Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord. Causes, incidence, and risk factors Multiple sclerosis (MS) affects women more than men. The disorder is most commonly diagnosed between ages 20 and 40, but can be seen at any age. MS is caused by damage to the myelin sheath. The nerve [...]

  Grading of murmurs   Grade Description Grade 1 Very faint Grade 2 Soft Grade 3 Heard all over the precordium Grade 4 Loud, with palpable thrill. Grade 5 Very loud, with thrill. May be heard when stethoscope is partly off the chest. Grade 6 Very loud, with thrill. May be heard with stethoscope entirely [...]

The RIFLE classification of Acute Renal Failure is as follows: Risk (R) – Increase in serum creatinine level X 1.5 or decrease in GFR by 25%, or urine output <0.5 mL/kg/h for 6 hours Injury (I) – Increase in serum creatinine level X 2.0 or decrease in GFR by 50%, or urine output <0.5 mL/kg/h for [...]

Insomnia is defined as repeated difficulty with the initiation, duration, maintenance, or quality of sleep that occurs despite adequate time and opportunity for sleep that results in some form of daytime impairment. Approximately one third of adults report some difficulty falling asleep and/or staying asleep during the past 12 months, with 17% reporting this problem [...]

The main syndrome of vitamin B12 deficiency is Biermer’s disease (pernicious anemia). It is characterized by a triad of symptoms: Anemia (megaloblastic anemia) Gastrointestinal symptoms Neurological symptoms Each of those symptoms can occur either alone or along with others. The neurological complex, defined as myelosis funicularis, consists of the following symptoms: Impaired perception of deep [...]