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Old 01-30-2013
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Default Can any body please help me over these topics?

1) What are the disorders in which bleeding time and clotting times are prolonged or normal? Von willebrand disease ,hemophilias.........

2) In eldery with iron deficiency anemia....we will do FOBT followed by sigmoidoscopy or colonoscopy ?

3) Prostrate cancer treatment....when to do orchidectomy,to give flutamide,androgens and radiation therapy ?

4) Sign and symptoms of central pontine myelinosis ?
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Old 01-30-2013
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1) in VWD BT is prolonged,aPTT is prolonged and platelet count is normal.
Remember BT is only valuable if platelet count is normal, if platelet count drops then automatically BT becomes abnormal.
In hemophilia a and b aPTT is prolonged rest all are normal and this aPTT normalises on mixing studies.
2)FOBT should always be followed by colonoscopy because you dont want to miss out on any tumor throughout the colon.
3)in prostrate cancer treatment-i think once you confirm its a tumor by biopsy you always do an orchidectomy and then give the antiandrogens. Radiation when it has mets to bones.
4)signs and symptoms of CPM- lethargy, seizures and coma
Be good , be better , be the BEST
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Old 01-30-2013
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I would like to add some points to what are mentioned by ts1234
(1) prolong BT reflect any defect in functions or number of Plts so in case of VWD there is defect in adhesion of plts to endothelium__> impaired functions--> so prolong BT with normal plts counts. Also VWF contains factor 8 so in patient with VWD factor 8 deficiency lead to prolong PTT same like Hem A in which factor 8 also is deficient.
(2) Colon cancer screen (colon cancer suspected in elderly patient with iron def anemia) can be done with one of 3 methods:
a> colonoscopy b> FOBT + flexible sigmoidoscopy c> FOBT
If you did FOBT and the result is abnormal the next step is colonoscopy as ts1234 said
If you did FOBT and the result is negative,i think you can continue in cancer survey if you highly suspect colon cancer or investigate for other causes
(3) I have no a lot off information about the treatment of prostatic cancer, but if the patient is not candidate for surgery palliation is best (radiotherapy), and if there is mets can do prostatectomy to remove source of androgen
(4)central pontine myelinosisor (lock in syndrome) patient present with bilateral paralysis (spastic quadriplegia + others signs of UMNLs) and cranial nerves palsy except CN3 so the patient is only respond to question by blinking his/her eyes + confusion.
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