ASTHMA

 Asthma is a disease of respiratory system

 It is chronic disease that affects the airways of your lungs.
 It is partially reversible.
 Prevalence: Affecting approximately 300 million people worldwide; 10-12%
adults and 15% children
 During asthma episode:
o The muscles around the airways tighten, making the airways smaller.
o The lining of the airways becomes swollen.
o Thick mucus forms, blocking small airways.
 The pathophysiology of asthma involves
o Airway inflammation,
o Intermittent airflow obstruction,
o Bronchial hyperresponsiveness.
 Factors that contribute to Asthma
o Genetic factors
o Environmental allergens (eg, house dust mites; animal allergens, especially
cat and dog; cockroach allergens; and fungi)
o Viral respiratory tract infections
o Exercise
o Gastroesophageal reflux disease
o Chronic sinusitis or rhinitis
o Aspirin or nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity,
sulfite sensitivity
o Use of beta-adrenergic receptor blockers (including ophthalmic
preparations)
o Obesity
o Environmental pollutants, tobacco smoke
o Occupational exposure
o Irritants (eg, household sprays, paint fumes)
o Various high- and low-molecular-weight compounds
o Emotional factors or stress
o Perinatal factors (premature birth)
 Symptoms
o Difficult breathing
o Coughing
o Wheezing
o Chest tightness
o Tachycardia
o Fatigue
o Moist skin
o Anxiety
 Diagnosis
o Spirometry test or pulmonary function test: Spirometry measurements
(FEV1, FVC, FEV1/FVC) before and after bronchodialator helps determine
whether there is airflow obstruction and whether it is reversible over the
short term
 Treatment
o Lifestyle management: Identify and reduce exposure to triggering factors
like pollen grains, dust etc.
o Acute attack: β2 agonist- Salbutamol
o Long term therapy: Corticosteroids, Cromolyn sodium, Leukotriene
blocker
 Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease

that causes obstructed airflow from the lungs.

Risk factors:
 Exposure to tobacco smoke.
 People with asthma who smoke
 Occupational exposure to dusts and chemicals.
 Exposure to fumes from burning fuel.
 Age.
 Genetics. alpha-1-antitrypsin deficiency

Symptoms:
 Shortness of breath, especially during physical activities
 Wheezing
 Chest tightness
 Having to clear your throat first thing in the morning, due to excess mucus in
your lungs
 A chronic cough that may produce mucus (sputum) that may be clear, white,
yellow or greenish
 Blueness of the lips or fingernail beds (cyanosis)
 Frequent respiratory infections
 Lack of energy
 Unintended weight loss (in later stages)
 Swelling in ankles, feet or legs

Causes of airway obstruction

1. Emphysema. This lung disease causes destruction of the fragile walls and elastic
fibers of the alveoli. Small airways collapse when you exhale, impairing airflow
out of your lungs.
2. Chronic bronchitis. In this condition, your bronchial tubes become inflamed and
narrowed and your lungs produce more mucus, which can further block the
narrowed tubes. You develop a chronic cough trying to clear your airways.
Diagnosis:
Lung function test
Treatment:
1. Quit smoking
2. Bronchodilators: β2 agonist: Terbutaline, Salbutamol
3. Anticholinergics: Ipatropium
4. Theophylline
5. Steroids: Glucocorticoids
 Diabetes Mellitus
 It is endocrine system disorder.
 Diabetes mellitus, disorder of carbohydrate metabolism characterized by impaired
ability of the body to produce or respond to insulin and thereby maintain proper levels
of sugar (glucose) in the blood.
 Types and causes:
1. Type I Diabetes
 Accounts for 10% diabetes.
 Type 1 diabetes is usually caused by destruction of the islets of Langerhans
of the pancreas.
2. Type 2 Diabetes
 Accounts for 90% diabetes
 It begins with insulin resistance, a condition in which cells fail to respond
to insulin properly.
3. Gestational Diabetes
 Occurs during pregnancy
 Symptoms
o Weight loss,
o polyuria (increased urination),
o polydipsia (increased thirst),
o polyphagia (increased hunger)
o blurry vision progressing to retinopathy
 Complications:
o Retinopathy
o Neuropathy
o Nephropathy
o Hypertension
o Stroke
o Increase in risk of cardiovascular disorders
 Diagnosis
o Fasting plasma glucose level ≥ 7.0 mmol/l (126 mg/dl)
o Plasma glucose ≥ 11.1 mmol/l (200 mg/dl) two hours after a 75 g oral
glucose load as in a glucose tolerance test
o Glycated hemoglobin (HbA1C) ≥ 48 mmol/mol (≥ 6.5 DCCT %)
 Management
 Diet control
 Exercise
 Smoking cessation (Stopping)
 Medications:
 Type I: Insulin
 Type II: Oral Hypoglycaemic agents: Metformin, Sitagliptin, Glipizide, Glimeperide,
Rosiglitazone
 RENAL CALCULI or KIDNEY STONES or UROLITHIASIS
 It is disorder of urinary system
 It is the condition when a solid piece of material (kidney stone) occurs in the urinary
tract.
 Kidney stones typically form in the kidney and leave the body in the urine stream. A
small stone may pass without causing symptoms
 If a stone grows to more than 5 millimeters (0.2 in) it can cause blockage of the ureter
resulting in severe pain in the lower back or abdomen. A stone may also result in
blood in the urine, vomiting, or painful urination.
 Risk factors:
o High urine calcium levels
o Obesity
o Hyperparathyroidism
o Gout
o Not drinking enough fluids
o Some medicines
 Diagnosis
o Imaging studies: Ultrasonography
o Laboratory examination: Microscopic examination of urine sample;
Calcium levels, Complete blood count; renal function test
 Treatment:
o Dietary measure: Increase fluid intake, Increase citric acid intake (lemon
juice),
o Urinary alkalinisation: Acetazolamide
o Diuretics: Chlorthalidone, Indapamide
o Pain management: Ketorolac
o Lithotripsy: Dissolving kidney stones by giving shock waves
o Surgery: Ureteroscopic, Anatrophic nephrolithotomy
 GOITER

 It is disorder of endocrine gland.

 A goiter (GOI-tur) is an abnormal enlargement of your thyroid gland.
 Risk factors:
o A lack of dietary iodine.
o Being female.
o Age. Goiters are more common after age 40.
o Medical history. A personal or family history of autoimmune disease
increases your risk.
o Pregnancy and menopause. For reasons that aren't entirely clear, thyroid
problems are more likely to occur during pregnancy and menopause.
o Medications. Amiodarone, Lithium
o Radiation exposure.
 Causes:
o Iodine deficiency
o Congenital hypothyroidism (Hypothyroidism by birth)
o Pituitary gland disorder
o Thyroid cancer
o Graves disease: Overstimulation of thyroid gland
o Hashimoto’s syndrome: Damage thyroid gland
 Symptoms:
o A visible swelling at the base of your neck that may be particularly obvious
when you shave or put on makeup
o A tight feeling in your throat
o Coughing
o Hoarseness
o Difficulty swallowing
o Difficulty breathing
 Diagnosis:
o Thyroid Hormone test
o Ultrasonography of neck
o Thyroid scan with radioactive isotope
o Biopsy
 Treatment
o Medications.
 Hypothyroidism  thyroid hormone replacement with
levothyroxine
 Inflammation Aspirin or a corticosteroid
 Hyperthyroidism Medications to normalize hormone levels.
o Surgery. Removing all or part of your thyroid gland (total or partial
thyroidectomy)
o Radioactive iodine: used to treat an overactive thyroid gland.
 ADDISON’S DISEASE/ ADRENAL INSUFFICIENCY

 It is disorder of endocrine system

 In Addison's disease, adrenal glands produce too little cortisol and often insufficient
levels of aldosterone as well.
 Life threatening disease
 Symptoms
o Extreme fatigue
o Weight loss and decreased appetite
o Darkening of your skin (hyperpigmentation)
o Low blood pressure, even fainting
o Salt craving
o Low blood sugar (hypoglycemia)
o Nausea, diarrhea or vomiting
o Abdominal pain
o Muscle or joint pains
o Irritability
o Depression
o Body hair loss or sexual dysfunction in women
 Causes:
o Adrenal destruction: Due to autoimmune disorder; Tuberculosis, cancer of
adrenal glands
o Problems in pituitary gland
o Impaired steroidogenesis
 Diagnosis
o Blood test. blood levels of sodium, potassium, cortisol and ACTH
o ACTH stimulation test. This test involves measuring the level of cortisol in
your blood before and after an injection of synthetic ACTH.
o Insulin-induced hypoglycemia test.
o Imaging tests: CT scan of your abdomen to check the size of your adrenal
glands
 Treatment:
o Corticosteroids: Hydrocortisone, Prednisone, cortisone acetate
 PREMENSTRUAL SYNDROME

 Premenstrual syndrome (PMS) has a wide variety of signs and symptoms, including
mood swings, tender breasts, food cravings, fatigue, irritability and depression. It's
estimated that as many as 3 of every 4 menstruating women have experienced some
form of premenstrual syndrome.
 Symptoms
o Emotional and behavioral signs and symptoms
o Tension or anxiety
o Depressed mood
o Crying spells
o Mood swings and irritability or anger
o Appetite changes and food cravings
o Trouble falling asleep (insomnia)
o Social withdrawal
o Poor concentration
o Change in libido
o Physical signs and symptoms
o Joint or muscle pain
o Headache
o Fatigue
o Weight gain related to fluid retention
o Abdominal bloating
o Breast tenderness
o Acne flare-ups
o Constipation or diarrhea
o Alcohol intolerance
 Causes
o Cyclic changes in hormones: hormonal fluctuations
o Chemical changes in the brain. Fluctuations of serotonin, a brain chemical
(neurotransmitter) that's play a crucial role in mood states, could trigger
PMS symptoms. Insufficient amounts of serotonin may contribute to
premenstrual depression, as well as to fatigue, food cravings and sleep
problems.
o Depression. Some women with severe premenstrual syndrome have
undiagnosed depression, though depression alone does not cause all of the
symptoms.
 Treatment:
o Lifestyle modifications
o Exercise
o Yoga and meditation
o Antidepressants. Fluoxetine, paroxetine, sertraline for reducing mood
symptoms.
o Nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen or
naproxen sodium can ease cramping and breast discomfort.
o Hormonal contraceptives.
 CYSTIC FIBROSIS

 Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive
system and other organs in the body.
 Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. People
with cystic fibrosis, a defective gene causes the secretions to become sticky and thick.
Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways,
especially in the lungs and pancreas.
 Risk factors:
o Family history
o Race: More in white people
 Symptoms
o Respiratory signs and symptoms
o A persistent cough that produces thick mucus (sputum)
o Wheezing
o Breathlessness
o Exercise intolerance
o Repeated lung infections
o Inflamed nasal passages or a stuffy nose
o Digestive signs and symptoms
o Foul-smelling, greasy stools
o Poor weight gain and growth
o Intestinal blockage, particularly in newborns (meconium ileus)
o Severe constipation
 Causes:
o In cystic fibrosis, a defect (mutation) in a gene changes a protein that
regulates the movement of salt in and out of cells
 Treatment:
o Antibiotics to treat and prevent lung infections
o Anti-inflammatory medications to lessen swelling in the airways in your
lungs
o Mucus-thinning drugs to help you cough up the mucus, which can improve
lung function
o Inhaled medications called bronchodilators that can help keep your
airways open by relaxing the muscles around your bronchial tubes
o Oral pancreatic enzymes to help your digestive tract absorb nutrients.