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management disease medicine emergency thrombosis anticoagulant insulin hospital type 2 thromboplatin old age lmwh diabetes assignment student case study alcohol hypersegmed neutrophils anemia presentation senecrio megaloblasatic anemia thyroid medical short macrocytic anemia pictures tinea scarring chronic complication dermatology introduction clinical features histology overview diagnosis treatment erythematosus discoid cutaneous lupus subacute sle acute potassuim ketogenesis hyperosmolar coma dehydration dka icu non-ketotic death causes