Lecture on Medical and Communicable Disorders

Introduction

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Key Topics Covered

1. Measles Diagnosis

• Symptoms in children: Cough, runny nose, red rash, fever, bluish-white spots on buccal mucosa (Koplik spots).
• Diagnosis: Measles (Rubeola); 11-month-old likely not vaccinated yet (vaccination starts at 12-15 months).
• Differential diagnosis: Mumps (salivary gland swelling), Allergic reaction (rash not typical), Varicella (vesicular rash).

2. Sickle Cell Disease Crisis Prevention

• Key strategy: Drink at least 64 ounces of water daily to prevent dehydration, a known trigger.
• Other triggers: Stress, cold weather, high altitude.
• Incorrect strategies: Self-managing flu symptoms, engaging in cold sports, bottling up emotions.

3. Idiopathic Thrombocytopenia (ITP) Treatment

• Case study: Patient with prolonged nosebleed and history of ITP.
• Treatment: IVIG to rapidly increase platelet levels.
• Incorrect treatments: Desmopressin (for hemophilia), Thrombin (coagulation aid), Factor VIII (also for hemophilia).

4. Electrocardiogram Changes and Electrolyte Imbalances

• Hypercalcemia: Prolonged QT interval is an indicator.
• Hypocalcemia: Inverted T-waves.
• Ventricular tachycardia: Linked to hypomagnesemia.
• Prolonged PR interval: Associated with hypokalemia.

5. Disseminated Intravascular Coagulation (DIC) Characteristics

• Symptoms: Microvascular clots, decreased platelets, impaired hemostasis.
• Misconception: Increased clotting factors are not a characteristic of DIC.

6. Immunocompromised Patients

• Scenario: Presents with fever greater than 100.4 degrees.
• Significance: Fever is a major indicator of infection for immunocompromised individuals.
• Lesser indicators: Neutrophil count, purulent drainage, localized infection signs.

7. Sickle Cell Crisis RBC Shape

• Shape: Crescent (half-moon) shape during crisis.
• Effect: Causes rigidity, blocks blood flow, leads to hypoxemia.

8. Hypomagnesemia Indicators

• Primary symptom: Muscle tetany.
• Contrast with hypermagnesemia: Muscle weakness, prolonged QT interval, loss of deep tendon reflexes.

9. Administration of IV Magnesium

• Key action: Administer infusion slowly to prevent cardiac arrest.
• Incorrect actions: Routine narcotic doses, infrequent vital monitoring.

10. Hypermagnesemia Case Indicators

• Symptoms: Prolonged QT interval, absent reflexes, low blood pressure, bradycardia, low respirations.

11. TB Skin Test Results

• Non-HIV patient: Induration more than 10 mm is a positive result.
• Immunocompromised: Greater than 5 mm induration is considered positive.
• Clarification needed: Close proximity to TB patient may fall under 5 mm category.

12. Adrenal Crisis Electrolyte Imbalance

• Common abnormality: Hyperkalemia due to Addison's disease (low mineralocorticoids).

13. Mononucleosis Management

• Understanding: Avoid strenuous and contact sports for safety due to splenomegaly.
• Misunderstandings: No sharing utensils, no vaccine available, not inherited.

14. Priority for Leukemia Patients

• Nursing priority: Place patient in a private room to avoid infection.

Conclusion

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