lead toxicity



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1. How do medication, other physiological conditions like pregnancy, and pathological conditions like acute hepatitis and chronic liver disease affect thyroid hormone metabolism and the requirement of levothyroxine if the patient is already on thyroid supplements? There are some proteins in blood like thyroxine-binding globulin (TBG) that transport levothyroxine (T3, T4) In blood to peripheral tissue. pregnancy, acute hepatitis, oral contraceptive pills containing estrogen, and medications like tamoxifen, and raloxifene increase TBG. When TBG rises in the blood, TBG binds to free T3 and free T4 increasing the total T3, and T4 in the blood and decreasing the concentration of free T3, and free T4. Peripheral tissue senses the low level of free T3, and free T4, thus it stimulates the pituitary gland to produce more TSH. TSH in turn stimulates the thyroid gland to produce free T3 and free T4. 2. what are conditions where TBG decreases? a. chronic liver disease b. drugs like androgenic horm
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  Group B streptococcal (GBS) infection in pregnancy It is also called streptococcus agalactie. If there is the colonization of this bacteria in the rectum and vagina, there is the possibility of transmission of this bacteria to newborns while delivery. so, if there is colonization, treat it we check with a rectovaginal swab at  35 to 37-week periods of gestation (POG). GBS colonization is transient or intermittent, that's why check at 35-37 weeks POG. Let us take one example to understand this: A female was admitted at 38 weeks of period of gestation because of a rupture of the membrane and labor pain. Her medical history included group B streptococcal colonization at 36-week periods of gestation in her previous pregnancy. At that time, she was treated with IV penicillin. Does this time also, require penicillin? The answer is: In this case, we do not know the colonization status of her in this pregnancy. so, we need to wait for 18 hours in this case. If she does not deliver by 18
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