Clinical Presentations of Pituitary Apoplexy

In this article, we will discuss the Clinical Presentations of Pituitary Apoplexy. So, let’s get started.

Signs and Symptoms

  • Headache, sudden and severe retro-orbital and frontal pain
  • Decreased visual acquity and visual field defects
  • Opthalmoplegia, ptosis, and pupilary defects
  • Nausea, vomiting, headache, alteration in the level of consciousness, e.g. lethargy, stupor, and coma
  • Hemiplegia
  • Acute adrenal insufficiency
  • Gonadal dysfunction
  • Diabetes insipidus
  • Hypofunction of thyroid
  • Fever, anosmia, CSF rhinorrhea, and facial pain, respiratory and cardiac rhythm disturbances

Structure involved/compressed

  • Sudden enlargement of tumor mass
  • Optic nerve
  • The III,IV, and VI cranial nerve compression
  • Meningeal irritation (disruption of dura or leakage of blood into subarachnoid space)
  • Internal carotid artery
  • Compression of corticotrophs (loss of ACTH)
  • Compression of gonadotrophs (loss of LH, FSH)
  • Compression of pituitary stalk
  • Compression of thyrotrophs
  • Nonspecific, noncompressive

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WHO Classification of Acute Myeloid Leukemia

In this article, we will discuss the WHO Classification of Acute Myeloid Leukemia (AML). So, let’s get started.

Classification

The WHO has modified FAB classification of acute myeloid leukemia by reducing the number of blasts required for diagnosis from 30 to 20% and incorporated molecular, morphologic and clinical features.

(1) AML with recurrent cytogenetic translocations

AML with t(8;21) (q22;q22); AML1 (CBFα)/ETO

Acute promyelocytic leukemia [AML with t(15;17) (q22;q12) and variants; PML/RARα]

AML with abnormal bone marrow eosinophils [inv (16) (p13;q22) or t(16;16) (p13;q22) CBFβ/MYH1]

AML with 11q23 (MLL) abnormalities

(2) AML with multilineage dysplasia

With prior myelodysplastic syndrome

Without prior myelodysplastic syndrome

(3) AML and myelodysplastic syndrome, therapy related

Alkylating agent-related

Topoisomerase type II-related

Other types

(4) AML not otherwise categorised

AML minimally differentiated

AML without maturation

AML with maturation

Acute myelomonocytic leukemia

Acute monocytic leukemia

Acute erythroid leukemia

Acute megakaryocytic leukemia

Acute basophilic leukemia

Acute panmyelosis with myelofibrosis

Myeloid sarcoma

Differential Diagnosis of Aplastic Anemia

In this article, we will discuss Differential Diagnosis of Aplastic Anemia. So, let’s get started.

Differential Diagnosis

Aplastic anemia should be differentiated from other conditions producing pancytopenia such as:

1. Subleukemic or aleukemic leukemia

2. Myelodysplastic syndrome

3. Hypersplenism (e.g. portal hypertension, infiltrative splenomegaly)

4. Bone marrow infiltration (carcinoma, myelofibrosis)

5. Megaloblastic anemia

6. Osteoporosis (marble bone disease)

7. Systemic lupus erythematosus

8. Paroxysmal nocturnal hemoglobinuria

9. Disseminated tuberculosis

10. Overwhelming infection

Clinical Features of Acute Hemolytic Crisis

In this article, we will discuss the Clinical Features of Acute Hemolytic Crisis. So, let’s get started.

Clinical Features

Symptoms: Pallor, weakness, dyspnea, tachycardia, fatigue, abdominal pain

Jaundice (scleral icterus i.e. yellowness of eyes)

Dark color of urine and faeces

Splenomegaly (recent appearance or sudden increase in pre-existing splenomegaly)

Hepatomegaly

Signs: Anemia, jaundice

Definition and Types of Mastoidectomy

In this article, we will discuss the Definition and Types of Mastoidectomy. So, let’s get started.

Definition

Mastoidectomy is a surgical procedure performed to remove the mastoid air cells. It can be done as part of treatment for mastoiditis, chronic suppurative otitis media or cholesteatoma or for access to the middle ear.

Types

Simple mastoidectomy: This aims at draining mastoid air cells by a post ant app. It does not disturb the structure and function of middle ear, hence the hearing is unaffected.

Radical mastoidectomy: In this operation the mastoid, the middle ear and external auditory canal are converted into a single cavity by lowering the wall between the mastoid and external ear and by the removal of the ruminants of the ear drum, malleus, and incus the stapes is not removed as the labyrinth gets exposed and may be damaged. Conductive deafness may be a sequale of this operation.

Modified radical mastoidectomy: The mastoid, attic, and external ear are converted into a single cavity without touching the mesotympanum. Hearing is not affected.