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Courtesy Churchill-Livingstone (Saunders) Press ©2002 CRC Press LLC Figure 5 generic furosemide 100 mg otc. There is extensive replacement of muscle fibers with fibrous tissue. There are multiple thin myoblastic chains and muscle fibers with prominent central myoblastic nuclei. Courtesy Churchill-Livingstone (Saunders) Press Figure 5. The transverse band of myoblast nuclei is noted to be central in a new muscle fiber. Courtesy Churchill-Livingstone (Saunders) Press ©2002 CRC Press LLC Figure 5. There is a central band of myoblast nuclei, each with two small dark nucleoli. Courtesy Churchill-Livingstone (Saunders) Press Figure 5. The lower field shows primarily collagen (yellow) with a few muscle fibers (red). Courtesy Churchill-Livingstone (Saunders) Press ©2002 CRC Press LLC Figure 5. Courtesy Churchill-Livingstone (Saunders) Press Figure 5. In the lower field, there are almost normal muscle fibers with visible mitochondria. Courtesy Churchill- Livingstone (Saunders) Press ©2002 CRC Press LLC Figure 5. There is degeneration of muscle with a few transverse Z-lines in a sea of debris. Courtesy Churchill-Livingstone (Saunders) Press Figure 5.
On the basis of clinical presentation buy discount furosemide 100 mg, how would you classify this patient’s seizure? Tonic-clonic seizure Key Concept/Objective: To understand the major classification of seizures The International League Against Epilepsy has classified epileptic seizures on the basis of the clinical presentation and electroencephalographic criteria. The classification divides seizures into three major categories: partial, generalized, and unclassified. Partial seizures are described as either simple or complex, depending on whether consciousness remains intact or is impaired during the seizure. Simple partial seizures can be motor, sensory, auto- nomic, or psychic. Complex partial seizures usually begin with arrest of motion and a blank stare. Automatisms, oroalimentary behavior, or verbal utterances may occur initial- ly or during the seizure. At the termination of the seizure, the patient may be momentarily confused, fatigued, or disoriented. Generalized seizures cause a spectrum of behavior from the nonconvulsive pattern of simple absence seizure through myoclonus to the fully developed generalized tonic-clonic seizure. Absence seizures are brief, usually lasting 10 seconds or less; the seizures are not preceded by an aura or followed by postictal effects, which helps differentiate them from complex partial seizures. Myoclonus consists of brief jerks or contractions of a specific muscle or group of muscles. Atonic seizures involve a sudden loss of postural tone. Convulsions are the most common types of generalized seizures; they are characterized by loss of con- sciousness associated with apnea and violent contractions of the musculature of the trunk and extremities. A 46-year-old diabetic man is started on insulin therapy for poorly controlled diabetes. After 2 weeks, he has a generalized tonic-clonic seizure and is brought to the emergency department by the emergency med- ical service.
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