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By: P. Gnar, M.B.A., M.D.
Assistant Professor, University of Alaska at Fairbanks
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In more severe cases, haemoglobinaemia and lost resulting in spherical transformation of the red cells haemoglobinuria may be present. It is, thus, the major site of red cell agglutinin disease and paroxysmal cold haemoglobinuria. These cold antibodies are usually directed against the I any apparent cause (idiopathic) but about a quarter of antigen on the red cell surface. Most cold agglutinins affect usual clinical features are as follows: juvenile red blood cells. It is seen In each type of drug-induced immunohaemolytic 313 in the course of certain infections. Mycoplasma anaemia, discontinuation of the drug results in gradual pneumonia, infectious mononucleosis) and in lymphomas. Cyanosis affecting the cold exposed regions such as tips characterised by red cell fragmentation (schistocytosis). Direct external trauma to red Treatment consists of keeping the patient warm and blood cells when they pass through microcirculation, espe treating the underlying cause. Low reticulocyte count since young red cells are affected grafts develop haemolysis. IgM class cold antibody small vessels may occur in the following conditions: has specificity for I antigen, while the rare IgG class i) Abnormalities of the vessel wall. Drugs may cause immunohaemolytic anaemia by 3 different iii) Haemolytic-uraemic syndrome. A small All these conditions are described in relevant sections proportion of patients receiving methyl dopa develop separately. Bartonellosis by direct infection of red cells by the proteins to which an antibody forms. Septicaemia with Clostridium welchii by damaging the red red blood cells or platelets. Normally, the spleen acts as a filter peripheral blood showing numerous ring stages and a crescent of and traps the damaged red blood cells, destroys them and gametocyte. Other microorganisms such as pneumococci, staphylococci splenomegaly exaggerates the damaging effect to which the and Escherichia coli. Lead poisoning shows basophilic stippling of red blood therapy relieves the anaemia as well as improves the cells. There are 3 important types of disease of the cell membrane while normal clone also inherited red cell membrane defects: hereditary continues to proliferate.
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As these patients have little or no functional reserve, anemia has a serious and deleterious effect on hemodynamics because of a reduction in oxygen-carrying capacity and a demand for higher cardiac output. The thoracic aorta runs posterior to the left atrium, is rounded, and on dynamic imaging is pulsatile. The membrane of cor triatriatum separates the pulmonary venous chamber from the lower part of the atrium and is best seen from parasternal long-axis and apical views. Mitral valve prolapse results in late systolic sagging of the mitral valve, not anterior motion. This is typical of pulsus alternans, which occurs in severe systolic heart failure. Note there is reduced opening and duration of opening of the aortic valve with every other beat, and this results from reduced stroke volume with every other beat. Also note that, in this instance, pulsus alternans was triggered by a premature ventricular complex. As the conduit has become too small for her body size and flow requirements, it was functionally stenotic, resulting in a very high systolic gradient. This is a classic flow because of severe coarctation of the aorta with systolic and diastolic components. Note that the flow is into the aortic lumen throughout the cardiac cycle, indicative of retrograde flow in the intercostal artery. This occurs in collateral dependent distal perfusion as it occurs in severe aortic coarctation. This flow is across the foramen ovale due to excessive stretching produced by high atrial pressures. Focal velocity profiles of medial (yellow) and lateral annulus (green) are produced offline by placing samples in these regions. Note that the peak of lateral annulus velocity is about 150 ms after the medial annulus velocity peak, suggestive of septolateral mechanical dyssynchrony. There was good diastolic synchrony, as judged by annular E wave velocity profiles. Note that the units are in percent, which is percentage shortening compared with original length. This was anomalous circumflex coronary artery originating from right coronary artery with retroaortic course between aorta and left atrium.
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Lateral wall 16) Cleft lip results from failure of fusion between: One answer only. Agar candida is present in normal faeces 13) Buprenorphine is partial agonis of: One answer only. Urethritis 19) One of the following drug does not increase teh serum level of theophylline One answer only. Ventricular tachycardia 11) A patient Chandu presents with eye deviated laterally and slightly downward. All of the above 12) In inter-segmental reflex, afferent is fromOne answer only. Prothrombin 18) After giving treatment for syphilis, the response to treamtment can be best assesse byOne answer only. Immobilizaion 19) In random sampling chance of being picked us isOne answer only. Kidney Liver Heart Spleen 3) Soft, friable node enlargement is seen in: One answer only. Typhoid Thaliasemia Syphillis Lymphoma 4) All of the following is correct about thromboxane A2, except: One answer only. To start bleedings To stop bleedings None Both 6) In which variant of Hodgkin disease lacunar cell is present: One answer only. Testis Lungs Liver Appendix 9) Hypertrophic cardiomyopathy left ventricular ejection fraction is: One answer only. Herpes Genitalis Herper Labialis Herper Gladitorum Zoster 12) Carrier stage of Hepatitis B Virus is for: One answer only. Sea weed African grass Wood portion of bee None of the above 14) Most common cause of renal Infraction is. Histamine Bradykinin Leukotrienes Platelet activating factor 17) Which of the following is not a primitive neuroectodermal tumours: One answer only. Neuroblastoma Glioblastoma Medulloblastoma All of the above 18) Feature of membranous glomerulonephritis is: One answer only. Urine sugar Glycosylatd Haemoglobin Glucose tolerance Post prandial blood sugar 21) Crescent formtion is seen in: One answer only. An electrocardiogram shows right atrial hypertrophy and a ventricular block pattern in the right chest leads. Pulmonic stenosis and a ventricular septal defect(tetralogy of fallot). Autism Micropenis Lax joints Large testes 13) A 2-year-old patient has microscopic and occasionally gross hematuria. D 20) In the newborn period which of the following is the least common sign on meningitis
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Fertility typically (A) Endometrial biopsy returns following the successful treatment of this disease. For women with high-risk disease, recurrence gynecologist with a 3-month history of vaginal bleedrates are estimated to range from approximately 15 to 25%, ing. She is diabetic and hypertensive, has no children, but decline significantly after remaining disease free for at and has been menopausal for 12 years. What is the next best step in clinicians recommend that contraception be continued for the management of her cancer Complete surgical staging of uterine cancer does not (D) Pelvic radiation include which one of the following procedures: (A) Bilateral salpingo-oophorectomy 7. Medical management of endometrial cancer can be Peritoneal cytology is negative for malignancy. What is considered when the following criteria are met: the next best step in the treatment of this patient A 55-year-old otherwise healthy female who has never been pregnant presented with a 2-month history of inter3. World Health Organization risk factors used to trimittent vaginal bleeding and 15-pound weight loss. She age women diagnosed with gestational trophoblastic has a 25-pack-year history of smoking. Endometrial (A) Number of pulmonary nodules biopsy showed high-grade endometrioid carcinoma. Para-aortic lymph node (D) Number of previous pregnancies sampling and peritoneal cytology were negative for disease. Pregnancy outcomes after fertility-sparing management in young women with early endometrial cancer. Radiation therapy and combined trial hyperplasia, endometrial carcinoma, sarcoma: diagnosis and chemo-irradiation in advanced and recurrent endometrial carcimanagement. Post Operative Radiation Therapy in cer in tamoxifen-treated breast cancer patients: findings from the Endometrial Carcinoma. Advanced and recurrent endometrial carcinoma: horof Treatment in Gynecological Cancer. Uterine carcinosarcomas (malignant mixed therapy regimen in recurrent or advanced endometrial carcinoma Risk factors that ifosfamide with or without paclitaxel in advanced uterine carcimitigate the role of paraaortic lymphadenectomy in uterine endonosarcoma: a Gynecologic Oncology Group Study.
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