: Transfusion Associated Circulatory Overload (TACO), Transfusion
–Related Acute Long Injury (TRALI), Hemolytic Transfusion Reactions,
Anaphylaxis and Allergic Transfusion Reactions, and Febrile Transfusion Reactions.
Transfusion–Associated Circulatory Overload (TACO) is a reaction that can happen during or shortly after the completion of the transfusion. It is a
frequent and often serious. TACO is causes pulmonary edema which mimic's congestive heart failure. This is due rapidly infusing a large volume
transfusion to a patient who is not able to handle the expanded blood volume. Some symptoms of TACO include headache, shortness of breath, and
systolic hypertension. In order to prevent this from happening, transfusions to susceptible patients must be carefully administered and monitored. If a
patient is at risk for volume overload, only a small amount of the transfused product should be transfused. For treatment, the excess volume must be
removed, clinically, by diuresis.
Transfusion–Related Acute Lung Injury

Summary: Disseminated Intravascular Coagulation
Disseminated intravascular coagulation (DIC) is a systemic process, characterized by widespread activation of blood coagulation. This leads to
microvascular thrombi in organs and subsequent exhaustion of coagulation products, which then leads to severe systemic bleeding (Levi, 2015). DIC
can exist in both acute and chronic forms. Acute DIC develops when the body is suddenly exposed to procoagulants (tissue factor (TF). This then leads
to intravascular coagulation. In acute DIC, compensatory hemostatic mechanisms become exhausted with the systemic coagulation, which eventually
leads to severe hemorrhage. In chronic DIC, the compensatory hemostatic mechanisms are not exhausted due to smaller amounts of chronic TF, so
severe intravascular coagulation or bleeding does not occur. In chronic DIC thrombosis usually predominates over bleeding, and many patients can be
even asymptomatic (Leung, 2015). DIC is estimated to occur in 1% of hospitalized patients. DIC is not a specific illness, but rather a complication of
an underlying condition or disease (Levi, 2015). Identifying DIC and treating the underlying cause promptly, is vital to treating DIC. Etiology of Acute
DIC... Show more content on Helpwriting.net ...
Transfusion reactions, vascular abnormalities (large aneurysms), hepatic failure, organ dysfunctions (pancreatitis), traumas (neurotraumas, burns,
MVAs), can also cause DIC. Malignancies, especially tumors and leukemia can result in DIC. Another cause is major obstetrical complications
(retained placenta/dead fetus, amniotic fluid embolisms, placental abruptions, HELP, severe preeclampsia and hemorrhages) (Levi, 2015). Less
common causes are heat stoke, crush injuries, amphetamine overdose, fat embolism, rattlesnake/venomous bites, hereditary protein c–deficiency and
organ transplant rejection (Leung,

Malignant Mesothelioma Case Study
A 72–year–old former miner with metastatic pulmonary mesothelioma is brought to the emergency department after his caregiver finds him
unresponsive. The caregiver provides all of the history and she states that over the past week, the man has been complaining of dyspnea, chest pain and
has become disoriented and delirious. Examination reveals a cachectic male exhibiting Cheyne–Stokes respiration who does not respond to any
commands. His temperature is 37В°C (98.6В°F), pulse is 60 beats/min, respirations are 23 breaths/min, and blood pressure is 140/70 mmHg. He
responds to painful stimuli in all four extremities. His pupils are equal in size, reactive, and light responsive. Gag reflex is intact, along with corneal
reflex. Mucous membranes and ... Show more content on Helpwriting.net ...
This patient's kidney function is normal, which makes this diagnosis unlikely. Acute tubular necrosis is diagnosed with a fractional excretion of sodium
> 3% and presence of muddy casts in the urinalysis.
Choice "B" is not the best answer. Ectopic ACTH secretion presents as a paraneoplastic syndrome in patients with small–cell lung cancer, pancreatic
carcinoma, neural tumors and thymomas. Elevated ACTH levels present with hyperglycemia, cushingoid features, acanthosis nigricans, cutaneous tags
in the axilla, osteoporosis, polyuria, and hypertension.
Choice "D" is not the best answer. While parathyroid hormone–related protein (PTHrP) is secreted by mesotheliomas rarely, this patient has a normal
calcium level, which excludes this diagnosis. Other cancers that secrete PTHrP include breast cancer, squamous–cell lung cancer, squamous carcinoma
of the head and neck, renal cell carcinoma, and bladder cancer to name a few.
Choice "E" is not the best answer. Primary hyperaldosteronism presents with hypertension, hypokalemia, high serum aldosterone, low serum rennin and
alkalosis. It is found in patients with adrenal adenomas, idiopathic adrenal hyperplasia, and rarely adrenal

Miliary Tuberculosis
Clinical manifestations of miliary tuberculosis are nonspecific and wide ranging, depends on the predominant site of involvement. Fever, night sweats,
anorexia, weakness and weight loss are presenting symptoms in the majority of cases. Occurrence of daily morning temperature spikes is reported to be
characteristic of miliary TB5. Patients have cough and other respiratory symptoms due to pulmonary involvement. Physical findings include
hepatomegaly, splenomegaly and lymphadenopathy. Eye examination may reveal choroidal tubercles, which are pathognomic of miliary TB, in up to
30% of cases. Various hematologic abnormalities may be seen, including anaemia with leukopenia, lymphopenia, neutrophilic leukocytosis and
leukemoid reactions, and polycythemia.... Show more content on Helpwriting.net ...
Bronchoalveolar lavage and transbronchial biopsy are more likely to provide bacteriologic confirmation, and granulomas are evident in liver or
bone–marrow biopsy specimens from many patients. If it goes unrecognized, miliary TB is lethal; with proper early treatment, however, it is amenable
to cure. The following criteria have been proposed for the diagnose of miliary TB6: (1) clinical presentation consistent with the diagnosis of TB– like
pyrexia with evening rise of temperature, night sweats, anorexia and weight loss of greater than 6weeks in duration – responding to antituberculosis
treatment; (2) typical miliary pattern on hest radiograph; (3) bilateral, diffuse reticulonodular lung lesions on a background of miliary shadows
demonstrable either on chest radiograph or HRCT scan and (4) microbiological or histopathological evidence of TB. Non parasitic causes of pulmonary
eosinophilia include miliary tuberculosis, Wegner granulomatosis, sarcoidosis and drug reactions, tropical pulmonary eosinophilia etc. There are some
diseases like JOB's syndrome in which there is hypereosinophilia, eczema, recurrent skin and pulmonary infections (like miliary tuberculosis) apart
from other

Case Study: Disseminated Intravascular Coagulation
Albert is a 16–year–old who has been treated for the past year for acute lymphocytic leukemia. He arrives in the emergency department with an altered
level of consciousness, low–grade fever, and purulent urine. His father states Albert reported pain on urination that morning. You require two attempts
to start his intravenous catheter and detect that he continues to bleed from these needle sticks after 5 minutes with hematoma formation at the first site.
You suspect that Albert has developed disseminated intravascular coagulation (DIC)."Disseminated intravascular coagulation (DIC) is an acquired
clinical syndrome characterized by widespread activation of coagulation, resulting in formation of fibrin clots in medium and small vessels throughout
the body." (Huether & McCance, 2012, p.527). There are many conditions associated with DIC, one of which is an acute leukemia. Diagnosis of DIC
will begin with the patient's medical history, a physical exam, and diagnostic test results. A cause for the DIC would also need to be determined.... Show
more content on Helpwriting.net ...
The CBC will measure the number of red blood cells and the clotting process. Platelets help with blood clotting so abnormal platelet numbers could
also be a sign of a bleeding disorder. A blood smear test may be able to reveal whether or not red blood cells have been damaged. Clotting factor
and clotting time tests, such as PT and PTT, will measure how long it takes blood clots to form. Serum fibrinogen will be tested because fibrinogen
is a protein that helps blood clot. Finally, a fibrin degradation test may be ordered to see how much of these substances are in the blood. This is
important to note because after blood clots dissolve the fibrin degradation is what is left in the blood (National Heart, Lung, and Blood Institute,

What Is Lactate?
Lactate and its Production 1.1 History of Lactate Lactate was first described or discovered if you will by the pseudo Swede Carl Wilhelm Scheele
way back in 1780. He did get credit for this discovery but much else he did not, such as his discovery of oxygen. The credit to that went elsewhere.
In terms of healthcare and disease, the first description of lactate belongs to Joseph Scherer who is the fist to identify the molecule in human blood.
He did so on two occasions, once in 1843 and again in 1851. The first occasion was that of a young pregnant woman who gave birth to a healthy child
but became sick herself. She developed what we would today recognise as classic sepsis like symptoms such fever, tachycardia and night sweats.
Unfortunately she was treated with blood letting and eventually died. Post mortem it was discovered that she had purulent endometritis along with
shocked internal organs. But what is interesting is that Scherer analysed her blood and found lactic acid to be present. It is thought that she may have
died from a streptococcus infection. Later that same year another pregnant female came to... Show more content on Helpwriting.net ...
In that paper they also synthesised the information necessary, the information found in all biochemistry books, to understand lactate metabolism. In
order to truly understand lactate we must understand ATP, the energy currency of the body. ATP drives a vast array or processes, from the
operation of ion channels to the contractions of muscle, to our ability to think. Without the ATP we would not survive. In order to keep up with he
demand of ATP our body has we like most living things have developed a way to utilise oxygen to extract energy via glycolysis and oxidative
phosphorylation. Glycolysis is an ancient process, formed 3 billion years ago according to Bakker et al, is capable of generating 2 molecules of ATP

Retinoblastoma Research Paper
consequences that impose on the brain. Retinoblastoma influences the eyes negatively and is more predominant in younger kids while teens are faced
with the repercussions of lymphoma and sarcoma.
Etiology
Various speculations of how cancer is produced have been looked into through numerous years and still, there is no clear answer or reason for how a
tumor is constructed particularly in pediatric community. Numerous scientists have connected hereditary qualities to the disease but has expressed that
heredity has little to nothing to do with malignancies. Studies have demonstrated that irregularities inside chromosomes of youth malignancies aids in
the advancement of numerous and distinctive types of tumors, in addition cell introduction. Sedentary ... Show more content on Helpwriting.net ...
Different strategies for bone marrow transplantation for treatment techniques are aimed at children who experience malignancies. The increase of
accomplishments with the treatment modality of surgical procedures can be accomplished when the affected area is in one region or organ of the
body, frequently called encapsulated or localized by methods of removing or by means of chemotherapy. Expelling all traces and structures of the
growth while reestablishing the bodies ordinary functioning is the most critical objective with the utilization of surgical procedures. Chemotherapy is
the most utilized form of treatment modality with cancer patients
Chemotherapy can be used as the essential treatment of therapy or alongside other treatments of therapy called adjunct. This source of treatment
hinders the function or the creation of RNA, DNA, and nucleic acid. Oncology nurses are working in harmful conditions when taking care of
chemotherapy
4
patients because of the medicine viscosity that causes extreme cellular damage if taken care of improperly. Different types of chemotherapy incorporate
radiotherapy. Radiotherapy treatment are utilized simultaneously with chemotherapy and surgical procedures and (BRM) biologic

Hyperthermia Case Studies
determine the exact cause of death (DiMaio & Dana, 2007).
Hyperthermia is a symptom also known as heat stroke. This occurs when the internal or core body temperature rises above 105Лљ Fahrenheit. Milder
forms of hyperthermia usually due to exertion can result in muscle cramps to areas such as the legs. Usually, the person's body temperature will remain
normal, but they will need to find salt replacement, fluids, and cool place to rest. Another mild form of hyperthermia is heat exhaustion, which is
similar to heat cramps. The person's body temperature may rise slightly (or be normal), but they may suffer from symptoms such as a headache,
dizziness, thirst, or weakness. Heat stroke is a life–threatening form of hyperthermia. The elevated

Meningococcal Disease Is a Severe and Deadly Disease that...
Meningococcemia
I. Introduction
A. Meningococcemia– an acute and potentially life–threatening infection of the bloodstream that can cause many symptoms in a person caused by a
bacteria
B. Thesis Statement: Meningococcal Disease is a severe and deadly disease that affects a portion of people resulting in severe complications; however,
with immediate medicalattention and patient effort one can treat the infection and possibly be avoided
II. Etiology
A. Transmission of meningococcal bacteria
i. Meningococcal is a bacteria that can be transmitted from person to person through droplets. Which starts of in the nasopharnx and makes its way to
the bloodstream. This can affect the rest of the organs of the body.
III. Pathopysiology ... Show more content on Helpwriting.net ...
Etiology Meningococcemia is caused by a bacteria called Neisseria meningitidis. This bacteria usually has sporadic or epidemic incidences in late
winter or spring where a person is more likely to take in the pathogen through droplet transmission. Meningococcemia can be spread from person to
person from kissing to living in close quarters like dorms. Humans who come in close contact with secretions or droplets of the pathogen, usually
house the bacteria in the nasopharynx. Neisseria meningitidis can stay in the upper respiratory tract for a few days to several months. After the
bacteria made its way to the nasopharynx, the meningococcus attaches to the fimbriae which causes an asymptomatic colonization to most people.
About ten percent of people have this type of bacteria in the back of their nose and throat with no signs or symptoms of disease making it easier to
pass along. However if the person gets sick more easily, this bacteria can enter into the blood vessels without much trouble causing damages to the
epithelium causing more complications as well (Talaro & Chess, 2012). The characteristic property of meningococci is to release an irregular bulge of
outer membrane vesicles which are rich in endotoxin. The endotoxin is part of the outer membrane that plays an important part in releasing large
quantities of

Disseminated Intravascular Coagulation Research Paper
Introduction
Disseminated intravascular coagulation (DIC) is a serious problem involving abnormal clotting of blood throughout the body. Normally, when you get
cut, special proteins help your blood clot at the injury site. In DIC, the protein factors that control blood clotting become abnormally active. Small blood
clots form that can clog up blood vessels and can cut off the blood supply to important organs, such as the liver, brain, or kidneys. As DIC worsens,
the blood does not clot very well and serious bleeding can occur. This can be life–threatening. DIC can be sudden onset (acute) or long–term (chronic).
DIC results in low levels of:
Blood cells that carry oxygen (red blood cells).
Blood cells that help clotting (platelets).
Chemicals ... Show more content on Helpwriting.net ...
What are the signs or symptoms?
Symptoms of this condition include:
Nosebleeds.
Bleeding from the gums.
Unexplained bruising or bruising very easily.
Bleeding very easily.
Fever.
Cough.
Difficulty breathing.
Confused thinking.
How is this diagnosed?
This condition may be diagnosed by:
Physical exam. This will look for bruising and small, pinpoint red or purple spots (petechiae).
Blood test may also be performed to:
Check your platelet count. Platelets are a type of blood cell that helps stop bleeding.
Find out how long it takes your blood to clot.
Check your levels of fibrinogen and other clotting factors. Fibrinogen is a protein produced by the liver, and it helps blood to clot.
Check the health of your liver, kidneys, and other vital organs.

How is this treated?
Treatment for this condition is aimed at treating the underlying cause. Treatment can include:
Red blood cells transfusion.
Platelet transfusion.
Blood–thinning medicines that help prevent the blood from clotting.
Follow these instructions at home:
Take over–the–counter and prescription medicines only as told by your health care provider.
If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel

Assignment On Hypertension
ABBREVIATION EXERCISE # 1 NAME: Caroline Geary
EXPLAIN WHAT IS WRONG WITH THE PATIENTS THAT HAVE THE FOLLOWING DIAGNOSIS ON ADMISSION. Spell out each abbreviation,
then explain as if you were telling someone with no medical knowledge. (2T means secondary to while r/o means rule out)
SOB, HTN, hyperglycemia
This patient is suffering from shortness of breath, hypertension, and hyperglycemia.
Hypertension is high blood pressure. The normal blood pressure range for adults is less than 120/80mm Hg. This patient has a blood pressure reading
above 140/90mm Hg. Hyperglycemia means the patient has an abnormally high blood glucose or sugar levels.
UTI, CHF
This patient has two problems. The first is the patient has a UTI or urinary tract infection. A urinary tract infection is a bacterial infection that occurs
in any part of the Urinary System. For this reason, the infection can affect the bladder, urethra, or kidneys. The infection is caused by the Escherichia
coli or E. coli bacterium. The infection can be treated with antibiotics. In addition, cranberry juice helps make the patient's urine acidic as the bacteria
prefer alkaline urine to grow rapidly.
The second problem is the patient is suffering from congestive heart failure. This means the patient's heart is not able to pump sufficient amounts of
blood to meet the body's needs. Congestive heart failure can be caused by coronary artery disease or hypertension.
r/o new CVA The patient was being tested to see if he

Hypothermia Case Studies
Rangel–Castillo et al. (2008) state that induced hypothermia can be used as an adjunctive treatment for increased ICP when other medical treatments
are not fully effective. Induced hypothermia, 32–34 degrees Celsius, may provide some neuroprotective effect to TBI patients by reducing the cerebral
metabolic rate of oxygen consumption. A single degree decrease in temperature will drop thebrain oxygen consumption rate by 5–7%, thereby
maintaining cerebral metabolism. However, there is not enough data currently available that supports the use and effectiveness of hypothermia in a
head injury (Dinsmore, 2013). Mantilla & Arboleda (2015) cite that induced hypothermia fails to improve outcomes, and in fact leads to an increased
morbidity. They suggest ... Show more content on Helpwriting.net ...
If, however, despite multiple treatments, the ICP control has failed, a decompressive craniectomy should be performed. A decompressive
craniectomy is the surgical removal of a section of the cranial vault, allowing the swollen brain to expand through the bone window to relieve
pressure and decrease ICP (Dinsmore, 2013). Despite an effective control of ICP and CBF in TBI patients, a decompressive craniectomy has some
disadvantages that can lead to a CSF leak, new subdural or epidural hematoma, seizures, cerebral herniation, and infection. The adverse outcomes were
more noticed with lower GCS score and increased age (Algattas & Huang, 2014). According to their study, a decompressive craniectomy had a positive
outcome in 50% of patients with severe TBI. On the other hand, the surgery had 26.4% of mortality rate

Cardiopulmonary System
ii)Cardiopulmonary system
Hypertension which is characteristic in preeclampsia has been linked to severe vasospasm as a result of marked increase in vascular reactivity as a
result of excessive inflammation from the released cytokines, and endothelial dysfunction (Ref). Failure of normal vasodilatation in patients with
preeclampsia result in lower intravascular volumes with less tolerance to blood loss associated with delivery, and generalised body oedema with sudden
weight gain in pregnancy which are not evident in this patient (Ref).
Damage to the endothelium of the vessels in the alveoli in the lungs leads to leakage of fluid into the alveoli causing pulmonary oedema which
manifests as difficulty in breathing especially when lying flat, ... Show more content on Helpwriting.net ...
Because emergency personnel do not have the necessary diagnostic tools to make a definitive diagnosis of preeclampsia, obtaining a focused history
including review of patient–held antenatal records, and concise physical examination are invaluable to arrive at a diagnosis and appropriate
management which is basically supportive care and prevention of eclampsia

D-Dimer Test Lab Report
Why am I having this test?
The D–dimer test is used to help diagnose conditions that cause abnormal or excessive blood clotting, such as thrombosis or disseminated intravascular
coagulation (DIC). This test may also be used to monitor treatment for a blood clotting disease.
What is being tested?
A blood sample is required for this test. It is usually collected by inserting a needle into a vein.
What kind of sample is taken?
A blood sample will be taken.
How do I prepare for this test?
There is no preparation required for this test.
What are the reference values?
Reference values are considered healthy values established after testing a large group of healthy people. The reference value for this test is <0.5 mcg
/mL. Reference values may vary

Invasive Pneumococcal Disease ( Ipd )
Invasive pneumococcal disease (IPD) is deп¬Ѓned as the recovery of an isolate of S. pneumoniae from a normally sterile site, such as blood,
cerebrospinal п¬‚uid (CSF), pleural п¬‚uid, joint aspirate, pericardial п¬‚uid, or peritoneal п¬‚uid [1]. Splenic abscesses are rare in the pediatric
population [2]. Early recognition and intervention are critical due to the high mortality rate associated with delayed diagnosis [3]. A literature review
revealed no case reports of splenic abscesses due to invasive pneumococcal disease (IPD). Purpura fulminans is a rare complication of IPD. We report a
case of IPD confirmed by blood culture and serotyping in a 15 month old African American female whose clinical coursewas complicated by splenic
abscesses and ... Show more content on Helpwriting.net ...
Laboratory investigations revealed a pH of 7.1, PCO2 of 35mmHg, PO2 of 52mmHg, HCO3 of 11mg/dl, prothrombin time of 37.8 seconds,
international normalized ratio (INR) of 3.8, activated partial prothrombin time of 101.4 seconds, total leukocyte count of 1900/mm3 with 10% banded
neutrophils and 25% segmented neutrophils, hemoglobin of 10.8g/dl and platelet count of 67,000/mm3. Lumbar puncture was performed and
revealed a white blood cell count of 1 per mm3, red blood cell count of 3 per mm3, glucose of 108mg/dl and protein 83mg/dl. Blood, urine and
cerebrospinal fluid (CSF) cultures were sent and she was started on broad spectrum antibiotics with vancomycin and ceftriaxone.
She was admitted to the pediatric intensive care unit (PICU) for management of septic shock, disseminated intravascular coagulopathy and multiple
organ dysfunction syndrome. Blood culture grew Streptococcus pneumoniae that was sensitive to penicillin and ceftriaxone with a minimum inhibitory
concentration (MIC) of less than 0.03 mcg/ml. She was initially hypotensive despite being placed on vasoactive medications for treatment of
refractory shock. During her PICU course, it was she was noted to develop dry gangrene of the distal phalanges on her upper (Figure 1A) and lower
extremities (Figure 1B), which were consistent with purpura fulminans. She remained febrile after resolution of septic shock. A computerized
tomography (CT) scan of abdomen with contrast revealed 3 rim–enhancing

Comparing The Plague And The Yersinia Pestis Bacteria
The Plague and the Yersinia Pestis Bacteria
Introduction:
The bacteria Yersinia Pestis is the cause of the black plague. Y. Pestis was discovered by Alexandre Yersin in 1849. The plague was the cause of one
of the world's most horrific epidemics in the entire world. The plague is an infectious disease that first appeared in 1347 in China and made its way to
Asia and then the Black Sea. The Black Plague has caused death to about 75 million lives. The plague is a deadly bacterial infection that can cause
death if left untreated. The plague got its name the "Black Death" due to the fact that this disease caused black boils on the skin and that its victims
were always on the verge of death when seen. The Plague would then soon arrive in Europe ... Show more content on Helpwriting.net ...
For the bubonic plague the doctors will look at the rapid swelling of your lymph glands. They will also look for the site of infection. The way that the
pneumonic and septicemic plague is diagnosed is usually by taking a sample from the patient usually from the blood or part of a swollen lymph gland
and getting it tested at a lab. Treatment of the plague is by commonly available antibiotics. The earlier a patient starts treatment the better chance of
them making a full recovery and getting back to perfect health. The antibiotics used are usually streptomycin or

Sepsis: Inflammation and White Cell Count Essay
This is the case study of Mr. Jones, a 65 year old male, who was admitted to the emergency department with persistent cough and episodes of chest
pain over the last five days. He appeared to be experiencing worsening dyspnoea, fever and feeling unwell. It was also noted that he had a poor
urine output over the last 24 hours. An indwelling catheter was inserted which only obtained 20 mLs of amber urine. Mr. Jones clinical assessment
revealed that his Glasgow Coma Score was 11/15. He was opening his eyes to speech, only making inappropriate words and localizes to pain. He was
also pyrexial with a temperature of 39.0 ЛљC, diaphoretic with hot peripheries, hypotensive BP 90/45 mmHg (MAP 60 mmHg), and tachyopneic at
30breaths/min and... Show more content on Helpwriting.net ...
Mr. Jones white cell count is elevated and revealed at 1400 mm while his CRP is also raised. Cytokinines are the one of the primary mediators that
signal other cells to release additional mediators such as tumour necrosis factor–a (TNF–a) interleukin (IL)–1, IL–6, IL–8, interferon, leukotrienes,
histamine, bradykinin, prostaglandins, thromboxane A2, serotonin, nitric oxide, arachidonic acid, platelet–activating factor (PAF), oxygen free radicals
and myocardial depressant factor (Munford, 2001:67). If the invading organism is a gram negative bacterium, endotoxins are also released, which
further stimulate the production of these inflammatory mediators (Jones & Bucher, 1999:134). Tumour necrosis factor (TNF) is responsible for the
disruption of the tight junction between endothelial cells which results in an increased permeability to plasma proteins and fluid, which worsens fluid
accumulation in the alveoli further impairing gas exchanged (Bersten & Soni, 2009:709). TNF comprises of two different molecules, firstly TNFa
which leads to programmed cell death in target cells, and when combined with IL–1 which acts on the central nervous system causing lethargy (Marieb,
2004). TNFB stimulates granulocyte activity and B cell proliferation which shows an increase in neutrophil count (Jean– Baptise, 2007:63). Monocytes,
macrophages, lymphocytes, astrocytes and endothelial cells secrete IL–1 which promotes fever, anorexia,

Does The Buerger's Disease Affect Blood Clotting?
Our blood is made up of several cells and plasma such as erythrocytes, red cells, that contain hemoglobin, leukocytes, known as white cells, that help the
body fight the prevention of bacteria and infection, and lastly thrombocytes, platelets that aid in the formation of blood clotting by discharging various
protein substances when one is injured. In addition, oxygenated blood is carried away from the heart through arteries, thick hollow tubes which are
elastic, allowing them to dilate and constrict as blood is forced down. When arteries become smaller through re–branching, they become arterioles that
feed capillaries. In fact, there are 3 types of capillaries, continuous, which allow small molecules to pass through, fenestrated, involving porous
endothelial cells allowing small molecules and limited amounts of protein to diffuse, and discontinuous, which are the most flexible in allowing
proteins and blood cells to pass through.
A genetic disorder that affects the blood vessels when injured that results in clotting is Hemophilia. This inherited disorder is not contagious and is
found through various lab tests such as a blood clotting test. The way someone can be aware if they could encounter Hemophilia is simply by viewing
their medical history, ... Show more content on Helpwriting.net ...
Buerger's disease, also known as thromboangiitis obliterans is a rare disease that affects the veins and arteries in the limbs. The damage of this
disease involves the blood vessels becoming inflamed, causing them to swell thus forming blood clots. This eventually damages or destroys skin
tissues and may lead to infection. The symptoms of Buerger's disease are recurring pain in the extremities, inflammation just below the skin alongside
a vein, pale fingers and toes, and lastly painful open sores on your toes or fingers. Even though there is not an exact cause known to cause this
disease, the usage of tobacco plays a role in its

A Brief Note On Coagulation And Clotting Factors Essay

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