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INFECTIVE ENDOCARDITIS (IE)

INFECTIVE ENDOCARDITIS (IE) It is the colonisation of the heart valves with microbiological organisms, leading to the formation of friable, infected vegetations and frequently valve injury. Types ACUTE INFECTIVE ENDOCARDITIS : caused by highly virulent organisms mainly Staphylococcus Aureus (20-30%), seeding a previously normal valve. SUBACUTE INFECTIVE ENDOCARDITIS : caused by organisms of moderate or low virulence mainly STREPTOCOCCI (60-70%), seeding an abnormal or previously injured valve. ENDOCARDITIS OCCURING IN I/V DRUG ABUSERS : caused predominantly by organisms found on the skin (S. aureus, Candida) and affecting the valves on the right side of the heart. PROSTHETIC VALVE ENDOCARDITIS : This may be early ( symptoms appearing within 60 days of valve insertion ), due to intraoperative infection of the valve or insertion of an infected valve or late ( after 60 days of valve insertion), due to late bacteremia. Predisposing factors to developement of IE Congenital cardiac anoma...
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Hodgkin's Lymphoma

Hodgkin's Lymphoma This is progressive, painless enlargement of lymphoid tissues throughout the body. EB virus involvement is thought to be one of the aetiologies. Pathological classification Lymphocyte predominant Nodular sclerosis Mixed cellularity Lymphocyte depleted Characteristically, cells with mirror image nuclei (REED-STERNBERG CELLS) are seen. Clinical features Patient present with enlarged, painless lymph nodes, alcohol induced pain pain over the enlarged nodes, and features due to the mass effect of the node. 25% have constitutional symptoms like fever, weight loss, night sweats and pruritus. Hepatosplenomegaly may also be present. Investigations Lymph node biopsy  Bone marrow biopsy Liver biopsy Lymphopenia indicates bad prognosis. Moderate eosinophilia may occur in 10 to 15% of the patients. Clinical staging (Ann-Arbor Classification) Stage 1 Involvement of a single lymph node region (1) or extra-lymphatic site (E) Stage 2 Involvement of two or more lymph node regions ...
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Rheumatoid arthritis (RA)

  Rheumatoid arthritis  is a chronic inflammatory, destructive and deforming symmetrical polyarthritis associated with systemic involvement. The individuals with HLA-D4 and HLA-DR4 are more prone to RA. It starts when your immune system, which is supposed to protect you, goes awry and begins to attack your body’s own tissues. It causes  inflammation   in the lining of your joints (the synovium). As a result, your joints may get red, warm, swollen, and painful. Symptoms of Rheumatoid Arthritis Joint pain and swelling Stiffness, especially in the morning or after you sit for a long time Fatigue Who Gets Rheumatoid Arthritis? Anyone can get RA. It affects about 1% of Americans. The disease is 2 to 3 times more common in women than in men, but men tend to have more severe symptoms. It usually starts in middle age. But young children and the elderly also can get it. Pathogenesis Synovitis (synovial cell hyperplasia, hypertrophy with CD4 lymphocytic infiltration and synovi...
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