25 Matching Annotations
  1. Nov 2022
  2. Jul 2022
  3. Mar 2022
    1. Hepatic hydrothorax may also contribute to respiratory symptoms.

      Trasudative pleural effusion in a patient with cirrhosis when other causes of trasudative pleural effusion are not apparent.

  4. Feb 2022
    1. Enterotoxin

      The enterotoxin disrupts the absorptive and secretory function of enterocytes --> infectious causes of secretory diarrhea, not inflammatory

  5. Aug 2021
    1. assessment of pain, function, and psychosocial context.

      Psychosocial: many patients will have exacerbation of symptoms due to psychosocial stressors. It is important to figure these out and try to work on them with patients through non pharmacological approaches. Also, there is high prevalence of interpersonal stress conditions in these patients. Keep these in mind. Function: useful to set treatment goals; assess function physically (activities, sports, hobbies), mentally (mood, cognition, school), and socially (relationships).

  6. Apr 2021
    1. Excessive excretion of free water, i.e., water without electrolytes, can also lead to hypovolemia. However, the effect on ECFV is usually less marked, given that two-thirds of the water volume is lost from the ICF.

      Loss of free water from the ECF would lead to a more concentrated ECF and thus water shifts from the ICF to maintain equal osmolality accross cell membranes. The result would be net water loss from all compartments, and since most water is in the ICF vascular integrity and organ perfusion would not decrease much; the larger volume would be lost from the intracellular fluid. On the other hand, isotonic loss of water + electrolytes from the ECF wouldn't cause an osmolar gradient, so there wouldn't be a water shift from the ICF and only ECF contraction.

  7. Mar 2021
  8. Dec 2020
    1. Stay in hotel or on cruise ship in previous 2 weeks

      Bacteria spreads in air, especially air conditioning

    1. damaged ring-form parasites (a process known as “pitting”)

      This is after treatment with artemisinins; kills the parasites. The removal of the dead parasites from previously infected RBCs without lysing them is called pitting. These previously infected RBCs return to the circulation, albeit their lifespan is shorter.

    1. secondary bacterial infection sometimes occurs.

      CL lesions are usually painless or less painful than expected for the extent of the lesion. There can be pain with bacterial infection of the wound.

  9. Jun 2020
    1. relatively high red cell mass

      ~18 mg/dL is normal hemoglobin. ~14 mg/dL is considered anemia in neonates. Placental venous blood has a PO2 of around 40 mm Hg. Fetal hemoglobin is therefore helpful, but the neonate also needs a lot of red cells to transport the low PO2 blood to the brain and other tissues efficiently (aortic blood may have a PO2 as low as 22 mm Hg). After birth, with respiration, the newborn's red cell mass is excessive and physiologic jaundice ensues with hemolysis of the excess erythrocytes.

  10. May 2020
    1. A low level of ALT in the serum is due to an alcohol-induced deficiency of pyridoxal phosphate.

      Vitamin B6 or Pyridoxine is a cofactor for ALT. Once ingested, B6 must be converted to its active form Pyridoxal 5 phosphate (PLP). Alcohol is metabolized to acetaldehyde which leads to PLP degradation. (Lack of ingestion does not fully explain the lack of B6 in alcoholism because IV injection of B6 does not increase PLP in patients who continue to drink alcohol)

  11. Apr 2020
    1. excess glucocorticoid secretion overcomes the ability of 11β-HSD2 to rapidly inactivate cortisol to cortisone in the kidney, thereby exerting mineralocorticoid actions, manifest as diastolic hypertension, hypokalemia, and edema

      11β-HSD2 is expressed in epithelial cells that also express the mineralocorticoid receptor. 11β-HSD2 converts cortisol to its inactive form, cortisone. In Cushing's syndrome, the elevated levels of circulating cortisol overcome the ability of this enzyme to inactivate cortisol and it binds to the mineralocorticoid receptor and this results in aldosterone-like activity. It is important to mention that normally, cortisol binds to the mineralocorticoid receptor with similar affinity than does aldosterone but the enzyme 11β-HSD2 can handle normal levels of cortisol.

  12. Mar 2020
    1. Laboratory testing for antibodies (serologic testing) is usually not helpful due to the low sensitivity and specificity

      Around 50% of people with a diagnosis of ITP test negative for antibodies

  13. Feb 2020
    1. diarrhea

      Diarrhea may be caused because vitamin deficiencies also affect epithelium in the gastrointestinal tract. For example, enterocyte damage can cause malabsorption and an osmotic diarrhea

    2. loss of proprioception and vibration sensation with positive Romberg and Lhermitte signs

      Lhermitte's sign is the sensation of an electrical shock that extends down the spine and into the legs after flexion of the neck (barber chair phenomenon)

    1. hypoglycemia-associated autonomic failure—i.e., the clinical syndromes of defective glucose counterregulation and of hypoglycemia unawareness.

      The neurogenic or autonomic symptoms of hypoglycemia cause hypoglycemia awareness. They are caused by the release of sympathetic mediators to maintain euglycemia i.e. norepinephrine . Recurrent hypoglycemia can cause the glycemic threshold to be lowered and thus neurogenic symptoms and hypoglycemia awareness occur at lower glucose levels.

    2. precise method

      Not a self-monitored method

    1. multiple esophageal rings

      A teacher described this as an esophagus that looks like a trachea

    2. The combination of symptomatic proximal esophageal webs and iron-deficiency anemia in middle-aged women constitutes Plummer-Vinson syndrome.

      Plummer-Vinson syndrome triad: dysphagia, esophageal webs, and iron-deficiency anemia

  14. Dec 2019
    1. palpable purpura is seen in virtually all patients

      Palpable purpura is not associated with thrombocytopenia. They are felt above the surface of the skin, thus the name palpable purpura. As all purpura, they do not disappear with pressure as do telangectasia. Palpable purpura can be seen in many vasculitides but sometimes also in lupus.

  15. Oct 2019
    1. These patients may also develop infective suppurative thrombosis of the portal vein and its tributaries along with intrahepatic abscesses.

      This is known as pylephlebitis; septic emboli to the portal circulation from an infectious site in the abdomen, in this case, the appendix but can occur due to diverticulitis or peritonitis