Question

describe the pathophysiology of diagnoses below. identify clinical manifestation, signs and symptoms, diagnostic labs and tests and treatment option for each diagnosis. cite the source

1. systolic heart failur

2. cognitive communication deficit

3. gastro-esophageal refulux

4. bening prostatic hyperplasia

5. insomnia

Answer 1

1.Systolic heart failure: An heart failure with reduced ejection fraction is called systolic failure.

Pathophysiology: Neuroharmonal activation is a major pathophysiology mechanism for ventricular remodelling and progression of heart failure.

Causes: high blood pressure, coronary artery disease, cardiomyopathy- heart muscle damage cannot pump blood as normal, heart valve problems.

Signs and symptoms : Shortness of breath, tiredness, swelling in feet, ankle, legs or abdomen, lasting cough or Wheezing,fast or irregular heartbeat, dizziness, confusion, nocturia,nausea and loss of appetite.

Diagnostic measures: blood investigation - RFT, ABG etc.

Electrocardiogram, chest X-ray, exercise test, heart catherisation.

Treatment: lifestyle changes- heart healthy diet, exercise regularly, quit smoking

Medications: diuretics, ACE inhibitors, Beta blockers, do go on, nitrate and hydralazine.

2. Cognitive communication deficit:

This is a problem with communication that have a underlying cause in a cognition deficit rather than a primary language or speech deficit.

Causes: It is caused by impaired functioning of one or more cognition process. Stroke, traumatic brain injury, brain tumor,degenerative disease, dysarthria, ataxia or aphasia.

Signs and symptoms: difficulty paying attention, staying on topic, remembering information, responding accurately,understanding jokes or metaphors or following directions.

Diagnostic measures: Montreal cognition assessment, scales of cognition ability for traumatic brain injury, cognitive linguistic quick test, function assessment of reasoning and executive strategy, assessment of language related functional activities.

Treatment: goal- restore function, compensate for deficit, educate the client and family

Remediate exercise, software to restrain discrete cognitive process, using internal and external memory strategies, space retrieval training, plan, do and review.

3. Gastro esophageal reflux

It is a digestive disorder that affect the lower esophageal sphincter, the ring muscle between esophagus and stomach. Most common in hiatal hernia.

Pathophysiology: gastro esophageal reflux occurs when the lower esophageal sphincter pressure is lower than intragastric pressure hence allowing the back flow of gastric acid to esophagus and affecting the esophageal lining.

Causes: hiatal hernia, dietary and lifestyle, cigarette smoking, obesity, sudden physical exertion.

Signs and symptoms : heartburn, a burning pain in the chest, upwards to the neck and throat

Diagnostic measures : through symptoms, and endoscopy.

Treatment: avoid foods and beverages that weaken the lower esophageal sphincter, decrease the portions of meal time, eat meal at least 2 to 3 hours before bedtime, quit smoking.

Antacids, H2 blockers and proton pump inhibitors are the choice of medicines.

4. Bening prostatic hyperplasia

It is a noncancerous increase in the size of the prostate.

Causes: unclear

Risk factors: family history, obesity, type 2 diabetes, erectile dysfunction and androgens.

Pathophysiology : as men age, the enzyme aromatase and 5 alpha reductase increases. Which are responsible for converting androgen hormone into estrogen and dihydrotestosterone. This in turn leads to increase in DHT and estrogen levels, which when combines cause a synergy to induce BPH.

Signs and symptoms: Frequent urination, trouble starting to urinate, weak stream, inability to urinate and loss of bladder control.

Diagnostic measures: based on symptoms, per rectal examination and ultrasonography.

Treatment: lifestyle modification, medications such as alpha blockers, terazosin, reductase inhibitors such as finasteride, anticholinergics. Catherisation.

Surgical treatment: transurethral resection of prostate, transurethral incision of the prostate, photoselctive vaporization of prostate.

5. Insomnia

It is also known as sleeplessness, is a sleep disorder where people have trouble sleeping.

Causes: usually unknown, may be due to psychological stress, chronic pain, heart failure, hyperthyroidism, heart burn, restless leg syndrome.

Signs and symptoms : trouble sleeping, day time sleepiness, low energy, irritability and depressed mood.

Diagnostic measures : based on symptoms and sleep study.

Treatment: sleep hygiene, cognitive behavioural therapy, sleeping pills.