36331925
"Mohammad’s Spleen is
Palpable"
- Anatomy and Palpation of the Spleen
- spleen is a lymphatic organ located right above the stomach in
the left hypochondriac region which corresponds to the ULQ.
- Spleen Functions:
- Filters the blood from pathogens and debris
- Controls the level of blood cells
- Removes any old or damaged red blood cells.
- Filters the blood from pathogens and debris
- Palpation of the spleen
- 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.
- 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.
- Causes of Splenomegaly
- Infections
- Mononucleosis
- Mononucleosis
- Diseases affecting the liver
- Hemolytic anemia
- Blood cancers
- How to Differentiate between leukocytosis, leukemia and leukemoid reaction?
- Leukocytosis
- Increase total number of WBCs to > 11,000/mm3.
- Common cause is neutrophilia followed by lymphocytosis.
- Pathological (tissue damage, infections & worm infestations)
- Pathological (tissue damage, infections & worm infestations)
- Common cause is neutrophilia followed by lymphocytosis.
- Increase total number of WBCs to > 11,000/mm3.
- Leukemoid reaction & leukemia
- Leukocytosis >50,000/microL when due to causes other than leukemia
- Characterized by a significant increase in early neutrophil
precursors (myelocytes, metamyelocytes)
- Leukemia: Uncontrolled production of WBCs mainly caused by cancerous mutation.
- Leukemoid reaction
- Proliferation of all the normal myeloid elements is observed in the BM
- Proliferation of all the normal myeloid elements is observed in the BM
- Classification of Leukemias
- According to the clinical course of the leukemia.
- According to their cell of origin in the hematopoiesis process.
- depending on which lineage is affected.
- FAB Classification of ALL
- What is Chronic Myeloid Leukemia?
- About 15% of leukemias in adults are CML
- Philadelphia
chromosome
- Translocation between chromosome 9 and 22.
- sometimes found in acute lymphocytic leukemia.
- sometimes found in acute lymphocytic leukemia.
- Translocation between chromosome 9 and 22.
- CML Phases
- Fatigue, weakness, night sweats
- Diagnosis
- Complete blood count (CBC)
- Bone marrow biopsy
- Bone marrow tissue sample
- Complete blood count (CBC)
- Risk Factors for CML
- Age
- Gender
- Congenital disorders
- Chemical & drugs
- Age
- Pathogenesis of CML
- caused by a reciprocal translocation t(9;22),
- a piece of chromosome 9 containing the ABL1 oncogene is
translocated to chromosome 22 and fused to the BCR gene
- BCR-ABL fusion gene to take place and for tyrosine kinase activity to become irregular.
- BCR-ABL fusion gene to take place and for tyrosine kinase activity to become irregular.
- caused by a reciprocal translocation t(9;22),
- Investigations of CML
- CBC
- blood smear
- Bone marrow biopsy
- Hypercellularity - cells of myeloid cell line precursors
- Hypercellularity - cells of myeloid cell line precursors
- Karyotypic analysis
- Fluorescent in situ hybridization FISH
- PCR: BCR-ABL-1 gene mapping
- CBC
- Treatment of CML
- Imatnib (first line treatment)
- Stem cell transplant
- Splenectomy
- Other treatments
- Treatment Complications
- Imatnib (first line treatment)
- Epidemiology
- Leukemia
- Males > females
- ALL ( 80%) > AML (20%) in children
- CLL affects adults > 65 years
- CML is rare in children
- Coping mechanisms
- Self Compassion
- Achieve Balance
- Managing thoughts
- Financial coping :
- Dh300,000 to Dh400,000
- Local charities
- Dh300,000 to Dh400,000
- Self Compassion
- Males > females
- CML
- Leukemia
- About 15% of leukemias in adults are CML
- According to the clinical course of the leukemia.
- Leukemoid reaction
- Leukemia: Uncontrolled production of WBCs mainly caused by cancerous mutation.
- Characterized by a significant increase in early neutrophil
precursors (myelocytes, metamyelocytes)
- Leukocytosis >50,000/microL when due to causes other than leukemia
- Leukocytosis
- How to Differentiate between leukocytosis, leukemia and leukemoid reaction?
- Infections
- spleen is a lymphatic organ located right above the stomach in
the left hypochondriac region which corresponds to the ULQ.
- Impact of the Internet on the Patient’s Understanding
- survey of 240 family physicians
- Most have observed patients seeking out “Dr. Google” at increasing rates
- 97% percent of physicians said their patients are coming into the
office with incorrect information.
- survey of 240 family physicians
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