Articles by "chronicdiseases"
Raynaud's Disease and Buerger's Diseases
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| Raynaud's Disease and Buerger's Disease |
Definition:
A peripheral vascular disease characterized by periodic vasoconstriction of the arteries that supply the extremities.
The digital arteries of hand and less commonly affected.
Aetiology:
Unknown, may be familial, triggered by emotional factors, or exposure to cold.
Most common among women aged between 16-40 years.
Signs and symptoms:
1- Hands moist and cold.
2- The colour of the hand is pale at the beginning then it changes into a bluish colour then it changes into the reddish colour, especially when putting it in warm water.
3- Ulcers and gangrene of the fingertips.
Treatment:
1- Avoid the factors that lead to the onset of the disease {stress, smoking, or exposure to cold}.
2- Avoid stress because it leads to vasoconstriction ( arteries).
3- Adrengeic blocking drugs to decrease sympathetic nerve stimulation which leads to decrease in vasoconstriction.
4- Sympathectomy: the surgical cut of the ganglionic sympathetic nerve.
5- Amputation in case of gangrene.
Buerger's Disease
Definition:
A condition that characterized by recurrent inflammation in the arteries and veins in the upper and lower extremities result in a clot formation, which leads to occlusion. This disease affects mainly the arteries and veins of the upper and lower limbs.
Aetiology:
Unknown occurs most often in men aged between 20-35 years.
Signs and symptoms:
1. Coldness in one or both feet.
2. Foot colour is pigmented red.
3. Slow healing ulcers or might change into gangrene.
4. Blood vessel infection.
5. Changes in skin and nails.
6. Pain in digital ( cramps in feet or legs after exercise ).
- Intermittent claudicating relived by rest.
- May be aggravated by emotional disturbances, smoking, and chilling.
7- Ulceration and gangrene may occur.
Treatment:
1- Stop smoking.
2- Rest and adequate hydration.
3- Daily washing of feet with warm water and soap.
4- Avoid trauma to the feet.
5- Wear shoes and stockings, protect feet from cold.
6- Vasodilatation.
7- If gangrene develops in the feet and toes, amputation well is done.
READ MORE:
Preterm Labor
Hydatidiform ( Vesicular ) mole
Hypotonic And Hypertonic Uterine Contraction
Chronic Obstructive Pulmonary Disease
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| Chronic Obstructive Pulmonary Disease |
Definition:
A group of respiratory disorders affecting the expiratory airflow, inspiratory airflow might be affected.
Example:
1. Chronic Bronchitis.
2. Pulmonary Emphysema.
Causes:
- Excessive accumulation of mucus and secretions block the airway as in bronchitis and bronchiolitis.
- Destruction of the walls of the alveoli leads to impaired CO2, O2 exchange as in emphysema.
Related factors :
- Genetic: lake of enzyme inhibitors that prevent the destruction of lung tissue by certain enzymes.
Environmental: as smoking, respiratory infection.
Air pollution, and allergy.
The process takes 20-30 years to develop, it progresses slowly, and the result is impaired ventilation.
Chronic Bronchitis:
Definition:
A serious disease that is characterized by hypersecretion of mucus by the bronchial glands as well as chronic or recurrent respiratory infection.
Aetiology:
Air pollution
Cigarette smoking
Chronic infection of the airway.
Signs and symptoms:
1. Chronic productive cough.
2. Thick white mucus that might change to purulent copious and blood-streaked mucus.
3. Recurrent acute respiratory infection.
Diagnosis:
1. Histor.
2. ABGs.
3. Chest X-ray.
4. Pulmonary function studies.
Treatment:
- Palliative treatment to relieve symptoms with an emphasis on avoidance of factors that trigger irritation of the bronchial mucosa.
- Stop smoking.
- Avoid chemical allergens.
- Antibiotics to treat recurrent bacterial infections.
- Bronchodilators to relieve spasm.
- Adequate oxygenation to promote alveolar ventilation .
Avoid respiratory irritant.
Pulmonary Emphysema:
A condition characterized by abnormal distention of air spaces with the destruction of the alveolar wall.
Smoking the major cause.
Several factors lead to airway obstruction:
- Inflammation and swelling of the bronchi.
- Increased mucus production.
- Loss of elastic recoil of the airway.
- A collapse of bronchioles.
- Redistribution of air to the functioning alveoli.
Signs and symptoms:
Dyspnea.
Patient has the barrel chest.
A chronic cough, wheezing, short of breathing and tachypnea.
Distended neck veins.
Decreased breath sounds with rhonchi, and prolonged expiration.
Diagnosis:
- History.
- CBC.
- ABGs.
- CXR.
Treatment:
1. Bronchodilators: as aminophylline, salbutamol.
2. Aerosol therapy: as saline and bronchodilator or my Celtics.
3. Treatment of infection: use antibiotics.
4. Corticosteroids: used as the bronchodilator and decrease oedema.
5. Oxygen therapy at the low rate.
READ MORE:
Hemophilia
Megaloblastic Anemia
Pancreatitis And Pancreatic Cyst
Megaloblastic Anemia
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| Megaloblastic Anemia |
Megaloblastic Anemia
Is the second most common nutritional anaemia seen during pregnancy?
Folate deficiency is the cause of the deficiency in Vit B12 must be considered.
Folate:
Folic acid, a water-soluble vitamin is widely available in the diet. Folate is absorbed in the proximal jejunum. pancreatic conjugases reduce folate to monoglutamate before its absorption conjugases activity is reduced by :
1. Anticonvulsants.
2. Oral contraceptive.
3. Alcohol.
4. Sulfa drugs.
Because adequate folate intake before and during the first weeks of pregnancy may reduce the occurrence of neural tube defects, all women considering become pregnant should consume 400 mcg/day of folate.
Vitamin B 12:
Abundantly available in diet bond to animal protein, its absorption requires HCL and pepsin to free the cobalamin molecule from protein most of the Vit B 12 is stored in the liver and most people have a 2-3 years store available.
Diagnosis of anaemia:
- Anaemia is not a diagnosis, but rather than assign as fever.
- Is the patient anaemic?
- What is the morphology of anaemia? CBC and reticulocyte are helpful.
- What is the mechanism of anaemia?
- Is there underlying disease?
History:
- Family history.
- History of tonics.
-History of GI bleeding
- Exposure to oxidant drugs ( risk of G6PD ) e.g. sulfonamides, PASA.
- Peripheral blood smear.
- Serum iron value ( less than 30 mcg /dl indicate IDA).
- The gold standard to determined iron stores is a bone marrow biopsy, which is rarely indicated in pregnancy patients.
Treatment:
- Preventable by routine use of iron supplementation. when not given supplemental iron 80 % of normal pregnant women will have Hb value less than 11g/dl at term.
- Correct the underlying causes.
READ MORE:
Congestive Heart Failure
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| Congestive Heart Failure |
Definition:
A condition in which the heart is inefficient . its pumping function is hampered. the heart is unable to meet the demands of the body. as a result, the blood circulation becomes. { the heart is unable to pump a sufficient amount of blood to meet the needs of the tissues for oxygenation and nutrient}.
The leads to congestion of many organs with blood and tissues fluids.
Heart failure can be mild or severe and might be Rt. Or Lt. or both.
When the patient receives treatment and shows no symptoms, the case is called compensated, while when he shows symptoms it is called decompensated.
Aetiology:
1. Rheumatoid fever ( destroys the heart valves).
2. Myocardial infarction ( occlusion of coronary veins and arteries ).
3. pericarditis ( lead to constriction of the heart ).
4. hyperthyroidism : ( it places excessive demand on the heart, it led to tachycardia or bradycardia ).
N.B:-
CHF might appear in older ages due to :
- Arteriosclerosis ( loss of the elasticity of the arterial wall).
- Atherosclerosis ( deposition of fat in the arterial walls).
- Increased blood pressure.
- Physiological changes in the heart muscles it becomes weak.
Pthophysiology:
Narrowing of the mitral valve impedes the blood flow from left atrium to left ventricle.
Left atrium cannot empty normally so it becomes enlarged, the pressure increased in it – this increased pressure causes lung congested with fluids, because of the distended Lt. atrium cannot effectively receive oxygenated blood coming from the lungs.
Lung congestion results in inefficient oxygenation of blood, the pt. develops (signs of Lt. sided HF) as dyspnea. orthopnea. a cough and sometimes hemoptysis.
Because of the congestion, Rt. Ventricle unable to pump blood effectively to the lungs, the Rt. The side of the heart becomes congested with blood.
Venous blood return to the Rt. Aside from the heart cannot pump blood to the lungs quickly and effectively so large veins leading to the heart and other organs and tissues develop congestion.
Dependent oedema appears in the feet, ankles on standing, ascites in the abdomen and the enlarged liver.
Signs and symptoms :
Related to retention of fluids in the lungs and peripheral tissues.
A- lt. side heart failure:
1- Dyspnea on exertion.
2- Weakness, and easily tiredness.
3- An Occasional cough without blood-streaked sputum.
B- Rt. Side heart failure:
1- As oedema increases, weight might increase.
2- Edema of the abdomen, thighs and legs follows.
3- Others symptoms might develop depending on the area of oedema ( e.g. abdominal signs and symptoms such as anorexia and flatulence etc. ).
4- Respiratory signs and symptoms as mentioned above.
N.B. Oedema in lower limbs is called pitting oedema.
Treatment:
Aimed at decrease the amount of circulating blood volume which leads to decrease the oxygen needed by the cardiac muscle.
1- Rest decrease the work of the heart.
2- Sedative to help patient rest.
3- Decrease intake of sodium.
4- Digitalis (decreases heart rate and increases the force of the heartbeat).
5- Diuretics.
6- Oxygen to improve ventilation.
READ MORE:
Maternal Nutrition
Septicemia Neonatorum
Nutrition Risk Factors In Pregnancy
Pulmonary Edema
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| Pulmonary Edema |
Definition
Chronic respiratory disorders characterized by the morphologic change in the lung tissue " distention of alveolar sac, rupture of alveolar walls, and destruction of alveolar capillary bed "
In this disorder, air is trapped in the lungs due to loss of lung elasticity.
On microscopic examination, the walls of the alveoli are broken down resulting in one large sac rather than multiple small air spaces "alveoli", the capillary bed previously located within the destroyed alveolar walls is destroyed and much of the tissue is replaced by fibrous tissue.
All of this leads to improper gas exchange during respiration.
Signs and Symptoms:
1. External dyspnea: shortness of breath with minimal action.
2. A chronic cough with mucopurulent sputum.
3. Use of muscles during respiration.
4. Wheezing.
5. If advanced: pallor, anxiety, drowsiness and confusion due to increased CO2 and decreased O2 levels in the blood.
Treatment:
1. Symptomatic treatment including O2 therapy. but not more than 2-3 litre/ min.
2. Bronchodilators.
3. Avoidance of infection.
1- Oxygen therapy.
2- Morphine.
3- Sit up position.
4- Tourniquets.
5- Digoxin.
6- Aminophylline.
7- Diuretic.
8- Indwelling Foley catheter.
9 – Phlebotomy (rarely, when the kidneys are impaired).
READ MORE:
Anemia in Pregnancy
Jaundice in the Newborn
The Common Cold and Acute Pharyngitis
Silent killer ( Hypertension ) HTN
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| Hypertension |
Hypertension disease
A person who has sustained the systolic pressure of 150mmhg or above and diastolic pressure above 90 or both are considered hypertensive
The tow type of Hypertension:
Primary Hypertension
Unknown cause .it affects 90% of Hypertensive patients
Secondary Hypertension
caused by:
1- enlargement of the adrenal gland " pheochromocytoma "
2 - Eclampsia
3 - Congenital heart anomalies
4 - Disease of the kidney
Primary Hypertension: is characterized by sustained elevation of diastolic blood pressure over of 90 mmHg.
Malignant Hypertension:
Specific term used to describe the condition when has a sudden onset and is followed by severe symptoms and complications the factors are:
- Age: old age more than younger.
- Obesity.
- Coffee intake.
- Smoking.
- Drugs.
- Emotional disturbances.
- Sex, affect female more than male.
Signs and Symptoms:
- Dizziness, headache fatigue, insomnia.
- Epistaxis bleeding from the nose.
- Blurred vision.
- May experience anginal pain and dyspnea.
- Renal symptoms: Including elevated B U N nocturia and creatinine.
- Prolonged elevation in blood pressure damage blood vessels in the eyes, heart, brain and kidneys. so that it will lead to vision problems.
- Coronary occlusion .C H F , renal failure, stroke.
- Diagnostic evaluation.
- Health history.
- Physical examination.
- Fundus exam.
- ECG ( electro cardio gram ).
- Urine analysis { protein in urine }.
- Kidney function test: urea, creatinine.
Treatment:
1-
Antihypertensive drug
Diuretics ex:
- lasix.
- Aldactone.
- Methyldopa.
- Chlorothiazide.
- Hydralazine.
- Propranolol.
2- Vasodilators.
3- Low salt diet.
4- Decrease stress and anxiety.
5- Regular exercise.
READ MORE:
Diabetes Mellitus
Anemia in Pregnancy
The Common Cold and Acute Pharyngitis
Diabetes Mellitus
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| Diabetes Mellitus |
Diabetes Mellitus: the Chronic condition that affects the body ability to use the energy that found in the food
They are three type of DM:
1) Diabetes Mellitus type1.
(Insulin Dependent) or Called Juvenile-Onset Diabetes.
2) Diabetes Mellitus type 2 (non-Insulin Dependent Insulin ).
3) Gestational Diabetes.
• Diabetes Mellitus type1
This type it often begins in childhood and considers an autoimmune condition. It's caused by the body attacking its own pancreas with antibodies. That lead to pancreas damage and not be able to produce insulin.
Diagnosis:
Exercise and called A1C TEST, The A1C test result reflects your average blood sugar level for the past two to three months.
Treatment:
a) Inject insulin throw skin used syringe .
b) Insulin Pens.
c) Insulin pumps that dispense insulin through flexible tubing to a catheter under the skin of the abdomen .
• Diabetes Mellitus type 2
This type affects adult, Obese and overweight kids.
• In this type, the pancreas usually produces some insulin. But either the amount produced is not enough for the body's needs.
• Lack of sensitivity to insulin.
• Insulin resistance.
There is no cure for DM II but will be controlled by nutrition, exercise, weight management and medication.
Diagnosis:
A1C test.
The A1C test is typically done a few times a year to see how well diet, exercise, and medications are working.
• Gestational Diabetes
Diabetes that's triggered by pregnancy.
It is often diagnosed in middle or late pregnancy. Because high blood sugar levels in a mother are circulated through the placenta to the baby.
Gestational diabetes usually resolves itself after pregnancy. Having gestational diabetes does, however, put mothers at risk of developing type 2 diabetes later in life.
Treatment
• Meal planning to ensure adequate pregnancy nutrients without excess fat and calories.
• Daily exercise.
• Controlling weight gain.
• Taking diabetes insulin to control blood sugar levels if needed.
READ MORE:
Anemia in Pregnancy
Silent killer ( hypertension ) HTN
The Common Cold and Acute Pharyngitis
