I always Feel Tired


Mind Map on I always Feel Tired, created by Fatma Shwaylia on 30/04/2017.
Fatma Shwaylia
Mind Map by Fatma Shwaylia, updated more than 1 year ago
Fatma Shwaylia
Created by Fatma Shwaylia about 7 years ago

Resource summary

I always Feel Tired
  1. Causes of generalized dyspnea
    1. Acute coronary syndrome
      1. Congestive heart failure
        1. Chronic obstructive pulmonary disease
          1. Asthma
            1. Pneumothorax
              1. Pneumonia
                1. Pulmonary embolism
                  1. History Taking
                    1. Onset, duration and progress
                      1. Trauma?
                      2. Age & sex
                        1. (different Hb levels)
                        2. Associated symptoms
                          1. (pain? bleeding? ulcer? cancer?)
                          2. Occupation
                            1. Family history
                              1. (thalassemia?)
                              2. History of chronic illness
                                1. What to ask a patient when he complains of tiredness and dyspnea
                                  1. Previous CBC
                                    1. history of gastrointestinal
                                      1. (Abdominal pain , consumption )
                                      2. Changes in body weight
                                        1. Changes in bowel habits
                                          1. any complains of Abnormal urine color
                                            1. (renal and hepatic disease )
                                            2. Diet
                                              1. deficiency of (Iron,B2,Folate)
                                              2. Drug ingestion
                                                1. NSAIDS
                                              3. Investigations done
                                                1. Blood Investigations
                                                  1. CBC
                                                    1. Hb
                                                      1. A hemoglobin test measures the amount of hemoglobin in blood
                                                      2. Hematocrit
                                                        1. The ratio of the volume of red blood cells to the total volume of blood.
                                                        2. RBC count
                                                          1. measure the number of red blood cells (RBCs) in the blood
                                                          2. RBC indices
                                                            1. MCV
                                                              1. Mean corpuscular volume (MCV) is the average volume of red cells.
                                                              2. MCH
                                                                1. mean corpuscular hemoglobin (MCH) is the average mass of hemoglobin per red blood cell in a sample of blood.
                                                                2. MCHC
                                                                  1. Mean corpuscular hemoglobin concentration, a measure of the concentration of haemoglobin in a given volume of packed red blood cells
                                                                3. WBC count
                                                                  1. measure the number of white blood cells (WBCs) in the blood.
                                                                  2. Platelet count
                                                                    1. a lab test to measure how many platelets are in blood
                                                                    2. Peripheral blood film
                                                                      1. Assessing red cell size
                                                                        1. Microcytosis
                                                                          1. If red cells are smaller than normal
                                                                            1. MCV 62 fl.
                                                                            2. Macrocytosis
                                                                              1. If red cells are bigger than normal
                                                                                1. MCV 105 fl
                                                                                2. Normocytosis
                                                                                  1. Normal RBC size
                                                                                  2. Anisocytosis
                                                                                    1. If red cells show greater variation in size than normal the blood film is said to show
                                                                                      1. Severe anisocytosis; the MCV was 133 fl but the macrocytosis is not uniform
                                                                                    2. Assessing red cell shape
                                                                                      1. Poikilocytosis
                                                                                        1. If red cells show more than the normal degree of variation in red cell shape there is said to be poikilocytosis .
                                                                                          1. Severe poikilocytosis; cells vary considerably in shape but no single shape dominates.
                                                                                            1. Individual cells of a particular shape have names that identify them.Diagrammatic representation of different types of poikilocyte
                                                                                      2. Assessing red cell colour
                                                                                        1. Hypochromia
                                                                                          1. Cells that have an area of central pallor more than a third of the diameter of the cell are said to be hypochromic
                                                                                          2. Hyperchromia
                                                                                            1. more highly colored than normal
                                                                                            2. normochromic
                                                                                              1. Normal red cells are reddish-brown with approximately the central third to quarter of the cell being paler.
                                                                                              2. Anisochromasia
                                                                                                1. Cells which show a greater than normal variation in the degree of haemoglobinization are said to show anisochromasia
                                                                                                2. Polychromasia
                                                                                                  1. Red cells that have a blue or lilac tinge are said to show polychromasia (‘many colours’) are young cells, newly released from the bone marrow
                                                                                            3. Iron studies
                                                                                              1. Serum iron
                                                                                                1. Measures amount of iron bound to transferrin.
                                                                                                  1. HIGH/NORMAL
                                                                                                    1. Liver disease, sideroblastic anemia, iron overload, hemochromatosis, Thalassemia, Vit B12 deficiency
                                                                                                    2. LOW
                                                                                                      1. Iron-deficiency, Anemia of chronic disease
                                                                                                    3. Male (87-150µg/dL) Female(72-130 µg/dL)
                                                                                                    4. Total iron-binding capacity
                                                                                                      1. (240-450 ug/dL) Transferrin(2-4g/L)
                                                                                                        1. High
                                                                                                          1. Fe deficiency
                                                                                                          2. low
                                                                                                            1. Thalassemia, hemolytic anemia, sideroplastic , anemia of chronic infections
                                                                                                          3. TIBC measures how well transferrin transports iron.
                                                                                                          4. Ferritin
                                                                                                            1. major iron storage protein
                                                                                                              1. Reflects body iron stores
                                                                                                                1. high/ normal
                                                                                                                  1. Hemochromatosis(Fe overload) Chronic disease
                                                                                                              2. Males( 30-400 ug/L) Females(13-150 ug/L)
                                                                                                          5. Gel Electrophoresis
                                                                                                            1. is the movement of molecules by an electric current.
                                                                                                              1. Equipments
                                                                                                                1. α-Thalassemia trait
                                                                                                                  1. Beta thalassemia major
                                                                                                                    1. both genes are beta-0
                                                                                                                      1. absence of hemoglobin A
                                                                                                                        1. about 5 to 10% Hb A2
                                                                                                                          1. and over 90% Hb F
                                                                                                                            1. Co-inheritance of genetic factors :increasing g-chain production γ-chains will combine with excess chains resulting in high HbF.
                                                                                                                      2. Beta-thalassemia Minor
                                                                                                                        1. Hb A: 83.6% Hb A2: 6.2% Hb F: 1.1%
                                                                                                                      3. Gel electrophoresis is a laboratory method used to separate mixtures of DNA, RNA, or proteins according to molecular size.
                                                                                                                    2. Stool Analysis
                                                                                                                      1. Guaiac – Based ( hemoccult) test
                                                                                                                        1. Guaiac is a colorless compound that turns blue on exposure to hemoglobin
                                                                                                                          1. Sensitive for detecting hemoglobin in stool
                                                                                                                        2. Positive for occult blood
                                                                                                                          1. Peptic ulcer disease (gastric ulcers)
                                                                                                                            1. group of medications known as NSAIDs Ulcers that bleed slowly doesn’t show symptoms and by time the person be anemic.
                                                                                                                              1. infection with Helicobacter pylori
                                                                                                                              2. Angiodysplaslia(colon)
                                                                                                                                1. Its related to aging and breakdown of blood vessels And the most common is vascular abnormality. the bleeding occurs in the right colon usually.
                                                                                                                                2. Esophageal varices
                                                                                                                                  1. abnormal, enlarged veins in the esophgus
                                                                                                                                  2. colorectal cancer
                                                                                                                                    1. Tumor enlarge, ulceration and hemorrhage
                                                                                                                                    2. Crohn’s disease
                                                                                                                                      1. inflammation of any part of the GI Tract usually the proixmal part. The cause is unknown.
                                                                                                                                      2. Diverticular Disease
                                                                                                                                        1. occurs when pouches (diverticula ) that have developed in the wall of the large intestine (colon) bleed. This condition is called:diverticulosis.
                                                                                                                                        2. Iron Deficiency anemia
                                                                                                                                          1. One of its symptoms: Dark, tar-colored stools or blood in the stool.
                                                                                                                                            1. Symptoms
                                                                                                                                              1. Angular cheilitis
                                                                                                                                                1. Pika
                                                                                                                                                  1. Glossitis
                                                                                                                                                  2. Treatment
                                                                                                                                                    1. Pharmacological
                                                                                                                                                      1. ferrous sulphate, taken orally two or three times a day.
                                                                                                                                                        1. side effects
                                                                                                                                                          1. nausea /sickness abdominal pain heartburn constipation diarrhoea / black stools
                                                                                                                                                          2. check-up two to four weeks after the patient has started taking iron supplements to assess how well he has responded to the treatment.
                                                                                                                                                        2. Nonpharmacological
                                                                                                                                                          1. Dietary advice
                                                                                                                                                            1. Eat
                                                                                                                                                              1. watercress and curly kale
                                                                                                                                                                1. iron-fortified cereals
                                                                                                                                                                  1. wholegrain
                                                                                                                                                                    1. beans
                                                                                                                                                                      1. meat
                                                                                                                                                                        1. nuts
                                                                                                                                                                          1. Apricots
                                                                                                                                                                            1. prunes
                                                                                                                                                                              1. raisins
                                                                                                                                                                              2. Avoid
                                                                                                                                                                                1. Tea and coffee
                                                                                                                                                                                  1. Calcium, found in dietary products
                                                                                                                                                                                    1. antacids
                                                                                                                                                                                      1. Proton pump inhibitors
                                                                                                                                                                                        1. Whole grain cereals
                                                                                                                                                                                  2. Complications
                                                                                                                                                                                    1. Heart problems.
                                                                                                                                                                                      1. Problems during pregnancy.
                                                                                                                                                                                        1. Growth problems
                                                                                                                                                                                      2. Divecular bleeding
                                                                                                                                                                                        1. Large amount of blood appears in stool.
                                                                                                                                                                                2. Anemia
                                                                                                                                                                                  1. An RBC consists of
                                                                                                                                                                                    1. Hemoglobin
                                                                                                                                                                                      1. Heme
                                                                                                                                                                                        1. Iron
                                                                                                                                                                                          1. any problem causes
                                                                                                                                                                                            1. Iron deficiency anemia
                                                                                                                                                                                          2. Porphyrin
                                                                                                                                                                                            1. any problem causes
                                                                                                                                                                                              1. Sideroblastic anemia
                                                                                                                                                                                          3. Globin
                                                                                                                                                                                            1. Any problem with it leads to
                                                                                                                                                                                              1. Thalassemia
                                                                                                                                                                                                1. Sickle cell anemia
                                                                                                                                                                                            2. Other problems relating to RBCS
                                                                                                                                                                                              1. Maturation
                                                                                                                                                                                                1. Megaloblastic anemia
                                                                                                                                                                                                2. Structure
                                                                                                                                                                                                  1. Hereditary spherocytosis
                                                                                                                                                                                                  2. Anemia of chronic disease
                                                                                                                                                                                                    1. Hemolytic anemia
                                                                                                                                                                                                      1. Number
                                                                                                                                                                                                        1. Immune hemolytic anemia
                                                                                                                                                                                                          1. RBC trauma:
                                                                                                                                                                                                            1. Mechanical heart valves breaking RBC’s
                                                                                                                                                                                                              1. MICROANGIOPATHIES: Hemolytic Uremic Syndrome
                                                                                                                                                                                                              2. Hemolytic anemia due to G6PD deficiency
                                                                                                                                                                                                                1. Parasitic hemolysis.
                                                                                                                                                                                                              3. According to the MCV of the rbc, anemia can be classified to
                                                                                                                                                                                                                1. Microcytic
                                                                                                                                                                                                                  1. MCV<80 fl
                                                                                                                                                                                                                    1. Iron deficiency
                                                                                                                                                                                                                      1. Anemia of chronic disease (some cases)
                                                                                                                                                                                                                        1. Sideroblastic anemia
                                                                                                                                                                                                                      2. Normocytic
                                                                                                                                                                                                                        1. MCV 80-100 fl
                                                                                                                                                                                                                          1. Many haemolytic anaemias
                                                                                                                                                                                                                            1. Anemia of chronic disease (some cases)
                                                                                                                                                                                                                              1. After acute blood loss
                                                                                                                                                                                                                                1. Renal disease
                                                                                                                                                                                                                                  1. BM failure, post chemotherapy, infiltration by CA
                                                                                                                                                                                                                                  2. Macrocytic
                                                                                                                                                                                                                                    1. MCV>100 fl
                                                                                                                                                                                                                                      1. Megaloblastic:Vitamin B12, or Folate deficiency
                                                                                                                                                                                                                                        1. Non-megaloblastic: alcohol, liver disease, aplastic anaemia
                                                                                                                                                                                                                                    2. Anemia symptoms
                                                                                                                                                                                                                                      1. a condition in which there is a deficiency of red cells or of haemoglobin in the blood, resulting in pallor and weariness.
                                                                                                                                                                                                                                        1. Insufficient oxygen transport
                                                                                                                                                                                                                                          1. Tissue hypoxia
                                                                                                                                                                                                                                            1. Brain
                                                                                                                                                                                                                                              1. somnolence and fatigue
                                                                                                                                                                                                                                              2. Heart
                                                                                                                                                                                                                                                1. Chest pain
                                                                                                                                                                                                                                                  1. Angina
                                                                                                                                                                                                                                                    1. heart attack
                                                                                                                                                                                                                                                    2. Lung
                                                                                                                                                                                                                                                      1. Dyspnea and low respiratory reserve
                                                                                                                                                                                                                                                      2. Skeletal muscles
                                                                                                                                                                                                                                                        1. Weakness and fatigue
                                                                                                                                                                                                                                                2. Life Span of Red Blood Cells
                                                                                                                                                                                                                                                  1. Erythropoiesis in the bone marrow(after birth)
                                                                                                                                                                                                                                                    1. Bone marrow is the flexible tissue found in the hollow interior of bones
                                                                                                                                                                                                                                                      1. produces the cellular elements of the blood, including platelets, red blood cells and white blood cells.
                                                                                                                                                                                                                                                        1. yellow marrow (consisting mainly of fat cells).
                                                                                                                                                                                                                                                          1. red marrow (consisting mainly of hematopoietic tissue)
                                                                                                                                                                                                                                                            1. Myeloid stem cells
                                                                                                                                                                                                                                                              1. give rise to erythrocytes, eosinophils, baso, neutrophils, monocytes and megakaryocytes
                                                                                                                                                                                                                                                              2. lymphoid stem cells
                                                                                                                                                                                                                                                                1. develop in the bone marrow
                                                                                                                                                                                                                                                          2. Differentiation of stem cells to mature cells is associated with:
                                                                                                                                                                                                                                                            1. Decreasing cell size
                                                                                                                                                                                                                                                              1. Hemoglobin production
                                                                                                                                                                                                                                                                1. Gradual decrease and loss of all cell organelles
                                                                                                                                                                                                                                                                  1. Changing cytoplasmic staining
                                                                                                                                                                                                                                                                    1. Condensation and eventual extrusion of the nucleus
                                                                                                                                                                                                                                                                  2. after RBCs' degradation
                                                                                                                                                                                                                                                                    1. Iron metabolism
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