approach to the patient with possible cardiovascular disease
Chapter 052. Approach to the Patient with a Skin Disorder (Part 1) ppt
... that the erosion is the primary lesion and the redness and scale are secondary, while the correct interpretation would be that the patient has a pruritic eczematous dermatitis with erosions caused ... differential diagnosis (Table 52-4) For instance, the finding of scaling papules (present in patients with psoriasis or atopic dermatitis) places the patient in a different diagnostic category than ... important to differentiate primary from secondary skin lesions If the examiner focuses on linear erosions overlying an area of erythema and scaling, he or she may incorrectly assume that the erosion...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 2) potx
... elicits the desire to scratch Pruritus is often the predominant symptom of inflammatory skin diseases (e.g., atopic dermatitis, allergic contact dermatitis); it is also commonly associated with ... epidermal atrophy) Scar: A change in the skin secondary to trauma or inflammation Sites may be erythematous, hypopigmented, or hyperpigmented depending on their age or character Sites on hair-bearing ... conditions that can be associated with pruritus include chronic renal disease, cholestasis, pregnancy, malignancy, thyroid disease, polycythemia vera, and delusions of parasitosis Figure 52-3 A schematic...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 4) doc
... hospitalized patient with a generalized erythematous exanthem is more likely to have a drug eruption than is a patient with a similar rash limited to the sun-exposed portions of the face Once the distribution ... patient with cutaneous small vessel vasculitis (Courtesy of Robert Swerlick, MD; with permission.)[newpage] APPROACH TO THE PATIENT: SKIN DISORDER In examining the skin it is usually advisable to ... as completely as possible This will minimize chances of missing important individual skin lesions and make it possible to assess the distribution of the eruption accurately The patient should first...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 5) pptx
... The distribution of some common dermatologic diseases and lesions Figure 52-7 Psoriasis This papulosquamous skin disease is characterized by small and large erythematous papules and plaques with...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 6) pdf
... contrast, lesions with a generalized arrangement are common and suggest a systemic etiology Figure 52-9 Erythema multiforme This eruption is characterized by multiple erythematous plaques with a target ... usually represents a hypersensitivity reaction to drugs (e.g., sulfonylamides) or infections (e.g., HSV) (Courtesy of the Yale Resident's Slide Collection; with permission.) Figure 52-10 ...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 7) ppt
... against the surface of the skin and rotated with downward pressure until it penetrates to the subcutaneous tissue The circular biopsy is then lifted with forceps, and the bottom is cut with iris ... area of skin is anesthetized with 1% lidocaine with or without epinephrine The skin lesion in question can be excised or saucerized with a scalpel or removed by punch biopsy In the latter technique, ... History of allergies Presence of photosensitivity Review of systems Family history (particularly relevant for patients with melanoma, atopy, psoriasis, or acne) 10 Social, sexual, or travel history...
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Chapter 052. Approach to the Patient with a Skin Disorder (Part 8) pptx
... to document sensitivity to a specific antigen In this procedure, a battery of suspected allergens is applied to the patient' s back under occlusive dressings and allowed to remain in contact with ... best performed by physicians with special expertise in patch testing and is often helpful in the evaluation of patients with chronic dermatitis FURTHER READINGS Dermatology Lexicon Project: www.futurehealth.rochester.edu/dlp2/ ... designed to assess whether a skin lesion will blanch with pressure as, for example, in determining whether a red lesion is hemorrhagic or simply blood-filled Urticaria (Fig 52-11) will blanch with...
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Chapter 077. Approach to the Patient with Cancer (Part 1) potx
... same as the prognosis of the person with aortic stenosis who develops the first symptoms of congestive heart failure (median survival, ~8 months) However, the patient with heart disease may ... cancer patient feels that he or she, and not just a body part, is diseased The Magnitude of the Problem No nationwide cancer registry exists; therefore, the incidence of cancer is estimated on the ... selection to seek advantage over normal cells in a recapitulation of evolution One consequence of the traitorous behavior of cancer cells is that the patient feels betrayed by his or her body The cancer...
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Chapter 077. Approach to the Patient with Cancer (Part 3) pptx
... The past medical history may alert the physician to the presence of underlying diseases that may affect the choice of therapy or the side effects of treatment The social history may reveal occupational ... predisposition and point out the need to begin surveillance or other preventive therapy for unaffected siblings of the patient The review of systems may suggest early symptoms of metastatic disease or a paraneoplastic ... 77-3 Patient Management Important information is obtained from every portion of the routine history and physical examination The duration of symptoms may reveal the chronicity of disease The past...
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Chapter 077. Approach to the Patient with Cancer (Part 4) pps
... Against Cancer and the American Joint Committee on Cancer (AJCC) The TNM classification is an anatomically based system that categorizes the tumor on the basis of the size of the primary tumor ... other prognostic factors have been identified (Chaps 104, 105, and 106) In addition to tumor burden, a second major determinant of treatment outcome is the physiologic reserve of the patient Patients ... are likely to fare worse, stage for stage, than fully active patients Physiologic reserve is a determinant of how a patient is likely to cope with the physiologic stresses imposed by the cancer...
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Chapter 077. Approach to the Patient with Cancer (Part 5) doc
... Internet.2 The skilled physician also has much to offer the patient for whom curative therapy is no longer an option Often a combination of guilt and frustration over the inability to cure the patient ... and the pressure of a busy schedule greatly limit the time a physician spends with a patient who is receiving only palliative care Resist these forces In addition to the medicines administered to ... complications of both the disease and its treatment as well as the complex psychosocial problems associated with cancer In the short term during a course of curative therapy, the patient' s functional...
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Chapter 077. Approach to the Patient with Cancer (Part 6) pdf
... trophoblastic Pregnancy disease, gonadal germ cell tumor Calcitonin Medullary cancer of the thyroid Catecholamines Pheochromocytoma Oncofetal Antigens Alphafetoprotein Hepatocellular carcinoma, ... Carcinoembryonic antigen Adenocarcinomas hepatitis Pancreatitis, of the colon, pancreas, hepatitis, lung, breast, ovary inflammatory bowel disease, smoking Enzymes Prostatic acid Prostate cancer phosphatase ... Neuron-specific enolase Lactate dehydrogenase Small cell cancer of the lung,neuroblastoma Lymphoma, Ewing's sarcoma Hepatitis, hemolytic many others Tumor-Associated Proteins anemia, Prostate-specific...
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Chapter 077. Approach to the Patient with Cancer (Part 7) ppt
... most patients who are cured of cancer return to normal lives Supportive Care In many ways, the success of cancer therapy depends on the success of the supportive care Failure to control the symptoms ... nonjudgmental, so that patients are more likely to discuss with the physician what they are actually doing The appearance of unexpected toxicity may be an indication that a supplemental therapy is being ... persists, the multidisciplinary team discusses a new salvage treatment plan If the patient has been rendered disease- free by the original treatment, the patient is followed regularly for disease...
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Chapter 077. Approach to the Patient with Cancer (Part 8) potx
... on which to indicate the severity of the pain The clinical condition is often dynamic, making it necessary to reassess the patient frequently Pain therapy should not be withheld while the cause ... signals in the chemoreceptor trigger zone in the medulla, the cerebral cortex, and peripherally in the intestinal tract lead to stimulation of the vomiting center in the medulla, the motor center ... caused by chemotherapy (Chap 81) Its severity can be predicted from the drugs used to treat the cancer Three forms of emesis are recognized on the basis of their timing with regard to the noxious...
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Chapter 077. Approach to the Patient with Cancer (Part 11) pot
... Sexual dysfunction is highly prevalent and needs to be discussed openly with the patient An empathetic health care team is sensitive to the individual patient' s needs and permits negotiation where ... adversely affect the course of treatment Cancer survivors have other sets of difficulties Patients may have fears associated with the termination of a treatment they associate with their continued ... that cancer therapy is substantially more toxic and less effective in the face of malnutrition Nevertheless, it remains unclear whether nutritional intervention can alter the natural history Unless...
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Chapter 077. Approach to the Patient with Cancer (Part 12) pot
... affected by the diagnosis and is coping with it is an important goal of patient management It is best to speak frankly with the patient and the family regarding the likely course of disease These discussions ... How to Care for Family and Friends at Home that teaches an approach to successful problem-solving in home care With appropriate planning, it should be possible to provide the patient with the ... difficult for the physician as well as for the patient and family The critical features of the interaction are to reassure the patient and family that everything that can be done to provide comfort...
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Care of the Patient with Retinal Detachment And Related Peripheral Vitreoretinal Disease docx
... on the patient' s chart or photodocumented, if observable with the fundus camera, for future reference cooperative.81 The optometrist should tell the patient that the risk associated with the ... epithelium becomes more visible in the area of the tear due to the loss of the overlying retina If the edge of the dialysis remains close to the RPE, then the tear may not be discovered unless ... of the American public and are often the first health care practitioners to diagnose patients with diseases of the retina This Optometric Clinical Practice Guideline for Care of the Patient with...
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Báo cáo Y học: Structural study on lipid A and the O-specific polysaccharide of the lipopolysaccharide from a clinical isolate of Bacteroides vulgatus from a patient with Crohn’s disease ppt
... in the induction of cytokines, including tumor necrosis factor, and the phosphate residue at the 4¢-position is a critical site for the activity [24] Therefore, the monophosphoryl lipid A in the ... Cleavage F indicated the chain length of the fatty acid on the acyoxyacyl group to be mainly 15, confirming the result of the compositional analysis In the minor triacylated lipid A, the fragmentation ... moiety in LPS To analyze the structure of the OPS moiety, the hydrophilic products from the acetic acid hydrolysate of LPS were separated by gel-filtration chromatography to give the highmolecular-mass...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 1) docx
... Approach to the Patient: Acute Febrile Illness A physician must have a consistent approach to acutely ill patients Even before the history is elicited and a physical ... should be performed for patients with possible acute endocarditis Asplenic patients should have a blood smear examined to confirm the presence of Howell-Jolly bodies (indicating the absence of splenic ... bacteria; these patients can have >106 organisms per milliliter of blood (compared with 10 4/mL in patients with an intact spleen) Blood smears from patients at risk for severe parasitic disease, ...
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Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 2) pptx
... (U.S.), Either: Atovaqu one and 01, 204 with fewer side or effects Treatmen Atovaquone t (750 mg q12h) plus with doxycycline c Azithromycin (100 mg bid ) (500-mg loading for potential dose, then 250 ... fludrocortisoneb or may improve outcome in Cefepime (2 g patients with q12h) septic shock Overwhel ming Streptoc post- occus g q12h) plus splenectomy pneumoniae, sepsis Haemophilus influenzae, If a ... If the patient is >50 years old or 76 has comorbid disease, add ampicillin (2 g q4h) for Listeria coverage Vancomycin (1 g q12h) Dexamet hasone (10 mg q6h x days) improves outcome adult in patients...
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