Common diseases and syndromes in people

Case definition: P. falciparum asexual parasitemia in the peripheral blood smear or by RDT. Symptomatic malaria without signs of severity or evidence of vital organ dysfunction.  Case scenario:                       A 45-year-old man is brought into your clinic with a sudden high fever, headache, vomiting, diarrhea, yellow sclera, and dark urine. He is drowsy but is able to answer your questions. On physical examination, his temperature is 103 Fahrenheit, pulse is 110/minute, respiratory rate is 36/min and he is jaundiced. There is some tenderness over the liver, but the abdomen is otherwise soft and non-tender. Lab tests accompanying him is as follows: Hb 9.8 gm/dl, W.B.C: 5,500/cm, platelets: 40,000/cm, total bilirubin: 5.8 mg/dl, ALT:65 I.U, Blood urea 65 mg/dl, S.creatinine: 4.5 mg/dl, MP shows trophozoites of P.falciparum. Warning signs: Hyperpyrexia Prostration Impaired consciousness Respiratory disease Multiple convulsio...

 Case scenario:                           A patient is treated for P.vivax with chloroquine. He felt well for the next 10 days, after which fever and shivering happened again. This time no parasites were seen on the smear. but you suspect malaria due to inadequate treatment. An episode of malaria within 14 days of the previous episode can be due to improper treatment of malaria from the underdosing, wrong or sub-standard drugs, poor absorption, inadequate timing of treatment, or drug resistance.  However, if a patient returns after 14 days then the first-line drug should be repeated since this represents possibly a new infection or relapse. Possibly, the drug concentration in blood was insufficient to suppress all parasites 

 Case scenario:                 A middle-aged woman has proved P.vivax around twice in the last 6 months and was treated adequately but continues to have periodic febrile episodes. She produces several recent lab reports of CBC, chemistry, and lipid profiles, all of which are normal, as is her examination. The malarial smear shows that trophozoites of P.vivax and G6PD are normal. P.vivax parasites may hide in the liver cells and remain silent for months or years. Using antimalarials against acute vivax malaria targets only schizonts in the peripheral blood and not liver parasites. Hypnozoites may be sent into the blood intermittently to produce intermittent fever and anemia. People who have been positive for P.vivax malaria in the past should be treated to prevent relapse or chronic malaria. 

 Case Scenario:                       A 25-year-old man, previously well, presents with high-grade fever for the past 5 days. Before the fever his body begins to hurt, He has headaches, vomiting, and abdominal discomfort. He feels very cold for a while, then his body shivers, his teeth clatter, after which the temperature rises to 104 degrees Fahrenheit. He sweats profusely, and then the fever subsides. For the rest of the day, he feels well. This happens every day or every other day. In your clinic the patient appears to be well, his body temperature is normal as so is his physical examination. Cost-effective lab test:                                 MP smears or/and RDT Treatment:          Please refer to your local doctor/family physician

Introduction:                    1) Malaria is a common and often life-threatening disease and a major risk in the tropical and subtropical countries                  2) The 2 most common types of species of malaria are P.vivax and P.falciparum. Life cycle:         1) Mosquitoes insert sporozoites in the skin when they bite humans through the skin.            2) Within 30 minutes the sporozoites enter the bloodstream and the lymphatic system of hepatocytes and where they differentiate to form hepatic sporozoites which burst and release merozoites into the bloodstream and invade erythrocytes.            3) merozoites develop from ring form to trophozoites and then to schizonts over 48 hours.            4) After breaking down the host RBC membrane 24 to 32 erythrocytes enter the bloodstr...

  Case Scenario:                           A 44-year-old man with fatigue, abdominal pain, and fever. His physical examination shows splenomegaly. his WBC count is 2 K/microliter(normal value is 4-11K/microliters), Hemoglobin 7.6 mg/dl(13.5-17.5 mg/dl, platelets are 65 K/microliter(150-200K/microliter), Aspartate aminotransferase is 634U/L(11-47U/L), Alanine aminotransferase is 164U/L(7-53 U/L), Total bilirubin 4.6 mg/dl(0.3-11 mg/dl), Direct bilirubin 3.1 mg/dl(0-0.3 mg/dl), Fibrinogen is 100 mg/dl(170-400 mg/dl), Ferritin is 123,000 ng/ml(22-322 ng/dl). Epidemiology:                           The occurrence of pancytopenia is more in males than in females. The male to female ratio is 1.56:1. Out of the case, studies for megaloblastic anemia 63.6% are males and 33.4% are females. likewise in aplastic anemia, 61.2% of the cases were female and 38.9% of t...

Introduction:                          Fever is a temporary increase in your body temperature above the normal temperature variations. The name of feeling feverish is not the same thing as having a real fever and a real fever if felt then it should be measured by a thermometer. Normal Variation:                            There is a normal daily diurnal variation of 0.5 degrees centigrade(0.9- degrees Fahrenheit) between the morning and evening and t is most in the late afternoon and early evening and the lowest in the early morning. A persistent morning temperature of more than 37.2 degrees centigrade(greater than 98.9 degrees Fahrenheit) or an evening temperature is more than 37.7 degrees centigrade(more than 99.9 degrees Fahrenheit) would define a fever. There are many factors that cause a difference in the normal body temperature variation such as ge...