sickle cell crisis | sickle cell anemia

Sickle cell crisis or Sickle cell anemia :-

1- hand foot syndrome
2-hemolytic crisis
3- vaso- oclusive or pain crisis

4- aplastic crisis or parvovirus

5- acute abdomen
6- sequestration crisis

Complication of sickle cell anemia

1- stroke
2- heart failure
3- "crew cut"
4-acute chest syndrome
5- auto splenoctomy
6-renal failure
7- parpism
8- leg ulcer
9- extra medullary hematopoiesis
10-hemosidrosis and pigmented gall stone

Investigation

1- blood smear.
2- electrophoresis

Treatment

Bone marrow transplantation

Comments

Tetanus | tetany | Hypoparathyroidism | Hypocalcemia | Disorder of parathyroid gland | hypercalcaemia | hyperparathyroidism

[Disorder of parathyroid gland]- There are two types of parathyroid disorder- 1. Hypoparathyroidism 2. Hyperparathyroidism 1. Hypoparathyroidism ( Hypocalcemia) • Hypo secretion of PTH(parathormone), leads to decrease in blood calcium level. Causes of hypoparathyroidism- a. Parathyroidectomy Surgical removal of parathyroid gland b. Thyroidectomy During Surgival removal of thyroid gland , removal of parathyroid gland c. Pseudo hypoparathyroidism • There is deficiency of receptors for parathormone (PTH) in target cells, • in this the secretion of PTH is normal or may be increased but hormone can not act on the target cells. d. Autoimmune disease >Effect of Hypoparathyroidism- • due to decrease in resorption of calcium from bones hypoparathyroidism leads to Hypocalcemia. • it causes neuromuscular hyperexcitability , resulting in hypocalcemic tetany. * Normally tetany occurs when plasma calcium level decreases below 6mg/dl. # normal plasma calcium level=

Stroke

Stroke- Presentation of stroke- Sudden onset focal deficit of cerebral function is the most common presentation. Alternative presentation include apparent confusion ( due to dysphasia or visualpatial impairment), seizures, declining level of consciousness or global loss of brain function and coma . If the symptoms last for >24 hrs ( or lead to death) and there is no apparent cause other than a vascular event,the diagnosis is most likely to be a stroke.if the symptoms last < 24 hrs and after adequate investigation, are presumed to be due to thrombosis or embolism, the diagnosis is a TIA.( Transient ischemic attack) CAUSE: Thrombosis or embolism causing cerebral infarction ( 80%) Primary inter cerebral haemorrhage (15%) Subarachnoid haemorrhage (5%) Cerebral venous thrombosis (1%) RISK FACTOR: GLOBAL Increasing age Hypertension Diabetes Family history Dyslipidemia Homocysteinaemia LIFESTYLE Drug abuse Smoking O

Polycythemia vera | Polycythemia | Ayerza disease

POLYCYTHEMIA- Increase in RBC count is called polycythemia. > Increase in RBC count occurs in these conditions- A. Physiological variation B. Pathological variations A. Physiological variations When RBC count increases in physiological conditions it is called physiological polycythemia. • increase in RBC count in this condition is temporary or marginal. It occurs in following conditions- 1. Age RBC count at birth= 8-10 million/cu mm of blood • in infants and growing childrens RBC count is more than adults. [RBC] infants > [RBC] adults * Physiological jaundice Because, Within 10days after birth RBC counts decrease due to destruction of RBCs. 2. High altitude Due to hypoxia ( decreased oxygen supply to tissue) RBC count in High altitude resedents, above 10000 feet from sea level( mountains) = >7 million/cu mm • Hypoxia stimulates kidney for secretion of erythropoietin hormone. • erythropoietin hormone stimulates the bone marrow for production of RBCs.

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