conditions of the systems

Conditions of the Integumentary System

Cellulitis, Dermatitis, Eczema, Skin Cancer (basal and melanoma)

Cellulitis

Skin of the affected area is swollen, red, and hot to the touch. Bacteria (typically Streptococcus or Staphylococcus) enters the skin through cuts or abrasions and causes infection of connective tissue with severe inflammation of the skin. Physical exam Wound culture and blood tests can confirm bacterial etiology. Resting the area, cutting away dead tissue if needed, antibiotics

Dermatitis

Red, itchy rash that may include blisters or oily scales. Allergic reaction to a specific allergen leading to inflammation of a region of the skin .Physical examination. Moisturizers, Steroid creams

Eczema

Red, itchy skin, Vesicular lesions (blisters) that may crust over. Believed to be caused by hereditary and environmental factors leading to inflammatory skin disease. Physical examination. Mild, fragrance-free soap and moisturizers, steroid creams, and antihistamines. Goals of treatment are to heal the affected skin and mitigate recurrence.

Skin cancer (basal cell)

Waxy bump or skin sore that does not heal within two months and continues to grow over time. Damage to DNA of basal cells caused by ultraviolet B (UVB) exposure from the sun and tanning beds. Physical examination and biopsy. Early diagnosis is vital.Surgical excision. Liquid nitrogen freezing or curettage

Skin cancer (melanoma)

A skin mole with specific characteristics. (Asymmetry

Conditions of the Skeletal System

Sprain,

Sprain

Painful swelling or bruising of a joint area with decreased mobility. The joint being pushed outside of its normal range of motion, leading to joint and ligament damage. Physical exam with imaging. RICE (Rest, Ice, Compression​​​​​​​, Elevation)

Osteoporosis

Typically, there are no symptoms. Severe disease can lead to increased fractures and back pain. Many factors including malnutrition, inadequate calcium intake/absorption, endocrine disorders, immobilization and lack of exercise, and aging can lead to bone loss, making bone weaker and more prone to fracture. Measuring bone mineral density using a DEXA scan Medications can slow bone loss and reduce the risk of fracture.

Osteoarthritis

Pain with movement in a specific joint. Stiffness in joint following periods of inactivity. Lack of flexibility. Degeneration (breakdown) of articular cartilage and changes in the synovial membrane. History, physical examination, and imaging. Physical therapy, exercise, and steroid injections can help relieve symptoms. Joint replacement may be needed if severe enough.

Rheumatoid arthritis

Systemic joint disorder typically starting with pain and decreased mobility in the smaller joints, such as fingers, before progressing to larger joints, such as knees and hips. Autoimmune disorder leading to changes in the connective tissues of the body, especially the joints. (*This may also be considered a disorder of the lymphatic/immune system). Physical examination, blood tests, and imaging. Physical therapy for mobility. Medication to manage inflammation and pain.

Gout

Red, hot, swollen joint. Most common in the big toe. Excessive accumulation of uric acid in a joint, forming needle-like crystals in the joint. Aspiration of the joint to obtain and identify the crystals at a microscopic level. Anti-inflammatory medications and dietary adjustments

Diseases of the Muscular System

Muscular dystrophy, myopothy, myalgia, repetitive stress disorder, shin splint

Muscular dystrophy

Chronic and progressive muscle weakness leading to eventual paralysis of muscle groups. Inherited or spontaneous genetic mutation in one of the genes involved with protecting muscle fibers from damage. Patient history, physical exam, muscle enzyme tests, electromyography, muscle biopsy, and genetic testing. Physical therapy, ambulatory devices, and medications to alleviate symptoms

Myopathy

Muscle weakness, cramps, stiffness, spasms, and tetany. Can result from many different disease processes. Based on symptoms. Focus is on understanding the underlying cause. Treatment is dependent on the underlying cause. Physical therapy, medication therapy, support bracing, surgery, and massage all may help.

Myalgia

Muscle pain (broad term). Several causes; Traumatic injury, Viral infection, Overuse or overstretching of muscle group​​​​​​​, Medications and vaccines. Based on symptoms. Focus is on understanding the underlying cause. Treatment is dependent on the underlying cause. Targeted symptomatic treatment includes massage, heat or cold therapy, and medication for pain and muscle relaxants.

Repetitive stress disorder (RSD)

Pain, tingling, numbness, swelling. Redness, loss of flexibility and muscle weakness. Repetitive tasks, forceful exertions, vibrations, mechanical compression and sustained uncomfortable positions can cause RSD.. Physical examination, patient history, and imaging. Early treatment

Shin splint

Pain and swelling in the lower leg. Repeated stress of the tibia and connective tissues. Physical examination and patient history. RICE. Surgery if severe enough

Diseases of the Cardiovascular System

Anemia, athersclerosis, congenital heart failure, hemophilia, hypertension, myocardial infarction/heart attack

Anemia

Fatigue, dizziness, cold extremities, headache, irregular heartbeat. Most common cause is blood loss. Dysfunction in the creation of hemoglobin. Excessive destruction of red blood cells. Blood test. Depends on cause. Blood loss can be treated with a blood transfusion. Other causes may be treated through increase of iron or vitamin K.

Atherosclerosis

Chest pain, transient ischemic attacks (TIAs), peripheral artery disease, and kidney disfunction. Hardening of the arteries due to fatty deposits causing narrowing of vessels potentially due to high blood pressure, high cholesterol, smoking, diabetes, and other diseases. Physical examination, medical history, blood tests, doppler ultrasound, EKG, stress test, angiogram, CT or MRI. Healthy diet, increased exercise, medications (cholesterol medication, beta blockers, ACE inhibitors, blood thinners, diuretics, calcium channel blockers), angioplasty, stents, endarterectomy, or bypass surgery

Congestive heart failure (CHF)

Fatigue, peripheral edema, shortness of breath. The heart’s decreased ability to pump adequately due to coronary artery disease, high blood pressure, cardiomyopathy, valvular disease, or heart defects. Medical history, physical examination, blood tests, EKG, echocardiogram, and chest x-ray. Varies depending on the type and severity. Can include weight loss, controlling blood pressure, ACE inhibitors, and beta blockers

Hemophilia

Excessive bleeding, frequent bruising. An absence of clotting factors in the blood as the result of a genetic defect. Family history, physical examination, and blood tests. Replacement therapy to slowly infuse clotting factors into a vein

Hypertension

Higher than normal blood pressure, headaches, irregular heart rhythms, vision changes, or chest pain. Genetics, smoking, obesity, stress, too much salt intake. Consistently high blood pressure over two or three office visits over the course of one to four weeks. Medications, weight management, healthy diet, and stress reduction

Myocardial infarction (MI or heart attack)

Acute chest pain, nausea, vomiting, heartburn, and profuse sweating. Cardiac muscle becomes ischemic and dies, typically due to occlusion of the cardiac muscle because of atherosclerosis of the coronary artery. EKG and blood tests. Fibrinolytic agents, diagnostic angiogram, stenting, and bypass surgery if severe enough

Diseases of the Urinary System

acute renal failure, chronic renal failure, renal calculi (kidney stones), urinary incontinence, urinary tract infection

Acute renal failure

Decreased urine output, fluid retention, fatigue, shortness of breath, confusion, and nausea. Direct damage to the kidneys or other causes leading to a sudden change where the kidneys can no longer filter blood effectively, leading to dangerous levels of toxic waste in the body. Observation of urine output, blood tests, urinalysis, and other imaging. Correcting the underlying cause, medications, and hemodialysis in the setting of severe disease

Chronic renal failure

Early stages, No symptoms. Later stages, High blood pressure, feeling generally ill and fatigued. Chronic and progressive disease in which the kidneys cannot adequately filter blood due to many potential factors including diabetes, high blood pressure and glomerulonephritis. Blood test. Controlling blood pressure is the primary treatment to slow chronic renal failure. If it progresses far enough, hemodialysis will be needed.

Renal calculi (kidney stones)

Severe episodes of back and side pain, pain with urination. Dark or foul-smelling urine, nausea, frequent urination, fever, chills. Hard crystalline deposits forming in the urine due to abnormally high levels of certain substances in the body. Blood tests, urine tests, and imaging. Drinking water, pain relievers, and shock wave therapy in the form of lithotripsy to help break down and flush out the stones through urination

Urinary incontinence

Leakage of urine. Loss of bladder control leading to leakage of urine, sometimes triggered by coughing, lifting, or sneezing. Urinalysis, medical history, physical examination. Kegel exercises to strengthen muscles that control the bladder. Surgery (bladder sling)

Urinary tract infection (UTI)

Persistent urge to urinate, burning with urination, strong smelling cloudy urine, pelvic or flank pain. Infection in the urinary system most commonly caused by Escherichia coli (E. coli). Urinalysis, urine cultures, and imaging. Antibiotics

Diseases of the Gastrointestinal System

appendicitis, celiac disease, colorectal cancer, diverticulosis, gastro-esophageal reflux disorder (GERD)

Appendicitis

Pain in the lower, right abdomen, loss of appetite, nausea, vomiting, abdominal swelling, fever Inflammation in the appendix due to blockage of the opening to the appendix, leading to rapidly multiplying bacteria in the appendix Patient history, blood and urine tests, imaging. Surgical removal of the appendix

Celiac disease

Anemia, diarrhea, gas, bloating, weight loss, fatigue. Immune response triggered by gluten leading to damage of the small intestine and an inability to absorb nutrients. Physical examination, medical history, blood tests, antibody tests, and endoscopy with biopsy. Avoid gluten in any form.

Colorectal cancer

Early stages, No symptoms. Later stages, Symptoms are nonspecific but can include fatigue, irregular bowel movements, blood in feces, cramps, bloating, and weight loss. Cancer of the colon. Risk factors are a high-fat diet, family history, and inflammatory bowel disease. Colonoscopy or barium enema Early stages, Surgical removal of cancer cells. Advanced stages, Chemotherapy.

Diverticulosis

Asymptomatic unless inflamed. When inflamed it is termed diverticulitis

Gastroesophageal reflux disease (GERD)

Heartburn, nausea after eating, difficulty swallowing. Lower esophageal sphincter muscle disfunction leading to stomach contents leaking back up the esophagus. Upper endoscopy, tests to measure amount of acid in the esophagus. Lifestyle/dietary changes, antacids. Surgery (severe cases)

Diseases of the Respiratory System

Acute respiratory distress (ARDS), asthma, bronchitis, chronic obstructive pulmonary disease, rhinitis.

Acute respiratory distress (ARDS)

Shortness of breath, low blood pressure, and rapid breathing (following an injury). Fluid buildup in the alveoli blocks oxygen from passing into the bloodstream following an acute injury, typically in those who are already critically ill or have had previous traumatic injuries. Arterial blood gas analysis, chest x-ray. Oxygen therapy, mechanical ventilation, and antibiotics

Asthma

Wheezing, shortness of breath, chest tightness, and coughing. Airway inflammation causes lining of air passages to swell and tighten, leading to a reduction in the amount of air that can pass into and out of the lungs. Pulmonary function tests. Medications, both inhaled and taken orally

Bronchitis

Shortness of breath, fever, chills, fatigue, coughing, and production of mucus. Acute- Caused by viral illnesses such as colds and flu. Chronic-Caused by smoking. Physical examination in which the lungs are listened to via stethoscope, chest x-ray, pulmonary function tests. Acute- Typically resolves without intervention. Chronic- Respiratory therapy.

Chronic obstructive pulmonary disease (COPD)

Chest tightness, productive cough, wheezing, shortness of breath with activity. Disease in which airflow into and out of the lungs is blocked, usually due to a combination of bronchitis and emphysema. Primary cause is smoking. Patient history, pulmonary function tests, chest x-ray, and CT scan. Smoking cessation, medication, and oxygen therapy

Rhinitis

Sneezing, coughing, runny nose, watering eyes, pressure in ears. Irritation and inflammation of the mucous membrane in the nose, along with excessive production of mucus. Allergic rhinitis is triggered by allergens in the air. Physical exam. Allergists can help determine the cause of allergic rhinitis. Antihistamines and corticosteroids.

Diseases of the Nervous System

alzheimers, cerebral concussion, sciatica. cerebrovascular accident (CVA/stroke), shingles.

Alzheimer’s disease

Memory loss, impaired judgement or language, inability to perform activities of daily living, inability to reason, paranoia, and agitation. Most common form of progressive dementia caused by progressive destruction on brain cells. No definitive diagnostic testing available. Diagnosis relies on medical history, physical exam, cognitive testing, brain scans, and lab tests. No available treatment to cure the disease. Focus of care is on symptom management while ensuring the patient is comfortable, safe, and otherwise physically healthy.

Cerebral concussion

Distorted vision, headache, dizziness, nausea and vomiting, sensitivity to light or noise, inability to concentrate. Caused by traumatic injury to the brain. Physical and neurological exam. Observation and rest for seven to ten days.

Sciatica

Pain radiating from lumbar spine to the buttocks and down the back of the leg. Pain can be a dull ache or sharp, burning sensation. Occurs from compression of the sciatic nerve, typically due to a herniated disc, bone spur, or tumor. Medical testing of muscle strength and reflexes. Imaging. Muscle relaxants, anti-inflammatory medications, physical therapy, corticosteroids

Cerebrovascular accident (CVA; stroke)

Symptoms vary depending on the area of the brain impact, but general symptoms are associated with the acronym FAST. Facial muscle weakness, Arm droop, Speech abnormalities. Time (occurs suddenly, treatment options limited by how quickly care can be initiated). Caused by a decrease in blood supply to the brain or a rupture of a blood vessel in the brain. Neurologic examination, CT or MRI scan, Doppler ultrasound or arteriography. Immediate treatment involves restoring blood to the brain or reducing pressure on the brain (depending on the cause). Long-term treatment focuses on rehabilitation for quality of life.

Shingles:

Blisters and pain on the skin in a bandlike pattern that follows the path of the affected nerves. Caused by the varicella zoster virus (also causes chicken pox). The virus can lie dormant for years following an infection of chicken pox, then reappear as shingles. History, location of pain, and pattern of rash. Antiviral medications increase rate of healing.Pain relievers for symptom management.

Diseases of the Endocrine System

cushing syndrome, T1D, T2D, hyper/hypothyroidism, graves disease

Cushing syndrome

Excessive fat deposits in the subscapular area and face. Most often caused by overuse of oral corticosteroid medications. Can also be caused by hypersecretion of glucocorticoids from the adrenal cortex. Indications of high blood pressure, loss of muscle mass, glucose intolerance, and weight gain. Medications used to lower levels of glucocorticoids.

Type 1 diabetes mellitus

Excessive thirst, frequent urination, extreme hunger, weight loss, fatigue, blurred vision, poorly healing wounds, numbness in hands and feet. Chronic condition caused by lack of insulin production. This is a genetic, autoimmune condition that often develops in childhood and is commonly known as juvenile diabetes. (*This may also be considered a disorder of the lymphatic/immune system.). Blood tests to evaluate glucose metabolism. Monitoring blood sugar levels, insulin therapy, eating a healthy diet, and managing weight

Type 2 diabetes mellitus

Excessive thirst, frequent urination, extreme hunger, weight loss, fatigue, blurred vision, poorly healing wounds, numbness in hands and feet. Chronic condition caused by insulin resistance, due to a mix of genetics, obesity, and lifestyle choices. Typically begins in adulthood but is being seen more often in adolescents. Blood tests to evaluate glucose metabolism. Monitoring blood sugar levels, eating a healthy diet, and managing weight. Medications to lower blood sugar, such as metformin. Insulin will be prescribed if the disease is uncontrolled or progresses.

Hyperthyroidism

Sudden weight loss, rapid heartbeat, increased appetite, anxiety, tremor, sweating, frequent bowel movements, enlarged thyroid gland. Overproduction of the thyroid hormone by the thyroid gland. Physical examination, blood tests, radioactive iodine uptake test, and thyroid scans. Antithyroid medications, oral radioactive iodine

Hypothyroidism

Increasing tiredness, dry skin, constipation, and weight gain. Underproduction of the thyroid hormone by the thyroid gland. Blood test measuring thyroid stimulating hormone and thyroxine. Use of synthetic thyroid hormone levothyroxine

Graves’ disease

Significant enlargement of the thyroid gland, increased heartbeat, muscle weakness, disturbed sleep, tremor, weight loss, anxiety, irritability, and bulging of the eyes. Caused by malfunction in the body’s immune system that disrupts normal thyroid regulation, resulting in hyperthyroidism. Typically diagnosed by symptoms. Thyroid hormone tests may also be used. Radioactive iodine therapy, antithyroid medications, beta blockers, and surgery

Diseases of the Reproductive System

Candidiasis, ectopic pregnancy, endometriosis, genital herpes, inguinal hernia, Cryptorchidism, testicle torsion, Benign prostatic hyperplasia (BPH),

Candidiasis

Vaginal itching, burning with urination, white vaginal discharge. Often called a “yeast infection”. Overgrowth of the fungal micro-organism. Candida albicans. Testing of vaginal discharge. Over-the-counter or prescription medications.

Ectopic pregnancy

Abdominal or pelvic pain with light bleeding. Severe pain and bleeding are symptoms of emergent condition. Zygote implantation in an area other than the uterine wall, most commonly in the uterine tubes Physical examination, blood tests, and ultrasound. Termination of the pregnancy, as it is not viable and can rupture the uterine tube if allowed to develop far enough, which would require surgery

Endometriosis

Pelvic pain with menstruation, pain with intercourse, pain with bowel movements and urination, infertility. Occurs when pieces of endometrial tissue grow outside of the uterine lining, typically on the ovaries, intestines, or pelvic wall Pelvic examination, ultrasound, and laparoscopy. Pain medication, hormone therapy, or laparoscopic surgery.

Genital herpes

Pain, itching, and sores in the genital area. Flu-like symptoms upon initial infection. Caused by the herpes simplex virus spread through sexual contact. Visual examination of sores, testing of sample from the sores. Incurable. Medications, typically antivirals, can prevent or shorten outbreaks

Inguinal hernia

Bulging in the groin area accompanied by an aching sensation, pain with lifting, coughing, or movement, weakness, or pressure in the groin. A portion of the intestines protrudes thought a weak point of the abdominal wall. Physical examination. If no symptoms, treatment is not indicated. Surgery to repair the hernia if symptoms present.

Cryptorchidism

Undescended testicles, when they fail to drop into the normal place of the scrotum. Some cases are unknown, others may be due to structural abnormalities, or there may be a mechanical problem.. Felt when conducting a physical examination. Only treatment choice is surgery and recommended after six months of age

Testicular torsion

When tissues surrounding the testicle are not well attached, causing the testes to twist around the spermatic chord cutting off blood flow to the testicle causing severe pain. Some causes are unknown. Some patients are born with no tissue holding the testes to the scrotum. Found when conducting a physical examination. The spermatic cord needs to be untwisted to restore blood supply. Patients need to see a urologist, and surgery is necessary to correct.

Benign prostatic hyperplasia (BPH)

Enlargement of the prostate. Common later in life. Can cause uncomfortable urinary symptoms, urinary tract infections, or kidney problems. Causes are unknown but are believed to be linked to hormonal changes. Digital rectal examination, urine test, or prostate specific antigen test. Transurethral resection of the prostate.