medical oncology pathways selectiv etiomain alphabet general toxicolo

top
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
asthma babesiosis diabetes

symptom analysis
drug considerations
diseases

The building up of medical knowledge into tiers

diseases
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Urinary Bladder cancer diabetes infectious disease pulmonary .........................................alveolar proteinosis
progresses slowly an unremittingly

causes non specific constitutional symptoms

weight loss
dypnea of increasing severity
alveolar filling loss of lung volume on  xray

symptom analysis
sarcoidosis......................................
sarcoid heart disease first degree av block
new onset RBBB
vaccines

influenza
pneumococcal infection pneumococcal polysaccharide vaccine
hepatitis-B

.

pulmonary embolism
pain of pe may be pleuritic
check the legs for calf pain of DVT

ASTHMA and Pulmonary Disease AREA
pulmonary
asthma
corticosteroids inhaled corticosteroids

criteria for mild persistent asthma :

self-treatment with a beta-agonist more than two days per week

nighttime awakenings related to asthma more than two days per month

or variability in the PEF of 20 to 30 percent).

criteria for persistent moderate asthma

daily self-treatment with a beta-agonist

nighttime awakenings once a week

more than 30 percent variability in PEF

diabetes
DKA 1/4 also hyperosmolar with osmolarity of 320 or more Normal Range = 285 - 295 mOsm/kg  

Serum Osmolality = (2 x (Na + K)) + (BUN / 2.8) + (glucose / 18)

The normal human serum osmolality is from 280 to 295 mOsm/Kg

[Na] - ([Cl] + [HCO3]) = [other anions] - [other cations] = "Anion Gap"

Normal values for the Anion Gap are 8-16 mEq/L plasma

diabetic coma insulin
the brain requires 75% of the glucose circulating in the blood stream. glucagon is the response to low glucose
MODY Maturity Onset  Diabetes of the the Young
younger than 25 appear lean have a positive family history have a dominant mode of inheritance
sulfonylureas stimulate the pancreas to produce insulin and require some pancreatic function. Sulfonylureas also increase use of glucose in the tissues and reduces the hepatic glucose output in children a single diabenese may be lethal monogenic defect
ketoacidosis

hyperglycemic hyperosmolar syndrome Uremia
alcoholic ketoacidosis lactic acidosis
starvation sepsis

Secondary  Diabetes
pancreatitis hemachromatosis
acromegaly cystic fibrosis
Cushing's syndrome pheochromocytoma
steroids furosemide
thiazide diuretics clonidine
oral contraceptives thyroid hormone
halperidol,lithium,phenothiazines progestins
tricyclic antidepressants, isoniazid, nicotinic acid, heparin cimetidine gestational

Diabetes

Type II DM is insulin resistance with present c-peptide dump (not c-reactive protein)
Type I is the DKA kind
glucose over 250 marked ketoacidosis
ph less than 7.35 low serum bicarb less than 15 positive serum ketones
insulin is the response to high glucose for more  SEE biochem
Inheritance of type I diabetes is carried in genes of the major histocompatibility complex (the human leukocyte antigen system).
insulin routes
fluid therapy
Bicarbonate therapy
fluid therapy
hyperosmolar coma phosphate replacement and respiratory depression, cardiac abnormality wariness for cerebral edema


NOTICE ANYTHING?  return                                                                                                                                                                              top
reverse transcriptase
mean qrs vector normally 0 to 90o, in right arm lead negative, lead 1 normally positive, in AVF positive normally
gives valuable information about the relative position of the heart a positive deflection in lead 1 indicates vector of 0-90o
a negative deflection in lead 1 indicates Right Axis deviation
mean qrs vector points away from infarction area of myocardium a negative vector in lead AVF indicates LAD or extreme RAD
is displaced toward the hypertrophied area of the myocardium
First Degree AV Block
acute rheumatic fever
sarcoid heart disease
well trained athletes
the young
those with hight vagal tone
Digitalis effect
anterior hemiblock
LAD left axis deviation
QRS slightly widened
Q1S3
slightly delayed depolarization upward to the anterior lateral and superior area of the left ventrical
causes late unopposed depolarization upward to the left recognized as left axis deviation
present in half of anterior myocardial infarctions

symptom analysis
onset record the date of onset what time of day was first occurence
total duration what about the onset what was the manner of onset circumstances related to the onset
 

characteristics of symptom at onset
Character or Quality refers to patient's subjective description of his complaint burning aching cramplike squeezing knifelike pressing
Location and Pattern of Radiation applies to the symptom of pain only
Intensity or Severity of symptom as expressed by the patient mild moderate severe
personality
age
race
social background

interpret accordingly

Temporal Character and Duration top  symptom analysis

total duration of symptom
time interval from its first occurrence until interview includes symptom free periods
recurrent or periodic illness symptom analysis

H
hematology

V
vaccines