"Mohammad’s Spleen is Palpable"

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Mindmap am "Mohammad’s Spleen is Palpable", erstellt von LAhmad B am 19/04/2022.
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Zusammenfassung der Ressource

"Mohammad’s Spleen is Palpable"
  1. Anatomy and Palpation of the Spleen
    1. spleen is a lymphatic organ located right above the stomach in the left hypochondriac region which corresponds to the ULQ.
      1. Spleen Functions:
        1. Filters the blood from pathogens and debris
          1. Controls the level of blood cells
            1. Removes any old or damaged red blood cells.
            2. Palpation of the spleen
              1. Place your right hand behind the patient's inferior rib cage to support it. Then, use your left hand to palpate along the left costal margin.
              2. Causes of Splenomegaly
                1. Infections
                  1. Mononucleosis
                  2. Diseases affecting the liver
                    1. Hemolytic anemia
                      1. Blood cancers
                        1. How to Differentiate between leukocytosis, leukemia and leukemoid reaction?
                          1. Leukocytosis
                            1. Increase total number of WBCs to > 11,000/mm3.
                              1. Common cause is neutrophilia followed by lymphocytosis.
                                1. Pathological (tissue damage, infections & worm infestations)
                            2. Leukemoid reaction & leukemia
                              1. Leukocytosis >50,000/microL when due to causes other than leukemia
                                1. Characterized by a significant increase in early neutrophil precursors (myelocytes, metamyelocytes)
                                  1. Leukemia: Uncontrolled production of WBCs mainly caused by cancerous mutation.
                                    1. Leukemoid reaction
                                      1. Proliferation of all the normal myeloid elements is observed in the BM
                                      2. Classification of Leukemias
                                        1. According to the clinical course of the leukemia.
                                          1. According to their cell of origin in the hematopoiesis process.
                                            1. depending on which lineage is affected.
                                              1. FAB Classification of ALL
                                                1. What is Chronic Myeloid Leukemia?
                                                  1. About 15% of leukemias in adults are CML
                                                    1. Philadelphia chromosome
                                                      1. Translocation between chromosome 9 and 22.
                                                        1. sometimes found in acute lymphocytic leukemia.
                                                      2. CML Phases
                                                        1. Fatigue, weakness, night sweats
                                                          1. Diagnosis
                                                            1. Complete blood count (CBC)
                                                              1. Bone marrow biopsy
                                                                1. Bone marrow tissue sample
                                                                2. Risk Factors for CML
                                                                  1. Age
                                                                    1. Gender
                                                                      1. Congenital disorders
                                                                        1. Chemical & drugs
                                                                        2. Pathogenesis of CML
                                                                          1. caused by a reciprocal translocation t(9;22),
                                                                            1. a piece of chromosome 9 containing the ABL1 oncogene is translocated to chromosome 22 and fused to the BCR gene
                                                                              1. BCR-ABL fusion gene to take place and for tyrosine kinase activity to become irregular.
                                                                            2. Investigations of CML
                                                                              1. CBC
                                                                                1. blood smear
                                                                                  1. Bone marrow biopsy
                                                                                    1. Hypercellularity - cells of myeloid cell line precursors
                                                                                    2. Karyotypic analysis
                                                                                      1. Fluorescent in situ hybridization FISH
                                                                                        1. PCR: BCR-ABL-1 gene mapping
                                                                                        2. Treatment of CML
                                                                                          1. Imatnib (first line treatment)
                                                                                            1. Stem cell transplant
                                                                                              1. Splenectomy
                                                                                                1. Other treatments
                                                                                                  1. Treatment Complications
                                                                                                  2. Epidemiology
                                                                                                    1. Leukemia
                                                                                                      1. Males > females
                                                                                                        1. ALL ( 80%) > AML (20%) in children
                                                                                                          1. CLL affects adults > 65 years
                                                                                                            1. CML is rare in children
                                                                                                              1. Coping mechanisms
                                                                                                                1. Self Compassion
                                                                                                                  1. Achieve Balance
                                                                                                                    1. Managing thoughts
                                                                                                                      1. Financial coping :
                                                                                                                        1. Dh300,000 to Dh400,000
                                                                                                                          1. Local charities
                                                                                                                      2. CML
                                                                                                  3. Impact of the Internet on the Patient’s Understanding
                                                                                                    1. survey of 240 family physicians
                                                                                                      1. Most have observed patients seeking out “Dr. Google” at increasing rates
                                                                                                        1. 97% percent of physicians said their patients are coming into the office with incorrect information.
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