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ANGINA: Chest pain that occurs secondary to the inadequate delivery of oxygen to the heart. Clinical features include: heavy or squeezing pain in the mid-sternal area of the chest, shortness of breath, nausea, diaphoresis (profuse sweating), etc. ANOREXIA: A psychophysical condition in girls and young women, characterized by the prolonged inability or refusal to eat, sometimes accompanied by vomiting, extreme emanciation, amenorrehea and other biological changes. ANXIETY: the unpleasant emotional state consisting of psychophysiological responses to anticipation of unreal or imagined danger, ostensibly resulting from unrecognized intrapsychic conflict. Physiological concomitants include increased heart rate, altered respiration rate, sweating, trembling, weakness and fatigue, psychological concomitants include feelings of impending danger, apprehension and tension. ARRHYTHMIA: any variation from the normal rhythm of the heart beat, including sinus arrhythmia, premature beat, heart block, atrial fibrillation, atrial flutter, pulsus alternans and paroxysmal tachycardia. ASTHMA: a disease process that is characterized by paradoxical narrowing of the bronchi (lung passageways) making breathing difficult. Symptoms include wheezing, difficulty breathing (particularly exhaling air) and tightness in the chest. Factors which can exacerbate asthma include rapid changes in temperature or humidity, allergies, upper respiratory infections, exercise, stress or smoke (cigarette). ATHEROSCLEROSIS: the progressive narrowing and hardening of the arteries over time. This is known to occur to some degree with aging, but other risk factors that accelerate this process have been identified. These factors include high cholesterol, high blood pressure, smoking, diabetes and family history for atherosclerotic disease. BENIGN PROSTATIC HYPERTROPHY: A benign enlargement of the prostate gland. Present in approximately 20 percent of males at age 40, increasing to 70 percent at 60 and 90 percent by the eighth decade. The condition is asymptomatic in most patients 5 to 10 percent require surgical intervention. Clinical features include increased urinary frequency, nocturia, difficulty starting and stopping the stream of urine, acute urinary retention, urinary tract infections, etc. BILE STASIS: The diminution (stoppage) of the fluid secreted by the liver, concentrated in the gallbladder and channeled into the small intestine via the bile duct. Bile helps in the alkalinizing of the intestinal absorption and digestion of fat. BULEMIA: A psychological disorder affecting adolescent girls and young women. The disorder is characterized by binge eating alternating with normal eating or fasting but without the extreme loss of weight as in Anorexia Nervosa. CHOLELITHIASIS: The presence or formation of stones in the gallbladder. The stones are the result of the spersaturation of bile with cholesterols or impaired hepatic secretion of bile salts and lecitinin creates an unstable supersaturated solution forming crystallization. Clinical features associated with nausea, vomiting, right upper quadrant abdominal pain and or intolerance of fatty foods. CLAUDICATION: A cramping pain felt in the lower legs while walking often relieved by rest. The pain is secondary to the inadequate delivery of oxygen to the lower extremities. CONGESTIVE HEART FAILURE: A pathophysiologic state in which cardiac output is insufficient to satisfy the body’s requirements. The condition manifest most commonly by pulmonary congestion and edema. Clinical features include: shortness of breath associated with exertion, difficulty breathing while lying flat, edema of bilateral lower extremities. CORONARY ARTERY DISEASE: Disease involving the vessels of the heart, such as arteriosclerosis-group of disease characterized by thickening and loss of elasticity of the arterial walls. DEGENERATIVE JOINT DISEASE: A form of arthritis that results in the destruction of the articular cartilage that line the joints. Seen predominately in the larger weight bearing joints of the hips, knees and spine, but may also be evident in the small joints of the hands. DIABETES INSIPIDUS:A rare form of diabetes in which the kidneys are unable to concentrate the urine. This condition is secondary to either deficient production of the antidiuretic hormone (ADH, vasopressin), the ADH receptor or deffective collecting duct in the kidney. Clinical features include: excessive thirst and increased urinary freqency. DIABETES MELLITUS: A chronic disorder affecting carbohydrate, fat and protein metabolism with hyperglycemia as the salient feature. A number of subsets: Primary diabetes Type I diabetes mellitis. IDDM (insuline dependent DM) 10 to 20 % of cases; onset under 20 years; normal weight; decrease blood insulin with islet cell antibodies; ketoacidosis common. Clinical features include: polydipsia, polyuria, polyphagia, infections, etc. Type II diabetes mellitis. NIDDM (non-insulin-dependent DM); adult onset over 30 years; obesity; normal or increased blood insulin: no islet cell antibodies; ketoacidosis rare. Clinical features include: Polydipsia, polyuria, obesity, etc. Secondary diabetes: hyperglycemia associated with identifiable causes of islet destruction: inflammatory pancreatic disease (pancreatitis) surgery (pancreatectomy), tumors (hormonal: pheochromcytoma, pituitary tumors),drugs (corticosteroids), iron overload (hemochromocytosis). ERECTILE DYSFUNCTION: a consistent inability to sustain an erection sufficient for sexual intercourse. Also commonly known as impotence. Medically, the term erectile dysfunction is used to differentiate impotence from other problems that interfere with sexual intercourse (such as lack of sexual desire and problems with ejaculation and orgasm). Impotence usually has a physical cause such as disease, injury, drug side-effects, or a disorder that impairs blood flow in the penis. Impotence is treatable in all age groups. ESOPHOGITIS: An inflammation of the esophagus. Predisposing conditions include: Reflux of the gastric contents (reflux esophogitis) Exposure to irritants: alcohol, corrosive acids or alkalis, etc. Uremia (an excess of the nitrogenous and products of protein and amino acid metabolism in the blood. Bacteremia or ulermia with direct infection of the esophagus: herpes, cytomegalovirus, etc. Fungal infection in debilitated patients: candido, aspergilosisl, mucormycosis, etc. Radiation and anticancer therapy In association with desquamative disorders: permphigoid, epidermolysis bullosa. Glaucoma: a group of eye diseases characterized by an increase in intraocular pressure which causes pathological changes in the optic disk and typical defects in the field of vision. IDEOPATHIC STEATORRHEA: Excess fat in the feces from an unknown origin. INFLAMMATORY BOWEL DISEASE:
A term encompassing Crohn's disease and ulcerative colitis. The term arose because of similarities in features and possible etiologies.Crohn's Disease is an idiopathic chronic ulcer constrictive inflammatory bowel disease characterized by sharply delimited segments of involvement associated with transmural, noncaseating granulatomis inflammation of all layers of the bowel wall. The disease most commonly affects the terminal ileum (distal part of the small intestine and the colon) hence terminal ileitis. As the disease progresses, long serpentine ulcers may form narrow fissures penetrating deeply into the bowel wall. Clinical features include intermittent attacks of diarrhea, fever; abdominal pain (e.g. in the right lower quadrant) may be precipitated by periods of physical or emotional stress. HEPATITIS: Inflammation of the liver. Any blood-borne infection may involve the liver, whether systemic in origin or arising in the abdominal cavity, including bacterial, fungal and parasitic infections. Systemic viral infections that may involve the liver include: infectious mononucleosis (Epstein-Barr Virus) cytomealovirus, herpes virus, yellow fever, etc. In children the liver is infrequently involved in rubella, adenovirus and enterovirus infections. However, unless otherwise specified, most cases of hepatitis refers to an infection of the liver by a small group of hepatotrophic viruses including: Hepatitis A: A self limited viral disease of worldwide distribution, usually transmitted by oral ingestion of infected material, but may also be transmitted parenterally (injection). Clinical features include: fever, malaise, nonspecific gastrointestinal symptoms, followed by jaundice, pruritus, dark urine, pale stools, hepatomegaly etc. Hepatitis B: An acute viral illness transmitted parentally or by oral ingestion of infected material. Prodromal symptoms include: urticarial skin lesions and arthritis. Clinical symptoms are similar to hepatitis A, however, the acute illness tends to be more prolonged and variable than in viral hepatitis A. Non-A, Non-B Hepatitis Viruses:Because there are cases of hepatitis for which serologic test have ruled out all known viral causes, it is thought that additional agents are involved. NANB hepatitis is transmitted primarily via the blood and resembles hepatitis B in its clinical course and severity. A chronic carrier state can occur. Most cases of post-transfusion hepatitis in the U.S. are now due to NANB viruses. One major cause of NANB hepatitis is hepatitis C, a virus resembling yellow fever virus, a flavivirus. Delta Agent (Hepatitis Delta Virus) - is a defective virus, because its genome does not code for its own protective envelope protein. This suggests that the delta hepatitis can occur only in individuals previously infected by HBV since the virus can replicate only in HBV-infected cells. Delta hepatitis is transmitted viathe blood and resembles hepatitis B in severity. chronic carrier state can occur. HYPERTENSION: Is a persistently high arterial blood pressure. When defined as diastolic greater than 90 mmHg and systolic greater than 140 mmHg. The prevalence of hypertension in the US is approximately 25 percent of the population. Approximately 90 percent of hypertension may have no known cause (essential, idiopathic or primary). The remaining is secondary and is mostly related to artery stenosis, endocrine abnormalities, vascular malformations, neurogenic disorders, etc. HYPOTENSION: Is a persistently low arterial blood pressure. When defined as systolic less than 90 and diastolic less than 50. Excessive hypotension may result in shock. LEUKEMIA: Is a malignant neoplasm of the hematopoietic stem cells, arising in the bone marrow, that flood the Circulation, blood or other organs. Leukemias are classified on the basis of the cell type involved (myeloid verses lymphoid) and the state of the leukemia cells. Acute leukemias are characteristic by the presence of very immature cells (called blasts) and by a rapidly fatal course in untreated patients; chronic leukemia is associated, at least initially, with well-differentiated (mature) leukocytes and a relative indolent course. Clinical features of acute leukemias include: fatigue due mainly to anemia, fever, petechiae (red spots), ecchymosis (bruising), epistaxis (nose-bleeds), gingival bleeding, generalized lymphadenopathy, splenomegaly, hepatomegaly, bone pain, headaches, papilledema (edema of the optic disk), etc. Clinical features of chronic leukemias include: easy fatigue, weakness, weight loss, extreme splenomegaly, fullness in the abdomen. MALABSORPTION: Malabsorption: Abnormal fecal excretion of fat (steatorrhea) owing to malabsorption of fats, fat soluble vitamins, proteins, carbohydrates, minerals and water. Malabsorption is the result of a disturbance in at least one of the following functions: 1. Digestion of nutrients of smaller molecules that can be absorbed or transported across the intestinal mucosal cell. 2. Reduction in the absorptive capacity of the bowel, particularly reduction in the surface area of the small bowel. 3. Abnormal transport of absorbed products. Clinical features include weight loss, anorexia, abdominal distension, borborygmi (rumbling noise caused by propulsion of gas through the intestine), muscle wasting, passage of abnormally bulky, frothy, greasy yellow or gray stools. Some common malabsorption syndromes include: Celia sprue is a malabsorption syndrome precipitated by ingestion of gluten-containing foods (wheat, grains). The clinical symptoms include diarrhea, frothy, fatty, fetid stools, abdominal distension, weight loss, asthenia, deficiency of vitamins B, D, K and electrolyte depletion. Tropical sprue is a malabsorption syndrome occurring almost exclusively in people living or visiting tropical or semi-tropical locales. Clinical symptoms include stomatitis (inflammation of the oral mucosa), diarrhea and anemia. Whipple's Disease is a malabsorption syndrome with small intestine disease, with malabsorption having systemic ramifications including involvement of skin, central nervous system, joints, heart, blood vessels, kidney, lung, serosal membrane, lymph node, liver and spleen. Clinical features include diarrhea, stentorrhea, abdominal cramps, distension, fever, weight loss, arthritis and central nervous system disease. MULTIPLE MYELOMA: Abnormal aggregates of plasma cells replacing 15 to 90 percent of the bone marrow. The neoplastic cells cause multifocal destructive bone lesions. Typically, individual lesions appear as sharply punched-out defects, having a rounded soap bubble like appearance on Xray film, but generalized osteoporosis may also be seen. Although any bone may be involved the vertebral column, ribs and skull are most frequently affected. Clinical features include: Bone infiltrates are manifested by pain and pathologic fractures, hyper- calcemia resulting from bone resorption may give rise neurologic manifestations, such as, confusion, weakness, lethargy, constipation polyuria, recurrent infections, renal insufficiency, etc. MYOCARDIAL INFARCTION:(Heart attack) occurs when there is a constriction or obstruction of one of the vessels that supplies a region of the heart. If blood flow is restricted significantly there is damage to that area – called ischemia. OBESITY: The state of being overweight. A person is considered to be obese if they are more than 20 percent over their ideal weight. That ideal weight must take into account the person’s height, age, sex, and build. Obesity is often multifactorial, based on both genetic and behavioral factors. OSTEOARTHRITIS: noninflammatory degenerative joint disease occurring chiefly in older persons, characterized by degeneration of the articular cartilage, hypertrophy of bone at the margins and changes in the synovial membrane. It is accompanied by pain and stiffness, particularly after prolonged activity. PANCREATITIS: An acute condition usually presenting with severe abdominal pain associated with increased pancreatic enzymes in the blood or urine caused by inflammation and necrosis of the pancreas. The condition is often caused by biliary tract disease especially cholelithiasis. Gallstones are present in some 35-60% of patients with pancreatitis. Other causes include alcoholism, trauma, extension of inflammation from adjacent tissue, sepsi, virus (hepatitis, mumps), vasculitis, hypercalcemia. Starts by unknown causes (ideopathic pancreatitis etc. Clinical features include pain that is constant and intense with upper back radiation, peripheral vascular collapse and shock. Death may occur from shock, respiratory distress syndrome (ARDS), and acute renal failure. PROSTATE CANCER: Cancer of the gland surrounding the neck of the bladder and urethra in the male; the gland contributes a secretion to the semen. Prostate cancer is the most common form of cancer in males; currently the third leading cause of cancer deaths. Clinical features include: an increase in the frequency of urination, a decrease in the pressure upon urination, urinary tract infections, subsequent obstruction, note: urinary obstruction does not usually occur in the early stages of the disease, secondary to the origin of most carcinomas; the periphery of the prostate. PYRONIE'S DISEASE: Is an abnormal curvature of the penis. This condition Is secondary to the contraction/scar tissue in the corpus cavernosum of the penis, upon erection the penis is pulled to one side resulting in a deviation. RETINITIS PIGMENTOSIS:A disease marked by the progressive loss of the neural elements used for the transmission and reception of visual stimuli in the eye. RHEUMATOID ARTHRITIS: Chronic inflammatory disease in which there is destruction of joints. Considered by some to be an autoimmune disorder in which immune complexes are formed in joints and excite an inflammatory response (complex mediated hypersensitivity). SCHIZOPHRENIA: A mental disorder or heterogenous group of disorders (the schizophrenias or schizophrenic disorders) comprising most major psychotic disorders. Characterised by disturbances in form and content of thought (loosening of associations, delusions and hallucination), mood disturbances (blunted, flattened or inappropriate affect), sense of self and relationship to the external world (loss of ego boundaries, and autistic withdrawal) and differences in behavior (bizarre, stereotyped activity or inactivity). SICKLE CELL ANEMIA:A disease common in races of individuals from areas in which malaria is endemic. This hereditary hema- globinopathy results from a point mutation of the globulin gene, is associated with the substitution of valine for glutamic acid. Upon deoxygenation Hbs molecules undergo aggregation and polymerization, leading to a sickling of the red cells. Clinical features include: propensity to develop gallstones, painful episodes of ischemic necrosis effecting the bone, lungs, liver, brain, penis spleen, increased susceptibility to infections, etc. STOMACH ULCER: an ulcer in the mucosal lining of the stomach. Ulcer formation results from gastric inflammation that may be triggered by the use of alcohol, aspirin or nonsteroidal anti-inflammatory agents. Symptoms include recurrent abdominal pains (may be relieved by antacids), nausea, vomiting, weight loss and fatigue. Complications include GI bleeding, obstruction, perforation and ulcer penetration into surrounding tissues. STROKE: a condition due to the lack of oxygen to the brain, which may lead to reversible or irreversible paralysis. The damage to a group of nerve cells in the brain is often due to interrupted blood flow, caused by a blood clot or blood vessel bursting. Depending on the area of the brain that is damaged, a stroke can cause coma, paralysis, speech problems and dementia. URTICARIA: a transient condition of the skin, usually caused by an allergic reaction, characterized by pale or reddened irregular, elevated patches and severe itching, hives. VALVULAR HEART DISEASE:Disease of the valves of the heart.
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