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The most common problem which confronts the fish health biologists as they examine the spleen has to blood pressure medication prices 25mg toprol xl mastercard do with its size basic arrhythmias 7th edition 100 mg toprol xl with mastercard, color and texture blood pressure exercise program toprol xl 100 mg for sale. There appears to arteria radicularis magna purchase 50mg toprol xl with amex be two sizes, too large and too small, many color variations, bright red to very dark purple and lumpy bumpy to smooth. The splenic pulp consists of sinusoidal phagocytic tissues in which large numbers of red blood cells may be held and hematopoietic tissue is supported. The teleost spleen is different than the mammalian spleen in that red and white pulp areas are diffuse and not very discrete, and the connective tissue framework is not prominent. When the red pulp area is filled with red blood cells, the white pulp nodules, primarily lymphatic tissue, can be seen easier. Thymus the thymus is a paired organ, an ovoid pad of lymphoid tissue situated subcutaneously in the dorsal commissure of the operculum. It arises from primordia associated with the epithelium of the pharyngeal pouches. Comparative studies of thymic morphology in fish have been made and have found that its life-span was very different in different species, involuting in lower teleosts before sexual maturity but surviving, and even growing, for several years after maturity in higher teleosts. In histological section, the thymus is an aggregate of small lymphocytes with a fibrous capsule and supporting cells. These are spherical or oval eosinophilic bodies present in the medulla of the thymus gland which increase in size and number with age. It is then pumped from the dorsal aorta to the arteries, down to the peripheral capillaries before it is returned via the venous system. The heart in teleosts has four chambers through which blood flows in simple succession: sinus venosus, atrium, ventricle, and bulbous arteriosus. Walls of the heart are made of 3 layers: inner endocardium, myocardium (muscle),and the outer pericardium. Deoxygenated venous blood enters the sinus venosus from the ductus cuvieri, or common cardinal veins, and main veins. There are no inlet valves and the sinus is so small that it can hardly be recognized as a discrete cardiac chamber. The wall is thin, composed mainly of collagenous connective tissue, although in some species it is muscular and contractile. Through two sino-atrial valves the blood passes into the atrium which lies dorsal to the ventricle. The atrium has a thin wall, and muscular trabeculae traverse the lumen in a loose meshwork. The endothelial lining is therefore large in area and has a phagocytic activity as part of the reticuloendothelial system. Here there are two layers of muscle including a distinct outer compact layer of muscle and an inner spongy layer with numerous trabeculae. The thickness of the compact layer is variable, being almost absent in less active species such as pleuronectides (such as flounders). Coronary vessels run over the outside of the ventricle, supplying the compact muscle while the spongy muscle obtains most of its oxygen supply from the venous blood in the lumen. Individual muscle fibers are approximately 6 fim in diameter, about half that of mammalian muscle. The fibers are similar to mammalian ones with intercalated discs between individual cells. From the ventricle the blood is passed into the bulbous arteriosus through a pair of valves. It has a complex structure but acts basically as a passive elastic reservoir which smoothes the pressure pulse from the ventricle and maintains blood flow during ventricular diastole. The elastic tissue of the bulbous is very different in structure from that of the elastica of arteries. The visceral epicardium encloses the heart in the pericardial space while the second layer called the parietal or outer pericardial sac lines the pericardial cavity. The arteries afferent to the gills have a normal vertebrate arterial structure made up of three wall layers: adventitia on the outside, media and intima. The endothelium of the intima is comprised of flattened cells which can usually be distinguished only by their dark-staining nuclei which bulge into the lumen. Contiguous cells interdigitate so that the endothelium forms a continuous surface. There is a fine basement membrane beneath the endothelium, but this is visible only with the electron microscope. The intima is largely elastic tissue and the media is composed of elastic tissue laminae, or fibers, with smooth muscle cells in between. The major veins are large in diameter and pressures are low, being less than 10 mm Hg. Capillaries consist of a single layer of endothelium in order for exchanges of oxygen, nutrients, and waste products to occur. The lymph volume is about four times the blood volume and its composition is almost identical to that of blood plasma. In the main bulk of the myomeres, or segments of muscle, the lymphatic circulation is the only circulation available since there are no significant blood vessels in the white muscles. There are various lymph propulsors or lymph hearts along the length of the major lymphatic vessels which aid lymph return during breathing movements. Lymph is collected from all areas through a system of vessels, sinuses, and ducts which can appear as empty spaces, or often indiscernible if collapsed, in sections. These layers are present in different amounts throughout the gastrointestinal tract. Their digestive function is confined to selection, seizure and orientation of food for transfer to the stomach. Chewing and pre-digestion, found in mammals, are not usually a function of the mouth of the teleost. The lining of the buccal cavity consists of a stratified mucoid epithelium on a thick basement membrane with a very condensed dermis binding it to bone or muscle. Its combination of an epithelial lining containing abundant mucous cells which provide for more lubrication and the extensive longitudinal folds of the inner surface, allows for easy swallowing of awkward food particles. It functions to churn contained material, mixing it thoroughly with the digestive juices that it secretes. Typically it is a sigmoid, highly distensible, sac with numerous folds in its lining. The stomach can be divided into 3 sections: cardiac (anterior), transitional (mid), and pyloric (posterior). All sections are highly muscular with the cardia demarcating the change from the striated muscle of the anterior digestive tract to the smooth muscle occurring distally. There are a number of layers of muscle, including a muscularis mucosa with adjacent layers of connective tissue often containing large numbers of eosinophilic granule cells. The gastric mucosa itself is very mucoid, with numerous glands at the bases of the folds. Found in many species, but notably in the salmonids where they may number 70 or more. Their histological and histochemical features resemble those of the intestine rather than the stomach. It may be straight, sigmoid or coiled, depending on the shape of the abdominal cavity. It has a simple, mucoid, columnar epithelium, overlying a submucosa often with abundant eosinophilic granule cells and limited by a dense muscularis mucosa and fibroelastic layer. The anterior portion of the intestine functions to 1) transport food material from the stomach to the posterior intestine, 2) to complete digestion by the secretion of enzymes from its walls and from accessory glands, 3) to absorb the final products of digestion into blood and lymph vessels in its wall, and 4) to secrete certain hormones. The posterior intestine functions include fluid absorption, mucous secretion (more goblet cells), and some digestion which is accomplished by enzymes present in food material, and excretion. Rectum the rectum has a thicker muscle wall than that of the intestine and its lining is highly mucigenic. The most common sites for it are as scattered islands of secretory tissue interspersed among the fat cells in the mesentery of the pyloric caeca, as a subcapsular investment, or part, of the spleen and as an external layer around the hepatic portal vein.

Rather heart attack effects 25mg toprol xl with visa, the product must also meet all other program requirements to blood pressure xanax withdrawal best 50 mg toprol xl be determined to hypertension jnc guidelines toprol xl 100mg sale be a drug or biological blood pressure medication guidelines buy toprol xl 25 mg otc. Combination drugs are also included in the definition of drugs if the combination itself or all of the therapeutic ingredients of the combination are included, or approved for inclusion, in any of the above drug compendia. Drugs and biologicals are considered approved for inclusion in a compendium if approved under the established procedure by the professional organization responsible for revision of the compendium. The prior statutory language referred to those drugs “which cannot be self-administered. That is, if a drug is available in both oral and injectable forms, the injectable form of the drug must be medically reasonable and necessary as compared to using the oral form. For certain injectable drugs, it will be apparent due to the nature of the condition(s) for which they are administered or the usual course of treatment for those conditions, they are, or are not, usually self-administered. For example, an injectable drug used to treat migraine headaches is usually self-administered. On the other hand, an injectable drug, administered at the same time as chemotherapy, used to treat anemia secondary to chemotherapy is not usually self-administered. Administered the term “administered” refers only to the physical process by which the drug enters the patient’s body. It does not refer to whether the process is supervised by a medical professional (for example, to observe proper technique or side-effects of the drug). Injectable drugs, including intravenously administered drugs, are typically eligible for inclusion under the “incident to” benefit. With limited exceptions, other routes of administration including, but not limited to, oral drugs, suppositories, topical medications are considered to be usually self-administered by the patient. Usually For the purposes of applying this exclusion, the term “usually” means more than 50 percent of the time for all Medicare beneficiaries who use the drug. For example, if a drug has three indications, is not self-administered for the first indication, but is self administered for the second and third indications, and the first indication makes up 40 percent of total usage, the second indication makes up 30 percent of total usage, and the third indication makes up 30 percent of total usage, then the drug would be considered usually self-administered. Reliable statistical information on the extent of self-administration by the patient may not always be available. Absent evidence to the contrary, presume that drugs delivered intravenously are not usually self-administered by the patient. Absent evidence to the contrary, presume that drugs delivered by intramuscular injection are not usually self-administered by the patient. Absent evidence to the contrary, presume that drugs delivered by subcutaneous injection are self-administered by the patient. If the condition were longer term, it would be more likely that the patient would self-administer the drug. For example, if the drug is administered once per month, it is less likely to be selfadministered by the patient. However, if it is administered once or more per week, it is likely that the drug is self-administered by the patient. Definition of Acute Condition For the purposes of determining whether a drug is usually self-administered, an acute condition means a condition that begins over a short time period, is likely to be of short duration and/or the expected course of treatment is for a short, finite interval. A course of treatment consisting of scheduled injections lasting less than 2 weeks, regardless of frequency or route of administration, is considered acute. By the Patient the term “by the patient” means Medicare beneficiaries as a collective whole. The determination is based on whether the drug is self-administered by the patient a majority of the time that the drug is used on an outpatient basis by Medicare beneficiaries for medically necessary indications. In evaluating whether beneficiaries as a collective whole self-administer, individual beneficiaries who do not have the capacity to selfadminister any drug due to a condition other than the condition for which they are taking the drug in question are not considered. For example, an individual afflicted with paraplegia or advanced dementia would not have the capacity to self-administer any injectable drug, so such individuals would not be included in the population upon which the determination for self-administration by the patient was based. Note that some individuals afflicted with a less severe stage of an otherwise debilitating condition would be included in the population upon which the determination for “self-administered by the patient” was based; for example, an early onset of dementia. Beneficiary Appeals If a beneficiary’s claim for a particular drug is denied because the drug is subject to the “self-administered drug” exclusion, the beneficiary may appeal the denial. Therefore, physicians or providers may charge the beneficiary for an excluded drug. Provider and Physician Appeals A physician accepting assignment may appeal a denial under the provisions found in Pub. That is, while a physician’s office visit may not be reasonable and necessary in a specific situation, in such a case an injection service would be payable. Drugs Treated as Hospital Outpatient Supplies In certain circumstances, Medicare pays for drugs that may be considered usually selfadministered by the patient when such drugs function as supplies. This is the case when the drugs provided are an integral component of a procedure or are directly related to it, i. Except for the applicable copayment, hospitals may not bill beneficiaries for these types of drugs because their costs, as supplies, are packaged into the payment for the procedure with which they are used. Listed below are examples of when drugs are treated as supplies and hospitals should bill Medicare for the drug as a supply and should not separately bill the beneficiary. This does not refer to the patient’s eye drops that the patient uses preand postoperatively. The following are examples of when a drug is not directly related or integral to a procedure, and does not facilitate the performance of or recovery from a procedure. In many of these cases the drug itself is the treatment instead of being integral or directly related to the procedure, or facilitating the performance of or recovery from a particular procedure. These two lists of examples may serve to guide hospitals in deciding which drugs are supplies packaged as a part of a procedure, and thus may be billed under Part B. The charge, if any, for the drug or biological must be included in the physician’s bill, and the cost of the drug or biological must represent an expense to the physician. Drugs and biologicals furnished by other health professionals may also meet these requirements. Payment may also be made for blood fractions if all coverage requirements are satisfied and the blood deductible has been met. For specific guidelines on coverage of Group C cancer drugs, see the Medicare National Coverage Determinations Manual. In the case of drugs used in an anti-cancer chemotherapeutic regimen, unlabeled uses are covered for a medically accepted indication as defined in §50. The following guidelines identify three categories with specific examples of situations in which medications would not be reasonable and necessary according to accepted standards of medical practice: 1. Not for Particular Illness Medications given for a purpose other than the treatment of a particular condition, illness, or injury are not covered (except for certain immunizations). Injection Method Not Indicated Medication given by injection (parenterally) is not covered if standard medical practice indicates that the administration of the medication by mouth (orally) is effective and is an accepted or preferred method of administration. For example, the accepted standard of medical practice for the treatment of certain diseases is to initiate therapy with parenteral penicillin and to complete therapy with oral penicillin. Excessive Medications Medications administered for treatment of a disease and which exceed the frequency or duration of injections indicated by accepted standards of medical practice are not covered. For example, the accepted standard of medical practice in the maintenance treatment of pernicious anemia is one vitamin B-12 injection per month. They will use the guidelines to screen out questionable cases for special review, further development, or denial when the injection billed for would not be reasonable and necessary. Antigens must be administered in accordance with the plan of treatment and by a doctor of medicine or osteopathy or by a properly instructed person (who could be the patient) under the supervision of the doctor. The purpose of the reasonable supply limitation is to assure that the antigens retain their potency and effectiveness over the period in which they are to be administered to the patient. In the absence of injury or direct exposure, preventive immunization (vaccination or inoculation) against such diseases as smallpox, polio, diphtheria, etc. However, pneumococcal, hepatitis B, and influenza virus vaccines are exceptions to this rule. For services furnished on or after May 1, 1981 through September 18, 2014, the Medicare Part B program covered pneumococcal pneumonia vaccine and its administration when furnished in compliance with any applicable State law by any provider of services or any entity or individual with a supplier number. Coverage included an initial vaccine administered only to persons at high risk of serious pneumococcal disease (including all people 65 and older; immunocompetent adults at increased risk of pneumococcal disease or its complications because of chronic illness; and individuals with compromised immune systems), with revaccination administered only to persons at highest risk of serious pneumococcal infection and those likely to have a rapid decline in pneumococcal antibody levels, provided that at least 5 years had passed since the previous dose of pneumococcal vaccine. Those administering the vaccine did not require the patient to present an immunization record prior to administering the pneumococcal vaccine, nor were they compelled to review the patient’s complete medical record if it was not available, relying on the patient’s verbal history to determine prior vaccination status. Effective July 1, 2000, Medicare no longer required for coverage purposes that a doctor of medicine or osteopathy order the vaccine. Therefore, a beneficiary could receive the vaccine upon request without a physician’s order and without physician supervision.

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The standard deviation of a distribution is defined as the square root of the variance blood pressure medication wiki generic 50mg toprol xl with mastercard, = v(x2)-(x) 2 Pictures Pictorial statistics present the numerical data that have been collected in graphs or charts blood pressure when pregnant cheap 100 mg toprol xl with amex, creating a picture of the data blood pressure medication side effects fatigue discount toprol xl 100 mg line. Summary Healthcare-associated infections are those that occur among patients who receive care in hospitals or other health care facilities lidocaine arrhythmia discount toprol xl 25 mg amex. The eficacy of infection surveillance and control programs in preventing nosocomial infections in U. Health care-associated infection: moving behind headlines to 38 Epidemiology of Health care-Associated Infections clinical solutions. The course provides an introduction to applied epidemiology and biostatistics; it consists of six lessons: Introduction to Epidemiology, Summarizing Data, Measures of Risk, Displaying Public Health Data, Public Health Surveillance, and Investigating an Outbreak. Continuing education credits are ofiered to physicians, nurses, veterinarians, pharmacists, certified public health educators, and other professionals. An early example of surveillance is the investigation of a cholera outbreak in London in 1854 by John Snow. With the ‘germ theory of disease’ still to be postulated, he used rudimentary microbiology, chemistry, epidemiologic, and statistical analysis to identify the Broad Street water pump as the cause. He recommended removing the pump handle, thereby preventing further consumption of the contaminated water and stopping the outbreak. Surveillance is ofendefined as: the systematic observation of the occurrence and distribution of disease within a population and of the events that increase or decrease the risk of the disease occurrence. Prevalence surveillance can be as efiective as continuous surveillance; it is particularly useful in low-resource countries. If limited to collection and dissemination of data, the efiect will be short lived; it must be followed by relevant interventions. The strength of surveillance is that it identifies a problem and enables focusing of scarce resources by providing information on the size of the problem and relevant risk factors. Establishing a Framework for Surveillance A sound infection surveillance framework6 includes: 1. Reporting and using surveillance information To assist with this framework, consider the following questions: 1. Is it necessary to survey the entire health care facility or only focus on high-risk patient groups/procedures or commonly performed proceduresfi Recent historical data or a rapid prevalence survey may help focus surveillance activities. How will a standard, validated, and reproducible definition of infection be appliedfi If not, then consider a one-o point prevalence survey as a basis for surveillance activities. Types of Surveillance Continuous surveillance or periodic prevalence surveys Continuous surveillance is typically undertaken prospectively; it is the best way to establish trends and distribution of disease incidence. Simple measures of age and average length of stay (as a measure of severity of illness) may be useful proxy risk factors. Extrinsic risk factors are easier to control; these include hand hygiene, pre-operative length of stay, duration of surgical procedures, surgical teams that include trainees, and pre-operative skin preparation. Positive laboratory reports do not always indicate infection, and negative ones do not always mean infection is absent. Whichever method is used, it is important to use the same definitions and data collection method over time so that any change in the rates is not due to changes in methodology. Prevalence surveys are a good substitute for continuous surveillance, performed ideally on a single day or week. They can be used to target areas or services where infection rates are suspected to be high. Performing a point prevalence survey of processes biannually of all patients with a central line to establish whether clinicians are practicing aseptic insertion techniques may be appropriate. If prevalence and incidence audits were taken simultaneously, the prevalence rate would be higher than the incidence rate for common infections and similar to it for rare infections. Alert-based surveillance Alert-based surveillance means monitoring specific clinical conditions, such as infectious diarrhoea, tuberculosis, surgical site infections caused by Group A Streptococcus, or meningococcal meningitis. Because this activity is not systematic and relies on data from the laboratory or alerts from ward sta, it does not measure true incidence. Alert organism surveillance is the continuous monitoring of specific microorganisms. Isolation of a microorganism is not necessarily indicative of infection; failure to isolate a microorganism does not prove the absence of infection. Alert organism surveillance is simple and cheap, and, in computerised laboratories, can be automated. Post-discharge surveillance A common question of surveillance programmes is: Do you need to include post-discharge surveillance in the surveillance planfi However, the method chosen to survey discharged patients depends on the patient population (such as their likelihood of returning to their surgeon for follow-up). An alternative is to send a questionnaire to the patients’ medical practitioners; however this can pose logistic problems and may be costly. Regardless, it will be important to highlight outcome data from inpatient or readmission versus that from post-discharge surveillance. Where post-discharge surveillance is inconsistently employed across facilities that routinely make inter-facility comparisons, post-discharge data should be excluded from rates made public. Important surveillance methodology considerations Whenever a measurement is taken, there will inevitably be an error; errors may be random or systematic. Random errors can never be eliminated, only reduced by increasing the sample size. This means the application of valid definitions is reliably performed in the same way every time. If the arrows hit to the side of the target each time then the results would be reliable but not valid. This includes infections acquired in the health-care facility but appearing after discharge and also occupational infections among health-care workers of the facility”. Infection rates will vary according to the definition used and comparisons should only be made if the same set of definitions is used and applied in exactly the same manner. Hence, it is ofen more meaningful to use surveillance data from your own institution to measure trends over time, either to alert sta of increasing problems or to monitor the efiectiveness of interventions. Published rates largely come from high resource health care systems12 and may not be appropriate for others. Rates are always calculated with the numerator (number of persons with the infection or condition) divided by the denominator (number of persons at risk for the infection). The more precisely the denominator captures the potentially preventable risk elements the beter. Denominator data should refiect the patient population at-risk in the numerator. The prevalence rate is the proportion of patients in the population who have an active infection at the time of the survey. Six patients were surveyed, and two had an active infection: Patient-3 developed a new infection during the surveillance period and Patient-6 had an existing infection. Therefore, the number of infections (numerator) would be two for six (denominator) patients. Patient-5 acquired an infection which is not included because it appeared afer the last day of the survey. Incidence density is a measure of cumulative incidence divided by a unit of risk exposure that is in common for all at-risk patients but that will difier for each patient. For example, the unit of risk may be 24 hours of exposure to an intravascular device; so each patient will have a difierent number of risk units, i. For example, in intensive care units, central catheters generally remain in situ for 4 days but many remain longer. Because incidence density rates are based on an accumulation of person-time units with a statistically rare numerator. This is a measure of the total patient-days in which a high-risk device was used, and can be used as a marker for risk of infection.

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Leiomyoma: estrogen sinsitive: changes size during pregnancy & menopause Bone Tumors 407 hypertension 2 nigerian movie toprol xl 25mg low cost. Dilated (Congestive) Cardiomyopathy: Alcohol blood pressure medication kalan 50mg toprol xl with mastercard, BeriBeri blood pressure bottom number is high toprol xl 50 mg on-line, Cocaine use blood pressure chart low to high discount toprol xl 25mg without a prescription, Coxsackie B, Doxorubicin 424. Multiple Sclerosis: (Charcot Triad = nystagmus, intention tremor, scanning speech) 463. Medulloblastoma of brain (cerebellum) Neoplasm – Child (2 most common) Neoplasm of the West 507. Prolactinoma (2nd – Somatotropic “Acidophilic” Adenoma) Pituitary Tumor Place for Primary Squamous 522. Pleomorphic Adenoma (Mixed) – 90% localized to the parotid Tumor Primary Hyperparathyroidism 525. Middle cerebral aa: contralateral paralysis; aphasias; motor & sensory loss Site of Metastasis 537. Mixed Cellularity (versus: lymphocytic predominance, lymphocytic depletion, nodular sclerosis) Type of Non-Hodgkin’s 552. Fetal Alcohol Syndrome Malformation Pharmacology Autonomic Nervous System Epinephrine 1. Prevent the releasal of Ach from vesicles @ the pre synaptic nerve ending bungarotoxin 36. At low doses Txt Shock= dilates renal and mesenteric aa= maintain urine output Esmolol 11. Txt Malignant Ventricular Arrhythmias but causes passing catecholamine release that can aggravate arrhythmias briefly Nimodipine 23. K dependent gamma carboxylation of clotting factors= anticoagulation state Heparin 30. Can cause ventricular extrasystoles & Malignant hyperthermia & Hepatitis Nitric Oxide 48. Irreversible (-)r of lactamases, but ot of transpeptidase = use w/ a lactamase sensitive penicillin Piperacillin 16. Pre Txt w/ Pyridoxine (Vit B6) can prevent peripheral neuritis‘ Pyrantel Pamoate 22. Long duration of action = given once every 3-4 weeks for Txt of Syphilis Praziquantel 48. Accumulates in keratinized layers of the skin = used in dermatomycoses infections Mefloquine 55. Can block/reduce Methotrexate = ^ folic acid via a reduced folate Bleomycin toxicities 87. Folic acid analog that (-) tetrahydrofolate synthesis by (-) dihydrofolate reductase 105. Wernicke-Korsakoff = ataxia; confusion; confabulation; memory loss Fibrinous Pericarditis 131. Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men Nephritic signs 146. Seen in organs w/ end arteries limited collateral circulation) = heart, lung, kidney, spleen Caseation necrosis 179. Associated w/ malignant hypertension, polyarteritis nodosa, immune mediated vasculitis Fat necrosis 183. Tapeworm infection causing megaloblastic anemia by consuming large amount of vit B12 in the host Subacute Bacterial 229. Usually accompanied w/ long history of severe hypertension, also seen w/ familial hyperlipidemia, atherosclerotic disease, Marfan’s Collagen disease 240. Right ventricular strain, associated w/ right ventricular hypertrophy Acute Cor Pulmonale 242. Malignant neoplasm of the lymph nodes causing pruritis; fever = looks like an acute infection 265. Lipid laden macrophages seen in villi of Erythroblastosis Fetalis Page 22 Retinopathy of Prematurity 283. Pt has recurrent infections & diarrhea w/ ^ respiratory tract allergy & autoimmune diseases 285. If Mono is treated w/ Ampicillin, thinking that it is a strep pharyngitis, a rash will occur. Anemia; splenomegaly; platelets > 1 million = extensive extra-medullary hematopoiesis Multiple Myeloma 306. Gonorrhoeae, but if unresponsive to penicillin think of Bacteroides species Duret Hemorrhages 315. Cri di Chat: mental retardation; small head; wide set eyes; low set ears; cat-like cry Trisomy 13 323. Patau’s: small head & eyes; cleft lip & palate; many fingers Acute Cold Agglutinaiton 324. Benign laryngeal polyps associated w/ smoking & overuse of the voice Paraseptal emphysema 334. Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax Page 23 Superior Vena Cava Syndrome 335. Osteoporosis: Albers-Schonberd Disease = inspite of ^d bone density, many fractures = v osteoclasts C5a 358. Hunter’s Syndrome (L-Iduronosulfate Sulfatase deficincy, ^ Heparan/Dermatan Sulfate) 403. Incomplete fusion of maxillary prominence w/ median nasal prominence Cleft Palate 419. Pituitary tumor usually calcified Lateral Geniculate Nucleus Inolved in Vision relay Medial Geniculate Body Involved in Hearing relay Lung Development Glandular: 5-17 fetal weeks Canalicular 13-25 fetal weeks Terminal Sac 24 weeks to birth Alveolar period birth-8yoa st 21-22 days Heart’s 1 Beat Foregut Mouth! Splenic flexure of the Colon supplied by Superior Mesenteric artery Hindgut Splenic Flexure! No dorsiflexion or eversion of the foot Diract inguinal hernia Goes through superficial inguinal ring. Seen @ 3rd week: Ecto, Meso & Endo Gastrula @ 2nd week: forms the primitive streak, from which Meso & Endo come from. Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine) Fanconi’s Syndrome 434. Nitroglycerin Industrial exposure > tolerance during week > loss of tolerance during weekend > headache, ach, dizziness upon re-exposure Orange Body Fluids 464. Plasmodium; Toxoplasma ghondi; Babesin; Leishmania; Trypanosoma Cruzi Obligate Non Intracellular Parasites 90. Mycoplasma pneumoniae has fried egg colonies on Eaton agar (needs cholesterol) Mycoplasma 94. Target shaped skin lesions w/ a black center and red ring surrounding the lesion Endospores G(+) 114. Gram (+): Bacillus & Clostridium – made up of dipicolinate & Keratin Multi Brain Abscess 115. Pseudomembranous colitis (can be precipitated by clindamycin/ampicillin) Spastic Paralysis toxin 136. Inhibits viral replication (translation or transcription) Acute Hemorrhagic Conjunctivitis 163. Dengue: Group B Togavirus, from the Arbovirus, transmitted by mosquitos HbsAg 169. Replicates, differentiates and releases elementary bodies to infect other cells 183. Wucheria bancrofti (infection aka elephantitis & wucheriasis Freshwater lake infection 192. Transmits Trypanoma cruzi (Chagas’ disease): Romana’s Sign Schistosoma Haematobium causes 194. Babesia (clinically rembles malaria) & Borelia burgdorferi Nantucket Protozoa 198. Babesia microti: Babesiosis & Borrelia burgdorferi: Lyme Disease Infection by Anopheles Mosquito 203. Trophozoites Motile trophozoites Fever Fever Spike Vivax Benign 3 degrees 48h Enlarged Host Cell Ovale Benign 3 degrees 48h Oval/Jagged Malariae 4 degrees of Malarial 72hrregular Crescent Falciparum Malignant 3 degrees Miscellaneous 1. However, the authors, editors and publishers are not responsible for errors and omissions or any consequences from application of the information in this booklet and make no warranty, expressed or implied, with respect to the content of the publication. Tel: (0)30 2304 211 / (0)30 2313 843 Designed by Logical Designs Tel: (0)30 2251 626, (0)244 215 903 E-mail: logicandy@gmail. They usually reflect the consensus on the optimal treatment options within a health system and aim at beneficially influencing prescribing behaviour at all levels of care.


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