Diagnosis of Ivemark Syndrome
Ivemark Syndrome Diagnosis: Book Excerpts
Diagnostic Tests for Ivemark Syndrome: Online Medical Books
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Cardiovascular disease in pregnancy:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
A diastolic murmur, cardiac enlargement, a systolic murmur of grade 3/6 intensity, and severe arrhythmia suggest cardiovascular disease. Determination of the disease’s extent and cause may necessitate electrocardiography, echocardiography (for valvular disorders such as rheumatic heart disease), or other studies. X-rays show cardiac enlargement and pulmonary congestion. Cardiac catheterization should be postponed until after delivery, unless surgery is necessary.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Palpable Spleen:
Differential Overview
(Field Guide to Bedside Diagnosis)
Infection
❑ Infectious mononucleosis
❑ Viral hepatitis
❑ HIV infection
❑ Bacterial endocarditis
❑ Falciparum malaria
❑ Typhoid fever
❑ Brucellosis
❑ Schistosomiasis
Immunologic Disorders
❑ Immune hemolytic anemia
❑ Rheumatoid arthritis
Hematologic Disorders
❑ Thalassemia minor
❑ Lymphoma
❑ Chronic myelogenous leukemia
❑ Polycythemia vera
Congestive
❑ Congestive heart failure
❑ Portal hypertension
Infiltrative
❑ Sarcoidosis
❑ Lysosome storage diseases
Other
❑ Splenic trauma
Diagnostic Approach
Palpation for splenic enlargement should be done with the patient supine, the examiner’s left hand supporting the posterior rib cage and the right hand feeling in the left upper quadrant for the spleen to tap the fingertips on inspiration. A palpable spleen is usually more than 50% enlarged (over 300 gm). Percussion is performed at the lowest rib margin in the left anterior axillary line (Castell space), listening and feeling for dullness in either inspiration or exhalation.
A palpable spleen may be found in 3% of young adults. If there is an
otherwise normal history and physical examination and if the CBC and chest x-ray are normal, the patient is without an increased risk of having/developing a systemic disease. In older adults, an underlying condition can usually be found on investigation.
Massive splenomegaly (down to the right iliac crest) may be found in non-Hodgkin lymphoma, chronic lymphocytic leukemia, chronic myelogenous leukemia, myelofibrosis with myeloid metalpasia, hairy cell leukemia, polycythemia vera, autoimmune hemolytic anemia, Gaucher, and chronic malaria.
Fever, peripheral adenopathy, and splenomegaly suggest infectious mononucleosis, Hodgkin lymphoma, sarcoidosis, serum sickness, HIV, or systemic lupus. In acute infections, the spleen will be soft and tender on palpation. In chronic and infiltrative diseases, the spleen will be firm and nontender.
Left upper quadrant masses that can be mistaken for an enlarged spleen include perinephric abscess, feces, and tumors of the kidney, adrenal gland, splenic flexure, or pancreas. Renal masses will usually retain the medial notch and will be more posterior. Colon masses will not have a well-defined edge. Pancreatic masses will be more medial.
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Source: Field Guide to Bedside Diagnosis, 2007
Cardiovascular disease in pregnancy:
Diagnosis
(Handbook of Diseases)
A diastolic murmur, cardiac enlargement, a systolic murmur of grade III or IV intensity, and severe arrhythmia suggest cardiovascular disease.
Determination of the extent and cause of the disease may necessitate electrocardiography, echocardiography (for valvular disorders such as rheumatic heart disease), or phonocardiography. X-rays show cardiac enlargement and pulmonary congestion. Cardiac catheterization should be postponed until after delivery, unless surgery is necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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Signs of Ivemark Syndrome
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