Normal: 119 : 90 mmHg
Prehypertension 99–90 : 120–139 mmHg
Stage 1 140–159 : 90–99 mmHg
Stage 2 ≥160 ^ ≥100 mmHg
Consequences and complications of hypertension: hardening of the arteries, peripheral vascular disease, strokes, heart attacks, heart failure, left ventricular hypertrophy, chronic kidney failure, hypertensive retinopathy, encephalopathy, shortened life expectancy.
Symptoms, signs, clinical manifestations, clinical features: mild to moderate essential hypertension: usually asymptomatic; accelerated hypertension: headache, drowsiness, confusion, vision disorders, nausea and vomiting, hypertensive encephalopathy, fatigue, blurred vision, nosebleeds, and facial paralysis.
History: a personal medical history or a previous history, a past medical history, a history of the present illness, a history of presenting complaint, a childhood illness history, an allergic history, a family history, a pregnancy history, an obstetric history, a gynecological history, a medication or drug history, an immunization history, a psychiatric history, an occupational history, a social history, a surgical history, an environmental history, a sexual history, a diet history, an alcohol consumption history, a smoking history, a sedentary life history, etc.
Physical examination: measurement of blood pressure.
Instrumental evaluation: tests to identify the underlying cause: renal tests: microscopic urinalysis, proteinuria, serum BUN (blood urea nitrogen) and/or creatinine; endocrine tests: serum sodium, potassium, calcium, TSH (thyroid-stimulating hormone); metabolic tests: fasting blood glucose, total cholesterol, HDL and LDL cholesterol, triglycerides; other tests: hematocrit, electrocardiogram, and Chest X-ray.
Commonly used prescription drugs: ACE inhibitors such as ramipril; angiotensin II receptor antagonists (e.g., candesartan; calcium channel blockers such as nifedipine; diuretics (e.g. hydrochlorothiazide (aHCTZ)); diuretics such a furosemide or low-dosages of spironolactone; alpha blockers such as terazosin; beta blockers such as metoprolol;
direct renin inhibitors such as aliskiren;
Prevention: lifestyle changes: weight reduction and regular aerobic exercise (e.g., walking), reducing dietary sugar intake, reducing sodium (salt) in the diet, diet rich in fruits and vegetables and low-fat or fat-free dairy products, reducing stress, relaxation therapy, such as meditation and other mindbody relaxation techniques, reducing environmental stress such as reduction of high sound levels and over-illumination, etc.
Phonetic exercise: atrial fibrillation [‘eitriəl ,faibri’lei∫n], heart rhythm [‘ha:t ‘riðm], arrhythmia [ə’riθmiə], chamber [‘t∫eimbə], chambers [‘t∫eimbəz], upper atria [‘Λpə ‘eitriə], epidemiology [‘epi,di:mi’ ləd3i], pressure [‘pre∫ə], mitral [‘maitrəl], congestive heart failure [kən’d3estiv ‘ha:t ‘feiljə], thyroid [‘θair id], esophageal [,is ’fəd3i:əIl, version [‘və:∫n]
Make a report on atrial fibrillation according to the plan below:
Definition: the most common cardiac arrhythmia (abnormal heart rhythm); involves the two upper chambers (atria) of the heart.
Epidemiology of AF: Approximately 2.2 million individuals in the United States and 4.5 million in the European Union.
Causes: hypertension (high blood pressure); coronary artery disease, mitral stenosis, mitral regurgitation, hypertrophic cardiomyopathy (HCM), pericarditis, congenital heart disease, previous heart surgery, lung diseases (such as pneumonia, lung cancer, pulmonary embolism), excessive alcohol consumption, hyperthyroidism, carbon monoxide poisoning, a family history, etc.
Symptoms, signs, clinical manifestations, clinical features: rapid and irregular heart rates, palpitations, exercise intolerance, shortness of breath; AF may be asymptomatic in many cases.
History: a personal medical history, a family history, a medication history, an occupational history, a professional history, an environmental history, etc.
Physical examination: observation, palpation, percussion, and auscultation
Instrumental evaluation: ECG, transthoracic echocardiogram, trans-esophageal echocardiography, cardiorespiratory monitoring, routine bloodwork, evaluation of the heart rate response to exercise, exercise stress testing, a chest x-ray, , and other studies.
Treatment: anticoagulation medications: aspirin, heparin, warfarin, and dabigatran; intravenous magnesium; beta blockers, calcium channel blockers, cardiac glycosides; cardioversion: a noninvasive conversion of an irregular heartbeat to a normal heartbeat using electrical or chemical means.
“Your heart is in great shape, but I’d recommend transplanting all of your other body parts”.
“You have a heart murmur and I’m starting to hear your liver and kidneys complain too “.
- “De Do Do Do, De Da Da Da…” – “I think your heart’s sending out an S.O.S.”
Doctor to his patient, “Irregular heartbeat. Due to irregular exercise.”
Doctor to his patient, “An aspirin a day will help prevent a heart atack if you have it for lunch instead of a cheeseburger.”
A man needing a heart transplant is told by his doctor that the only heart available is that of a sheep. The man finally agrees and the doctor transplants the sheep heart into the man.
A few days after the operation, the man comes in for a checkup.
The doctor asks him "How are you feeling?"
The man replies "Not BAAAAD!"
ECG of a student - NORMAL HEART- _,"._/\_,"._/\,_,",_/\_
EXAM TIME- _/|_/|_/|_/|_/|_/|_ &
WHEN RESULTS ARE ANNOUNCED- _____________
Toaster – a defibrillator.
A's and B's - apnea and bradycardia...sometimes, particularly when referring to a neonate
Phonetic exercise: blood [bl d], circulating tissue [‘s :kjuleitiŋ ‘tisju:], supply [sə’plai], oxygen [‘ ksid3ən], glucose [‘glu:kous], fluid [‘fluid], plasma [‘plæzmə], carbon dioxide [‘k bən dai’ ksaid], lactic acid [‘læktik ‘æsid], marrow [‘mærou], erythrocytes [i’ri:θrəsaits], leukocytes [‘lju:kəsaits], thrombocytes [‘θr mbəsaits], platelets [‘pleitlets], proteins [‘proutiinz], albumin [‘ælbju:min], immunoglobulins [i,mju:nəu’globjulin], anaemia [ə’ni:miə], leukaemia [lju:’ki:miə], haemophilia [,hi:mou’filiə]
Make a report on the blood according to the plan below:
Definition: circulating tissue.
Functions: f irst(ly), to supply nutrients (oxygen, glucose) and constitutional elements to tissues and second(ly), to remove waste products (such as carbon dioxide and lactic acid).
Location: in blood vessels (arteries, veins, capillaries).
Production: produced in the bone marrow
Structure: fluid plasma and cells.
The main three groups of blood cells: red blood cells or erythrocytes; white blood cells or leukocytes and platelets or thrombocytes.
Erythrocytes: red blood cells; not true cells, lack a nucleus; 96% of blood cells; normal erythrocyte count: 4.0-5.0 million erythrocytes per cubic millimeter; the main functions: to contain haemoglobin and to distribute oxygen.
Leukocytes: white blood cells; true cells, have a nucleus; 3.0% of blood cells; normal leukocyte count: 4,000-9,000 leukocytes per cmm; the main function: to fight against infections.
Thrombocytes: blood platelets; not true cells; 1% of blood cells; normal thrombocyte count: 180,000- 320, 000 per cmm.; function: blood clotting, or coagulation
Blood plasma: 96% of water, 4% of blood plasma proteins: albumin; blood clotting factors; immunoglobulins, and other components
Volume: 4.7 - 5 liters; plasma: 2.7-3 liters
The most common diseases: anaemia, leukaemia, haemophilia, von Willebrand disease, etc.
Phonetic exercise: blood [blΛd], anemia [əˈniːmiə], leukaemia [lju:’ki:miə], haemophilia [,hi:mou’filiə], deficiency [di’fi∫ənsi], disorder [dis’ :də], excessive [ik’sesiv], diagnosis [,daiə‘gn usis], diagnose [‘daiəgn uz], evaluate [i’væljueit], evaluation [i,vælju’ei∫n] refer [ri’f :], cause [‘k :z], factors [‘fæktəz], complications [,k mplikei∫nz], signs [sainz], features [‘fi:t∫əz], manifestations [,mænifes‘tei∫nz], auscultation [, :skə‘tei∫n], percussion [pə‘kΛ∫ən], observation [, bzə‘vei∫n], epidemiology [‘epi,di:mi’ ləd3i], cyanosis [,saiə’nəusis], hemoglobin [,hi:m ’gloubin], tachycardia [,tæki’ka:diə], disturbance [dis’tə:bəns], characterized [‘kærəktəraizd]
Make a report on anemia according to the plan below:
Definition: a decrease in normal number of red blood cells; the most common disorder of the blood.
Classification: three main classes of anemia: excessive blood loss (such as a hemorrhage), excessive blood cell destruction (hemolysis) or deficient red blood cell production (ineffective hematopoiesis).
Symptoms, signs, clinical manifestations, clinical features: weakness, fatigue, general malaise, sometimes poor concentration, shortness of breath, dyspnea, on exertion, palpitations, angina, intermittent claudication of the legs, symptoms of heart failure, pallor (pale skin), jaundice, bone deformities, a fast heart rate (tachycardia), cardiac enlargement,
behavioral disturbances in children, reduced scholastic performance in children of school age, restless legs syndrome, swelling of the legs or arms, chronic heartburn, vague bruises, vomiting, increased sweating, and blood in stool.
Evaluation: History: a personal medical history or a previous history, a past medical history, a history of the present illness, a history of presenting complaint, a childhood illness history, an allergic history, a family history, a pregnancy history, an obstetric history, a gynecological history, a medication or drug history, an immunization history, a psychiatric history, an occupational history, a social history, a surgical history, an environmental history, a diet history, an alcohol consumption history, a smoking history, a sedentary life history, etc.
Physical examination: observation, percussion, palpation, and auscultation.
Instrumental evaluation: complete blood counts, RBC count, hemoglobin level tests, hematocrit, examination of a blood smear using a microscope, a quantitative measure of the bone marrow's production of new red blood cells, vitamin B12, renal function tests, etc.
Treatment: oral iron supplementation, vitamin C, vitamin B 12; blood transfusion may be necessary, etc.
Complications: diminished capability to perform physical activities, hypoxemia, rigid fingernails, cold intolerance, behavioral disturbances in children, etc.
Phonetic exercise: blood [blΛd], anemia [əˈniːmiə], leukaemia [lju:’ki:miə], haemophilia [,hi:mou’filiə], marrow [‘mær u], platlets [‘pletlets], leukocytes [‘lju:kəsaits], increase [‘inkri:s], chronic [‘kr nik], acute [ə‘kju:t], myelogenous [,maiə’d3i:nəs], abnormalities [,æbn :’mælitiz], characterized [‘kæktəraizd], occur [ə‘k :], predisposition [,pri:’dispə‘z∫n], epidemiology [‘epi,di:mi’ ləd3i]
Make a report on leukemia according to the plan below:
Definition: white blood; a cancer of the blood or bone marrow characterized by an abnormal increase of blood cells, usually leukocytes (white blood cells).
Epidemiology: 256,000 children and adults around the world develop some form of leukemia annually, and 209,000 die from it.
Classification: acute leukemia: characterized by the rapid increase of immature blood cells; chronic leukemia: characterized by the excessive build up of relatively mature, but still abnormal, white blood cells; lymphoblastic or lymphocytic leukemias and myeloid or myelogenous leukemias:
Epidemiology of different types of leukemia:
acute lymphoblastic leukemia: the most common type of leukemia in young children;
chronic lymphocytic leukemia: occurs in adults over the age of 55;
acute myelogenous leukemia: occurs more commonly in adults than in children, and more commonly in men than women;
chronic myelogenous leukemia: mainly in adults
Causes: different causes: mutations in the DNA, natural and artificial ionizing radiation, a few viruses, some chemicals, use of tobacco, a genetic predisposition, chromosomal abnormalities or other genetic conditions, etc.
Symptoms, signs, clinical manifestations, clinical features: lack of blood platelets, red blood cell deficiency, anemia, pallor, feeling sick, fevers, chills, night sweats, flu-like symptoms, fatigue, an enlarged liver and spleen, headaches, etc.
History: a personal medical history, a family history, a medication history, an occupational history, an environmental history, a surgical history, etc.
Physical examination: observation, palpation, percussion, and auscultation.
Instrumental evaluation: repeated complete blood counts, a bone marrow examination, lymph node biopsy, blood chemistry tests, X-ray, MRI, or ultrasound, etc.
Treatment: pharmaceutical medications, a multi-drug chemotherapy, radiation therapy, bone marrow transplantation, CNS prophylaxis (preventive therapy) to stop the cancer from spreading to the brain and nervous system in high-risk patients, splenectomy, chemotherapy, and bone marrow transplantation, etc.
Phonetic exercise: Blood vessels [‘bl d ‘veselz], circulatory system [,s :kjə’leitri ‘sistəm ‘sistim], tubes [‘tju:bz], transport [træns’p :t, ‘trænsp :t], throughout [θru’aut], arteries [‘a:triz] , veins [veinz], capillaries [kə’pilriz], endothelium [,endo’θi:liəm], layer [leiə], adventitia [,ædven’ti∫iə], average [‘ævrid3], exchange [iks’t∫eind3], atherosclerosis [, θər sklə’r usis], phlebitis [fli’baitis]
Make a report on blood vessels according to the plan below:
Definition: part of the circulatory system, a system of tubes.
Function: to transport blood throughout the body.
Types of blood vessels: arteries, veins, capillaries.
Structure: the endothelium, the subendothelial connective tissue, a layer of vascular smooth muscles, a further layer of connective tissue known as the adventitia.
Length: Laid end to end, all the blood vessels in an average human body: 62,000 miles.
The main functions: arteries: to carry blood from the heart; veins: to carry blood to the heart; capillaries: gas exchange.
The most common diseases: atherosclerosis, DVT or deep vein thrombosis, phlebitis, thrombophlebitis.
Phonetic exercise: atherosclerosis [,æθər sklə’r usis], blood vessels [‘bl d ‘veselz], circulatory system [,s :kjə’leitri; ‘s :kjə’lətri; ‘sistəm ‘sistim], arteries [‘a:triz] , veins [veinz], capillaries [kə’pilriz], phlebitis [fli’baitis], hypertension [,haipə’ten∫n], hypertensive [,haipə’tensive], diabetes [,daiə’bi:ti:z], cessation [səs’ei∫n], plaques [pla:ks; plæks]
Make a report on atherosclerosis according to the plan below:
Definition: a condition in which an artery wall thickens as the result of a build-up of fatty materials such as cholesterol.
Causes: formation of multiple plaques within the arteries, low-density lipoprotein, cholesterol plaques, an infection of the vascular smooth muscle cells, cytomegalovirus (CMV) infection, etc.
Risk factors, risk sitiations, risk groups: hyperlipidemia, hypertension and cigarette smoking; diabetes or impaired glucose tolerance, dyslipoproteinemia, an LDL:HDL ratio greater than 3:1, advanced age, male sex, close relatives who have had some complication of atherosclerosis (e.g. coronary heart disease or stroke), genetic abnormalities, obesity, a sedentary lifestyle, stresses or symptoms of clinical depression, hyperthyroidism (an over-active thyroid), short sleep duration, etc.
Symptoms: often asymptomatic.
Evaluation: History: a personal medical history, a family history, a drug history, an occupational history, an environmental history, etc.
Physical examination: observation and palpation.
Instrumental evaluation: microphotography of arterial walls, coronary calcium scoring by CT, lipoprotein analysis, blood pressure measurement, methods to elevate blood glucose, etc.
Treatment: non-pharmaceutical means: cessation of smoking, regular exercises, reducing carbohydrate intake, diet low in fats, dietary supplements of Omega-3 oils; pharmaceutical means: statins, low dose aspirin, vitamin C, ACE inhibitors, diuretics, beta blockers, folic acid; invasive angioplasty procedures, bypass surgery, etc.
Prophylaxis: low-dose aspirin, statins, warfarin, etc.
DEEP VEIN THROMBOSIS
Phonetic exercise: phlebitis [fli’baitis], thrombophlebitis [,θrombəfli:’baitis], veins [veinz], occur [ə‘kə:], thrombus [‘θr mbəs], swelling [‘sweliŋ], intravenous [,intrə’vi:nəs], miscarriage [mis’kærid3], genes [‘d3i:nz], prevalence [‘prevələns], occurrence [ə’kΛrəns; ə’k :rəns], morbidity [m :’biditi, m :’bidəti], mortality [m :’tæləti], epidemiology [‘epi,di:mi’ ləd3i], disorder [dis’so:də; diz’o::də]
Make a report on deep vein thrombosis according to the plan below:
Definition: the formation of a blood clot ("thrombus") in a deep vein, a form of thrombophlebitis (inflammation of a vein with clot formation).
Epidemiology, death rates, and mortality rates: about 1 per 1000 persons per year. It is estimated that approximately 350,000 to 600,000 Americans each year suffer from DVT and pulmonary embolism and at least 100,000 deaths may be directly or indirectly related to these diseases. DVT is much less common in the pediatric population. About 1 in 100,000 people under the age of 18 experiences deep vein thrombosis.
In pregnant women, it has an incidence of 0.5 to 7 per 1,000 pregnancies, and is the second most common cause of maternal death in developed countries after bleeding.
Causes: recent surgery or hospitalization, advanced age, obesity, infection, immobilization, tobacco usage and air travel ("economy class syndrome"), a combination of immobility and relative dehydration, tendency to develop thrombosis, etc.
Risk factors: use of estrogen-containing hormonal contraception, recent long flying, intravenous drug use, a history of miscarriage, (which is a feature of several disorders that can also cause thrombosis). In the case of long-haul flying, recent studies have shown that risk of DVT is higher in travellers who smoke, who are obese, or are currently taking contraceptive pills. A family history can reveal a hereditary factor in the development of DVT. Approximately 35 percent of DVT patients have at least one hereditary thrombophilia, including deficiencies in the anticoagulation factors protein C,etc.
Symptoms, signs, clinical manifestations, clinical features: pains, swelling, redness of the leg, dilation of the veins, cyanosis of the legs, etc.
History: a personal medical history, a family history, a drug history, an occupational history, a flying history, a driving history, etc.
Physical examination: observation, percussion, palpation, and auscultation.
Instrumental examination: venography, blood tests: complete blood count, coagulation studies, liver enzymes, renal function tests, electrolytes, imaging the leg veins, Doppler ultrasonography, ultrasound scanning of the leg veins, etc.
Дата: 2018-09-13, просмотров: 24.