muhammed's spleen is palpable

muhammed's spleen is palpable

1. spleeen

   • histology
     • stroma
       • capsule
       • trabeculae
       • reticular network
     • parenchyma
       • white pulp
       • red pulp
   • upper left quadrant of the abdomen
   • causes of splenomegaly
     • complications
       • anemia
       • fullness
       • spleen infarction
       • frequent infection
     • hemolytic anemia
     • storage disease
       • gaucher
       • neimans pick
     • splenic vein hypertension
       • cirrhosis
     • immunologicinflammatory disorders
       • lupus
       • amyloidosis
       • sarcoidosis
     • primary or metastic neoplasm
       • leukemia
       • cancer
       • sarcoma
       • lymphoma

2. epidemiology

3. investigation

   • cbc
     • blood smear
   • biopsy
   • genetic tests
     • karyotyping
     • FISH
     • PCR

4. WBC

   • disorders
     • neoplastic
       • lymphoid
         • non- hodking's lymphoma
         • hodgkin's lymphoma
         • acute lymphoblastic leukemia
           • age under 15
           • tdt +
           • more that 20% blast cells
         • multiple myeloma
         • chronic lymphocytic leukemia
           • age to 6o+
             • smudge cells
           • proliferation of b cell. lymphoid cells
       • myeloid
         • chronic myeloproliferative disorders
           • abl-bcr...... t(9:22)
             • chronic myeloid leukemia
               • slow progressiom
               • age: 40-60
               • risk factors
                 • ionizing radiation in high doses
               • decreased LAP
               • stages
                 • chronis
                 • accelerated
                 • blast
               • treatment
                 • thyrosin kinase inhibitors
                   • chemotherapy
                     • stem cell
           • JAK 2 mutation
             • myelofibrosis
               • polycythemia vera
                 • thrombocythemia
         • acute myeloid leukemia
           • age 15-609
           • uer bodies
           • more than 20% blasts
     • non neoplastic
       • neutrophilic leukocytosis
       • eosinophilic leukocytosis
       • basophilic leukocytosis
       • monocytosis
       • lymphocytosis
       • reactive leukamoid reaction
         • nap and lap positive
         • 1500-100000 cells

5. breaking bad news

   • explain diagnosis and treatment
     • face to face
       • honesty
         • arrange review

6. emotional/finantial coping

   • family and friends
     • pt groups
   • caonsellors
   • cancer support nurses

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