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Wednesday, December 23, 2009

NUCLEAR MEDICINE-IN VITRO, IN VIVO TESTS-LESSON 141



NUCLEAR MEDICINE TESTS:
Procedures: Nuclear medicine physicians use two types of tests in the diagnosis of disease. In vitro (in the test tube) procedures and in vivo (in the body) procedures. In vitro procedures involve analysis of blood and urine specimens using radioactive chemicals. For example, a radioimmunoassay (RIA) is an in vitro procedure that combines the use of radioactive chemicals and antibodies to detect hormones and drugs in a patient's blood. The test allows the detection of minute amounts of drug. RIA is used to monitor the amount of digitalis, a drug used to treat heart disease in a patient's bloodstream and can detect hypothyroidism in newborn infants.
In vivo tests trace the amounts of radioactive substances within the body. They are given directly to a patient to evaluate the function of an organ or to image it. For example, in tracer studies a specific radionuclide is incorporated into a chemical substance and administered to a patient. The combination of the radionuclide and a drug or chemical is called a radiopharmaceutical or labeled compound. Each radiopharmaceutical is designed to concentrate in a certain organ. The organ can then be imaged with the radiation given off by the radionuclide.
A sensitive external detection instrument called scintillation scanner is used to determine the distribution and localization of the radiopharmaceutical in various organs, tissues, and fluids. The amount of radiopharmaceutical at a given location is proportional to the rate at which the gamma rays are emitted. Nuclear medicine studies depict the physiological behavior (how the organ works) rather than the specific anatomy of an organ.
The procedure of making an image to follow the distribution of radioactive substance in the body is called scanning. The image produced is called scan. Uptake refers to the rate of absorption of the radiopharmaceutical into an organ or tissue.
Radiopharmaceuticals may be administered by many different routes to obtain a scan of a specific organ in the body. For example, in the case of a lung scan, the radiopharmaceutical can be given intravenously (perfusion studies, which rely on passage of the radioactive compound through the capillaries of the lungs) or by inhalation of xenon-133 gas (ventilation studies), which fills the air sacs (alveoli). The combination of these tests permits sensitive and specific diagnosis of clots in the lung (pulmonary emboli).
In the next lesson we will learn about diagnostic procedures that utilize radionuclides. Okay.

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Tuesday, December 22, 2009

CARDIAC-LAB CHEMISTRY-LESSON 140


Cardiac
Creatine phosphokinase (CK) - Levels rise 4 to 8 hours after an acute MI, peaking at 16 to 30 hours and returning to baseline within 4 days
25-200 U/L
32-150 U/L

CK-MB CK isoenzyme - It begins to increase 6 to 10 hours after an acute MI, peaks in 24 hours, and remains elevated for up to 72 hours.
<>400 IU/L

(LDH) Lactate dehydrogenase - Total LDH will begin to rise 2 to 5 days after an MI; the elevation can last 10 days.
140-280 U/L

LDH-1 and LDH-2 LDH isoenzymes - Compare LDH 1 and LDH 2 levels. Normally, the LDH-1 value will be less than the LDH-2. In the acute MI, however, the LDH 2 remains constant, while LDH 1 rises. When the LDH 1 is higher than LDH 2, the LDH is said to be flipped, which is highly suggestive of an MI. A flipped pattern appears 12-24 hours post MI and persists for 48 hours.
LDH-1 18%-33%
LDH-2 28%-40%


SGOT - will begin to rise in 8-12 hours and peak in 18-30 hours
10-42 U/L


Myoglobin - early and sensitive diagnosis of myocardial infarction in the emergency department This small heme protein becomes abnormal within 1 to 2 hours of necrosis, peaks in 4-8 hours, and drops to normal in about 12 hours.
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In the next lesson we will learn about nuclear medicine. Okay.

Monday, December 21, 2009

THYROID LAB CHEMISTRY-LESSON 139


Thyroid Chemistry:  THYROXINE (T4) - Increased levels are found in hyperthyroidism, acute thyroiditis, and hepatitis. Low levels can be found in Cretinism, hypothyroidism, cirrhosis, malnutrition, and chronic thyroiditis.
Normal Adult Range: 4 - 12 ug/dl
Optimal Adult Reading: 8 ug/dl

T3-UPTAKE - Increased levels are found in hyperthyroidism, severe liver disease, metastatic malignancy, and pulmonary insufficiency. Decreased levels are found in hypothyroidism, normal pregnancy, and hyperestrogenis status.
Normal Adult Range: 27 - 47%
Optimal Adult Reading: 37 %

FREE T4 INDEX (T7)
Normal Adult Range: 4 - 12
Optimal Adult Reading: 8

THYROID-STIMULATING HORMONE (TSH) - produced by the anterior pituitary gland, causes the release and distribution of stored thyroid hormones. When T4 and T3 are too high, TSH secretion decreases, when T4 and T3 are low, TSH secretion increases.
Normal Adult Range: .5 - 6 miliIU/L.

In the next post we will learn about Cardiac Lab Chemistry. Okay.

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Sunday, December 20, 2009

GENERAL LAB VALUES-ELECTROLYTES IN HUMAN BODY-LESSON 138


Electrolyte Values: SODIUM - Sodium is the most abundant cation in the blood and its chief base. It functions in the body to maintain osmotic pressure, acid-base balance and to transmit nerve impulses. Very Low value: seizure and Neurologic Sx.
Normal Adult Range: 135-146 mEq/L
Optimal Adult Reading: 140.5

POTASSIUM - Potassium is the major intracellular cation. Very low value: Cardiac arythemia.
Normal Range: 3.5 - 5.5 mEq/L
Optimal Adult Reading: 4.5

CHLORIDE - Elevated levels are related to acidosis as well as too much water crossing the cell membrane. Decreased levels with decreased serum albumin may indicate water deficiency crossing the cell membrane (edema).
Normal Adult Range: 95-112 mEq/L
Optimal Adult Reading: 103

CO2 (Carbon Dioxide) - The CO2 level is related to the respiratory exchange of carbon dioxide in the lungs and is part of the bodies buffering system. Generally when used with the other electrolytes, it is a good indicator of acidosis and alkalinity.
Normal Adult Range: 22-32 mEq/L
Optimal Adult Reading: 27
Normal Childrens Range - 20 - 28 mEq/L
Optimal Childrens Reading: 24

CALCIUM - involved in bone metabolism, protein absorption, fat transfer muscular contraction, transmission of nerve impulses, blood clotting and cardiac function. Regulated by parathyroid.
Normal Adult Range: 8.5-10.3 mEq/dl
Optimal Adult Reading: 9.4

PHOSPHORUS - Generally inverse with Calcium.
Normal Adult Range: 2.5 - 4.5 mEq/dl
Optimal Adult Reading: 3.5
Normal Childrens Range: 3 - 6 mEq/dl
Optimal Childrens Range: 4.5

ANION GAP (Sodium + Potassium - CO2 + Chloride) - An increased measurement is associated with metabolic acidosis due to the overproduction of acids (a state of alkalinity is in effect). Decreased levels may indicate metabolic alkalosis due to the overproduction of alkaloids (a state of acidosis is in effect).
Normal Adult Range: 4 - 14 (calculated)
Optimal Adult Reading: 9

CALCIUM/PHOSPHORUS Ratio
Normal Adult Range: 2.3 - 3.3 (calculated)
Optimal Adult Reading: 2.8
Normal Children’s range: 1.3 - 3.3 (calculated)
Optimal Children’s Reading: 2.3

SODIUM/POTASSIUM
Normal Adult Range: 26 - 38 (calculated)
Optimal Adult Reading: 32

In the next post we will see about the Common lab values of liver enzymes. Okay.

Saturday, December 19, 2009

COMMON LAB VALUES-BLOOD-LESSON 137


Hematology Values
HEMATOCRIT (HCT)
Normal Adult Female Range: 37 - 47%
Optimal Adult Female Reading: 42%
Normal Adult Male Range 40 - 54%
Optimal Adult Male Reading: 47
Normal Newborn Range: 50 - 62%
Optimal Newborn Reading: 56

HEMOGLOBIN (HGB)
Normal Adult Female Range: 12 - 16 g/dl
Optimal Adult Female Reading: 14 g/dl
Normal Adult Male Range: 14 - 18 g/dl
Optimal Adult Male Reading: 16 g/dl
Normal Newborn Range: 14 - 20 g/dl
Optimal Newborn Reading: 17 g/dl

MCH (Mean Corpuscular Hemoglobin)
Normal Adult Range: 27 - 33 pg
Optimal Adult Reading: 30

MCV (Mean Corpuscular Volume)
Normal Adult Range: 80 - 100 fl
Optimal Adult Reading: 90
Higher ranges are found in newborns and infants

MCHC (Mean Corpuscular Hemoglobin Concentration)
Normal Adult Range: 32 - 36 %
Optimal Adult Reading: 34
Higher ranges are found in newborns and infants

R.B.C. (Red Blood Cell Count)
Normal Adult Female Range: 3.9 - 5.2 mill/mcl
Optimal Adult Female Reading: 4.55
Normal Adult Male Range: 4.2 - 5.6 mill/mcl
Optimal Adult Male Reading: 4.9
Lower ranges are found in Children, newborns and infants

W.B.C. (White Blood Cell Count)
Normal Adult Range: 3.8 - 10.8 thous/mcl
Optimal Adult Reading: 7.3
Higher ranges are found in children, newborns and infants.

PLATELET COUNT
Normal Adult Range: 130 - 400 thous/mcl
Optimal Adult Reading: 265
Higher ranges are found in children, newborns and infants

NEUTROPHILS and NEUTROPHIL COUNT - this is the main defender of the body against infection and antigens. High levels may indicate an active infection.
Normal Adult Range: 48 - 73 %
Optimal Adult Reading: 60.5
Normal Children’s Range: 30 - 60 %
Optimal Children’s Reading: 45

LYMPHOCYTES and LYMPHOCYTE COUNT - Elevated levels may indicate an active viral infections such as measles, rubella, chickenpox, or infectious mononucleosis.
Normal Adult Range: 18 - 48 %
Optimal Adult Reading: 33
Normal Children’s Range: 25 - 50 %
Optimal Children’s Reading: 37.5

MONOCYTES and MONOCYTE COUNT - Elevated levels are seen in tissue breakdown or chronic infections, carcinomas, leukemia (monocytic) or lymphomas.
Normal Adult Range: 0 - 9 %
Optimal Adult Reading: 4.5

EOSINOPHILS and EOSINOPHIL COUNT - Elevated levels may indicate an allergic reactions or parasites.
Normal Adult Range: 0 - 5 %
Optimal Adult Reading: 2.5

BASOPHILS and BASOPHIL COUNT - Basophilic activity is not fully understood but it is known to carry histamine, heparin and serotonin. High levels are found in allergic reactions.
Normal Adult Range: 0 - 2 %
Optimal Adult Reading: 1

In the next post we will see about normal electrolyte values. Okay.

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NUCLEAR MEDICINE-RADIOACTIVITY-LESSON 136


Radioactivity:
The giving out of power or energy in the outward appearance of elements or beams originating from the center of a matter is called radioactivity.
Radionuclides:
A radionuclide is a material that imparts elevated power particles or beams seeing that it falls to pieces. Radionuclides are created in what's more a nuclear reactor or an electrically exciting substance to gather speed. Not later than glow with established particles bring about commotion and wavering.
Half-life period:
Half-life is the point in time or occasion necessary intended for electrically excited substances that are radionuclides to go down partial that is half of its radioactivity by breakdown.
Why Radionuclides are Important in Medicine Field?
1. The information of the half-life of a radionuclide is of great consequence to be decisive how far the radioactive material will send out radioactive material will give off radioactivity in a patient's body.
2. The half-life is obliged to designate extensive adequate amount to make available for an investigative illustrations at the same time to curtail patient contact to radiation of the patient. For instance the half-life period of technetium 99 m (99m Tc) is about six hours is a perfect radionuclide used in investigative illustrations through imaging technique in medicine.
3. Radionuclides give out three kinds of radioactive particles such as alpha, beta particles, and gamma. In all the three gamma rays have the greatest break through power comparing with alpha rays and beta rays. Gamma rays are further having ionizing power and convenient to physicians together in the diagnosis and the management a disease.
The next lesson will describe about nuclear medicine tests. Okay.
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Friday, December 18, 2009

VISUAL EXAMINATIONS USED IN RADIOLOGY-LESSON 135




VISUAL EXAMINATIONS USED IN RADIOLOGY:  The radiopaque studies may create some side effects in some patients as the radiopaque substance contains iodine contrast materials. The side effects may be of some bland reactions for instance redness of the skin, queasiness, warmth or itchiness sensations, and sometimes may be serious reactions like spasm in the airway, hives, swelling of the larynx, vasodilation, and rapid heart rate etc., Management of this situation is immediate fixing of ventilation followed by injections of adrenaline and corticosteroids or any antihistamine injection.
When the patient is prone to allergic reactions some other studies like fluoroscopy, tomography, and MRI or magnetic resonance imaging are used. We will see about these procedures one by one.
Fluoroscopy: X-rays are taken using a fluorescent screen by passing the equipment through the patient. The method of functioning of fluoroscopy is that when the rays of light energy the fluorescent plate absorbs it glows as a result of it. In this way images of the body tissues are taken. The scans of the mobile body organs like heart, intestinal systems are taken using fluoroscopic technique. These films when taken from different position changing at the same time give a good diagnostic idea to the physician about the disease process. While doing this procedure a radiologist can at the same time perform radiologic interventions like any abscess drainage, bleeding occlusion in any vessels, placement of catheters for drainage etc.,
Tomography: X-ray films are taken in series of any layer of body selectively. Numerous picture of the same area from front and behind are taken. These films are called tomograms. The films are taken as slices. Any firm lesions or any calcification missed from other x-ray types can be found by these sliced films.
Using this visual exam method three views such as sagittal or anteroposterior; coronal or frontal, and axial or cross-sectional images can be taken. No radioactive material is used as a medium in this study. The science of MRI scanning is the magnetic field of the nuclei of atoms like hydrogen in the water is used to create a magnetic field inside the body organs naturally by applying a large magnetic field from externally.
MRI is very useful in identifying tumors in the brain, spinal cord images, tumors in the chest and abdomen, and also in the visual examination of the heart and its valves.
In the next post we will study about ultrasound and MRI scans. Okay.
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Wednesday, December 16, 2009

USE OF ULTRASOUND AND MRI TECHNIQUES-LESSON 134


Ultrasound: High-frequency impossible to hear muffled sound waves are sent and these waves are bounced off by body tissues. The movement of sound waves are recorded to give the information about the structure of the inside organs. The good transmission of waves is ensured by placing an instrument near the skin and by smother the skin surface by an oily substance. Oil substance probably a mineral oil is put for the diffusion of sound waves properly.
The ultrasound instrument produces dumpy sound waves in cyclic beats. Each wave is in different speed of motion and invades through the tissues inside the body and becomes aware of boundaries amid tissues of diverse compactness. These waves are passed back to the ultrasound monitor and recorded. This record is called echogram or sonogram.
This instrument is used not only by radiologists, but also by ophthalmologists to detect intracranial and ophthalmic lesions. Cardiologists also use this instrument to identify blood valve and heart valve ailments. This is called echocardiogram.
Gastroenterologists use this equipment to track down of any abdominal masses in the GI tract.
Gynecologists and obstetricians use this equipment to make a distinction between whether there is a single child or more than one in the uterus.
Obstetricians perform amniocentesis to track down tumors or cysts if any in the uterus. Measurement of fetal size and age of the fetus can also be calculated using ultrasound wave technique.
ADVANTEAGES OF THE ULTRASOUND:
Comparing iodine contrast study and other studies ultrasound is very safe and has side effects as the sound waves used in this method are nonionizing. Passing these waves inside the body will not damage the internal organs or any tissues.
In the next post we will study about Different views of x-ray positions. Okay.
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DIFFERENT VIEWS OF X-RAY FILMS-LESSON 133









In order to take the best possible view of the part of the body being radiographed, the patient, film, and x-ray tube must be positioned in the most favorable alignment possible. There are special terms used by radiologists to designate the position for direction of the x-ray beam, the patient's position, and the motion and position of the part of the body to be examined. Some of the important x-rays terms are as follows:
AP view or anteroposterior view: In this view the patient is usually supine i.e. lying on the back and the x-ray tube is aimed from above at the frontal side of the body and the beam is passed from the anterior to posterior. The film lies underneath the patient. The AP view may also be taken with the patient in the upright position.

PA view or posteroanterior view: In this view, the patient is upright with back to the x-ray machine and the film to the chest. The x-ray machine is aimed horizontally at a distance of about 6-feet from the film.
Lateral view: In this view, the x-ray beam passes from one side of the body toward the opposite side. In taking a right lateral view, the right side of the body is held closely against the x-ray film and the x-ray beam passes from the left to the right through the body.
Oblique view: In this view, the x-ray tube is positioned at an angle from the perpendicular plane. Oblique views are used to show regions that would be hidden and superimposed in routine AP and PA views.

BODY POSITION RELATED TERMS USED IN THE X-RAY EXAMINATION:
1. Abduction: Moving the part of the body away from the midline of the body or away from the body.
2. Adduction: Moving the part of the body toward the midline of the body or toward the body.
3. Eversion: Turning outward.
4. Extension: Lengthening or straightening a flexed limb.
5. Flexion: Bending a part of the body.
6. Inversion: Turning inward
7. Lateral decubitus: Lying down on the side with x-ray beam horizontally positioned. Another term for this is cross-table lateral.
8. Prone: Lying on the belly i.e. face down.
9. Recumbent: Lying down i.e. prone or supine.
10. Supine: Lying on the back i.e. face up.
In the next lesson we will study about Nuclear Medicine. Okay.
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IMPORTANT CANCER TERMS AND ITS MEANINGS-LESSON 132


1. Adjuvant therapy: Assisting primary treatment. Drugs are given early in the course of treatment along with surgery or radiation to attack cancer cells that may be too small to be detected by diagnostic techniques.
2. Alkylating agents: Synthetic chemicals containing alkyl groups that interfere with DNA synthesis.
3. Anaplasia: Loss of differentiation of cells. Reversion to a more primitive cell type.
4. Antibiotics: Chemical substances produced by bacteria that inhibit the growth of cells used in cancer chemotherapy.
5. Antimetabolites: Chemicals that prevent cell division by inhibiting the formation of substances necessary to make DNA and used in cancer chemotherapy.
6. Apoptesis: Programmed cell death. Apo- means off, away, and -ptosis means to fall. Normal cells undergo apoptesis when they are damaged or aging. Some cancer cells have lost the ability to undergo apoptesis and live forever.
7. Benign: Noncancerous.
6. Biological response modifiers: Substances produced by normal cells that either directly block tumor growth or stimulate the immune system.
7. Biological therapy: Use of the body's own defense mechanism to fight tumor cells.
8. Carcinogens: Agents that cause cancer. Chemicals and drugs, radiation, and viruses.
9. Cellular oncogens: Pieces or DNA hat when broken or dislocated can cause a normal cell to become malignant.
10. Chemotherapy: Treatment with drugs
11. Combination chemotherapy: Use of several therapeutic agents together in the treatment of tumors.
12. Dedifferentiation: Loss of differentiation of cells. Reversion to a more primitive, embryonic cell type anaplasia.
13. DNA or deoxyribinucleic acid: Genetic material within the nucleus of a cell that controls cell division and protein synthesis.
14. Differentiation: Specialization of cells.
In the next post we will see the continuation of this post. Okay.
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BIOLOGICAL CHEMOTHERAPEUTIC AGENTS-1-LESSON 131


BIOLOGICAL THERAPY TO CURE CANCER:  An additional fresh line of attack to cancer management is the employment of the body's individual resistance systems to scrap tumor cells. Researchers see the sights how the ingredients of the immune system can be brought back, developed, imitated, and influenced to annihilate cancer cells within the body. Chemical materials brought into being by standard cells that moreover in a straight line wedge tumor development before kindle the immune system and additional body barricades are called genetic reaction modifiers. The instances of these materials are interferon prepared by lymphocytes, monoclonal antibodies created by mouse cells, and proficiency of strapping to human tumors, colony-stimulating factors or CSFs so as to accelerate blood-forming cells and turn around the upshots of chemotherapy, and interleukins with the intentions of stimulating the immune system to annihilate tumors.
Now we will sort out chemotherapeutic and biological events one by one.

CHEMOTHERAPEUTIC AGENTS:
ALKYLATING CHEMOTHERAPEUTIC AGENTS:
1. BCNU or carmustine
2. Cisplatin and carboplatin
3. Cyclophosphamide or Cytoxan
4. Melphalan or Alkeran
5. Nitrogen mustard
6. Chlorambucil
ANTIBIOTIC CHEMOTHERAPEUTIC AGENTS:
1. Actinomycin D
2. Bleomycin sulfate
3. Daunorubicin hydrochloride
4. Doxorubicin hydrochloride or Adriamycin
5. Idarubicin
6. Mitomycin C
ANTIMETABOLITE CHEMOTHERAPEUTIC AGENTS:
1. Cystosine arabinoside or ara-C
2. 5-fluorouracil or 5-FU
3. Methotrexate or MTX
4. 6-thioguanine or 6-TG
5. Fludarabine
6. Pentostatin
The next post describes the continuation of BIOLOGICAL CHEMOTHERAPEUTIC AGENTS. Okay.
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CHEMOTHERAPEUTIC AGENTS-LESSON 130


CHEMOTHERAPEUTIC AGENTS:  The subsequent list categorizes all cancer chemotherapeutic agents:
1. Plant byproducts: These chemical substances are drawn from plants. These chemical materials are used recurrently in mixture as a supplement to other chemotherapeutic agents. The offshoot effects take account of myelosuppression, alopecia, and smash up of nerves.

2. Antimetabolites: These drugs slow down the amalgamation of drugs so as to the essential part of DNA or possibly will unswervingly hunk the copying DNA. The offshoot consequences of antimetabolites are myelosuppression with leukopenia, thrombocytopenia, and bleeding. The other side effects are toxicity to the oral and digestive tract, as well as stomatitis called sore mouth, nausea, and vomiting.

3. Alkylating agents: These are artificial amalgams be full of two or more element groups names alkyl groups. The chemical substances get in the way by means of the development of DNA fusion next to putting together to DNA molecules. Venomous side effects take account of nausea and vomiting, diarrhea, bone marrow depression or myelosuppression, and alopecia or hair loss. These are widespread impacts for the reason that the cells in the gastrointestinal tract, bone marrow and scalp are hurriedly dividing cell, which is having for the above ground growth division that by the side of tumor cells are predisposed to the toxic consequences of chemotherapeutic drugs. The side effects fade away subsequent to treatment is on the edge.

4. Steroids: These are a course group of substances prepared in the body, and these chemical substances contain imperative consequences on duplication of sex cells during reproduction process, energy manufacture, and aging process, the instances for these kind are estrogens and androgen. These hormones bring bear to their encounter by means of putting together to receptor proteins in objective tissues. The development of a number of tumors for example breast and prostate is over and over again reliant lying on steroid hormones. A number of breast cancers encompass estrogen receptors or ER and will act in response on the way to the elimination of estrogen through oophorectomy otherwise the utilization of antiestrogen drugs such as tamoxifen. Those drugs break apart estrogenic end products. Fluid withholding, masculinization or feminization, nausea, and vomiting are selected feasible impacts of different steroids.

5. Antibiotics: These drugs are fashioned by bacteria or fungi. A lot of these chemical substances medication their duty by strapping to DNA and RNA inside the cell as a result nip in the budding of standard reproduction of cells. Poisonous upshots on or after their application take account of alopecia or hair loss, stomatitis, myelosuppression, and gastrointestinal turmoils.

In the next lesson we will see about Biological Therapy to cure cancer. Okay.
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The Longest Medical Word

Today, we will know about an interesting medical term in medical language. This post is just to know about a different thing in the medica...