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Thursday, 17 October 2013
Neuroanatomy, Text and Atlas, 3rd Edition
Netter's Atlas of Human Physiology
Netter's Atlas of Human Physiology
Human Anatomy, Color Atlas and Textbook 5 edition
Grant's Dissector 14 edition
Gray's Anatomy for Students
Delmar's Fundamentals of Anatomy and Physiology
Clinical Neuroanatomy: Brain Circuitry and Its Disorders
Clinical Anatomy for Your Pocket
Case Files Anatomy 2nd Edtition
Basic Clinical Neuroscience 2nd Edition
Atlas of Neuroanatomy and Neurophysiology - Frank H. Netter
Applied Radiological Anatomy for Medical Students
Anatomy, Physiology, and Pathophysiology for Allied Health
Anatomy Recall, 2nd Edition
Wednesday, 16 October 2013
Tuesday, 15 October 2013
Friday, 4 October 2013
PATHOLOGY CASE 3
PATHOLOGY CASE 3
INTRODUCTION
A 57-year-old man presents with fatigue for several months and has noticed recently that the waistbands of his pants are tight in spite of a 15-pound weight loss. He has not had diarrhea, nausea, vomiting, or other gastrointestinal symptoms. He does not take any medications and denies using illegal drugs. He underwent a blood transfusion with several units in 1982 after an automobile accident. Physical examination reveals generalized jaundice, a firm nodular liver edge just below the right costal margin, and a mildly protuberant abdomen with a fluid wave. Initial laboratory studies show the following:
Patient's Value Reference Range Alanine aminotransferase (ALT): 80 U/L 8-20 U/L Alkaline phosphatase: 60 U/L 20-70 U/L Aspartate aminotransferase (AST): 50 U/L 8-20 U/L Albumin: 2.0 g/dL 3.5-5.5 g/dL Bilirubin, serum, total: 5 mg/dL 0.1-1.0 mg/dL Bilirubin, serum, direct: 4.2 mg/dL 0.0-0.3 mg/dL Prothrombin time (PT): 28 s 11-15 s Partial thromboplastin time (PTT): 50 s 28-40 s
· What is the most likely diagnosis?
· What are the possible etiologies of this disorder?
· What other tests would be appropriate?
· What are the possible complications?
Summary: A 57-year-old man with a prior history of blood transfusion presents with jaundice and ascites, along with mildly elevated transaminases as well as evidence of impaired hepatic synthetic function (hypoalbuminemia and coagulopathy).
· Most likely diagnosis: Chronic hepatitis/cirrhosis.
· Possible etiologies of this disorder: Most commonly caused by chronic toxin exposure (alcohol) or chronic viral infection; sometimes chronic hepatitis may be caused by inherited metabolic disorders such as hemochromatosis.
· Other appropriate tests: Hepatitis virus serologies and possibly a liver biopsy.
· Possible complications: Hepatic failure, gastrointestinal bleeding, hepatocellular carcinoma.
Thursday, 3 October 2013
PATHOLOGY CASE 2
PATHOLOGY CASE 2
INTRODUCTION
A 30-year-old male banker complains of midepigastric gnawing and boring pain for the last week. The pain is worse at night and is somewhat better immediately after he eats. He has not had any fever, nausea, or vomiting. He takes about one 500-mg acetaminophen tablet a week for headaches but does not take any other medications. Upper endoscopy reveals a 2-cm mucosal defect in the antrum of the stomach. There is mild edema in the adjacent mucosa, but there is no thickening of the edges of the ulcer.
· What is the most likely diagnosis?
· What are complications from this condition?
· What is the most likely mechanism of this disorder?
Summary: A 30-year-old man has acute onset of midepigastric pain somewhat relieved by eating. Upper endoscopy reveals a 2-cm gastric ulcer.
· Most likely diagnosis: Peptic ulcer disease.
· Long-term complications: Erosion or perforation with bleeding; gastric carcinoma in patients with chronic gastritis.
· Most likely mechanism: Most often associated with Helicobacter pylori organisms that produce bacterial urease and protease, damaging the mucus layer and exposing the underlying epithelium to acid-peptic injury.
PATHOLOGY CASE 1
PATHOLOGY CASE 1
INTRODUCTION
A 42-year-old policeman has been seen by his family physician for "heartburn" of 5 years' duration. He has been intermittently taking ranitidine, a histamine-2 blocking agent, with some relief. An upper endoscopic examination that was performed recently revealed some reddish discoloration and friability of the lower esophageal region. A biopsy of the lower esophagus was performed, and the microscopic examination revealed columnar cells containing goblet cells.
· What is the most likely diagnosis?
· What is a long-term complication of this process?
· What is the most likely mechanism of this process?
Summary: A 42-year-old man has a 5-year history of heartburn unrelieved by a histamine-2 blocking agent. Upper endoscopy reveals reddish discoloration of the distal esophagus, which on biopsy shows columnar epithelium with goblet cells.
· Most likely diagnosis: Barrett esophagus.
· Long-term complication of this process: Adenocarcinoma of the esophagus.
· Most likely mechanism: Repeated acid reflux to the distal esophagus leading to metaplasia of the normal squamous epithelium into columnar epithelium.
Applying the Basic Sciences to Clinical Medicine
Applying the Basic Sciences to Clinical Medicine
Pathology is best learned by a systematic approach, first by learning the language of the discipline and then by understanding the function of the various processes. Increasingly, the understanding of cell and organ function plays an important role in the understanding of disease processes and the treatment of disease. Initially, some of the "language" must be memorized in the same way that the alphabet must be learned by rote; however, the appreciation of the way the "pathology words" are constructed requires an understanding of mechanisms, in essence, an awareness of "how things are put together and work together."
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