Three things which define encephalopathy
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encephalopathy AND definition
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encephalopathy definition diffuse brain dysfunction altered mental status reliable source
The three core features of encephalopathy are:
- Altered mental status: impaired attention, confusion, drowsiness, agitation, or reduced consciousness.
- Diffuse brain dysfunction: global rather than focal neurological impairment, often with disorientation and cognitive slowing.
- Neuromuscular abnormalities: such as asterixis, tremor, myoclonus, abnormal tone/reflexes, or seizures.
It is a syndrome with many causes, including metabolic disturbances, hypoxia, toxins/drugs, liver or renal failure, infection, and hypertension.
Grades of clubbing and grades of anemia
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anemia severity classification hemoglobin
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WHO haemoglobin concentrations anaemia severity classification mild moderate severe 2024 guideline
Grades of clubbing
| Grade | Clinical finding |
|---|---|
| I | Fluctuation and softening of the nail bed |
| II | Loss of the normal nail-fold angle, called Lovibond angle. Normally it is about 160°; in clubbing it becomes ≥180°. |
| III | Increased convexity or curvature of the nails |
| IV | Bulbous enlargement of the terminal phalanx, giving a “drumstick” appearance |
| V | Hypertrophic osteoarthropathy: clubbing with periostitis, bone/joint pain, and swelling of long bones |
Grades of anemia
Anaemia severity is graded by haemoglobin (Hb) and varies with age, sex, and pregnancy status.
Adults and children ≥12 years
| Group | Mild | Moderate | Severe |
|---|---|---|---|
| Non-pregnant women | 11.0-11.9 g/dL | 8.0-10.9 g/dL | <8.0 g/dL |
| Men | 11.0-12.9 g/dL | 8.0-10.9 g/dL | <8.0 g/dL |
| Pregnancy | 10.0-10.9 g/dL | 7.0-9.9 g/dL | <7.0 g/dL |
Children
| Age | Mild | Moderate | Severe |
|---|---|---|---|
| 6-23 months | 9.5-10.4 g/dL | 7.0-9.4 g/dL | <7.0 g/dL |
| 24-59 months | 10.0-10.9 g/dL | 7.0-9.9 g/dL | <7.0 g/dL |
| 5-11 years | 11.0-11.4 g/dL | 8.0-10.9 g/dL | <8.0 g/dL |
These are the WHO haemoglobin-based severity cutoffs, described in the WHO anaemia guideline.
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