- Lymphadenopathy - presentation.

Lymphadenopathy presentation

- By

Dr.Manal Abdel Hamid

Assistant professor
Mansoura University, Oncology center.

- Download (Click here)

- Parasites affecting Heart.

Parasites affecting Heart

"Heart Team" 

Heterophyes heterophyes (Eggs)

Taenia solium (cysticercosis), 
Trichinella spiralis (Trichina capsule),
Trypanosoma cruzi (Leishmanial form),
Toxoplasma gondii (true tissue cyst).

Echinococcus granulosus (Hydatid cyst).
Acanthocheilonema perstans (Adult worm in the pericardium).
Mansonella ozzardi (Adult worm in the pericardium).

or  Arabic students can use the word "Hatem"

Dr Ibrahim

- Kallmann syndrome.

 Kallmann syndrome

- Def :- It is a rare X-linked recessive genetic disease which characterized by delayed or absent puberty and an impaired sense of smell, also referred as olfactogenital dysplasia.

- Kallmann syndrome is a form of secondary hypogonadism, reflecting that the primary cause of the defect in sex-hormone production lies within the pituitary and hypothalamus rather than a physical defect of the testes or ovaries.

- Kallmann syndrome was described in 1944 by Franz Josef Kallmann, a German-American geneticist.(1)(2)

- Incidence:-

It affects primarily males at an incidence of 1 out of 10,000 in a study of French conscripts.(3)
The male-to-female ratio ranges from 4:1 to 5:1.

- Cause:-

Mutations in the KAL1, FGFR1, PROKR2, and PROK2 genes cause Kallmann syndrome.
These genes play a role in the development of certain areas of the brain before birth. Although some of their specific functions are unclear, these genes appear to be involved in the formation and movement (migration) of a group of nerve cells that are specialized to process smells (olfactory neurons).(4)

- Synonyms:-

• de Morsier’s syndrome II.
• Morsier-Gauthier syndrome.
• Kallmann-de Morsier syndrome.
• Maestre-Kallmann-de Morsier syndrome.
• Maestre de San Juan-Kallmann syndrome.
• Maestre de San Juan-Kallmann-de Morsier syndrome.
• anosmic hypogonadism.
• anosmic idiopathic hypogonadotropic hypogonadism.
• hypogonadotropic hypogonadism and anosmia.
• hypogonadotropic hypogonadism-anosmia syndrome.
  
  

- Sertoli-cell-only syndrome (germinal cell aplasia).

Sertoli-cell-only syndrome (SCO)

-Def:- It is a condition in which only Sertoli cells line the seminiferous tubules of the testes and characterized by male sterility (due to azoospermia) without sexual abnormality.

- Synonyms:-

• Del Castillo syndrome.
• Germ cell aplasia.

-The etiology (1):-

• Most causes of SCO syndrome are idiopathic. A congenital absence of germ cells due to failure of migration of gonocytes is theoretically possible.
• Massive deletions in the azoospermia factor (AZF) region of the Y chromosome. found.
• Exposure to chemicals and toxins may cause SCO; however, direct cause-and-effect relationships in humans have been difficult to document.
• Klinefelter syndrome, 47 XXY, results in a characteristic biopsy appearance of SCO and Leydig cell hyperplasia.
  
  

- Anthony Atala on growing new organs.

Anthony Atala's state-of-the-art lab grows human organs -- from muscles to blood vessels to bladders, and more. He shows footage of his bio-engineers working with some of its sci-fi gizmos, including an oven-like bioreactor (preheat to 98.6 F) and a machine that "prints" human tissue.

What amazing!!

- Parasites affecting Spleen.

Parasites affecting Spleen

"Spleen"

Schistosoma species.

PLasmodia species.

LEishmania donovani.

EchiNococcus granulosus .

Dr Ibrahim

- Nematodes transmitted through contaminated soil.

 Nematodes transmitted through contaminated soil
(Nematodal geoparasites)

(Alessandro Nesta the famous Italian footballer )

(source of pic here )

you will surprise what the relation between Alessandro Nesta and Nematodes.!? really i will need "Nesta" part to help us to remember nematodes transmitted through contaminated soil..

"Nesta" 

Necator americanus (filariform larvae).

Enterobius vermicularis (eggs).
Strongyloides  stercoralis (filariform larvae).
Toxocara canis and cati (eggs),Trichocephalus trichiurus.
Ascaris lumbricoides,Ancylostoma duodenale.
 

Dr Ibrahim

- Nematodes transmitted by eating raw vegetables.

Nematodes transmitted by eating raw vegetables

"Eat"

Enterobius vermicularis (eggs).

Ascaris lumbricoides (eggs).

Toxocara canis and cati(eggs) ,Trichocephalus trichiurus(eggs),Trichostrongylus colubriformis (Larvae).

Dr Ibrahim

- Parasites affecting oropharynx.

Parasites affecting oropharynx

"Melt"

Myiasis : larvae of calliphora and gasterophilus.

Entamoeba gingivalis.

leishmania brasiliense.

Trichomonas buccalis.

Dr Ibrahim

- Grades in medicine.

Grades in medicine 

In many branches of medicine we meet what is called "grades" this grades were put to classify certain conditions. Here I will put the grades what i had found as they meet me in books in simple way......... so you can share us.

• Grading of Murmurs (click here).
• Grading of Vesicoureteric Reflux (click here).
• Grades of Dyspnea (click here).
• Grades of respiratory distress. (click here).
• Grades of splenomegaly. (click here).
• Grading of hypertensive retinopathy (click here).
• Grades of binocular single vision. (click here).
• Grades for quantitative assessment of muscle power (click here).
• Deep tendon reflex grading (click here).
• Poisoning severity grading (click here).
• Grading of function in rheumataid disease(click here).
•  ASA Grading system (click here).
• Renal trauma grading scale (click here).
• Compound fracture grading- Gustilo-Anderson grading (click here).
• Sperm Motility grading.(click here).
• Wagner Grading System for Diabetic Foot Infections.(click here).
• Savary miller endoscopic grading of GORD.(click here).
• Sher's grading of abruptio placentae.(click here).

Dr Ibrahim

- Air Borne parasitic infections.

Air Borne parasitic infections

"Net Cam"

Naegleria fowleri (Trophozoites).

Enterobius vermicularis (eggs).

Taenia solium (eggs),Toxoplasma gondii (Oocyst).

Cryptosporidium parvum (Oocyst).

Acanthamoeba castellanii (Trophozoites),Ascaris lumbricoides (eggs).

Microsporidia (spores).

Dr Ibrahim

- Laboratory acquired nematodal infections.

Laboratory acquired nematodal infection.

"Sheat"

Strongyloides stercoralis.

Hook worm.

Enterobius vermicularis.
Ascaris lumbricoides.
Trichocephalus trichiurus,Trichinella spiralis.

Dr Ibrahim

- Parasites transmitted through trans-mammary route.

Parasites transmitted through trans-mammary route

(International Breastfeeding Symbol)

"SAT"

Strongyloides stercoralis larvae.

Ancylostoma duodenale larvae.

Toxocara canis and cati  larvae.

Dr Ibrahim 

- Grades of splenomegaly.

Grades of splenomegaly.  

1. Grade I :- Spleen is palpable under the costal margin.
2. Grade II :- Spleen is palpable between the costal margin and umbilicus.
3. Grade III :- Spleen is palpable below the  umbilicus.

Dr Ibrahim

Return to list of medical grades (click here) 

- Metabolic syndrome (Syndrome X).

 Metabolic syndrome

-Def :- It is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes (1).

-Synonyms :-syndrome X, insulin resistance syndrome, Reaven's syndrome or dysmetabolic syndrome.

 

- Grades of respiratory distress.

Grades of respiratory distress

1. Grade I (mild distress):- tachypnea ,working ala nasi and tachycardia .
2. Grade II (moderate distress):- Chest retraction "in-drawing" (e.g subcostal and intercostal) due to moderate hypoxemia.
3. Grade III (severe distress):- Grunting which is due to severe hypoxemia and indicate alveolar lesion (i.e parenchymatous lung disease).Here O2 supply is needed and patient must be hospitalized.Grunting is the last compensatory mechanism.
4. Grade IV:- Cyanosis and disturbed consciousness and endotracheal tube is needed here.

Dr Ibrahim

Return to list of medical grades (click here) 

- Grades of Dyspnea.

Grades of Dyspnea

Two scoring systems can be adopted to evaluate the dysnea changing it from subjective complaint to objective complaint.

1-American Thoracic society score (ATS):
Grade 0:- No breathlessness except with strenuous exercise.
Grade 1:- Breathlessness when hurrying on the level or walking up a slight hill.
Grade 2:- Walks slower than people of the same age on the level because of breathlessness or has to stop for breath when walking at own pace on level.
Grade 3:- stop for breath after walking about 100 yards (96 meter) or a few minutes on the level.
Grade 4:- Too breathless to heave the house or breathless when dressing or underdressing.

2-New york heart association score (NYHA)

There are four functional  grades of  Dyspnea as follows:-

1. Grade I (minimal Dyspnea):  Dyspnea on running or on doing more than ordinary effort .

2. Grade II : on doing ordinary effort .

3. Grade III (considerable Dyspnea) : on doing less than  ordinary effort .
4. Grade IV : Dyspnea at rest.

*Ordinary effort is that of the person himself as regard his previous effort tolerance and usual life style.

*Reference:-
- Basics of respiratory medicine,Staff members,Thoracic medicine department,mansourauniversity,3ed,2009,symptoms of chest disease P.g 57.

Return to list of medical grades (click here) 

- Human Skin Histology.

-Human skin is considered the largest organ of the body and form  about 16% of the body weight (1) with a surface area somewhat less than 1.5 m² (2).
-The skin form the external surface of the human body.At the orifices of the mouth,nose and the anal canal, the skin join the mucous membrane at the muco-cutaneous junction (3).

-Types of human skin (1):-

1. Thick skin (Non-Hairy) which has thick epidermis and found only in the palms and soles as they are the most sites subjected to abrasions and trauma and thick skin shows characteristic parallel ridges and grooves which are called "Finger prints".
2. Thin skin (Hairy) which has thin epidermis and covers the rest of the body.
   

-Histological structure of the skin :-

skin is composed of 3 layers

1. Epidermis
2. Dermis
3. Hypodermis (Subcutaneous fatty layer) 

1- Epidermis:-

• It is the outer superficial epithelial layer of skin.
• It is composed of Stratified squamous keratinized epithelium.
• The thickness of the epidermis varies in different types of skin. It is the thinnest on the eyelids and the thickest on the palms(0.8mm) and soles(1.4mm).
• The epidermis is ectodermal in origin.
  
• The epidermis is devoid of blood vessels and gets its nutrition through diffusion.
  
  
  

- What are the symptoms of pleural mesothelioma?

What are the symptoms of pleural mesothelioma?

Mary Hesdorffer, MS, APRN, nurse practitioner with the Mesothelioma Applied Research Foundation discusses symptoms of pleural mesothelioma.

- What does a pleural mesothelioma diagnosis mean?

What does a pleural mesothelioma diagnosis mean?

Mary Hesdorffer, MS, APRN, nurse practitioner at the Mesothelioma Applied Research Foundation talks about the importance of consulting with a pleural mesothelioma expert when discussing a diagnosis.