B.

Non communicable diseases

1. Alzheimer’s disease
2. Amyotrophic lateral sclerosis (ALS) (also called Lou Gehrig’s disease)
3. Arthritis
4. Attention deficit hyperactivity disorder (ADHD)
5. Autism spectrum disorder (ASD)
6. Bell’s palsy
7. Bipolar disorder
8. Birth defects
9. Cancer
10. Cerebral palsy
11. Chronic kidney disease
12. Chronic pain
13. Chronic pancreatitis
14. Chronic traumatic encephalopathy (CTE)
15. Clotting/bleeding disorders
16. Congenital hearing loss
17. Cooley’s anemia (also called beta thalassemia)
18. Crohn’s disease
19. Diabetes
20. Depression
21. Down syndrome
22. Eczema
23. Epilepsy
24. Fetal alcohol syndrome
25. Fibromyalgia
26. Fragile X syndrome (FXS)
27. Hypertension
28. Heart attack
29. Hemochromatosis
30. Hemophilia
31. Inflammatory bowel disease (IBD)
32. Insomnia
33. Jaundice in newborns
34. Kidney disease
35. Lead poisoning
36. Liver disease
37. Muscular dystrophy (MD)
38. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
39. Myelomeningocele (a type of spina bifida)
40. Obesity
41. Primary thrombocythemia
42. Psoriasis
43. Seizure disorder
44. Sickle cell anemia
45. Sleep disorders
46. Stress
47. Systematic lupus erythematosus (also called lupus)
48. Systemic sclerosis (also called scleroderma)
49. Temporomandibular joint (TMJ) disorder
50. Tourette syndrome (TS)

Explanation of some non communicable diseases

1. Hypertension
Pulmonary hypertension
Pulmonary hypertension is a type of high blood pressure that affects the arteries in your lungs
and the right side of your heart.
In one form of pulmonary hypertension, called pulmonary arterial hypertension (PAH), blood
vessels in your lungs are narrowed, blocked or destroyed. The damage slows blood flow through
your lungs, and blood pressure in the lung arteries rises. Your heart must work harder to pump
blood through your lungs. The extra effort eventually causes your heart muscle to become weak
and fail.
In some people, pulmonary hypertension slowly gets worse and can be life-threatening. Although
there's no cure for some types of pulmonary hypertension, treatment can help reduce symptoms
and improve your quality of life.
Symptoms
The signs and symptoms of pulmonary hypertension develop slowly. You may not notice them
for months or even years. Symptoms get worse as the disease progresses.
Pulmonary hypertension symptoms include:
 Shortness of breath (dyspnea), initially while exercising and eventually while at rest
 Fatigue
 Dizziness or fainting spells (syncope)
 Chest pressure or pain
 Swelling (edema) in your ankles, legs and eventually in your abdomen (ascites)
 Bluish color to your lips and skin (cyanosis)
 Racing pulse or heart palpitations

o Causes
Chambers and valves of the heart

Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood
passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs
through a large blood vessel (pulmonary artery).
In your lungs, the blood releases carbon dioxide and picks up oxygen. The blood normally flows
easily through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left
side of your heart.
However, changes in the cells that line your pulmonary arteries can cause the walls of the
arteries to become stiff, swollen and thick. These changes may slow down or block blood flow
through the lungs, causing pulmonary hypertension.
Pulmonary hypertension is classified into five groups, depending on the cause.
Group 1: Pulmonary arterial hypertension (PAH)
Causes include:
 Unknown cause (idiopathic pulmonary arterial hypertension)
 A genetic mutation passed down through families (heritable pulmonary arterial
hypertension)
 Use of some prescription diet drugs or illegal drugs such as methamphetamines — and
other drugs
 Heart problems present at birth (congenital heart disease)
 Other conditions, such as connective tissue disorders (scleroderma, lupus, others), HIV
infection or chronic liver disease (cirrhosis)
Group 2: Pulmonary hypertension caused by left-sided heart disease
Causes include:
 Left-sided heart valve disease, such as mitral valve or aortic valve disease
 Failure of the lower left heart chamber (left ventricle)

Group 3: Pulmonary hypertension caused by lung disease

Causes include:
 Chronic obstructive pulmonary disease (COPD)
 Pulmonary fibrosis, a condition that causes scarring in the tissue between the lungs' air
sacs (interstitium)
 Obstructive sleep apnea
 Long-term exposure to high altitudes in people who may be at higher risk of pulmonary
hypertension
Group 4: Pulmonary hypertension caused by chronic blood clots
Causes include:
 Chronic blood clots in the lungs (pulmonary emboli)
 Other clotting disorders

Group 5: Pulmonary hypertension triggered by other health conditions

Causes include:
 Blood disorders, including polycythemia vera and essential thrombocythemia
 Inflammatory disorders such as sarcoidosis and vasculitis
 Metabolic disorders, including glycogen storage disease
 Kidney disease
 Tumors pressing against pulmonary arteries

Eisenmenger syndrome and pulmonary hypertension

Eisenmenger syndrome is a type of congenital heart disease that causes pulmonary hypertension.
It's most commonly caused by a large hole in your heart between the two lower heart chambers
(ventricles), called a ventricular septal defect.
This hole in your heart causes blood to flow incorrectly in your heart. Oxygen-carrying blood
(red blood) mixes with oxygen-poor blood (blue blood). The blood then returns to your lungs —
instead of going to the rest of your body increasing the pressure in the pulmonary arteries and
causing pulmonary hypertension.
o Risk factors
Growing older can increase your risk of developing pulmonary hypertension. The condition is
more often diagnosed in people ages 30 to 60. However, idiopathic PAH is more common in
younger adults.
Other things that can raise your risk of pulmonary hypertension include:
 A family history of the condition
 Being overweight
 Blood-clotting disorders or a family history of blood clots in the lungs
 Exposure to asbestos
 Genetic disorders, including congenital heart disease
 Living at a high altitude
 Use of certain weight-loss drugs
 Use of illegal drugs such as cocaine
 Use of selective serotonin reuptake inhibitors (SSRIs), used to treat depression and
anxiety
o Complications
Complications of pulmonary hypertension include:
 Right-sided heart enlargement and heart failure (cor pulmonale). In cor pulmonale,
your heart's right ventricle becomes enlarged and has to pump harder than usual to move
blood through narrowed or blocked pulmonary arteries.
At first, the heart tries to compensate by thickening its walls and expanding the chamber
of the right ventricle to increase the amount of blood it can hold. But these changes create
more strain on the heart, and eventually the right ventricle fails.
  Blood clots. Having pulmonary hypertension makes it more likely you'll develop clots in
the small arteries in your lungs, which is dangerous if you already have narrowed or
blocked blood vessels.
 Arrhythmia. Pulmonary hypertension can cause irregular heartbeats (arrhythmias),
which can lead to a pounding heartbeat (palpitations), dizziness or fainting. Certain
arrhythmias can be life-threatening.
 Bleeding in the lungs. Pulmonary hypertension can lead to life-threatening bleeding into
the lungs and coughing up blood (hemoptysis).
 Pregnancy complications. Pulmonary hypertension can be life-threatening for a woman
and her developing baby.
o Diagnosis
Pulmonary hypertension is hard to diagnose early because it's not often detected in a routine
physical exam. Even when the condition is more advanced, its signs and symptoms are similar to
those of other heart and lung conditions.
Your doctor will perform a physical exam and talk to you about your signs and symptoms. You'll
be asked questions about your medical and family history.
Your doctor will order tests to help diagnose pulmonary hypertension and determine its cause.
Tests for pulmonary hypertension may include:
 Blood tests. Blood tests can help your doctor determine the cause of pulmonary
hypertension or look for signs of complications.
 Chest X-ray. A chest X-ray creates pictures of your heart, lungs and chest. It can show
enlargement of the right ventricle of the heart or the pulmonary arteries, which can occur
in pulmonary hypertension. Your doctor may also use a chest X-ray to check for other
lung conditions that can cause pulmonary hypertension.
 Electrocardiogram (ECG). This noninvasive test shows your heart's electrical patterns
and can detect abnormal heartbeats. An ECG may also reveal signs of right ventricle
enlargement or strain.
 Echocardiogram. Sound waves can create moving images of the beating heart. An
echocardiogram lets your doctor see how well your heart and its valves are working. It
can be used to determine the size and thickness of the right ventricle, and to measure the
pressure in your pulmonary arteries.
Sometimes, an echocardiogram is done while you exercise on a stationary bike or
treadmill to understand how well your heart works during activity. You may be asked to
wear a mask that checks how well your heart and lungs use oxygen and carbon dioxide.
An echocardiogram may also be done after diagnosis to assess how your treatments are
working.
 Right heart catheterization. If an echocardiogram reveals pulmonary hypertension,
you'll likely have a right heart catheterization to confirm the diagnosis.
During this procedure, a cardiologist places a thin, flexible tube (catheter) into a vein in
your neck or groin. The catheter is then threaded into your right ventricle and pulmonary
artery.
Right heart catheterization allows your doctor to directly measure the pressure in the
main pulmonary arteries and right ventricle of the heart. It's also used to see what effect
different medications may have on your pulmonary hypertension.
Your doctor might also order one or more of the following tests to check the condition of your
lungs and pulmonary arteries and further determine the cause of pulmonary hypertension:
 Computerized tomography (CT). This imaging test creates cross-sectional pictures of
the bones, blood vessels and soft tissues inside your body. A CT scan can show the
heart's size, spot blood clots in the lungs' arteries, and look closely for lung diseases that
might lead to pulmonary hypertension, such as COPD or pulmonary fibrosis.
Sometimes, a special dye, called contrast, is injected into your blood vessels before the
CT scan (CT angiography). The dye helps your arteries show up more clearly on the
images.
 Magnetic resonance imaging (MRI). An MRI scan uses a magnetic field and pulses
of radio wave energy to make pictures of the body. Your doctor may order this test to
check the right ventricle's function and blood flow in the lung's arteries.
 Pulmonary function test. This noninvasive test measures how much air your lungs
can hold, and the airflow in and out of your lungs. During the test, you'll blow into a
simple instrument called a spirometer.
 Polysomnogram. This test measures your brain activity, heart rate, blood pressure,
oxygen levels and other factors while you sleep. It can help diagnose a sleep disorder
such as obstructive sleep apnea, which can cause pulmonary hypertension.
 Ventilation/perfusion (V/Q). In this test, a tracer is injected into a vein in your arm.
The tracer shows blood flow and air to your lungs. A V/Q test can determine whether
blood clots are causing symptoms of pulmonary hypertension.
 Open-lung biopsy. Rarely, a doctor might recommend an open-lung biopsy to check for
a possible cause of pulmonary hypertension. An open-lung biopsy is a type of surgery in
which a small sample of tissue is removed from your lungs while you are under general
anesthesia.
Genetic tests
If a family member has had pulmonary hypertension, your doctor might screen you for genes that
are linked with pulmonary hypertension. If you test positive, your doctor might recommend that
other family members also be screened.
Pulmonary hypertension classifications
Once you've been diagnosed with pulmonary hypertension, your doctor might classify the
severity of your disease into one of several classes, including:
 Class I. Although you've been diagnosed with pulmonary hypertension, you have no
symptoms with normal activity.
 Class II. You don't have symptoms at rest, but you have symptoms such as fatigue,
shortness of breath or chest pain with normal activity.
 Class III. You're comfortable at rest, but have symptoms when you're physically active.
 Class IV. You have symptoms while at rest and during physical activity.

o Treatment
There's no cure for pulmonary hypertension, but your doctors can prescribe treatments to help
you manage your condition. Treatment may help improve your symptoms and slow the progress
of pulmonary hypertension.
It often takes some time to find the most appropriate treatment for pulmonary hypertension. The
treatments are often complex and require extensive follow-up care.
When pulmonary hypertension is caused by another condition, your doctor will treat the
underlying cause whenever possible.
o Medications
 Blood vessel dilators (vasodilators). Vasodilators relax and open narrowed blood
vessels, improving blood flow. One of the most commonly prescribed vasodilators for
pulmonary hypertension is epoprostenol (Flolan, Veletri).
This drug continuously flows through an intravenous (IV) line attached to a small pump,
which you wear in a pack on your belt or shoulder. Potential side effects of epoprostenol
include jaw pain, nausea, diarrhea, leg cramps, and pain and infection at the IV site.
Other types of vasodilators, including treprostinil (Tyvaso, Remodulin, Orenitram), can
be inhaled, injected, or taken by mouth. The drug iloprost (Ventavis) is given while you
breathe in through a nebulizer, a machine that vaporizes your medication.
Side effects associated with treprostinil include chest pain, often with headache and
nausea, and breathlessness. Possible side effects of iloprost include headache, nausea and
diarrhea.
 Guanylate cyclase (GSC) stimulators. Riociguat (Adempas) increases nitric oxide in
the body, which relaxes the pulmonary arteries and lowers pressure within them. Side
effects include nausea, dizziness and fainting. You should not take GSC stimulators if
you're pregnant.
 Endothelin receptor antagonists. These medications reverse the effect of
endothelin, a substance in the walls of blood vessels that causes them to narrow.
Such drugs include bosentan (Tracleer), macitentan (Opsumit), and ambrisentan
(Letairis). These drugs may improve your energy level and symptoms. However,
they can damage your liver. You may need monthly blood tests to check your liver
function. Endothelin receptor antagonists shouldn't be taken if you're pregnant.
 Sildenafil and tadalafil. Sildenafil (Revatio, Viagra) and tadalafil (Adcirca, Cialis)
are commonly used to treat erectile dysfunction. But they also open the blood
vessels in the lungs and allow blood to flow through more easily. Side effects can
include an upset stomach, headache and vision problems.
 High-dose calcium channel blockers. These drugs help relax the muscles in the
walls of your blood vessels. They include amlodipine (Norvasc), diltiazem
(Cardizem, Tiazac, others) and nifedipine (Procardia, others). Although calcium
channel blockers can be effective, only a small number of people with pulmonary
hypertension improve while taking them.
 Warfarin. Warfarin is a type of drug called an anticoagulant (blood thinner). Your
doctor is likely to prescribe warfarin (Coumadin, Jantoven) to help prevent blood
clots in the lung's arteries. This medication delays the clotting process and might
put you at risk of bleeding, especially if you're having surgery or an invasive
procedure. Talk to your doctor about whether you need to stop taking a blood-
thinning medication before surgery and for how long.
Many other drugs, herbal supplements and foods can interact with warfarin, so talk
to your doctor about your diet and other medications. You'll need occasional blood
tests while taking warfarin to check how well it's working.
 Digoxin. Digoxin (Lanoxin) helps the heartbeat stronger and pump more blood. It
can help control the heart rate if you have arrhythmias.
  Diuretics. Commonly known as water pills, these medications help your kidneys
remove excess fluid from the body. This reduces the amount of work your heart has
to do. They may also be used to limit fluid buildup in your lungs, legs and
abdomen.
 Oxygen therapy. Your doctor might suggest that you sometimes breathe pure
oxygen to help treat pulmonary hypertension, especially if you live at a high
altitude or have sleep apnea. Some people who have pulmonary hypertension
eventually need continuous oxygen therapy.
o Surgery
 Atrial septostomy. If medications don't control your pulmonary hypertension, this
open-heart surgery might be an option. In an atrial septostomy, a surgeon creates an
opening between the upper left and right chambers of your heart (atria) to relieve
the pressure on the right side of your heart.
Atrial septostomy can have serious complications, including heart rhythm problems
(arrhythmias).
 Transplantation. In some cases, a lung or heart-lung transplant might be an option,
especially for younger people who have idiopathic pulmonary arterial hypertension.
Major risks of any type of transplantation include rejection of the transplanted
organ and serious infection. You must take immunosuppressant drugs for life to
help reduce the chance of rejection.

2. Diabetes Mellitus
Diabetes mellitus is a disease that prevents your body from properly using the energy from the
food you eat. Diabetes occurs in one of the following situations:
 The pancreas (an organ behind your stomach) produces little insulin or no insulin at all.
Insulin is a naturally occurring hormone, produced by the beta cells of the pancreas,
which helps the body use sugar for energy.

-Or-

 The pancreas makes insulin, but the insulin made doesn't work as it should. This
condition is called insulin resistance.

To better understand diabetes, it helps to know more about how the body uses food for energy (a
process called metabolism).
Your body is made up of millions of cells. To make energy, the cells need food in a very simple
form. When you eat or drink, much of your food is broken down into a simple sugar called
glucose. Glucose provides the energy your body needs for daily activities.
The blood vessels and blood are the highways that transport sugar from where it is either taken in
(the stomach) or manufactured (in the liver) to the cells where it is used (muscles) or where it is
stored (fat). Sugar isn't able to go into the cells by itself. The pancreas releases insulin into the
blood, which serves as the helper, or the "key," that lets sugar into the cells for use as energy.
When sugar leaves the bloodstream and enters the cells, the blood sugar level is lowered.
Without insulin, or the "key," sugar can't get into the body's cells for use as energy. This causes
sugar to rise. Too much sugar in the blood is called "hyperglycemia" (high blood sugar).
 o Types
There are two main types of diabetes: Type 1 and Type 2:

 Type 1 diabetes occurs because the insulin-producing cells of the pancreas (beta cells) are
damaged. In Type 1 diabetes, the pancreas makes little or no insulin, so sugar can;t get
into the body's cells for use as energy. People with Type 1 diabetes must use insulin
injections to control their blood glucose. Type 1 is the most common form of diabetes in
people who are under age 30, but it can occur at any age. Ten percent of people with
diabetes are diagnosed with Type 1.
 In Type 2 diabetes (adult onset diabetes), the pancreas makes insulin, but it either doesn't
produce enough, or the insulin doesn't work properly. Nine out of 10 people with diabetes
have Type 2. This type occurs most often in people who are over 40 years old but can
occur even in childhood if there are risk factors present. Type 2 diabetes may sometimes
be controlled with a combination of diet, weight management and exercise. However,
treatment also may include oral glucose-lowering medications (taken by mouth) or
insulin injections (shots).

Other types of diabetes might result from pregnancy (gestational diabetes), surgery, use of
certain medicines, various illnesses and other specific causes.
Gestational diabetes
Gestational diabetes occurs when there is a high blood glucose level during pregnancy. As
pregnancy progresses, the developing baby has a greater need for glucose. Hormone changes
during pregnancy also affect the action of insulin, which brings about high blood glucose levels.
Pregnant women who have a greater risk of developing gestational diabetes include those who:

 Are over 35 years old.

 Are overweight.
 Have a family history of diabetes.
 Have a history of polycystic ovary syndrome (PCOS).

Blood glucose levels usually return to normal after childbirth. However, women who have had
gestational diabetes have an increased risk of developing Type 2 diabetes later in life.
o Causes
The causes of diabetes are not known. The following risk factors may increase your chance of
getting diabetes:

 Family history of diabetes or a personal history of gestational diabetes.

 African-American, Hispanic, Native American, or Asian-American race, Pacific Islander
or ethnic background.
 Injury to the pancreas (such as infection, tumor, surgery or accident).
 Autoimmune disease.
 Age (risk increases with age).
 Physical stress (such as surgery or illness).

There are risk factors that you might have more control over, including:

 High blood pressure.

 Abnormal blood cholesterol or triglyceride levels.
  Smoking.
 Being overweight.
 Use of certain medications, including steroids

It is important to note that sugar itself doesn't cause diabetes. Eating a lot of sugar can lead to
tooth decay, but it doesn't cause diabetes.
o Symptoms
The symptoms of diabetes include:

 Increased thirst.
 Increased hunger (especially after eating).
 Dry mouth.
 Frequent urination.
 Unexplained weight loss (even though you are eating and feel hungry).

Other symptoms include:

 Weak, tired feeling.

 Blurred vision.
 Numbness or tingling in the hands or feet.
 Slow-healing sores or cuts.
 Dry and itchy skin.
 Frequent yeast infections or urinary tract infections.

What are the symptoms of low blood sugar?

Most people have symptoms of low blood sugar (hypoglycemia) when their blood sugar is less
than 70 mg/dl. (Your healthcare provider will tell you how to test your blood sugar level.)
When your blood sugar is low, your body gives out signs that you need food. Different people
have different symptoms. You will learn to know your symptoms.
Common early symptoms of low blood sugar include the following:

 Feeling weak or dizzy, including trembling and feeling shaky.

 Feeling hungry.
 Sweating.
 Pounding heart.
 Pale skin.
 Feeling frightened or anxious.

Late symptoms of low blood sugar include:

 Feeling confused or being able to keep your mind on one subject.

 Headache.
 Poor coordination.
 Bad dreams or nightmares.
 Feeling cranky.
 Numbness in your mouth and tongue.
 Passing out.
 o Diagnosed
Diabetes is diagnosed with fasting sugar blood tests or with A1c blood tests, also known as
glycated hemoglobin tests. A fasting blood sugar test is performed after you have had nothing to
eat or drink for at least eight hours. Normal fasting blood sugar is less than 100 mg/dl (5.6
mmol/l). You do not have to be fasting for an A1c blood test. Diabetes is diagnosed by one of the
following (see chart):

 Your blood sugar level is equal to or greater than 126 mg/dl (7 mmol/l).
 You have two random blood sugar tests over 200 mg/dl (11.1 mmol/l) with symptoms.
 You have an oral glucose tolerance test with results over 200 mg/dl (11.1 mmol/l).
 Your A1c test is greater than 6.5 percent on two separate days.

An A1c test should be performed in a laboratory using a method that is certified by the National
Glycohemoglobin Standardization Program (NGSP) and standardized to the Diabetes Control
and Complications Trial (DCCT) assay.

Type of test Normal Pre-diabetes Diabetes

       

Less than 100

Fasting 100-125 126 or higher
glucose test

Less than 140

Random 140-199 200 or higher
(anytime)
glucose test

Less than 5.7%

A1c test 5.7 - 6.4% 6.5% or higher
 
 o Treatment
Insulin pumps
Insulin pumps are small, computerized devices, about the size of a small cell phone that you
wear on your belt, in your pocket, or under your clothes. They deliver rapid-acting insulin 24
hours a day through a small flexible tube called a cannula. The cannula is inserted under the skin
using a needle. The needle is then removed leaving only the flexible tube under the skin. The
pump user replaces the cannula every two to three days.
It is important for pump users to frequently monitor their glucose levels either with a continuous
glucose monitor or a fingerstick monitor. The pump delivers a continuous flow of insulin that
can be adjusted if needed for things like exercise and stress. A pump user regularly enters
information about their food intake and blood sugar levels into the pump so it can help them
calculate insulin doses for food intake and high blood sugar levels.
Benefits of an insulin pump include fewer insulin injections, a more flexible lifestyle, and a more
consistent and adjustable delivery of insulin.
Can I take both pills and insulin to control my blood sugar?
Yes. The combination of insulin and an oral medication, when taken as directed by your
healthcare provider, is very safe and effective in controlling blood sugar. A typical combination
therapy consists of taking an oral medication during the day and insulin at night.
Once you begin taking insulin, you will need to monitor your blood sugar more often to reduce
the risk of low blood sugar reactions. Combination therapies are often helpful for people who
have Type 2 diabetes. If you have been taking an oral medication, your doctor may change your
treatment plan to include insulin injections. This change is often made to help people with Type
2 diabetes gain better control of their blood sugar.

3. Stroke
A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing
brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.
A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain
damage and other complications.
o Symptoms
If you or someone you're with may be having a stroke, pay particular attention to the time the
symptoms began. Some treatment options are most effective when given soon after a stroke
begins.
Signs and symptoms of stroke include:
 Trouble speaking and understanding what others are saying. You may experience
confusion, slur your words or have difficulty understanding speech.
 Paralysis or numbness of the face, arm or leg. You may develop sudden numbness,
weakness or paralysis in your face, arm or leg. This often affects just one side of your
body. Try to raise both your arms over your head at the same time. If one arm begins to
fall, you may be having a stroke. Also, one side of your mouth may droop when you try to
smile.
 Problems seeing in one or both eyes. You may suddenly have blurred or blackened
vision in one or both eyes, or you may see double.
 Headache. A sudden, severe headache, which may be accompanied by vomiting,
dizziness or altered consciousness, may indicate that you're having a stroke.
  Trouble walking. You may stumble or lose your balance. You may also have sudden
dizziness or a loss of coordination.
When to see a doctor
Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they
seem to come and go or they disappear completely. Think "FAST" and do the following:
 Face. Ask the person to smile. Does one side of the face droop?
 Arms. Ask the person to raise both arms. Does one arm drift downward? Or is one arm
unable to rise?
 Speech. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?
 Time. If you observe any of these signs, call 911 or emergency medical help
immediately.
If you're with someone you suspect is having a stroke, watch the person carefully while waiting
for emergency assistance.
o Causes
There are two main causes of stroke: a blocked artery (ischemic stroke) or leaking or bursting of
a blood vessel (hemorrhagic stroke). Some people may have only a temporary disruption of
blood flow to the brain, known as a transient ischemic attack (TIA), that doesn't cause lasting
symptoms.
Ischemic stroke

This is the most common type of stroke. It happens when the brain's blood vessels become
narrowed or blocked, causing severely reduced blood flow (ischemia). Blocked or narrowed
blood vessels are caused by fatty deposits that build up in blood vessels or by blood clots or other
debris that travel through your bloodstream and lodge in the blood vessels in your brain.
Some initial research shows that COVID-19 infection may be a possible cause of ischemic
stroke, but more study is needed.
Hemorrhagic stroke
Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain
hemorrhages can result from many conditions that affect your blood vessels. Factors related to
hemorrhagic stroke include:
 Uncontrolled high blood pressure
 Overtreatment with blood thinners (anticoagulants)
 Bulges at weak spots in your blood vessel walls (aneurysms)
 Trauma (such as a car accident)
 Protein deposits in blood vessel walls that lead to weakness in the vessel wall (cerebral
amyloid angiopathy)
 Ischemic stroke leading to hemorrhage
A less common cause of bleeding in the brain is the rupture of an abnormal tangle of thin-walled
blood vessels (arteriovenous malformation).
Transient ischemic attack (TIA)
A transient ischemic attack (TIA) — sometimes known as a ministroke — is a temporary period
of symptoms similar to those you'd have in a stroke. A TIA doesn't cause permanent damage.
They're caused by a temporary decrease in blood supply to part of your brain, which may last as
little as five minutes.
Like an ischemic stroke, a TIA occurs when a clot or debris reduces or blocks blood flow to part
of your nervous system.
Seek emergency care even if you think you've had a TIA because your symptoms got better. It's
not possible to tell if you're having a stroke or TIA based only on your symptoms. If you've had a
TIA, it means you may have a partially blocked or narrowed artery leading to your brain. Having
a TIA increases your risk of having a full-blown stroke later.
o Risk factors
Many factors can increase your stroke risk. Potentially treatable stroke risk factors include:
Lifestyle risk factors

 Being overweight or obese

 Physical inactivity
 Heavy or binge drinking
 Use of illegal drugs such as cocaine and methamphetamine
Medical risk factors

 High blood pressure

 Cigarette smoking or secondhand smoke exposure
 High cholesterol
 Diabetes
 Obstructive sleep apnea
 Cardiovascular disease, including heart failure, heart defects, heart infection or abnormal
heart rhythm, such as atrial fibrillation
 Personal or family history of stroke, heart attack or transient ischemic attack
 COVID-19 infection
Other factors associated with a higher risk of stroke include:

 Age — People age 55 or older have a higher risk of stroke than do younger people.
 Race — African Americans have a higher risk of stroke than do people of other races.
 Sex — Men have a higher risk of stroke than women. Women are usually older when
they have strokes, and they're more likely to die of strokes than are men.
 Hormones — Use of birth control pills or hormone therapies that include estrogen
increases risk.
o Complications
A stroke can sometimes cause temporary or permanent disabilities, depending on how long the
brain lacks blood flow and which part was affected. Complications may include:

 Paralysis or loss of muscle movement. You may become paralyzed on one side of your
body, or lose control of certain muscles, such as those on one side of your face or one
arm.
 Difficulty talking or swallowing. A stroke might affect control of the muscles in your
mouth and throat, making it difficult for you to talk clearly, swallow or eat. You also may
have difficulty with language, including speaking or understanding speech, reading, or
writing.
  Memory loss or thinking difficulties. Many people who have had strokes experience
some memory loss. Others may have difficulty thinking, reasoning, making judgments
and understanding concepts.
 Emotional problems. People who have had strokes may have more difficulty controlling
their emotions, or they may develop depression.
 Pain. Pain, numbness or other unusual sensations may occur in the parts of the body
affected by stroke. For example, if a stroke causes you to lose feeling in your left arm,
you may develop an uncomfortable tingling sensation in that arm.
 Changes in behavior and self-care ability. People who have had strokes may become
more withdrawn. They may need help with grooming and daily chores.
o Prevention
Knowing your stroke risk factors, following your doctor's recommendations and adopting a
healthy lifestyle are the best steps you can take to prevent a stroke. If you've had a stroke or a
transient ischemic attack (TIA), these measures might help prevent another stroke. The follow-up
care you receive in the hospital and afterward also may play a role.
Many stroke prevention strategies are the same as strategies to prevent heart disease. In general,
healthy lifestyle recommendations include:
 Controlling high blood pressure (hypertension). This is one of the most important
things you can do to reduce your stroke risk. If you've had a stroke, lowering your blood
pressure can help prevent a subsequent TIA or stroke. Healthy lifestyle changes and
medications are often used to treat high blood pressure.
 Lowering the amount of cholesterol and saturated fat in your diet. Eating less
cholesterol and fat, especially saturated fat and trans fats, may reduce the buildup in your
arteries. If you can't control your cholesterol through dietary changes alone, your doctor
may prescribe a cholesterol-lowering medication.
 Quitting tobacco use. Smoking raises the risk of stroke for smokers and nonsmokers
exposed to secondhand smoke. Quitting tobacco use reduces your risk of stroke.
 Managing diabetes. Diet, exercise and losing weight can help you keep your blood sugar
in a healthy range. If lifestyle factors don't seem to be enough to control your diabetes,
your doctor may prescribe diabetes medication.
 Maintaining a healthy weight. Being overweight contributes to other stroke risk factors,
such as high blood pressure, cardiovascular disease and diabetes.
 Eating a diet rich in fruits and vegetables. A diet containing five or more daily
servings of fruits or vegetables may reduce your risk of stroke. The Mediterranean diet,
which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful.
 Exercising regularly. Aerobic exercise reduces your risk of stroke in many ways.
Exercise can lower your blood pressure, increase your levels of good cholesterol, and
improve the overall health of your blood vessels and heart. It also helps you lose weight,
control diabetes and reduce stress. Gradually work up to at least 30 minutes of moderate
physical activity — such as walking, jogging, swimming or bicycling — on most, if not all,
days of the week.
 Drinking alcohol in moderation, if at all. Heavy alcohol consumption increases your
risk of high blood pressure, ischemic strokes and hemorrhagic strokes. Alcohol may also
interact with other drugs you're taking. However, drinking small to moderate amounts of
alcohol, such as one drink a day, may help prevent ischemic stroke and decrease your
blood's clotting tendency. Talk to your doctor about what's appropriate for you.
  Treating obstructive sleep apnea (OSA). Your doctor may recommend a sleep study if
you have symptoms of OSA — a sleep disorder that causes you to stop breathing for short
periods repeatedly during sleep. Treatment for OSA includes a device that delivers positive
airway pressure through a mask to keep your airway open while you sleep.
 Avoiding illegal drugs. Certain street drugs, such as cocaine and methamphetamine, are
established risk factors for a TIA or a stroke.


o Preventive medications
If you've had an ischemic stroke or TIA, your doctor may recommend medications to help reduce
your risk of having another stroke. These include:
 Anti-platelet drugs. Platelets are cells in your blood that form clots. Anti-platelet drugs
make these cells less sticky and less likely to clot. The most commonly used anti-platelet
medication is aspirin. Your doctor can help you determine the right dose of aspirin for you.
Your doctor might also consider prescribing Aggrenox, a combination of low-dose aspirin
and the anti-platelet drug dipyridamole to reduce the risk of blood clotting. After a TIA or
minor stroke, your doctor may give you aspirin and an anti-platelet drug such as
clopidogrel (Plavix) for a period of time to reduce the risk of another stroke. If you can't
take aspirin, your doctor may prescribe clopidogrel alone.
 Anticoagulants. These drugs reduce blood clotting. Heparin is fast acting and may be
used short-term in the hospital.
Slower-acting warfarin (Coumadin, Jantoven) may be used over a longer term. Warfarin is
a powerful blood-thinning drug, so you'll need to take it exactly as directed and watch for
side effects. You'll also need to have regular blood tests to monitor warfarin's effects.
Several newer blood-thinning medications (anticoagulants) are available for preventing
strokes in people who have a high risk. These medications include dabigatran (Pradaxa),
rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa). They're shorter acting
than warfarin and usually don't require regular blood tests or monitoring by your doctor.
These drugs are also associated with a lower risk of bleeding complications.
o Diagnosis
Things will move quickly once you get to the hospital, as your emergency team tries to
determine what type of stroke you're having. That means you'll have a CT scan or other imaging
test soon after arrival. Doctors also need to rule out other possible causes of your symptoms,
such as a brain tumor or a drug reaction.
Some of the tests you may have include:
Stroke consultation
 A physical exam. Your doctor will do a number of tests you're familiar with, such as
listening to your heart and checking your blood pressure. You'll also have a neurological
exam to see how a potential stroke is affecting your nervous system.
 Blood tests. You may have several blood tests, including tests to check how fast your
blood clots, whether your blood sugar is too high or low, and whether you have an
infection.
 Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a
detailed image of your brain. A CT scan can show bleeding in the brain, an ischemic
stroke, a tumor or other conditions. Doctors may inject a dye into your bloodstream to view
 your blood vessels in your neck and brain in greater detail (computerized tomography
angiography).
 Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets
to create a detailed view of your brain. An MRI can detect brain tissue damaged by an
ischemic stroke and brain hemorrhages. Your doctor may inject a dye into a blood vessel to
view the arteries and veins and highlight blood flow (magnetic resonance angiography or
magnetic resonance venography).
 Carotid ultrasound. In this test, sound waves create detailed images of the inside of the
carotid arteries in your neck. This test shows buildup of fatty deposits (plaques) and blood
flow in your carotid arteries.
 Cerebral angiogram. In this uncommonly used test, your doctor inserts a thin, flexible
tube (catheter) through a small incision, usually in your groin, and guides it through your
major arteries and into your carotid or vertebral artery. Then your doctor injects a dye into
your blood vessels to make them visible under X-ray imaging. This procedure gives a detailed
view of arteries in your brain and neck.
 Echocardiogram. An echocardiogram uses sound waves to create detailed images of
your heart. An echocardiogram can find a source of clots in your heart that may have traveled
from your heart to your brain and caused your stroke.
4. Chronic Kidney Failure
Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney
function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted
in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid,
electrolytes and wastes can build up in your body.
In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic
kidney disease may not become apparent until your kidney function is significantly impaired.
Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage,
usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage
kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.
o Symptoms
Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses
slowly. Signs and symptoms of kidney disease may include:
 Nausea
 Vomiting
 Loss of appetite
 Fatigue and weakness
 Sleep problems
 Changes in how much you urinate
 Decreased mental sharpness
 Muscle twitches and cramps
 Swelling of feet and ankles
 Persistent itching
 Chest pain, if fluid builds up around the lining of the heart
 Shortness of breath, if fluid builds up in the lungs
 High blood pressure (hypertension) that's difficult to control
Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by
other illnesses. Because your kidneys are highly adaptable and able to compensate for lost
function, signs and symptoms may not appear until irreversible damage has occurred.
When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms of kidney disease.
If you have a medical condition that increases your risk of kidney disease, your doctor is likely to
monitor your blood pressure and kidney function with urine and blood tests during regular office
visits. Ask your doctor whether these tests are necessary for you.
o Causes
Chronic kidney disease occurs when a disease or condition impairs kidney function, causing
kidney damage to worsen over several months or years.
Diseases and conditions that cause chronic kidney disease include:
 Type 1 or type 2 diabetes
 High blood pressure
 Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis), an inflammation of the kidney's
filtering units (glomeruli)
 Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney's
tubules and surrounding structures
 Polycystic kidney disease
 Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate,
kidney stones and some cancers
 Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to back
up into your kidneys
 Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis)

o Risk factors
Factors that may increase your risk of chronic kidney disease include:
 Diabetes
 High blood pressure
 Heart and blood vessel (cardiovascular) disease
 Smoking
 Obesity
 Being African-American, Native American or Asian-American
 Family history of kidney disease
 Abnormal kidney structure
 Older age

o Complications
Chronic kidney disease can affect almost every part of your body. Potential complications may
include:
 Fluid retention, which could lead to swelling in your arms and legs, high blood pressure,
or fluid in your lungs (pulmonary edema)
 A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your
heart's ability to function and may be life-threatening
 Heart and blood vessel (cardiovascular) disease
 Weak bones and an increased risk of bone fractures
 Anemia
  Decreased sex drive, erectile dysfunction or reduced fertility
 Damage to your central nervous system, which can cause difficulty concentrating,
personality changes or seizures
 Decreased immune response, which makes you more vulnerable to infection
 Pericarditis, an inflammation of the saclike membrane that envelops your heart
(pericardium)
 Pregnancy complications that carry risks for the mother and the developing fetus
 Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring
either dialysis or a kidney transplant for survival
o Prevention

To reduce your risk of developing kidney disease:

 Follow instructions on over-the-counter medications. When using nonprescription
pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen
(Tylenol, others), follow the instructions on the package. Taking too many pain relievers
could lead to kidney damage and generally should be avoided if you have kidney disease.
Ask your doctor whether these drugs are safe for you.
 Maintain a healthy weight. If you're at a healthy weight, work to maintain it by being
physically active most days of the week. If you need to lose weight, talk with your doctor
about strategies for healthy weight loss. Often this involves increasing daily physical
activity and reducing calories.
 Don't smoke. Cigarette smoking can damage your kidneys and make existing kidney
damage worse. If you're a smoker, talk to your doctor about strategies for quitting
smoking. Support groups, counseling and medications can all help you to stop.
 Manage your medical conditions with your doctor's help. If you have diseases or
conditions that increase your risk of kidney disease, work with your doctor to control them.
Ask your doctor about tests to look for signs of kidney damage.
o Diagnosis
Kidney biopsy
As a first step toward diagnosis of kidney disease, your doctor discusses your personal and
family history with you. Among other things, your doctor might ask questions about whether
you've been diagnosed with high blood pressure, if you've taken a medication that might affect
kidney function, if you've noticed changes in your urinary habits, and whether you have any
family members who have kidney disease.
Next, your doctor performs a physical exam, also checking for signs of problems with your heart
or blood vessels, and conducts a neurological exam.
For kidney disease diagnosis, you may also need certain tests and procedures, such as:
 Blood tests. Kidney function tests look for the level of waste products, such as creatinine
and urea, in your blood.
 Urine tests. Analyzing a sample of your urine may reveal abnormalities that point to
chronic kidney failure and help identify the cause of chronic kidney disease.
 Imaging tests. Your doctor may use ultrasound to assess your kidneys' structure and size.
Other imaging tests may be used in some cases.
 Removing a sample of kidney tissue for testing. Your doctor may recommend a kidney
biopsy to remove a sample of kidney tissue. Kidney biopsy is often done with local
 anesthesia using a long, thin needle that's inserted through your skin and into your kidney.
The biopsy sample is sent to a lab for testing to help determine what's causing your kidney
problem.

o Treatment
Kidney transplant
Depending on the underlying cause, some types of kidney disease can be treated. Often, though,
chronic kidney disease has no cure.
Treatment usually consists of measures to help control signs and symptoms, reduce
complications, and slow progression of the disease. If your kidneys become severely damaged,
you may need treatment for end-stage kidney disease.
Treating the cause
Your doctor will work to slow or control the cause of your kidney disease. Treatment options
vary, depending on the cause. But kidney damage can continue to worsen even when an
underlying condition, such as high blood pressure, has been controlled.
Treating complications
Kidney disease complications can be controlled to make you more comfortable. Treatments may
include:
 High blood pressure medications. People with kidney disease may experience
worsening high blood pressure. Your doctor may recommend medications to lower your
blood pressure — commonly angiotensin-converting enzyme (ACE) inhibitors or
angiotensin II receptor blockers — and to preserve kidney function. High blood pressure
medications can initially decrease kidney function and change electrolyte levels, so you
may need frequent blood tests to monitor your condition. Your doctor will likely also
recommend a water pill (diuretic) and a low-salt diet.
 Medications to lower cholesterol levels. Your doctor may recommend medications
called statins to lower your cholesterol. People with chronic kidney disease often
experience high levels of bad cholesterol, which can increase the risk of heart disease.
 Medications to treat anemia. In certain situations, your doctor may recommend
supplements of the hormone erythropoietin (uh-rith-roe-POI-uh-tin), sometimes with added
iron. Erythropoietin supplements aid in production of more red blood cells, which may
relieve fatigue and weakness associated with anemia.
 Medications to relieve swelling. People with chronic kidney disease may retain fluids.
This can lead to swelling in the legs, as well as high blood pressure. Medications called
diuretics can help maintain the balance of fluids in your body.
 Medications to protect your bones. Your doctor may prescribe calcium and vitamin D
supplements to prevent weak bones and lower your risk of fracture. You may also take
medication known as a phosphate binder to lower the amount of phosphate in your blood,
and protect your blood vessels from damage by calcium deposits (calcification).
 A lower protein diet to minimize waste products in your blood. As your body
processes protein from foods, it creates waste products that your kidneys must filter from
your blood. To reduce the amount of work your kidneys must do, your doctor may
 recommend eating less protein. Your doctor may also ask you to meet with a dietitian who
can suggest ways to lower your protein intake while still eating a healthy diet.

5. Cancer
Cancer is a broad term. It describes the disease that results when cellular changes cause the
uncontrolled growth and division of cells.
Some types of cancer cause rapid cell growth, while others cause cells to grow and divide at a
slower rate. Certain forms of cancer result in visible growths called tumors, while others, such as
leukemia, do not. Most of the body’s cells have specific functions and fixed lifespans. While it
may sound like a bad thing, cell death is part of a natural and beneficial phenomenon called
apoptosis. A cell receives instructions to die so that the body can replace it with a newer cell that
funcions better. Cancerous cells lack the components that instruct them to stop dividing and to
die. As a result, they build up in the body, using oxygen and nutrients that would usually nourish
other cells. Cancerous cells can form tumors, impair the immune system and cause other changes
that prevent the body from functioning regularly. Cancerous cells may appear in one area, then
spread via the lymph nodes. These are clusters of immune cells located throughout the body.

o Causes

There are many causes of cancer, and some are preventable. In addition to smoking, risk factors
for cancer include:

 heavy alcohol consumption

 excess body weight
 physical inactivity
 poor nutrition
Other causes of cancer are not preventable. Currently, the most significant unpreventable risk
factor is age. According to the American Cancer Society, doctors in the U.S. diagnose 87 percent
of cancer cases in people ages 50 years or older.

o Treatments

Innovative research has fueled the development of new medications and treatment technologies.
Doctors usually prescribe treatments based on the type of cancer, its stage at diagnosis, and the
person’s overall health.Below are examples of approaches to cancer treatment:
 Chemotherapy aims to kill cancerous cells with medications that target rapidly dividing
cells. The drugs can also help shrink tumors, but the side effects can be severe.
 Hormone therapy involves taking medications that change how certain hormones work or
interfere with the body’s ability to produce them. When hormones play a significant role,
as with prostate and breast cancers, this is a common approach.
  Immunotherapy uses medications and other treatments to boost the immune system and
encourage it to fight cancerous cells. Two examples of these treatments are checkpoint
inhibitors and adoptive cell transfer.
 Precision medicine, or personalized medicine, is a newer, developing approach. It
involves using genetic testing to determine the best treatments for a person’s particular
presentation of cancer. Researchers have yet to show that it can effectively treat all types
of cancer, however.
 Radiation therapy uses high-dose radiation to kill cancerous cells. Also, a doctor may
recommend using radiation to shrink a tumor before surgery or reduce tumor-related
symptoms.
 Stem cell transplant can be especially beneficial for people with blood-related cancers,
such as leukemia or lymphoma. It involves removing cells, such as red or white blood
cells, that chemotherapy or radiation has destroyed. Lab technicians then strengthen the
cells and put them back into the body.
 Surgery is often a part of a treatment plan when a person has a cancerous tumor. Also, a
surgeon may remove lymph nodes to reduce or prevent the disease’s spread.
 Targeted therapies perform functions within cancerous cells to prevent them from
multiplying. They can also boost the immune system. Two examples of these therapies
are small-molecule drugs and monoclonal antibodies.

Doctors will often employ more than one type of treatment to maximize effectiveness.

Doctos classify cancer by:

 its location in the body

 the tissues that it forms in

For example, sarcomas develop in bones or soft tissues, while carcinomas form in cells that
cover internal or external surfaces in the body. Basal cell carcinomas develop in the skin, while
adenocarcinomas can form in the breast. When cancerous cells spread to other parts of the body,
the medical term for this is metastasis. A person can also have more than one type of cancer at a
time.