General Medicine

 

I.Overview Malnutrition is directly responsible for 300,000 deaths per year in children younger than 5 years in developing countries and contributes indirectly to more than half of all deaths in children worldwide. In addition, it increases health care costs.  See the image below. II.Sign and Symptoms The most common and clinically significant micronutrient deficiencies and their consequences include the following: Iron: Fatigue, anemia, decreased cognitive function, headache, glossitis, and nail changes Iodine: Goiter, developmental delay, and mental retardation Vitamin D: Poor growth, rickets, and hypocalcemia Vitamin A: Night blindness, xerophthalmia, poor growth, and hair changes Folate - Glossitis, anemia (megaloblastic), and neural tube defects (in fetuses of women without folate supplementation) Zinc: Anemia, dwarfism, hepatosplenomegaly, hyperpigmentation and hypogonadism, acrodermatitis enteropathica, diminished immune response, and poor wound healing

I.Overview Kawasaki disease causes inflammation in the walls of medium-sized arteries throughout the body. It primarily affects children. The inflammation tends to affect the coronary arteries, which supply blood to the heart muscle. Kawasaki disease is sometimes called mucocutaneous lymph node syndrome because it also affects lymph nodes, skin, and the mucous membranes inside the mouth, nose and throat. II.Sign and Symptoms Kawasaki disease symptoms usually appear in three phases. 1st phase Signs and symptoms of the first phase may include: A fever that is often is higher than 102.2 F (39 C) and lasts more than three days Extremely red eyes (conjunctivitis) without a thick discharge A rash on the main part of the body (trunk) and in the genital area Red, dry, cracked lips and an extremely red, swollen tongue (strawberry tongue) Swollen, red skin on the palms of the hands and the soles of the feet Swollen lymph nodes in the neck and perhaps elsewhere Irritability

Normally during pregnancy, erythroid hyperplasia of the marrow occurs, and RBC mass increases. However, a disproportionate increase in plasma volume results in hemodilution (hydremia of pregnancy): Hct decreases from between 38 and 45% in healthy women who are not pregnant to about 34% during late single pregnancy and to 30% during late multifetal pregnancy. Thus during pregnancy, anemia is defined as Hb  <  10 g/dL (Hct  <  30%). If Hb is  <  11.5 g/dL at the onset of pregnancy, women may be treated prophylactically because subsequent hemodilution usually reduces Hb to  <  10 g/dL. Despite hemodilution, oxygen-carrying capacity remains normal throughout pregnancy. Hct normally increases immediately after birth. Anemia occurs in up to one third of women during the 3rd trimester. The most common causes are Iron deficiency Folate deficiency Symptoms and Signs Early symptoms of anemia are usually nonexistent or nonspecific (eg, fatigue, weakness, li

I.Vaginal bleeding in early pregnancy      Vaginal bleeding during pregnancy is any discharge of blood from the vagina. It can happen any time from conception (when the egg is fertilized) to the end of pregnancy. Some women have vaginal bleeding during their first 20 weeks of pregnancy. The Difference Between Spotting and Bleeding Spotting is when you notice a few drops of blood every now and then on your underwear. It is not enough to cover a panty liner. Bleeding is a heavier flow of blood. With bleeding, you will need a liner or pad to keep the blood from soaking your clothes. Ask your health care provider more about the difference between spotting and bleeding at one of your first prenatal visits. Should I Worry about Spotting? Some spotting is normal very early in pregnancy. Still, it is a good idea to tell your provider about it. If you have had an  ultrasound  that confirms you have a normal pregnancy, call your provider the day you firs

I. Overviews The anatomy of the uterus consists of the following 3 tissue layers : The inner layer:  called the endometrium, is the most active layer and responds to cyclic ovarian hormone changes; the endometrium is highly specialized and is essential to menstrual and reproductive function. The middle layer:  or myometrium, makes up most of the uterine volume and is the muscular layer, composed primarily of smooth muscle cells. The outer layer of the uterus:  the serosa or perimetrium, is a thin layer of tissue made of epithelial cells that envelop the uterus. II. Gross Anatomy The uterus is a pear-shaped organ located in the female pelvis between the  urinary bladder  anteriorly and the rectum posteriorly (see the image below). The average dimensions are approximately 8 cm long, 5 cm across, and 4 cm thick, with an average volume between 80 and 200 mL. The uterus is divided into 3 main parts: the fundus, body, and cervix. Blood is provided to the uterus by the ova

I. Definition Cervical polyps are small, elongated   tumors   that grow on the cervix. The cervix is the narrow canal at the bottom of the uterus that extends into the vagina. The  cervix  connects the  uterine  cavity and the upper portion of the  vagina . It acts as the passageway for sperm to fertilize an egg, which could result in pregnancy. During labor, the cervix becomes thinner and wider. This allows the baby to pass through the birth canal. II. Sign And Symptoms Polyps on the cervix may not cause any noticeable symptoms. However, see your  gynecologist  right away if you experience  vaginal discharge  of white or yellow mucus, or abnormally heavy periods. You should go to hospital if you experience vaginal  spotting  or bleeding: after sexual intercourse between periods after   douching after   menopause    III. Causes       High estrogen levels Estrogen levels naturally fluctuate throughout a woman’s life. Your estrogen levels will be highest during c

I. Definition A goiter (GOI-tur) is an abnormal enlargement of your thyroid gland. Your thyroid is a butterfly-shaped gland located at the base of your neck just below your Adam's apple. Although goiters are usually painless, a large goiter can cause a cough and make it difficult for you to swallow or breathe. II. Causes The most common cause of goiters worldwide is a lack of iodine in the diet. In the United States, where the use of iodized salt is common, a goiter is more often due to the over- or underproduction of thyroid hormones or to nodules that develop in the gland itself. III. Sign and Symptoms Not all goiters cause signs and symptoms. When signs and symptoms do occur they may include: A visible swelling at the base of your neck that may be particularly obvious when you shave or put on makeup A tight feeling in your throat Coughing Hoarseness Difficulty swallowing Difficulty breathing IV. Risk Factors Goiters can affect anyone. They may be present at

I. Defintion Henoch-Schonlein purpura (HEN-awk SHURN-line PUR-pu-ruh) is a disorder that causes inflammation and bleeding in the small blood vessels in your skin, joints, intestines and kidneys. II. Sign and Symptoms The four main characteristics of Henoch-Schonlein purpura include: Rash (purpura).  Reddish-purple spots, which look like bruises, are the most distinctive and universal sign of Henoch-Schonlein purpura. The rash develops mainly on the buttocks, legs and feet, but it can also appear on the arms, face and trunk and may be worse in areas of pressure, such as the sock line and waistline. Swollen, sore joints (arthritis).  People with Henoch-Schonlein purpura often have pain and swelling around the joints — mainly in the knees and ankles. Joint pain sometimes precedes the classical rash by one or two weeks.  Gastrointestinal symptoms.  Many children with Henoch-Schonlein purpura develop gastrointestinal symptoms, such as abdominal pain, nausea, vomiting or bloody st

i. Definition Nephrotic syndrome is a kidney disorder that causes your body to excrete too much protein in your urine. Nephrotic syndrome is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste and excess water from your blood. Nephrotic syndrome causes swelling (edema), particularly in your feet and ankles, and increases the risk of other health problems. Treatment for nephrotic syndrome includes treating the underlying condition that's causing it and taking medications. Nephrotic syndrome can increase your risk of infections and blood clots. Your doctor may recommend medications and dietary changes to prevent these and other complications of nephrotic syndrome. ii. Sign and Symptoms Signs and symptoms of nephrotic syndrome include: Severe swelling (edema), particularly around your eyes and in your ankles and feet Foamy urine, which may be caused by excess protein in your urine Weight gain due to excess fluid ret