Day 1 Menopause • occurs around 45-55 years, when the ovaries stop ovulating and menstrual periods end • Most women experience several years of changes in their menstrual periods before stopping completely ◦ Menstrual periods more or less often than usual ◦ Have bleeding that lasts for fewer days ◦ Skip one or more menstrual periods Symptoms ◦ As ovaries stop working, estrogen levels fall, leading to many symptoms – these often begin during menopausal transition, before stopping periods completely ◦ Hot flashes is the most common, affecting 60-80% of women ◦ Typically begin as a sudden feeling of heat …

Day 1: Pneumonia Pneumonia is most common and dangerous in very young children, people over the age of 65, and people with underlying medical conditions such as heart disease, diabetes, or chronic lung disease. This patient who comes from a nursing home will most likely have Nursing home acquired pneumonia (NHAP). It is one of the most common infectious diseases in long term care facilities and is a significant cause of mortality and morbidity among residents of such facilities. Dysphagia has been identified as a risk factor. This type of pneumonia closely resembles community acquired pneumonia.  The pathophysiology of NHAP …

DAY 1: Clinical manifestations of ALL  Acute lymphocytic leukemia (ALL) aka acute lymphoblastic leukemia is the most common type of malignancy in children, making up 25% of childhood cancers. The incidence of ALL is about 1:25,000 children per year, including 3,000 children per year in the United States. The peak is 2-5 years of age, and is seen more in males than females. Children with Down syndrome have a 14 fold increase in the overall rate of leukemia.  ALL is a malignancy arising from immature lymphoid stem cells in the bone marrow. There is an overpopulation of immature WBCs (blasts) …