Part of me…In words

Friday, Yes another friday. THe reason why i like friday is because there will be two days on holiday following. But not for this time. Today is the last day for our lecturer to teach us and she had been with us for 3 weeks. 3 weeks is considerably short, but i dunno why that feeling just came out. Frankly, i know i am emotional. Haha. Anyway, looking forward to next week, with our new lecturer. She is the kind of lecturer who likes to talk abd lecture us about haematological diseases, not like others who ‘enjoy’ ask us to read ourself.

Today we discussed about TTP and plenty of ECG. What are the findings in pericarditis? Okay… THere are diffuse ST elevation which is concave (saddle shaped) and commonly associated with atrial flutter. This is because pericarditis causes irritation of the atrium leading to conduction abnormalities. If there are no other co-morbidities, the atrial flutter will resolve with pericarditis.

Thrombotic thrombocytopenic purpura (TTP). First thing to say is that it is a medical emergency. Seen in older patient as contrast to haemolytic Uraemic syndrome (HUS). Basically these 2 diseases has a quite similar presentation, so its better to compare to both of them.
Patho: Acquired presence of antibody that cross react with metalloprotease or absence of the protease which function to cleaves multimer of von Willebrand Factor, vWF. This causes vWF multimer to be activated causing platelet aggregation and fibrin deposition in small vessels. 2 consequences: 1. Fibrin deposition causing formation of fibrin mesh and microangiopathic hemolytic anaemia (MAHA) 2. Formation of mirothrombi due to activation of clotting cascade.
5 clinical Features: 1. MAHA 2. Neuro sequelae (TIA, Stroke, seizure) 3. Renal imparment 4. Fever 5. thrombocytopenia
Cause: assoc with drugs(clopidogrel), HIV, Autoimmune disease like SLE
Ix: PBF to look for schistiocytes, target cells, coag profile is normal, protease assay
Mx: plasmapheresis, cryoprep depleted FFP

well that’s it la about TTP. oh ya, HUS has a cause and its more common in paediatric age group with features of acute renal failure, thrombocytopenia, and MAHA. Cause is E. coli H0157. presenting with previous history of diarrhoeal disease.

I’m in Green box now, while writing this. I like to sing, but cant sing well, that’s why i just sing rarely in K. thats wat i wanna comment about Karaoke….

Coming weekend is time to concentrate in OH.