Download Core Clinical Cases in Basic Biomedical Science by Samy Azer PDF

By Samy Azer

Middle scientific circumstances courses you to consider the sufferer as an entire, instead of as a series of unconnected signs. With its functional strategy strongly associated with underlying idea, the sequence integrates your wisdom with the realities of dealing with medical difficulties, and offers a foundation for constructing problem-solving talents.

The middle parts of undergraduate examine are lined in a logical series of studying actions: every one is through a close solution, in addition to a couple of short-answer inquiries to assist you perform for examinations within the first to 3 years of your path. Mechanisms displaying the pathogenesis of a sickness procedure and causes of the medical findings and laboratory investigations were included.

This ebook offers a hugely based case background textual content masking all the very important parts of the undergraduate biomedical sciences, within the kind of forty five medical eventualities. every one situation is by means of 8 to 10 questions and solutions with specified suggestions.

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Paracetamol toxicity is caused by a metabolite, which constitutes only 5 per cent of paracetamol metabolites. This metabolite is known as N-acetyl-p-benzoquinonimine and when it is produced in large amounts it binds to glutathione (GSH) to form a GSH conjugate. After a toxic dose of paracetamol, total hepatic GSH is depleted by as much as 90 per cent and, as a result, the metabolite covalently binds to cysteine groups on intracellular protein, forming paracetamol–protein adducts. It is believed that these protein adducts play a central role in centrilobular hepatic necrosis observed in paracetamol overdose At the usual therapeutic doses, this metabolite (N-acetyl-pbenzoquinonimine) is detoxified in the liver by conjugating with sulphhydryl group of glutathione and excreted in urine as mercapturic acid and cysteine conjugates 42 Liver A plasma paracetamol concentration of 55 μg/ml at 20 h after ingestion indicates high probability of hepatic injury and the need to start treatment with N-acetylcysteine.

He also has mild discomfort in the right upper quadrant of his abdomen. Further questions reveal that, about 6 weeks ago, he was working with an international aid organization in Eritrea as a volunteer nurse. He is not on any medications apart from the anti-malarial drugs that he received for his travel overseas. He used to drink an Eritrean herbal drink three times daily. He denies intravenous drug use. He had sexual intercourse with two girls while over there. On examination, both his sclerae are yellowish in colour.

The liver cells are variable in size and some cells show evidence of fatty change (steatosis) where the cytoplasm displays fat globules and as a result the nucleus is pushed to one side. There are also Mallory’s hyaline bodies (accumulation of filaments and cytoskeleton of damaged cells) in the cytoplasm of some liver cells. A few neutrophils infiltrating the injured liver cells are seen. 3 – My urine is as dark as tea. Dr MacLeod arranges for some blood and urine tests for Graham. 10. 0 Serum bilirubin (total) (μmol/L) 100 0–19 Serum ALP (IU/L) 180 0–120 Serum AST (IU/L) 4707 0–40 Serum ALT (IU/L) 4855 0–55 Serum albumin (g/L) 37 35–50 Prothrombin time (s) 26 18–22 Hb (g/L) 9 Screening for hepatitis Hepatitis C virus (HCV) antibody: negative HCV RNA polymerase chain reaction (PCR): negative Hepatitis B surface antigen (HBsA): negative Hepatitis B core antibody (HBcA): negative Serum IgM anti-HBV: negative Serum IgM anti-hepatitis A virus (anti-HAV): ++++ Serum IgG anti-HAV: +.

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