Pathophysiology - Diseases

cerebral atrophy

• loss of brain neurons and degeneration of neural pathways

• results in memory loss, coordination issues, cognitive decline, speech and language issues

• risk factors: age, family hx, TBI, alcohol abuse, MS, stroke

• treatment includes treating underlying disease

cardiac hypertrophy

• thickening of the heart muscle in response to sustained stress

• results in SOB, chest pain, fatigue, dizziness, palpitations, swelling in lower extremities

• risk factors: hypertension, obesity, diabetes, age

• treatment includes beta blockers, anti-arrhythmic, anti-coagulants, diuretics

acromegaly

• skeletal overgrowth due to chronic GH overproduction

• often due to pituitary tumor making the liver release high levels of insulin-like growth factor

• results in enlarged hands and feet, prominent forehead, protruding jaw, deepening of voice, joint pain, excessive sweating, fatigue

• risk factors: family hx, rare genetic conditions, adrenal tumors, early menopause, young age at first childbirth

• treatment includes growth hormone receptor antagonists

cervical metaplasia

• normal process where cervical cells adapt to an external stimulus

• sometimes show no symptoms, however symptoms can include abnormal vaginal bleeding or discharge, pain during intercourse

• risk factors: HPV, weakened immune system

• no standard medications used to treat

cervical dysplasia

• abnormal cell growth and maturation that is often caused by HPV and can be pre-cancerous

• sometimes show no symptoms, however symptoms can include abnormal vaginal bleeding or discharge, pain during intercourse

• risk factors: HPV, weakened immune system

• no standard medications used to treat

osteoporosis

• decrease in bone density and structural integrity due to an imbalance in bone remodeling (bone breakdown > bone formation), often due to low calcium and decrease in estrogen

• result sin back pain, stooped posture, shrinking, fractures from mild trauma or normal daily activities

• risk factors: female, age, white or asian ethnicity, small body frame, family hx

• treatment includes increased calcium intake, bisphosphonates (to slow down bone loss), and anabolic drugs (to stimulate new bone growth)

sinusitis

• can be acute or chronic

• inflammation of nasal passages and sinuses due to upper respiratory infection causing mucosal swelling and obstruction of the sinuses

• results in congestion, yellow or green nasal discharge, facial pain/pressure, cough, fatigue, sore throat, ear pain, sometimes a fever can occur

• risk factors: obstructed nasal passages, exposure to smoke or air pollution, weakened immune system, diabetes, day care settings, previous sinus infections

• treatment includes corticosteroids, antibiotics, saline nasal rinses, decongestants

acute sinusitis

sinusitis lasting 4-8 weeks

chronic sinusitis

sinusitis lasting 12+ weeks

burns

• tissue damage due to heat exposure, chemicals, or electricity

• results in redness, pain, blisters, swelling, shiny skin, leathery skin, white/brown/black skin

• risk factors: older age, young children, males, alcohol use, occupational hazards

• treatment includes NSAIDs or opioids to manage pain, antibiotics if infected, topical agents

rheumatoid arthritis

• autoimmune response where the immune response attacks the synovial membrane lining in the joints causing inflammation, swelling, and bone/cartilage erosion

• results in pain, swelling, stiffness, and tenderness of joints, fatigue, malaise, weight loss, anemia, rheumatoid nodules

• risk factors: family hx, smoking, female, increased age, compromised immune system, low vitamin D

• treatment includes corticosteroids, NSAIDs

gastritis

• inflammation of the stomach lining caused by bacterial or viral infection, autoimmune disorders, alcohol, smoking, or stress

• results in upper abdominal burning pain, nausea, vomiting, bloating, indigestion, loss of appetite, tarry stools or blood vomit in severe cases

• risk factors: infection, smoking, alcohol abuse, chronic stress, bad diet, increased age, male, underlying medical conditions

• treatment includes antibiotics, antacids, NSAIDs

pancreatitis

• inflammation of the pancreas causing tissue damage, scar tissue, and even loss of pancreatic function

• results in fever, nausea, vomiting, tender/swollen abdomen, oily stools, unintended weight loss, indigestion, sometimes jaundice

• risk factors: hx of gallstones, alcohol abuse, high-fat diet, obesity, smoking, trauma to pancreas

• treatment includes pain management using analgesics, antibiotics, electrolyte replacement, enteral feeding

crohn’s disease

• breakdown of immune regulation in the intestinal tract where the immune system attacks bacteria in the gut leading to chronic inflammation and tissue damage in the intestines

• results in diarrhea, abdominal pain, cramping, unexplained weight loss, fatigue, rectal bleeding

• risk factors: family hx, eating habits, antibiotics, high stress, male, 15-30 years old, white

• treatment includes anti-inflammatory drugs, immunomodulators, antibiotics, anti-diarrheal medications

ulcerative colitis

• T cells and macrophages attack healthy epithelial cells in the colon leading to inflammation and damaged colon function

• results in diarrhea, rectal bleeding, abdominal pain, fatigue, weight loss, fever, anemia, liver issues

• risk factors: family hx, smoking, high processed food diet, stress, use of NSAIDs, young adult or oder adult, low vitamin D

• treatment includes corticosteroids, immunosuppressants

AIDS

• HIV weakens the immune system causing low CD4 T cell count

• diagnosed when CD4 count is less than 200 cells/microliter

• results in contraction of opportunistic infections, fever, weight loss, fatigue, sweating, chronic diarrhea

• risk factors: multiple sexual partners/sexual contact, sharing needles or syringes, mother to baby, excessive use of drugs and alcohol

• treatment includes antiretroviral therapy (ART)

anaphylactic reaction

• immune system recognizes and allergen and overreacts, histamine is released which dilates blood vessels and increases their permeability which causes swelling and low BP

• results in hives, itching, swelling, difficulty breathing, wheezing, dizziness, fainting, nausea and vomiting, drop in BP, weak or fast pulse

• risk factors: severe allergies, asthma, mast cell disease, child or older adult, family hx

• treatment includes epinephrine

systemic lupus erythematosus (SLE)

• chronic autoimmune disorder in which antibodies produced target organs and tissues within the body

• results in fatigue, joint pain, rashes, photosensitivity, anemia, blood clots, seizures, memory issues, hair loss

• risk factors: family hx, certain genetic mutations, women (especially during childbearing years), autoimmune disorders, smoking, pregnancy, UV exposure, stress

• treatment includes corticosteroids, immunosuppressants, NSAIDs

Rh isoimmunization

• immune response by Rh negative mother to Rh positive RBC of fetus causing maternal antibodies to attack foreign RBC of fetus

• results in fetal anemia, yellow amniotic fluid, severe swelling, jaundice, lethargy, pallor, difficulty feeding, tachycardia, tachypnea

• risk factors: Rh negative expecting mother exposed to Rh positive blood, hx. of previous pregnancies, abdominal trauma, bleeding placenta

• treatment includes RhoGAM as prevention, and intrauterine blood transfusion as treatment

bacterial meningitis

• an infection of the meninges, the membranes that cover the brain and spinal cord

• results in fever, stiff neck, and altered mental status (confusion or sleepiness), horrible headache

• risk factors: young child, older adult, immunocompromised, living in crowded environment, not vaccinated

• treatment includes IV antibiotics, corticosteroids, fluids, and immunizations to prevent

influenza

• viral infection of epithelial cells in the airway (3 types: A, B, & C)

• results in cough, sore throat, nasal congestion and drainage, chills, fever, body aches, weakness, malaise

• risk factors: age, heart disease, lung disease, diabetes, pregnancy, obesity, smoking, crowded environments

• treatment includes antiviral drugs and analgesics (help with pain)

viral hepatitis

• inflammation of the liver caused by viral infection, can be due to alcohol abuse or ingestion of toxins causing liver damage…can lead to liver cirrhosis

• results in fatigue, anorexia, malaise, low-grade fever, jaundice, dark urine, clay-colored stools, tender and enlarged liver

• risk factors: exposure to infected blood or bodily fluids, shared needles, unprotected sex, occupational hazards

• treatment includes vaccination prevention, analgesics, antiviral medications

tuberculosis

• bacterial infection that fights the lungs

• results in malaise, weight loss, fatigue, anorexia, fever, night sweats, bloody sputum

• 90% of cases are asymptomatic

• risk factors: HIV, diabetes, malnutrition, alcohol and drug use, older age

• treatment includes antimicrobial drugs and directly observed therapy (DOT)

urinary tract infection

• infection anywhere from urethral meatus to the bladder…E coli. attaches to epithelial cells of urinary tract causing an inflammatory response

• results in dysuria, urinary urgency and frequency, hematuria (blood in urine), cloudy urine, concentrated urine, confusion/altered mental state

• risk factors: female, poor hygiene, sexual activity, diabetes, kidney stones, young child and older adults

• treatment includes antibiotics

pyelonephritis

• infection of urinary tract spreading to kidneys leading to inflammation and often scarring

• results in fever, CVA pain, nausea, vomiting, dysuria, urinary frequency and urgency, hematuria (blood in urine)

• risk factors: urinary tract structural abnormalities, enlarged prostate, history of UTIs and other infections, diabetes, HIV, chemotherapy

• treatment includes IV fluids, antibiotics, pain meds, sometimes surgery

tinea

• fungal skin disease caused by direct contact…fungus can be found on skin, feet, nails, scalp, and groin

• results in ringworm like inflammation, hypopigmentation of skin, hair loss, itching, raised patches on skin

• risk factors: close contacted with infected people, excessive sweating, public showers/locker rooms, poor hygiene, diabetes

• treatment includes topical anti-fungal agents and oral anti-fungal agents

malaria

• inflammation of plasmodium protozoa transmitted to humans through mosquito bite, plasmodia enters into blood to feed on proteins and RBC

• results in headache, fever, chills, sweating, cough, fatigue, malaise, joint/muscle aches

• risk factors: environment, high temps, and humidity, young children and infants, genetics

• treatment includes anti-malarial drugs and antipyretics

huntington disease

• an autosomal dominant neurologic disorder involving the degeneration of basal ganglia and cortical regions of the brain

• progressive disease caused by caused by a defective gene on chromosome 4

• results in involuntary movements, cognitive impairment, personality changes, loss of memory, antisocial and impulsive behaviors, restlessness, dyskinesia, abnormal eye movements, chorea

• risk factors: family history, between 30 and 50 years old, female, smoking, alcohol abuse, obesity

• treatment includes physical and occupational therapies, emotional support groups, medications for symptom management…there is no cure

sickle cell disease

• autosomal recessive group of inherited RBC disorders which affects hemoglobin on RBC…hemoglobin A gets replaced by hemoglobin S

• transmitted parent to child and caused by single gene mutation

• makes hemoglobin stiff and distorted

• results in vasooclussion, hemolysis, pain, jaundice, anemia, stroke, priapism (painful, prolonged erection), organ damage (spleen, kidneys, and liver)

• risk factors: family history and stress

• treatment includes pain medication, antibiotics if there’s an infection, blood transfusions

down syndrome

• extra copy of chromosome 21 making a total of 47 chromosomes

• results in intellectual disability, eyes slanted upwards, epicanthal fold, small/low set ears, small mouth, flattened nose bridge, short neck, cardiac defects, intestinal malformations, vision and hearing impairments

• risk factors: maternal age over 35, family history, marriage between close relative

• treatment includes medications used to prevent and treat underlying conditions…there is no cure

turner syndrome

• occurs in females when chromosome X is altered…completely or partially missing

• results in short fingers and neck, cleft palate, osteoporosis, delayed bone age/development, webbed neck, low hairline, cardiac, kidney, and liver abnormalities, hearing loss, ovarian dysgenesis

• risk factors: advanced maternal age

• treatment includes growth hormones/supplements, hormone therapy

klinefelter syndrome

• occurs when a male has an extra X chromosome

• karotype is 46XXY and phenotype is male

• results in little pubic hair, atrophic testes, small penis, infertile, lack of facial hair, wide hips, breast development

• risk factors: advanced maternal age

• treatment includes growth hormones/supplements, hormone therapy

fragile X syndrome

• sex linked (X linked) dominant disorder due to mutation of the long arm of the X chromosome which prevents the mental retardation protein (FMRP) to be made which is vital in brain development

• results in attention deficit, hyperactivity, expressive delay, negative response to touch, repetitive speech, social anxiety, autism, seizures, distinctive facial features, hyperflexible joints, below average height, enlarged testicles

• risk factors: family history, advanced maternal age

• treatment includes antidepressants and antipsychotics, medications to help with focusing and compulsive behaviors

neural tube defects

• serious birth defects of brain and spinal cord that occurs during embryonic development

• incomplete closure of neural tube…the degree of closure determines the type of defect

• results in anencephaly → fatal, spina bifida → could be anything from small dimple at base of spine to lower body paralysis

• risk factors: family history, gene mutations, maternal age, smoking/alcohol consumption during pregnancy, decreased folic acid intake during first trimester

• treatment includes pain management, depression and anxiety medications

progeria

• mutation of LMNA gene which encodes for a protein that helps maintain nuclear structure and function…protein called progerin is produced and disrupts normal cellular function

• results in slow growth, hair loss, wrinkled skin, atherosclerosis, skeletal issues, dental problems, hearing and vision loss

• risk factors: family history, age of father, no definite risk factors

• treatment includes lonafarnib (Zokinvy), medications to treat symptoms, pain medications

lung cancer

• neoplasms develop in lung tissue or tumor grows and metastisizes

• due to smoking 90% of the time…can be due to environmental exposures or toxins

• leading cause of cancer deaths in the world

• results in cough, hemoptysis (bloody sputum), chest pain, shortness of breath

• risk factors: smoking, increased age, family history, exposure to radon, exposure to asbestos

• treatment includes chemotherapy, radiation, surgery, pain management

colon cancer

• mutations leading to overgrowth creating nonneoplastic polyps, neoplastic polyps (pre-cancer), and cancers (adenomas, adenocarcinomas)

• most frequently occurring type of GI tract cancer

• results in occult blood in stool, frank blood in stool, abdominal pain, bowel obstruction, anemia

• risk factors: increasing age, family history, smoking, alcohol use, chronic inflammatory bowel disease, obesity, high fiber diet

• treatment includes chemotherapy, radiation, surgery, pain medications, symptom management

brain cancer

• often occurs due to metastatic spread form other cancerous tissues

• gliomoas (astrocytomas) are common and are caused by gene mutation

  • can be present in brain stem, cerebellum, spinal cord, or cerebral hemispheres

• common in children (2nd to leukemia)

• results in motor or sensory loss, vision changes, weakness, paralysis, irritability, forgetfulness, depression, personality changes

• risk factors: family history, exposure to radiation, smoking, alcohol use, obesity, head trauma

• treatment includes chemotherapy, surgery, radiation, anticonvulsants, mood stabilizers, antidepressants

acute leukemia

• malignant neoplasms of the blood, over proliferation of WBC, creating immature WBC called blasts, blasts then replace cells in bone marrow and then move to other organs

• common in children

• results in infections, anemia, bruising, bleeding problems, frequent nose bleeds, fatigue, bone pain, headaches, nausea, vomiting, seizures, coma, unexplained weight loss

• risk factors: smoking, chemical/chemo/radiation exposures, family history, blood disorders, older adults, children, male

• treatment includes chemotherapy, radiation, symptom management, pain management

hodgkin lymphoma

• malignant but curable cancer of lymphoid tissue

• enlargement of cervical lymph nodes

• macrophages are surrounded by neutrophils, eosinophils, plasma cells, small lymphocytes, and fibroblasts which causes inflammation in the lymph nodes

• results in non-tender enlarged lymph nodes in neck, firm and rubbery, low grade fever, fatigue, weight loss, itching, drenching night sweats, liver issues, spleen issues, reed stern-burg cells present

• risk factors: exposure to Epstein-Barr virus (EBV), genetics, family history, immunosuppressants

• treatment includes chemotherapy, radiation, stem cell transplant, pain management, symptom management

non hodgkin lymphoma

• protooncogenes or tumor suppressor genes causing expansion of B and T cell production

• affects unconnected lymph nodes

• results in painless enlargement of lymph nodes, fever, night sweats, weight loss, increased risk of infection

• risk factors: older adult, male, family history, infections, smoking, obesity, alcohol use

• treatment includes chemotherapy, radiation, stem cell transplant, pain management, symptom management

cirrhosis

• increased vascular resistance due to local blood flow interference causes and increase in pressure in the liver leading to increased fluid movement

• also known as liver disease

• results in ascites, abdominal discomfort, increased abdominal girth, increased weight, severe sodium retention, renal failure

• risk factors: hepatitis B and C infections, alcohol use, obesity, diabetes, metabolic issues, genetics

• treatment includes diuretics, paracentesis, IV albumin

dehydration

• negative fluid balance caused by decreased fluid intake, increased fluid output, or a fluid shift between compartments

• results in decreased level of consciousness, increase in capillary refill time, dry mucous membranes, decreased or absent tears, increased respiratory rate, hypotension, sunken eyes, decreased or absent urine output

• risk factors: humidity and heat, prolonged sun exposure, physical exertion, diarrhea, diabetes, kidney disease, diuretics and laxatives, children, older adults, chronic illnesses

• treatment includes IV fluids and electrolytes

hypoparathyroidism

• low level of parathyroid hormone secretion often due to damage parathyroid glands which causes parathyroid glands to become unable to tell the body that calcium levels are low which causes hypocalcemia

• results in nail dryness and loss, nail ridges and breakage, skin dryness, bone loss, tingling in extremities, visual changes, muscle cramps, seizures, fatigue

• risk factors: thyroid/neck surgery, Hashimoto’s or Grave’s disease, family history, older adults, female

• treatment includes recombinant parathyroid injection and calcium supplements

HAART

• adverse affects from antiretroviral drugs used to treat HIV that could lead to hyperlactatemia or lactic acidosis

• inhibition of DNA polymerase leading to mitochondrial dysfunction leading to increased lactate levels in the blood

• highly active antiretroviral associated acidosis

• results in nausea, vomiting, abdominal discomfort, weight loss, hepatic stenosis (fatty liver), hepatomegaly (enlarged liver), elevated liver enzymes

• can be asymptomatic

• risk factors: female, pregnancy, obesity, low CD4, use of NRTIs

• treatment includes stopping NRTI medications, IV bicarbonate, and IV fluids

renal tubulopathy

• an autosomal recessive disorder characterized by metabolic acidosis

• impaired electrolyte reabsorption in renal tubules due to a gene defect that alters 5 renal membrane proteins

• results in polyuria (excessive urine output), herpercalciuria (excessive calcium in urine), fever, vomiting, diarrhea

•  risk factors: certain meds, exposure to heavy metals, smoking, alcohol, HIV, autoimmune conditions, obesity, older age, white

• treatment includes fluid management, sodium supplements, potassium supplements, diuretics, calcium supplements, magnesium supplements, a prostaglandin inhibitor

metabolic acidosis in parenteral nutrition

• from the infusion of acidic components which increases the acid load beyond the body’s ability to buffer it…the body fails to maintain acid-base homeostasis

• can occur with TPN or PPN

• results in anorexia, nausea, vomiting, weakness, lethargy, confusion, coma, vasodilation, decreased heart rate, flushed skin

• risk factors: high chloride content in PN, titratable acidity, thiamine deficiency, overfeeding, metabolic complications

• treatment includes adjusting TPN or PPN intake, switching to enteral feeding, hydration/IV fluids

cerebral palsy

• disorder resulting from damage to upper motor neurons causing altered central control of movement…occurs during prenatal, perinatal, or postnatal development

• results in altered body movement and muscle coordination, delay in reaching milestones in infancy, speech difficulties, seizures

• risk factors: premature, low birth weight, multiples, infections during pregnancy, placental complications, birth complications, maternal age over 40

• treatment includes anticonvulsants, muscle relaxers, braces, PT, OT, speech therapy

multiple sclerosis

• progressive neurogenerative disorder characterized by the degeneration of myelin that affects nerves in the CNS and PNS

• results in weakness/numbness, difficulty walking, difficulty coordinating movements, muscle stiffness, tremors, paralysis

• risk factors: female, 25-49 year old, northern european ancestry, history of infections, geographic location, sunlight exposure, family history

• treatment includes immunomudulators, copaxone (mimics the effects of myelin)

hydrocephalus

• increased CSF fluid accumulation brain ventricles or subarachnoid space due to an imbalance of fluid produces and the rate that fluid is absorbed

• results in increased head circumference, prominent scalp veins, enlarged fontanelles, separation of bony sutures, protruding forehead, sunset eyes, lethargy, irritability, hyperactive reflexes

• risk factors: infant, older adult, family history, congenital abnormalities, brain tumors, infections

• treatment includes medications to relieve symptoms

spinal cord injury

• partial or complete tear within the spinal cord…degree of symptoms depends on the location of the tear, type of injury, degree of tear

• results in quadriplegia, sweating, unregulated BP, unregulated body temp., respiratory problems, paraplegia, issues with bladder, bowel, and sexual function

• risk factors: trauma, older age, male, smoking, alcohol and drug use

• treatment includes opioids, anticonvulsants, and muscle relaxants

parkinson’s disease

• chronic, progressive neurologic condition affecting neurons in the midbrain and pons…impaired transport of dopamine alters excitability and release of neurotransmitters

• results in tremors, bradykinesia, akinesia, jerky movements, sweating, altered BP and thermal regulation, constipation, incontinence, cognitive and personality changes

• risk factors: older age, family history, male, head trauma, certain medications

• treatment includes Levodopa (replaces dopamine), medications to manage symptoms

alzheimer’s disease

• neurodegenerative disorder involving progressive cognitive decline and memory loss

• results in memory loss, difficulty problem-solving and decision making, orientation changes, trouble with daily functions, mood and personality changes, loss of bladder and bowel control, loss of appetite/weight loss, increased risk of falls

• risk factors: older age, heart issues, obesity, smoking, alcohol use, physical inactivity, head trauma

• treatment includes Donepezil, Rivastigmine, Galantamine, Antipsychotics

generalized anxiety

• panic or overthinking, cause is unknown but norepinephrine, serotonin, dopamine, and GABA seem to be involved

• results in persistent worrying, overthinking plans and solutions, focusing of the worst possible outcomes, difficulty handling uncertainty, indecisiveness, nervousness

• risk factors: timid or negative personality, genetics/family history, traumatic life experiences, chronic illnesses/medical problems

• treatment includes antidepressants, benzos, and nonbenzos

PTSD

• anxiety disorder caused by extreme events, fight or flight response kicks in and releases norepinephrine and epinephrine, serotonin is reduced, amygdala becomes hyperactive which leads to increased fear responses

• results in flashbacks, dreams/nightmares, unwanted memories that don’t go away, avoidance, negative thoughts and emotions, detached from family and friends, feeling numb, trouble sleeping easily startled

• risk factors: severe traumatic experiences, childhood, abuse, military/first responder, drug abuse, family history, other mental health problems

• treatment includes antidepressants, anti-anxiety medications

major depressive disorder

• exact cause is unknown but thought to be due to neurotransmitter imbalances leading to sadness and hopelessness

• results in sadness, emptiness, hopelessness, irritability, lost of interest or pleasure in normal activities, insomnia, sleeping too much, tiredness, anxiety, suicidal thoughts/behaviors

• risk factors: personality traits such as negativity and low self-esteem, traumatic events, family history, alcohol and drug use, chronic illnesses, some medications 

• treatment includes SSRIs, SNRIs, MAOIs, atypical antidepressants, tricyclic antidepressants

bipolar affective disorder

• exact cause is unknown but thought to be due to genetics, dopamine, serotonin, and norepinephrine imbalances, amygdala and prefrontal cortex structural changes

• results in mania, irritability, rapid and excessive speech, distractibility, racing thoughts, impaired judgement, impulsivity, goal oriented, psychosis

• risk factors: family history, high stress, traumatic event, drug use, alcohol use

• treatment includes mood stabilizers, antipsychotics, antidepressants, anti-anxiety meds, outpatient programs, support groups

ADHD

• neurodevelopmental disorder of cognitive functions causing attention deficit, hyperactivity, and impulsiveness

• results in easily distracted, can’t sit still, forgetful, misses details, loses things, day-dreaming, constantly in motion, inpatient, continuous talking, interruptive

• risk factors: family history, genetics, low birth weight, premature, bullying, lack of sleep, poor nutrition, male

• treatment includes amphetamines, psychotherapy, CBT, good sleep and diet

autism

• altered brain connectivity and abnormal neuronal migration that causes social and behavioral changes

• results in difficulty understanding and responding to social cues, reduced eye contact, little non-verbal communication, insists on routines, rocking or hand-flipping, unusual reactions to stimuli, delayed language development

• risk factors: male, family history, other genetics conditions, premature, older parents

• treatment includes antipsychotics, antidepressants, behavior and communication therapy, educational support

fibromyalgia

• long-term widespread body pain…affects the way the brain and spinal cord process painful and non-painful events

• results in widespread pain, fatigue, brain fog, irritable bowel syndrome, painful bladder symptom, migraines, headaches, anxiety, depression

• risk factors: female, family history, osteoarthritis, rheumatoid arthritis, lupus, obesity

• treatment includes pain relievers, antidepressants, anticonvulsants, PT/OT, counseling

migraine headache

• recurrent, moderate to severe headaches that last 1-2 days, characterized by neurologic dysfunction involving the impairment of cortical, subcortical, and brainstem areas

• results in visual changes/loss, pins and needles feeling, pain that throbs or pulses, increased sensitivity to light and sound, nausea and vomiting

• risk factors: family history, teen to mid 30s, female, hormonal changes

• treatment includes pain relievers, anti-nausea meds, prevention meds (Triptans), neuromodulation therapy

otitis media

• infection of the middle ear, bacteria or virus enters into the middle ear cavity through the Eustachian tube

• results in ear pain/pressure, trouble sleeping, trouble hearing or replying to sounds, loss of balance, fever, fluid coming from ear, headache, loss of appetite

• risk factors: 6 months to 2 years old, daycare, bottle fed, fall and winter time, poor air quality, cleft palate

• treatment includes antibiotics, pain medications, ear tubes, ear drops, infection prevention measures

meniere disease

• inner ear problem that can cause dizzy spells and hearing loss, often affects ONE ear

• results in vertigo (dizzy spells), hearing loss, tinnitus (ringing in the ear), feeling of fullness in the ear

• risk factors: 40-60 years old, female, family history, autoimmune disorder

• treatment includes motion sickness meds, anti-nausea, middle ear injections, hearing aid in affected ear, surgery, rehab therapy to improve balance

macular degeneration

• eye condition affecting the macula which results in visual distortions and central vision loss → two types: dry and wet

  • dry: most cases, retinal deterioration resulting in yellow deposits under the macula…thins and drys out the macula

  • wet: new blood vessel formation, fluid leakage and bleeding alters the shape of the macula

• results in fluctuating vision, difficulty reading, limited night vision, vision loss

• risk factors: older than 60, smoking, hypertension, obesity, family history

• treatment includes no meds for dry MD, meds to block vascular endothelial growth, photodynamic therapy

glaucoma

• eye condition that damages the optic nerve, damage is mostly caused by elevated intraocular pressure (IOP) which can lead to vision loss or blindness

• results in sometimes no symptoms in early stages, gradual irreversible vision, “blind spots“, eye pain, headache, nausea, blurred vision, rainbows around lights at night

• risk factors: over 60, family history, diabetes, hypertension, sickle cell anemia, eye trauma, long-term steroid use

• treatment includes eye drops, oral medications, surgery, laser treatment, eye drainage tubes, surgery

SIADH

• condition of excessive production and release of ADH despite changes to serum osmolarity and blood volume…most common explanation is a tumor

• results in hyponatremia, decreased UOP, concentrated urine, anorexia, nausea, vomiting, headache, irritability, disorientation, muscle cramps, muscle weakness, psychosis, gait disturbances, seizures, coma

• risk factors: CNS disorders, some cancers, lung diseases, antidepressants, anticonvulsants

• treatment includes demeclocycline, loop diuretics, ADH receptor antagonist, fluid/water restriction, isotonic or hypertonic fluids, salt tablets

diabetes insipidus

• causes fluids in the body to become out of balance, inability of the body to concentrate or retain water

• results in excessive thirst, unconcentrated/pale urine, urinating during the night, drink water often during the night

• risk factors: family history, diuretics, kidney problems, head injury, brain surgery

• treatment includes desmopressin, low salt diet, low protein diet

hyperthyroidism

• thyroid gland produces too much thyroid hormone (T3 & T4)…graves disease

• results in losing weight without trying, tachycardia, arrhythmias, heart palpatations, increased hunger, tremor, sweating, increased sensitivity to heat, goiter, tiredness, thin/brittle hair

• risk factors: family history, recent pregnancy, female

• treatment includes anti-thyroid medication, radioiodine therapy, thyroidectomy, low iodine therapy

hypothyroidism

• thyroid gland doesn’t produce enough thyroid hormone (T3 & T4)…hashimoto’s disease

• results in tiredness, increased sensitivity to cold, constipation, dry skin, weight gain, puffy face (moon face), muscle weakness and tenderness, bradycardia, depression

• risk factors: female, family history, diabetes, celiac, autoimmune diseases, radiation exposure to neck or upper chest

• treatment includes levothyroxine (thyroid replacement med), balanced diet rich in iodine, vitamin D, and zinc, regular exercise

cushing syndrome

• condition due to prolonged exposure to glucocorticosteroids and cortisol

• results in weight gain in trunk with skinny arms and legs, moon face, buffalo hump, striae, thick and dark hair on face and body, irregular menstruation/no period, lower sex drive, reduced fertility

• risk factors: exposure to cortisol, long-term glucocortiocsteroid use, tumor, female, genetics, between 30 & 50, white

• treatment includes reducing glucocortiocsteroid use, meds to control cortisol production, surgery, radiation, well balanced diet, exercise

addison disease

• acute ACTH deficiency that is a very serious endocrine disorder, occurs as a result of insufficient production of cortisol and aldosterone form the adrenal cortex

• results in fatigue, postural hypotension, hypoglycemia, upset stomach, diarrhea, vomiting, muscle cramps/weakness, widespread pain/joint pain, depression, lower sex drive

• risk factors: autoimmune disorders, TB, HIV, tumors, long-term corticosteroid and anticoagulant use, genetics

• treatment includes corticosteroids, fludrocortisone acetate (replaces aldosterone)

pelvic inflammatory disease

• result of STI, infection attaches to the epithelial cells and elicit inflammatory and immune response

• results in lower abdominal pain, pelvic pain, purulent cervical discharge, cervical motion tenderness, fever, malaise, infertility

• risk factors: sexually active, multiple sexual partners, less than 25 years old, not using condom, STI history

• treatment includes antibiotics, fluids, avoid reinfection, abstain from intercourse during treatment

PCOS

• excess androgen production from ovaries

• results in irregular cycles, increased androgen production, long periods, cycle length longer than 35 days, acne, facial hair, obesity

• risk factors: obesity, family history, hormone imbalances, early puberty, stress

• treatment includes gonadotropins, antiestrogen (when trying to get pregnant), metformin (lowers insulin levels), birth control, sprinolactone, surgery, exercise

menopause

• complete cessation of ovarian activity, follicles become exhausted and are unable to respond to functional demands, no longer able to produce estrogen and progesterone

• results in menstrual cycle cessation, breast tenderness, moodiness, hot flashes, vaginal dryness, sleep disruption, bone demineralization

• risk factors: female, 40s or 50s

• treatment includes selective estrogen receptor modulators (SERMS), hormone replacement therapy, pelvic floor exercises, relaxation techniques

erectile dysfunction

• inability to achieve or maintain an erection sufficient for satisfactory sexual performance

• results in anxiety, low self-esteem, depression, inability to get or maintain erection

• risk factors: tobacco use, obesity, alcohol use, older age

• treatment includes testosterone replacement, Viagra, therapy, mental health support, penile implants

benign prostatic hyperplasia

• nonmalignant overgrowth of prostate tissue

• results in urinary frequency, dribbling, hesitancy, incontinence, urgency, retention

• risk factors: older age, family history, obese, diabetes

• treatment includes hormonal replacement, symptom management, transurethral restection of the prostate (TURP), stent placement, social and emotional support

prostate cancer

• malignant transformation of epithelial cells, androgens and estrogens seem to support carcinogenesis

• asymptomatic or results in urinary frequency, dribbling, hesitancy, incontinence, urgency, retention

• risk factors: older age, family history, smoking

• treatment includes androgen-deprivation hormone therapy, symptom management meds, surgery (prostate removal), radiation, chemotherapy

testicular cancer

• highly treatable and curable cancer

  • seminomas → malignant germ cells that resemble sperm cells

  • nonseminomas → do not resemble sperm cells

• results in painless mass, enlargement of testicle, enlargement of scrotum

• risk factors: undescended testicle, family history, white, 15 to 45 years old

• treatment includes symptom management, pain meds, surgery, radiation, chemotherapy

ovarian cancer

• neoplasias that form in reproductive tract, can form from epithelial tumors, germ cell tumors, or sex cord tumors

• asymptomatic or results in bloating, abdominal distention, abdominal pressure, abdominal pain

• risk factors: family history, obesity, older age, endometriosis, never been pregnant

• treatment includes symptom management, pain meds, surgery, radiation, chemotherapy

pneumonia

• acute inflection causing inflammation of the lungs and fluid and exudate buildup making it hard to breathe

• caused by microorganisms (like bacteria, viruses, or fungi) spread through respiratory droplets

• results in crackles, fever, chills, cough, greenish sputum, fatigue, dyspnea, tachypnea, tachycardia, pleuritic pain, headaches, confusion

• risk factors: children under 2, older adults, chronic diseases, smoking, hospitalized, HIV/AIDS

• treatment includes antibiotics, antipyretics, analgesics, antifungals, O2 therapy, fluids, chest physiotherapy, chest tube if severe

emphysema

• irreversible enlargement of the airspaces, beyond the terminal bronchioles especially in the alveoli, and destruction of alveolar walls

• developed inflammation in alveoli resulting in the loss of elastic recoil

• results in hypoxemia, hypercapnia, chronic productive cough, dyspnea, wheezing, barrel chest, pursed lip breathing

• risk factors: smoking, second-hand smoke, occupational hazards, pollution, genetics

• treatment includes danazol, tamoxifen, bronchodilators, steroid anti-inflammatories, antibiotics, oxygen therapy, lung volume reduction, lung transplant, pulmonary rehabilitation

chronic bronchitis

• presence of a persistent, productive cough with excessive mucous production that lasts for 3 months or longer for 2 or more consecutive years

• caused by chronic inflammation and swelling of the airways causing airway deformities

• results in productive cough, purulent sputum, dyspnea with minimal exertion, wheezing and crackles in the lungs, hypoxemia, hypercapnia, cyanosis

• risk factors: smoking, air pollution, occupational exposures, genetics, older adults, asthma

• treatment includes steroid anti-inflammatories, antibiotics, bronchodilators, smoking cessation, pulmonary rehabilitation, oxygen therapy

asthma

• chronic inflammatory disorder of the airways

• results in wheezing, breathlessness, chest tightness, excessive sputum production, coughing, anxiety, tachypnea, use of accessory muscles

• risk factors: family history, allergies, obesity, smoking, secondhand smoke, pollution

• treatment includes bronchodilators, anti-inflammatories, emergency action plan

cystic fibrosis

• autosomal recessive disorder of electrolyte and water transport that affects certain epithelial cells in the respiratory, digestive, and reproductive tract

• caused by a mutation on the CFTR gene that causes CFTR protein to be dysfunctional

• results in cough, wheezing, lung infections, sinus infections, stuffy nose, foul smelling stools, greasy stools, poor weight gain and growth, blocked intestines, constipation, delayed sexual development, male fertility issues

• risk factors: european descent, family history, genetics

• treatment includes antibiotics, anti-inflammatories, bronchodilators, stool softeners, chest physiotherapy

acute respiratory distress syndrome

• severe acute inflammation and pulmonary edema without evidence of fluid overload or impaired cardiac function

• occurs about 48 hours after trauma

• caused by damage to alveolar epithelium and vascular endothelium

• results in tachypnea, dyspnea, retractions, crackles, restlessness, use of accessory muscles

• risk factors: hospitalized, critically ill, infections, COVID-19, alcohol or substance use, smoking

• treatment includes analgesics, antibiotics, oxygen therapy, intubation, ECMO, fluids, lung transplant, smoking cessation

hypertension

• progressive cardiovascular disease detected by an elevation in blood pressure

• usually no symptoms

• results in headache, new-onset blurred vision, nausea, vomiting, weakness, fatigue, confusion, mental status changes

• risk factors: obesity, diabetes, chronic kidney disease, family history, aging, chronic stress, excessive sodium intake, smoking, alcohol

• treatment includes diuretics (if it’s a fluid problem), calcium channel blockers, ACE inhibitors, ARBs, antihypertensive meds, weight loss programs, smoking cessation, decrease sodium intake, exercise, limit stressors

shock

• condition of circulatory failure and impaired perfusion of vital organs

• includes cardiogenic, hypovolemic, septic, neurogenic, anaphylactic

• risk factors: heart disease, sepsis, severe allergies, trauma, spinal cord injury, low BP, diabetes, older age

• treatment includes inotropic meds, epinephrine, norepinephrine, vasodilator, vasopressors, corticosteroids, fluids, surgery, oxygen therapy, blood transfusion

cardiogenic shock

• ineffective cardiac pumping → PUMP PROBLEM

• results in weak pulses, pulmonary edema, cool extremities, cyanosis, crackles in the lungs

• ex. heart failure, myocardial infarction, valve disease, arrhythmias

• FIX THE HEART

hypovolemic shock

• decreased blood volume → VOLUME PROBLEM

• results in tachycardia, hypotension, dry mucous membranes, weak pulses, cool skin

• ex. hemorrhage, dehydration, burns

• GIVE BLOOD/FLUIDS

obstructive shock

• physical blockage of blood flow → MECHANICAL PROBLEM

• results in distended neck veins (JVD), muffles heart sounds, pulsus paradoxus, tachycardia, cyanosis

• ex. pulmonary embolism, cardiac tamponade (fluid filled heart), tension pneumothorax

• leads to decreased cardiac output and decreased perfusion

distributive shock

• widespread systemic vasodialtion → PIPE PROBLEM/VASODILATION PROBLEM

• blood vessels lose tone/stiffness leading to pooling of the blood in the blood vessels

• results in warm skin early, cold extremities late, altered mental status, weak pulses

septic shock

• severe infection in the blood…systemic inflammatory response → PIPE PROBLEM/VASODILATION PROBLEM

• inflammatory mediator response causing vasodilation and leaky capillaries

• results in fever, warm skin early, cold extremities late, hypotension, tachycardia, tachypnea, altered LOC

neurogenic shock

• systemic vasodilation because of spinal cord/brainstem injury…loss of SNS control → PIPE PROBLEM/VASODILATION PROBLEM

• loss of sympathetic nervous system tone…parasympathetic system in overdrive

• results in hypotension, bradycardia, warm dry skin

anaphylactic shock

• systemic vasodilation due to allergic reaction…IgE mediated response → PIPE PROBLEM/VASODILATION PROBLEM

• histamine response causing vasodilation and leaky capillaries

• results in hives, swelling, stridor, difficulty breathing, hypotension

myocardial infarction

• heart attack, total occlusion of one or more coronary arteries resulting in ischemia and death of myocardial tissues

• most common cause is atherosclerosis

• results in chest pain, crushing pressure, pain (often radiating to left arm, shoulder, and jaw), dizziness, sweating, heartburn, weakness, shortness of brea

• risk factors: family history, hypertension, smoking, blood cholesterol levels, type 2 diabetes

• treatment includes MONA → morphine, oxygen, nitroglycerin, aspirin; beta blockers, ACE inhibitors, stabilize ABCs, surgery

left sided heart failure

• inadequate pumping of the heart to maintain blood circulation

• fluid accumulates in the lung tissue because fluid backs up in pulmonary vein and left atrium

• results in decreased cardiac output, pulmonary congestion, activity intolerance, impaired gas exchange, pulmonary edema, cyanosis, hypoxia, cough with frothy sputum, orthopnea

• risk factors: coronary artery disease, heart valve disease, hypertension, congenital heart disease, diabetes, sleep apnea, obesity

• treatment includes ACE inhibitors, angiotensin blockers, beta blockers, surgery (replace defective valves), stop drinking alcohol, stop smoking, limit salt and fluid intake, manage weight, supplemental oxygen

right sided heart failure

• inadequate pumping of the heart to maintain blood circulation

• impairs ability to move deoxygenated blood forward to pulmonary circulation

• results in edema, ascites, GI tract congestion, liver congestion, anorexia, GI distress, weight loss or gain

• risk factors: coronary artery disease, heart valve disease, hypertension, congenital heart disease, diabetes, sleep apnea, obesity

• treatment includes diuretics, ACE inhibitors, angiotensin blockers, beta blockers, surgery (replace defective valves), stop drinking alcohol, stop smoking, limit salt and fluid intake, manage weight, supplemental oxygen

stroke

• acute neurologic injury that results from things like shock, cerebral hemorrhage, ischemia, infarction…considered a cerebrovascular accident

• 3 types → thrombotic, embolic, hemorrhagic

• results in loss of function/weakness on one side of the body, vision loss, visual field deficits, double vision, dizziness, aphasia, decreased LOC

• risk factors: hypertension, smoking, diabetes, overweight, drinking, high cholesterol, family history

• treatment includes anticoagulants, antithrombotic therapy, TPA → clot cluster, manage underlying conditions

disseminated intravascular coagulation

• condition of uncontrolled activation of clotting factors that results in widespread thrombi formation followed by a depletion of clotting factors and platelets leading to mass hemorrhaging

• often occurs with trauma, surgery, burns, malignant neoplasms, infections, and shock

• results in blood in sputum, stool, emesis, and urine; headache, weakness, seizures, coma, cough, shortness of breath, respiratory distress, chest pain

• risk factors: infections, trauma, cancer, vascular disorders

• treatment includes anticoagulants, heparin, blood transfusion…TREAT UNDERLYING CAUSE

iron deficiency anemia

• reduced number of red blood cells circulating in the vascular system due to an the iron demand not being met

• often asymptomatic until more severe

• results in pale skin and mucous membranes, fatigue, weakness, lightheadedness, breathlessness, palpitations, headache, tachycardia, syncope, pica → chew or eat non-food, pagophagia → chews ice

• risk factors: women with heavy periods, infants, children, vegetarian/vegan, gastric bypass patients, digestive conditions, patients who donate blood often

• treatment includes iron supplements/injections, iron rich diet, vitamin C supplement, blood transfusion if severe