Question

1.Includes a summary of the conditions with definition, signs and symptoms and treatment

2. Place the conditions by a system in alphabetical order

Endocrine
1. Type I Diabetes Mellitus
2. Type II Diabetes Mellitus
3. Hyperthyroidism
4. Hypothyroidism
5. Addison’s
6. Cushing’s
Cardio
1. Anemia
2. Hypertension
3. Dysrhythmias
4. Congestive Heart Failure (CHF)
5. Coronary Artery Disease (CAD)
6. Myocardial Infarction

Answer 1

ENDOCRINE

1-) ADDISON DISEASE

Addison’s disease is a disorder in which the adrenal glands – which sit on top of the kidneys – do not produce enough of the hormones cortisol and aldosterone. (Hormones are chemicals that control the function of tissues or organs.)

Cortisol helps the body respond to stress, including the stress of illness, injury, or surgery. It also helps maintain blood pressure, heart function, the immune system and blood glucose (sugar) levels.

Aldosterone affects the balance of sodium and potassium in the blood. This in turn controls the amount of fluid the kidneys remove as urine, which affects blood volume and blood pressure.

Addison’s disease is also called “primary adrenal insufficiency.” A related disorder, “secondary adrenal insufficiency,” occurs when the pituitary, a small gland at the base of the brain, does not secrete enough adrenocorticotropic hormone (ACTH), which activates the adrenal glands to produce cortisol.

2-) CUSHING DISEASE

Cushing's disease is a serious condition of an excess of the steroid hormone cortisol in the blood level caused by a pituitary tumor secreting adrenocorticotropic hormone (ACTH). ACTH is a hormone produced by the normal pituitary gland. ACTH stimulates the adrenal glands (located on top of the kidneys) to produce cortisol, commonly referred to as the stress hormone.

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Cortisol Levels in Cushings DiseaseCushing's Disease: Physiology

Cushing's disease is rare, affecting 10 to 15 people per million each year, most commonly adults between 20 and 50 years of age. Women account for more than 70 percent of cases.

Most patients with Cushing's disease have small tumors (pituitary microadenomas). However, it can be difficult to diagnosis Cushing's disease, and the diagnosis is often delayed. An endocrinologist should always supervise the evaluation for Cushing's disease. At the UCLA Pituitary Tumor Program, our specialists have years of experience diagnosing and managing Cushing's disease.

Cushing's Disease: Understanding Normal Cortisol Physiology

Cortisol affects the body in many ways, including:

Maintaining normal blood pressure; inadequate cortisol production is usually associated with low blood pressure.

Response to stress situations. Cortisol is one of the "fight or flight" hormones.

An increased blood level of cortisol is essential for you to be able to cope with acutely stressful situations, including surgery.

Inadequate cortisol release can be fatal.

The adrenal glands produce cortisol in varying amounts throughout the day:

Blood and saliva cortisol levels are very low at midnight.

Blood cortisol levels are usually highest in the early morning.

3-)

Hyperthyroidism is a condition of the thyroid. The thyroid is a small, butterfly-shaped gland located at the front of your neck. It produces tetraiodothyronine (T4) and triiodothyronine (T3), which are two primary hormones that control how your cells use energy. Your thyroid gland regulates your metabolism through the release of these hormones.

Hyperthyroidism occurs when the thyroid makes too much T4, T3, or both. Diagnosis of overactive thyroid and treatment of the underlying cause can relieve symptoms and prevent complications.

4-)Hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones.

Hypothyroidism may not cause noticeable symptoms in the early stages. Over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility and heart disease.

Accurate thyroid function tests are available to diagnose hypothyroidism. Treatment with synthetic thyroid hormone is usually simple, safe and effective once you and your doctor find the right dose for you.

Symptoms

Thyroid gland showing larynx and trachea

Thyroid gland Open pop-up dialog box

The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone deficiency. Problems tend to develop slowly, often over a number of years.

At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and weight gain. Or you may simply attribute them to getting older. But as your metabolism continues to slow, you may develop more-obvious problems.

Hypothyroidism signs and symptoms may include:

Fatigue

Increased sensitivity to cold

Constipation

Dry skin

Weight gain

Puffy face

Hoarseness

Muscle weakness

Elevated blood cholesterol level

Muscle aches, tenderness and stiffness

Pain, stiffness or swelling in your joints

Heavier than normal or irregular menstrual periods

Thinning hair

Slowed heart rate

Depression

Impaired memory

Enlarged thyroid gland (goiter)

5-) type I diabetes mellitus

Type 1 diabetes is a disease in which the body does not make enough insulin to control blood sugar levels. Type 1 diabetes was previously called insulin-dependent diabetes or juvenile diabetes.

During digestion, food is broken down into basic components. Carbohydrates are broken down into simple sugars, primarily glucose. Glucose is a critically important source of energy for the body's cells. To provide energy to the cells, glucose needs to leave the blood and get inside the cells.

Insulin traveling in the blood signals the cells to take up glucose. Insulin is a hormone produced by the pancreas. When levels of glucose in the blood rise, like following a meal, the pancreas normally produces more insulin.

Type 1 diabetes occurs when some or all of the insulin-producing cells in the pancreas are destroyed. This leaves the patient with little or no insulin. Without insulin, sugar accumulates in the bloodstream rather than entering the cells. As a result, the body cannot use this glucose for energy. In addition, the high levels of glucose that remain in the blood cause excessive urination and dehydration, and damage tissues of the body.

Type 1 diabetes is an autoimmune disease. This means it begins when the body's immune system attacks cells in the body. In type 1 diabetes, the immune system destroys insulin-producing cells (beta cells) in the pancreas.

Why the immune system attacks the beta cells remains a mystery. Some people are genetically predisposed to the disease. That does not mean they will necessarily get the disease. It just means that they are more likely to do so. Something in the environment, such as particular viral infections or something about the diet, may trigger this autoimmune disease in people with a genetic predisposition.

Type 1 diabetes is not caused by the amount of sugar in a person's diet before the disease develops.

Type 1 diabetes is a chronic disease. It is diagnosed most commonly between ages 10 and 16. Type 1 diabetes equally affects males and females.

Symptoms

Initial Symptoms

Symptoms usually come on suddenly and strongly. Typically the most prominent symptoms are excessive urination and extreme thirst. This is because the increased glucose in the blood causes the kidneys to create more urine than usual. Losing more fluid in the urine makes a person dehydrated. And dehydration leads to great thirst. Children may start to wet the bed again.

Weight loss, with no loss of appetite, also is common. The weight loss is due in part to dehydration. Water has weight. Imagine holding a gallon jug of water: it weighs about eight pounds. People with new, uncontrolled type 1 diabetes can lose a gallon of water from dehydration.

Other common symptoms are weakness, fatigue, confusion, nausea and vomiting. These symptoms can be caused both by dehydration and by a condition called ketoacidosis.

Ketoacidosis occurs because cells can't use the glucose they need for energy. So the cells have to use something else. In response to low insulin levels, the liver produces an alternative fuel called ketones. Ketones are a kind of acid. When they build up in the blood, it's called ketoacidosis. Ketoacidosis can cause heart problems and affect the nervous system. Within hours, it may put a person at risk of coma or death.

Chronic Symptoms

Even after it is diagnosed and treatment is begun, type 1 diabetes can affect all body systems. It is less likely to damage the body, and cause symptoms, if the blood sugar levels are well controlled by treatment.

The serious and potentially life-threatening complications that can occur with type 1 diabetes include:

Eye damage (retinopathy) — Tiny blood vessels of the retina (the back of the eye, the part that senses light) are damaged by high blood sugar. Damage to the vessels can stop the flow of blood to a part of the retina, or cause bleeding into the retina. Both events damage the ability of the retina to sense light. Diabetes also can cause a proliferation of new blood vessels that don't effectively feed blood to the retina, but that do leak and bleed. Caught early, retinopathy can be stopped by tightly controlling blood sugar and laser therapy. If blood sugar remains high, retinopathy eventually causes blindness.

Nerve damage (neuropathy) — High blood sugar can damage nerves, leading to pain or numbness of the affected body part. Damage to nerves in the feet, legs and hands (peripheral neuropathy) is most common. Nerves that control body functions, such as digestion and urination, also can be damaged.

Foot problems — Sores and blisters commonly occur on the feet of people with diabetes. If peripheral neuropathy causes numbness, a sore may not be noticed. If it is not noticed, it can more easily become infected. Blood circulation can be poor, leading to slow healing. Left untreated, a simple sore can lead to gangrene. Amputation may be necessary.

Kidney disease (nephropathy) — High blood sugar can damage the kidneys. If blood sugar remains high, it can lead to kidney failure.

Heart and artery disease — People with type 1 diabetes are more likely to have heart disease, strokes and problems related to poor circulation.

Hypoglycemia — Low blood sugar (hypoglycemia) can result from treatments to lower blood sugar, either insulin injections or pills (see Treatment section, below). Hypoglycemia may occur if too much sugar-lowering medicine is taken or meals are skipped. Symptoms include:

Weakness

Dizziness

Trembling

Sudden sweating

Headache

Confusion

Irritability

Blurry or double vision

Hypoglycemia can lead to coma if it is not corrected by eating or drinking carbohydrates. Glucagon is a substance that makes the liver release glucose into the bloodstream. An injection of glucagon can also correct hypoglycemia.

Diagnosis

Type 1 diabetes is diagnosed by a combination of symptoms, a person's age and blood tests. The blood tests include tests for sugar levels and for other substances.

Fasting plasma glucose (FPG) test. Blood is taken in the morning after fasting overnight. Normally, blood sugar levels remain between 70 and 100 milligrams per deciliter (mg/dL). Diabetes is diagnosed if a fasting blood sugar level is 126 mg/dL or higher.

Oral glucose tolerance test (OGTT). Blood sugar is measured two hours after drinking 75 grams of glucose. Diabetes is diagnosed if the 2-hour blood sugar level is 200 mg/dL or higher.

Random blood glucose test. A blood sugar of 200 mg/dL or greater at any time of day combined with symptoms of diabetes is sufficient to make the diagnosis.

Hemoglobin A1C (glycohemoglobin). This test measures the average glucose level over the prior two to three months. Diabetes is diagnosed if the hemoglobin A1C level is 6.5% percent or higher.

Expected Duration

Type 1 diabetes currently is a lifelong disease.

People with type 1 diabetes need regular checkups. They must carefully monitor their blood sugar levels every day. They must receive insulin treatment throughout life.

A small number of people can become exceptions to this rule. Some people with diabetes eventually require kidney transplants. A transplant of the pancreas, or of the insulin-producing cells from the pancreas (called "islets"), sometimes is performed at the same time. Since the new pancreas can make insulin, this can cure the diabetes.

On unusual occasions, when someone's type 1 diabetes is very hard to control with available treatments, pancreas or islet transplantation may be performed even when kidney transplantation is not necessary. However, this approach is still experimental, and is not generally recommended.

Scientists have recently reported exciting but still experimental new ways for encouraging the pancreas to again start producing its own insulin-producing beta cells.

Prevention

There is no proven way to prevent type 1 diabetes. Vitamin D deficiency, which is very common, may increase the risk of diabetes. However, correcting the deficiency has not been yet shown to prevent diabetes. Likewise, avoiding cow's milk during infancy may possibly prevent type 1 diabetes in genetically susceptible infants. But there is no definite proof that this prevents the disease.

Treatment

Treatment of type 1 diabetes requires daily insulin injections. The injected insulin makes up for the insulin that is not produced by the body. Most people with type 1 diabetes need two to four injections per day.

People with type 1 diabetes must properly regulate both their dietary intake and their dose of insulin. If a person takes too much insulin relative to their dietary intake, or if they forget to eat, they can develop dangerous hypoglycemia. If they take too little insulin, or eat too much, they can develop ketoacidosis.

In order to properly regulate their insulin intake, people with type 1 diabetes need to monitor their blood sugar levels several times per day. They do this by testing a sample of blood. They must prick their finger and place a small drop of blood on a test strip. The test strip is inserted into a device called a glucose monitor. An accurate reading of blood sugar levels is returned within seconds.

Newer glucose monitors have test strips that take the blood directly from the spot that was pricked. This process requires less blood. Other monitors allow blood to be taken from the forearm, thigh or the fleshy part of the hand. This can be less painful.

Some people use a syringe for injections. Other patients use semiautomatic injector pens that help to measure precise amounts of insulin.

An increasing number of patients use insulin pumps. Insulin pumps deliver a regulated dose of insulin through a needle implanted under the skin. The insulin pump is worn in a pack on the body. Some pumps include a sensor that constantly measures the level of blood sugar, and adjusts the dose of insulin accordingly. Whether devices with such sensors lead to improved health is not yet certain.

Fast-acting insulin may be taken as needed, depending on the amount of carbohydrates ingested. Your doctor or dietitian will help you determine the best insulin and diet schedule for you or your child.

A healthy diet and regular exercise are important for everyone—but particularly for people with diabetes. A healthy diet for someone with type 1 diabetes not only keeps the amount of glucose in the blood relatively constant. It also includes eating "good carbs" instead of "bad carbs", "good fats" instead of "bad fats".

6-) TYPE II DIABETES MELLITUS

Type 2 diabetes is a chronic disease. It is characterized by high levels of sugar in the blood. Type 2 diabetes is also called type 2 diabetes mellitus and adult-onset diabetes. That's because it used to start almost always in middle- and late-adulthood. However, more and more children and teens are developing this condition. Type 2 diabetes is much more common than type 1 diabetes, and is really a different disease. But it shares with type 1 diabetes high blood sugar levels, and the complications of high blood sugar.

During digestion, food is broken down into basic components. Carbohydrates are broken down into simple sugars, primarily glucose. Glucose is a critically important source of energy for the body's cells. To provide energy to the cells, glucose needs to leave the blood and get inside the cells.

Insulin traveling in the blood signals the cells to take up glucose. Insulin is a hormone produced by the pancreas. The pancreas is an organ in the abdomen. When levels of glucose in the blood rise (for example, after a meal), the pancreas produces more insulin.

Type 2 diabetes occurs when your body's cells resist the normal effect of insulin, which is to drive glucose in the blood into the inside of the cells. This condition is called insulin resistance. As a result, glucose starts to build up in the blood.

In people with insulin resistance, the pancreas "sees" the blood glucose level rising. The pancreas responds by making extra insulin to maintain a normal blood sugar. Over time, the body's insulin resistance gets worse. In response the pancreas makes more and more insulin. Finally, the pancreas gets "exhausted". It cannot keep up with the demand for more and more insulin. It poops out. As a result, blood glucose levels start to rise.

Type 2 diabetes runs in families. Obesity greatly increases the risk of diabetes.

Symptoms

The symptoms of diabetes are related to high blood glucose levels. They include:

Excessive urination, thirst and hunger

Weight loss

Increased susceptibility to infections, especially yeast or fungal infections

Extremely high blood sugar levels also can lead to a dangerous complication called hyperosmolar syndrome. This is a life-threatening form of dehydration. In some cases, hyperosmolar syndrome is the first sign that a person has type 2 diabetes. It causes confused thinking, weakness, nausea and even seizure and coma.

The treatment of type 2 diabetes also can produce symptoms. Too much glucose-lowering medicine, relative to dietary intake, can lead to the complication of low blood sugar (called hypoglycemia). Symptoms of hypoglycemia include:

Sweating

Trembling

Dizziness

Hunger

Confusion

Seizures and loss of consciousness (if hypoglycemia is not recognized and corrected)

You can correct hypoglycemia by eating or drinking something that has carbohydrates. This raises your blood sugar level.

Type 2 diabetes affects all parts of the body. It can cause serious, potentially life-threatening complications. These include:

Atherosclerosis — Atherosclerosis is fat buildup in the artery walls. This can impair blood flow to the all the organs. The heart, brain and legs are most often affected.

Retinopathy — Tiny blood vessels in the retina (the back of the eye that sees light) can become damaged by high blood sugar. The damage can block blood flow to the retina, and can lead to bleeding into the retina. Both damage the ability of the retina to see light. Caught early, retinopathy damage can be minimized by tightly controlling blood sugar and using laser therapy. Untreated retinopathy can lead to blindness.

Neuropathy — This is nerve damage. The most common type is peripheral neuropathy. The nerves to the legs are damaged first, causing pain and numbness in the feet. This can advance to cause symptoms in the legs and hands. Damage to the nerves that control digestion, sexual function and urination can also occur.

Foot problems — Sores and blisters on the feet occur for two reasons:

If peripheral neuropathy causes numbness, the person may not feel irritation in the foot. The skin can break down, form an ulcer, and the ulcer can get infected.

Blood circulation can be poor, leading to slow healing. Left untreated, a simple sore can become infected and very large. If medical treatment cannot heal the sore, an amputation may be required.

Nephropathy — Damage to the kidneys. This is more likely if blood sugars remain elevated and high blood pressure is not treated aggressively.

Diagnosis

Diabetes is diagnosed by testing the blood for sugar levels. Blood is tested in the morning after you have fasted overnight.

Typically, the body keeps blood sugar levels between 70 and 100 milligrams per deciliter (mg/dL), even after fasting. If a blood sugar level after fasting is greater than 125 mg/dL, diabetes is diagnosed.

Your doctor will examine you to look for:

Obesity, especially abdominal obesity—a condition that greatly raises a person's risk for type 2 diabetes.

High blood pressure—a condition often present in people with type 2 diabetes, that together with diabetes greatly increases the risk of heart disease and strokes.

Deposits of blood, or puffy yellow spots in the retina of your eyes—complications of both diabetes and high blood pressure, that increase the risk of blindness

Decreased sensation in the legs—which can cause a person with diabetes to fail to notice developing foot sores, particularly sores on the underside of the feet

Weak pulses in the feet—a condition that can slow or prevent the healing of foot sores, and possibly lead to amputation

Blisters, ulcers or infections of the feet

Laboratory tests are also used routinely to evaluate diabetes. These include:

Fasting plasma glucose (FPG) test. Blood is taken in the morning after fasting overnight. Normally, blood sugar levels remain between 70 and 100 milligrams per deciliter (mg/dL). Diabetes is diagnosed if a fasting blood sugar level is 126 mg/dL or higher.

Oral glucose tolerance test (OGTT). Blood sugar is measured two hours after drinking 75 grams of glucose. Diabetes is diagnosed if the 2-hour blood sugar level is 200 mg/dL or higher.

Random blood glucose test. A blood sugar of 200 mg/dL or greater at any time of day combined with symptoms of diabetes is sufficient to make the diagnosis.

Hemoglobin A1C (glycohemoglobin). This test measures the average glucose level over the prior two to three months. Diabetes is diagnosed if the hemoglobin A1C level is 6.5% percent or higher.

Blood creatinine and urine microalbumin. Tests for evidence of kidney disease.

Lipid profile. Measures levels of triglycerides and total, HDL, and LDL cholesterol. This evaluates the risk of atherosclerosis. People with diabetes who also have high levels of total cholesterol or LDL cholesterol are at greatly increased risk for heart disease and strokes.

CARDIO

1-) ANAEMIA

SECTIONSFOR ANEMIA

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Overview

Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia can make you feel tired and weak.

There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. See your doctor if you suspect that you have anemia. It can be a warning sign of serious illness.

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Treatments for anemia range from taking supplements to undergoing medical procedures. You might be able to prevent some types of anemia by eating a healthy, varied diet.

Types

Aplastic anemia

Iron deficiency anemia

Sickle cell anemia

Thalassemia

Vitamin deficiency anemia

Symptoms

Anemia signs and symptoms vary depending on the cause. If the anemia is caused by a chronic disease, the disease can mask them, so that the anemia might be detected by tests for another condition.

Depending on the causes of your anemia, you might have no symptoms. Signs and symptoms, if they do occur, might include:

Fatigue

Weakness

Pale or yellowish skin

Irregular heartbeats

Shortness of breath

Dizziness or lightheadedness

Chest pain

Cold hands and feet

Headaches

At first, anemia can be so mild that you don't notice it. But symptoms worsen as anemia worsens.