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DÌSEASES OF THE BLOOD, CARDÌOVASCULAR SYSTEM, LYMPHATÌC SYSTEM AND

RESPÌRATORY SYSTEM

________________

A Project Submitted to
Mr. Glenn Añora
Liceo de Cagayan University
_______________

Ìn Partial Fulfillment
of the Requirements for the Course
Human Anatomy and Physiology

_______________

By

Maria Christi B. Amper
BMLS ÷ 2B

September 2011






























ANEMIA

Anemia is a decrease in number of red blood cells (RBCs) or less than the normal
quantity of hemoglobin in the blood. However, it can include decreased oxygen-binding ability
of each hemoglobin molecule due to deformity or lack in numerical development as in some
other types of hemoglobin deficiency.
Because hemoglobin (found inside RBCs) normally carries oxygen from the lungs to the
tissues, anemia leads to hypoxia (lack of oxygen) in organs. Because all human cells depend
on oxygen for survival, varying degrees of anemia can have a wide range of clinical
consequences.
Anemia is the most common disorder of the blood. There are several kinds of anemia,
produced by a variety of underlying causes. Anemia can be classified in a variety of ways,
based on the morphology of RBCs, underlying etiologic mechanisms, and discernible clinical
spectra, to mention a few. The three main classes of anemia include excessive blood loss
(acutely such as a hemorrhage or chronically through low-volume loss), excessive blood cell
destruction (hemolysis) or deficient red blood cell production (ineffective hematopoiesis).
Signs and symptoms
Most commonly, people with anemia report non-specific symptoms of a feeling of
weakness, or fatigue, general malaise and sometimes poor concentration. They may also
report dyspnea (shortness of breath) on exertion. Ìn very severe anemia, the body may
compensate for the lack of oxygen-carrying capability of the blood by increasing cardiac
output. The patient may have symptoms related to this, such as palpitations, angina (if
preexisting heart disease is present), intermittent claudication of the legs, and symptoms of
heart failure.
On examination, the signs exhibited may include pallor (pale skin, mucosal linings and
nail beds) but this is not a reliable sign. There may be signs of specific causes of anemia, e.g.,
koilonychia (in iron deficiency), jaundice (when anemia results from abnormal break down of
red blood cells ÷ in hemolytic anemia), bone deformities (found in thalassemia major) or leg
ulcers (seen in sickle-cell disease).
Ìn severe anemia, there may be signs of a hyperdynamic circulation: tachycardia (a fast
heart rate), bounding pulse, flow murmurs, and cardiac ventricular hypertrophy (enlargement).
There may be signs of heart failure.


auses
Broadly, causes of anemia may be classified as impaired red blood cell (RBC)
production, increased RBC destruction (hemolytic anemias), blood loss and fluid overload
(hypervolemia). Several of these may interplay to cause anemia eventually. Ìndeed, the most
common cause of anemia is blood loss, but this usually doesn't cause any lasting symptoms
unless a relatively impaired RBC production develops, in turn most commonly by iron
deficiency.
Treatments
Ìron deficiency from nutritional causes is rare in men and post-menopausal women. The
diagnosis of iron deficiency mandates a search for potential sources of loss such as
gastrointestinal bleeding from ulcers or colon cancer. Mild to moderate iron-deficiency anemia
is treated by oral iron supplementation with ferrous sulfate, ferrous fumarate, or ferrous
gluconate. When taking iron supplements, it is very common to experience stomach upset
and/or darkening of the feces. The stomach upset can be alleviated by taking the iron with
food; however, this decreases the amount of iron absorbed. Vitamin C aids in the body's ability
to absorb iron, so taking oral iron supplements with orange juice is of benefit.
Vitamin supplements given orally (folic acid) or subcutaneously (vitamin B-12) will replace
specific deficiencies.
Ìn anemia of chronic disease, anemia associated with chemotherapy, or anemia associated
with renal disease, some clinicians prescribe recombinant erythropoietin, epoetin alfa, to
stimulate red-cell production.
Ìn severe cases of anemia, or with ongoing blood loss, a blood transfusion may be necessary.
ood transfusions
Ìn severe, acute bleeding, transfusions of donated blood are often lifesaving. Ìmprovements in
battlefield casualty survival is attributable, at least in part, to the recent improvements in blood
banking and transfusion techniques.
Transfusion of the stable but anemic hospitalized patient has been the subject of numerous
clinical trials.





emophiia
emophiia is a group of hereditary genetic disorders that impair the body's ability to
control blood clotting or coagulation, which is used to stop bleeding when a blood vessel is
broken. Haemophilia A (clotting factor VÌÌÌ deficiency) is the most common form of the disorder,
occurring at about 1 in 5,000÷10,000 male births.

Haemophilia B (factor ÌX deficiency) occurs
at about 1 in about 20,000÷34,000 male births.
Haemophilia lowers blood plasma clotting factor levels of the coagulation factors
needed for a normal clotting process. Thus when a blood vessel is injured, a temporary scab
does form, but the missing coagulation factors prevent fibrin formation, which is necessary to
maintain the blood clot. A haemophiliac does not bleed more intensely than a person without it,
but can bleed for a much longer time. Ìn severe haemophiliacs even a minor injury can result in
blood loss lasting days or weeks, or even never healing completely. Ìn areas such as the brain
or inside joints, this can be fatal or permanently debilitating.
Signs and symptoms
Characteristic symptoms vary with severity. Ìn general symptoms are internal or
external bleeding episodes, which are called "bleeds".

Patients with more severe haemophilia
suffer more severe and more frequent bleeds, while patients with mild haemophilia typically
suffer more minor symptoms except after surgery or serious trauma. Moderate haemophiliacs
have variable symptoms which manifest along a spectrum between severe and mild forms.
auses
O aemophiia A is a recessive X-linked genetic disorder involving a lack of functional
clotting Factor VÌÌÌ and represents 80% of haemophilia cases.
O aemophiia is a recessive X-linked genetic disorder involving a lack of functional
clotting Factor ÌX. Ìt comprises approximately 20% of haemophilia cases.
O aemophiia is an autosomal genetic disorder (i.e. not X-linked) involving a lack of
functional clotting Factor XÌ. Haemophilia C is not completely recessive: heterozygous
individuals also show increased bleeding.
!reventive exercises
Ìt is recommended that people affected with haemophilia do specific exercises to
strengthen the joints, particularly the elbows, knees, and ankles.

Exercises include elements
which increase flexibility, tone, and strength of muscles, increasing their ability to protect joints
from damaging bleeds.


Leukemia
Leukemia is a type of cancer of the blood or bone marrow characterized by an
abnormal increase of white blood cells. Leukemia is a broad term covering a spectrum of
diseases. Ìn turn, it is part of the even broader group of diseases affecting the blood, bone
marrow and lymphoid system, which are all known as hematological neoplasms.
Signs and symptoms
People with leukemia may easily become bruised, bleed excessively, or develop
pinprick bleeds (petechiae).
White blood cells, which are involved in fighting pathogens, may be suppressed or
dysfunctional. This could cause the patient's immune system to be unable to fight off a simple
infection or to start attacking other body cells. Because leukemia prevents the immune system
from working normally, some patients experience frequent infection, ranging from infected
tonsils, sores in the mouth, or diarrhea to life-threatening pneumonia or opportunistic
infections.
auses
Leukemia, like other cancers, results from mutations in the DNA. Certain mutations can
trigger leukemia by activating oncogenes or deactivating tumor suppressor genes, and thereby
disrupting the regulation of cell death, differentiation or division. These mutations may occur
spontaneously or as a result of exposure to radiation or carcinogenic substances.
Among adults, the known causes are natural and artificial ionizing radiation, a few
viruses such as Human T-lymphotropic virus, and some chemicals, notably benzene and
alkylating chemotherapy agents for previous malignancies. Use of tobacco is associated with a
small increase in the risk of developing acute myeloid leukemia in adults. Cohort and case-
control studies have linked exposure to some petrochemicals and hair dyes to the
development of some forms of leukemia. A few cases of maternal-fetal transmission have
been reported
.
Diet has very limited or no effect, although eating more vegetables may confer
a small protective benefit.
Treatment
Most forms of leukemia are treated with pharmaceutical medication, typically combined
into a multi-drug chemotherapy regimen. Some are also treated with radiation therapy. Ìn some
cases, a bone marrow transplant is useful. Promising treatment through gene therapy is
currently being pursued.
Sepsis
Sepsis is a potentially deadly medical condition that is characterized by a whole-body
inflammatory state (called a systemic inflammatory response syndrome or SÌRS) and the
presence of a known or suspected infection. The body may develop this inflammatory
response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues. A
lay term for sepsis is blood poisoning, also used to describe septicaemia. Severe sepsis is the
systemic inflammatory response, plus infection, plus the presence of organ dysfunction.
Signs and symptoms
Ìn addition to symptoms related to the provoking infection, sepsis is characterized by
presence of acute inflammation present throughout the entire body, and is, therefore,
frequently associated with fever and elevated white blood cell count (leukocytosis) or low white
blood cell count and lower-than-average temperature, and vomiting.The modern concept of
sepsis is that the host's immune response to the infection causes most of the symptoms of
sepsis, resulting in hemodynamic consequences and damage to organs. This host response
has been termed systemic inflammatory response syndrome (SÌRS) and is characterized by an
elevated heart rate (above 90 beats per minute), high respiratory rate (above 20 breaths per
minute or a partial pressure of carbon dioxide in the blood of less than 32), abnormal white
blood cell count (above 12,000, lower than 4,000, or greater than 10% band forms) and
elevated or lowered body temperature, i.e. under 36 °C (97 °F) or over 38 °C (100 °F). Sepsis
is differentiated from SÌRS by the presence of a known or suspected pathogen. For example
SÌRS and a positive blood culture for a pathogen indicate the presence of sepsis. However, in
many cases of sepsis no specific pathogen is identified.
auses
Many different microbes can cause sepsis. Although bacteria are most commonly the cause,
viruses and fungi can also cause sepsis. Ìnfections in the lungs (pneumonia), bladder and
kidneys (urinary tract infections), skin (cellulitis), abdomen (such as appendicitis), and other
areas (such as meningitis) can spread and lead to sepsis. Ìnfections that develop after surgery
can also lead to sepsis.
Treatment
Severe sepsis is usually treated in the intensive care unit with intravenous fluids and
antibiotics. Ìf fluid replacement isn't sufficient to maintain blood pressure, specific vasopressor
medications can be used. Mechanical ventilation and dialysis may be needed to support the
function of the lungs and kidneys, respectively. To guide therapy, a central venous catheter
and an arterial catheter may be placed; measurement of other hemodynamic variables (such
as cardiac output, or mixed venous oxygen saturation) may also be used. Sepsis patients
require preventive measures for deep vein thrombosis, stress ulcers and pressure ulcers,
unless other conditions prevent this.
emochromatosis
emochromatosis is an inherited disease in which too much iron builds up in your
body. Ìt is one of the most common genetic diseases in the United States.
Ìron is a mineral found in many foods. Your body normally absorbs about 10 percent of
the iron in the food you eat. Ìf you have hemochromatosis, you absorb more iron than you
need. Your body has no natural way to get rid of the extra iron. Ìt stores it in body tissues,
especially the liver, heart and pancreas. The extra iron can damage your organs. Without
treatment, it can cause your organs to fail.
Signs and symptoms
Women are more likely to have general symptoms first, such as fatigue (tiredness). Ìn
men, complications such as diabetes or cirrhosis (scarring of the liver) often are the first signs
of the disease.
Signs and symptoms also vary based on the severity of the disease. Common signs
and symptoms of hemochromatosis include joint pain, fatigue, general weakness, weight loss,
and stomach pain.
auses
The causes can be distinguished between primary cases (hereditary or genetically
determined) and less frequent secondary cases (acquired during life).

People of Celtic (Ìrish,
Scottish, Welsh) origin have a particularly high incidence of whom about 10% are carriers of
the gene and 1% sufferers from the condition.
Treatment
Routine treatment in an otherwise-healthy person consists of regularly scheduled
phlebotomies (bloodletting). When first diagnosed, the phlebotomies may be fairly frequent,
perhaps as often as once a week, until iron levels can be brought to within normal range. Once
iron and other markers are within the normal range, phlebotomies may be scheduled every
other month or every three months depending upon the patient's rate of iron loading.
For those unable to tolerate routine blood draws, there is a chelating agent available for use.
The drug Deferoxamine binds with iron in the bloodstream and enhances its elimination via
urine and faeces. Typical treatment for chronic iron overload requires subcutaneous injection
over a period of 8÷12 hours daily.

Lymphangitis
Lymphangitis is the inflammation of the lymphatic vessels and channels. This is
characterized by certain inflammatory conditions of the skin caused by bacterial infections.
Thin red lines may be observed running along the course of the lymphatic vessels in the
affected area, accompanied by painful enlargement of the nearby lymph nodes.
Symptoms
O Chills
O Enlarged lymph nodes (glands) -- usually in the elbow, armpit, or groin
O Fever
O General ill feeling (malaise)
O Headache
O Loss of appetite
O Muscle aches
O Red streaks from the infected area to the armpit or groin (may be faint or obvious)
O Throbbing pain along the affected area
auses
The lymph system is a network of lymph nodes, lymph ducts, lymph vessels, and
organs that produce and move a fluid called lymph from tissues to the bloodstream. For more
information on this part of the body, see lymph system.
Lymphangitis most often results from an acute streptococcal infection of the skin. Less
often, it is caused by a staphylococcal infection. The infection causes the lymph vessels to
become inflamed.
Lymphangitis may be a sign that a skin infection is getting worse. Ìt should raise
concerns that bacteria may spread into the bloodstream, which can cause life-threatening
problems.
Lymphangitis may be confused with a clot in a vein (thrombophlebitis).
Treatment
Lymphangitis may spread within hours. Treatment should begin promptly.
Treatment may include:
O Analgesics to control pain
O Antibiotics to treat any infection
O Anti-inflammatory medications to reduce inflammation and swelling
O Warm moist compresses to reduce inflammation and pain
Spenomegay

Spenomegay is an enlargement of the spleen beyond its normal size. The spleen is
an important organ in the immune system. The functions of the spleen normally include
clearance of invading organisms in the blood (bacteria) from the circulation, production of
antibodies for the immune system, and removal of abnormal blood cells.
A normal-sized spleen cannot be palpated (felt) during the physical examination of the
abdomen, except in slender people. Enlarged spleen (splenomegaly) may be easier to palpate
during careful abdominal examination. Approximately 2% to 5% of the American population
may have a palpable or enlarged spleen.
Symptoms
Splenomegaly does not have any specific symptoms. Vague abdominal pain and
bloating are the most common, but still nonspecific, symptoms of an enlarged spleen. Some
individuals with a very enlarged spleen may complain of early satiety (anorexia) and gastric
reflux symptoms because of the stomach displacement and pressure on the stomach as a
result of the enlarged spleen.
auses
The causes of splenomegaly vary widely and range from malignancy (cancers),
infections, congestion (increased blood flow), infiltration of the spleen from other diseases,
inflammatory conditions, and blood cell diseases.
Medica Treatment
The treatment of splenomegaly essentially depends on the cause of it.
Ìn many conditions, the spleen enlarges a result of performing its normal physiologic
function in response to another medical condition, for example, cirrhosis. The main objective is
then not necessarily to improve splenomegaly that is a consequence of the disease, but to
treat the underlying cause, such as cirrhosis.
Ìn many other situations, such as infections, lymphomas, or leukemias, again the
treatment is directed towards the underlying disorder, using antibiotics or chemotherapy.



Tonsiitis
Tonsiitis is an inflammation of the tonsils most commonly caused by viral or bacterial
infection. Symptoms of tonsillitis include sore throat and fever. While no treatment has been
found to shorten the duration of viral tonsillitis, bacterial causes are treatable with antibiotics.
Symptoms
Common symptoms of tonsillitis include:
O red and/or swollen tonsils
O white or yellow patches on the tonsils
O tender, stiff, and/or swollen neck
O sore throat
O painful or difficult swallowing
O cough
O headache
O sore eyes
O body aches
O earache
O fever
O chills
O nasal congestions
auses
The most common causes of tonsillitis are the common cold viruses (adenovirus,
rhinovirus, influenza, coronavirus, respiratory syncytial virus). Ìt can also be caused by
Epstein-Barr virus, herpes simplex virus, cytomegalovirus, or HÌV. The second most common
causes are bacterial. The most common bacterial cause is Group A µ-hemolytic streptococcus
(GABHS), which causes strep throat. Less common bacterial causes include: $taphylococcus
aureus, $treptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae,
pertussis, Fusobacterium, diphtheria, syphilis, and gonorrhea.
Treatment
Treatments to reduce the discomfort from tonsillitis symptoms include:
O pain relief, anti-inflammatory, fever reducing medications (acetaminophen/paracetamol
and/or ibuprofen)
O sore throat relief (salt water gargle, lozenges, warm liquids)
Ìf the tonsillitis is caused by group A streptococus, then antibiotics are useful with penicillin or
amoxicillin being first line. A macrolide such as erythromycin is used for patients allergic to
penicillin.
Lymphoma
Lymphoma is a cancer in the lymphatic cells of the immune system. Typically,
lymphomas present as a solid tumor of lymphoid cells. Treatment might involve chemotherapy
and in some cases radiotherapy and/or bone marrow transplantation, and can be curable
depending on the histology, type, and stage of the disease. These malignant cells often
originate in lymph nodes, presenting as an enlargement of the node (a tumor). Ìt can also
affect other organs in which case it is referred to as extranodal lymphoma. Extranodal sites
include the skin, brain, bowels and bone. Lymphomas are closely related to lymphoid
leukemias, which also originate in lymphocytes but typically involve only circulating blood and
the bone marrow (where blood cells are generated in a process termed haematopoesis) and
do not usually form static tumors. There are many types of lymphomas, and in turn,
lymphomas are a part of the broad group of diseases called hematological neoplasms.
Symptoms
O Anorexia
O Dyspnea
O Fatigue
O Fever of unknown origin
O Lymphadenopathy
O Night sweats
O Pruritus
O Weight loss
auses
Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal
cells in the body follow an orderly path of growth, division, and death. Programmed cell death
is called apoptosis, and when this process breaks down, cancer results. Scientists do not know
exactly what causes lymphoma, but they have identified several potential risk factors such as
genetic factors, carcinogens and other medical factors.
Treatment
These depend on the specific form of lymphoma. For some forms of lymphoma,
watchful waiting is often the initial course of action. Ìf a low-grade lymphoma is becoming
symptomatic, radiotherapy or chemotherapy are the treatments of choice; although they do not
cure the lymphoma, they can alleviate the symptoms, particularly painful lymphadenopathy.
Patients with these types of lymphoma can live near-normal lifespans, but the disease is
incurable. Treatment of some other, more aggressive, forms of lymphoma can result in a cure
in the majority of cases, but the prognosis for patients with a poor response to therapy is
worse. Treatment for these types of lymphoma typically consists of aggressive chemotherapy,
including the CHOP or RCHOP regimen.
Lymphedema
Lymphedema also known as ymphatic obstruction, is a condition of localized fluid
retention and tissue swelling caused by a compromised lymphatic system.
The lymphatic system returns the interstitial fluid to the thoracic duct and then to the
bloodstream, where it is recirculated back to the tissues. Tissues with lymphedema are at risk
of infection.
Lymphedema should not be confused with edema arising from venous insufficiency,
which is not lymphedema. However, untreated venous insufficiency can progress into a
combined venous/lymphatic disorder which is treated the same way as lymphedema.
Signs and symptoms
Symptoms may include severe fatigue, a heavy swollen limb or localized fluid
accumulation in other body areas, including the head or neck, discoloration of the skin
overlying the lymphedema, and eventually deformity (elephantiasis).
auses
Lymphedema may be inherited (primary) or caused by injury to the lymphatic vessels
(secondary). Ìt is most frequently seen after lymph node dissection, surgery and/or radiation
therapy, in which damage to the lymphatic system is caused during the treatment of cancer,
most notably breast cancer. Ìn many patients with cancer, this condition does not develop until
months or even years after therapy has concluded. Lymphedema may also be associated with
accidents or certain diseases or problems that may inhibit the lymphatic system from
functioning properly. Ìn tropical areas of the world, a common cause of secondary
lymphedema is filariasis, a parasitic infection. Ìt can also be caused by a compromising of the
lymphatic system resulting from cellulitis.
Treatment
Treatment for lymphedema varies depending on the severity of the edema and the
degree of fibrosis of the affected limb. Most people with lymphedema follow a daily regimen of
treatment as suggested by their physician or certified lymphedema therapist. The most
common treatments for lymphedema are a combination of manual compression lymphatic
massage, compression garments or bandaging. Complex decongestive physiotherapy is an
empiric system of lymphatic massage, skin care, and compressive garments. Although a
combination treatment program may be ideal, any of the treatments can be done individually.



























ardiomyopathy
ardiomyopathy, which literally means "heart muscle disease," is the deterioration of
the function of the myocardium (i.e., the actual heart muscle) for any reason. People with
cardiomyopathy are often at risk of arrhythmia or sudden cardiac death or both.
Cardiomyopathy can often go undetected, making it especially dangerous to carriers of the
disease.
Signs and symptoms
Symptoms and signs may mimic those of almost any form of heart disease. Chest pain
is common. Mild myocarditis or cardiomyopathy is frequently asymptomatic; severe cases are
associated with heart failure, arrhythmias, and systemic embolization. Manifestations of the
underlying disease (e.g., Chagas' disease) may be prominent. Most patients with biopsy-
proven myocarditis report a recent viral prodrome preceding cardiovascular symptoms.
auses
Possible causes of cardiomyopathy include:
O Long-term high blood pressure
O Heart valve problems
O Heart tissue damage from a previous heart attack
O Chronic rapid heart rate
O Metabolic disorders, such as thyroid disease or diabetes
O Nutritional deficiencies of essential vitamins or minerals, such as thiamin (vitamin B-1),
selenium, calcium and magnesium
O Pregnancy
O Excessive use of alcohol over many years
O Abuse of cocaine or antidepressant medications, such as tricyclic antidepressants
O Use of some chemotherapy drugs to treat cancer
O Certain viral infections, which may injure the heart and trigger cardiomyopathy
O Ìron buildup in your heart muscle (hemochromatosis)
Treatment
Treatment depends on the type of cardiomyopathy, but may include medication,
implanted pacemakers, defibrillators, or ventricular assist devices (LVADs), or ablation. The
goal of treatment is often symptom relief, and some patients may eventually require a heart
transplant. Treatment of cardiomyopathy (and other heart diseases) using alternative methods
such as stem cell therapy is commercially available but is not supported by convincing
evidence. Due to the severity of the disease, treatment requires the use of numerous
chemicals and drugs, which have to be taken for the rest of the patient's life.
oronary Artery Disease
oronary artery disease (AD; also atheroscerotic heart disease) is the end result
of the accumulation of atheromatous plaques within the walls of the coronary arteries that
supply the myocardium (the muscle of the heart) with oxygen and nutrients. Ìt is sometimes
also called coronary heart disease (CHD), although CAD is the most common cause of CHD,
it is not the only one.
CAD is the leading cause of death worldwide. While the symptoms and signs of
coronary artery disease are noted in the advanced state of disease, most individuals with
coronary artery disease show no evidence of disease for decades as the disease progresses
before the first onset of symptoms, often a "sudden" heart attack, finally arises. After decades
of progression, some of these atheromatous plaques may rupture and (along with the
activation of the blood clotting system) start limiting blood flow to the heart muscle. The
disease is the most common cause of sudden death, and is also the most common reason for
death of men and women over 20 years of age. According to present trends in the United
States, half of healthy 40-year-old males will develop CAD in the future, and one in three
healthy 40-year-old women.

According to the Guinness Book of Records, Northern Ìreland is
the country with the most occurrences of CAD. By contrast, the Maasai of Africa have almost
no heart disease.
Symptoms
O Chest pain or Angina pectoris with physical stress; the pain may spread to the left arm
or the neck, back, throat, or jaw. There might be present a numbness (paresthesia) or a
loss of feeling in the arms, shoulders, or wrists
O Coronary angiography demonstrates "normal¨ coronary arteries, i.e. no blockages or
stenoses can be detected in the larger epicardial vessels
O No inducible coronary artery spasm present during cardiac catheterization
O Characteristic ischemic ECG changes during exercise testing
O ST segment depression and angina in the presence of left ventricular wall perfusion
abnormalities during thallium or other stress perfusion test
O Consistent response to sublingual nitrates.
O Postmenopausal or menopausal status
Treatment
A variety of drugs are used in the attempt to treat the Syndrome-X coronary artery
disease: nitrates, calcium channel antagonists, ACE-inhibitors, statins, imipramine (for
analgesia), aminophylline, hormone replacement therapy (oestrogen), even electrical spinal
cord stimulation are tried to overcome the symptomatology -all with mixed results. Quite often
the quality of life for these women remains poor.

Aneurysm
An aneurysm or aneurism (from Greek: vsúpuoµd - aneurusma "dilatation", from
vsupúvsiv - aneurunein "to dilate") is a localized, blood-filled balloon-like bulge in the wall of
a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain (the circle
of Willis) and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle
of the heart. When the size of an aneurysm increases, there is a significant risk of rupture,
resulting in severe hemorrhage, other complications or death. Aneurysms can be hereditary or
caused by disease, both of which cause the wall of the blood vessel to weaken.
Symptoms
Symptoms for an aneurysm that has not ruptured:
O Fatigue
O Loss of perception
O Loss of balance
O Speech problems
Symptoms for a ruptured aneurysm:
O Severe headaches
O Loss of vision
O Double vision
O Neck pain and/or stiffness
O Pain above and/or behind the eyes
O Death
auses
Abdomina aortic aneurysm causes:
O Atherosclerosis
O Smoking
O Hypertension
O Vasculitis (infection in the aorta)
O Cocaine use

Treatment
Historically, the treatment of arterial aneurysms has been limited to either surgical
intervention, or watchful waiting in combination with control of blood pressure. Ìn recent years,
endovascular or minimally invasive techniques have been developed for many types of
aneurysms.
Myocardia infarction
Myocardia infarction (MI) or acute myocardia infarction (AMI), commonly known as
a heart attack, is the interruption of blood supply to a part of the heart, causing heart cells to
die. This is most commonly due to occlusion (blockage) of a coronary artery following the
rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids (fatty
acids) and white blood cells (especially macrophages) in the wall of an artery. The resulting
ischemia (restriction in blood supply) and oxygen shortage, if left untreated for a sufficient
period of time, can cause damage or death (infarction) of heart muscle tissue (myocardium).
Signs and Symptoms
Classical symptoms of acute myocardial infarction include sudden chest pain (typically
radiating to the left arm or left side of the neck), shortness of breath, nausea, vomiting,
palpitations, sweating, and anxiety (often described as a sense of impending doom). Women
may experience fewer typical symptoms than men, most commonly shortness of breath,
weakness, a feeling of indigestion, and fatigue. Approximately one quarter of all myocardial
infarctions are "silent", without chest pain or other symptoms.
auses
Heart attack rates are higher in association with intense exertion, be it psychological
stress or physical exertion, especially if the exertion is more intense than the individual usually
performs. Quantitatively, the period of intense exercise and subsequent recovery is associated
with about a 6-fold higher myocardial infarction rate (compared with other more relaxed time
frames) for people who are physically very fit. For those in poor physical condition, the rate
differential is over 35-fold higher. One observed mechanism for this phenomenon is the
increased arterial pulse pressure stretching and relaxation of arteries with each heart beat
which, as has been observed with intravascular ultrasound, increases mechanical "shear
stress" on atheromas and the likelihood of plaque rupture.
!revention
The risk of a recurrent myocardial infarction decreases with strict blood pressure management
and lifestyle changes, chiefly smoking cessation, regular exercise, a sensible diet for those
with heart disease, and limitation of alcohol intake. People are usually commenced on several
long-term medications post-MÌ, with the aim of preventing secondary cardiovascular events
such as further myocardial infarctions, congestive heart failure or cerebrovascular accident
(CVA).


ardiac Arrhythmia

Any kind of irregularity in the heart beat is known as cardiac arrhythmia. Heart rate is
controlled by a number of factors. These include the sympathetic and parasympathetic
impulses. Cardiac arrhythmias can be very benign or can even be life threatening. They can
manifest as rapid or irregular heartbeats such as premature beats or as ventricular
tachycardias or fibrillation. Many a times, cardiac arrhythmias may be the first manifestation of
an underlying cardiac ailment.

Symptoms

There are various types of arrhythmias that may manifest themselves as irregular heart
beats in the form of occasional premature heartbeats, ventricular tachycardias andventricular
fibrillation. They can also manifest as extra systoles or ectopic beats, supraventricular ectopic
beats, ventricular premature beats etc.

auses:
O Harmless arrhythmias maybe produced due to severe anxiety and stress.
O Excessive intake of tea, coffee, alcohol or tobacco and nicotine can spur on arryhtmias.
O Certain metabolic factors such as diabetic ketoacidosis,
hypoglycemia, hypercalcemia etc.
O Endocrinal disorders like hyperthyroidism, pheochromocytoma, hypothyroidism,
hyperaldosteronism etc.
O Electrolyte disturbances like hypokalemia, alterations in magnesium
levels, hyperkalemia, hypernatremia etc.
O Drug toxicity caused by drugs like digitalis, diuretics, antidepressants, phenothiazone
etc.
O Other heart ailments like ischemic heart disease, valvular heart disease, congenital
heart disease etc.

Treatment
O The basic approach of management of arrhythmias is to make an accurate diagnosis of
the underlying cardiac condition. This can be done by taking a detailed history so as to
look out for signs that suggest a specific disease or condition.
O Depending on the type of condition that is causing the arrhythmia, specific drugs will be
administered. These include beta blockers like propranolol, acebutalol and atenolol.
Other drugs are procainamide, diazepam, lignocaine etc.
O Some cases may require surgical placement of automated external defibrillators.

Asthma
Asthma (from the Greek óo0µd, Esthma, "panting") is the common chronic
inflammatory disease of the airways characterized by variable and recurring symptoms,
reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing,
chest tightness, and shortness of breath. Asthma is clinically classified according to the
frequency of symptoms, forced expiratory volume in 1 second (FEV1), and peak expiratory
flow rate. Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic).
Signs and symptoms
Common symptoms of asthma include wheezing, shortness of breath, chest tightness
and coughing, and use of accessory muscle. Symptoms are often worse at night or in the early
morning, or in response to exercise or cold air. Some people with asthma only rarely
experience symptoms, usually in response to triggers, whereas other may have marked
persistent airflow obstruction.
auses
Asthma is caused by environmental and genetic factors. These factors influence how
severe asthma is and how well it responds to medication. The interaction is complex and not
fully understood.
Studying the prevalence of asthma and related diseases such as eczema and hay fever
have yielded important clues about some key risk factors. The strongest risk factor for
developing asthma is a history of atopic disease; this increases one's risk of hay fever by up to
5x and the risk of asthma by 3-4x. Ìn children between the ages of 3-14, a positive skin test for
allergies and an increase in immunoglobulin E increases the chance of having asthma. Ìn
adults, the more allergens one reacts positively to in a skin test, the higher the odds of having
asthma.
!revention
The evidence for the effectiveness of measures to prevent the development of asthma
is weak. Ones which show some promise include: limiting smoke exposure both in utero and
after delivery, breastfeeding, increased exposure to respiratory infection per the hygiene
hypothesis (such as in those who attend daycare or are from large families).




hronic Obstructive !umonary Disease
hronic obstructive pumonary disease (O!D), also known as chronic
obstructive ung disease (OLD), chronic obstructive airway disease (OAD), chronic
airfow imitation (AL) and chronic obstructive respiratory disease (ORD), is the co-
occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases of
the lungs in which the airways become narrowed. This leads to a limitation of the flow of air to
and from the lungs, causing shortness of breath (dyspnea). Ìn clinical practice, COPD is
defined by its characteristically low airflow on lung function tests. Ìn contrast to asthma, this
limitation is poorly reversible and usually gets progressively worse over time. Ìn England, an
estimated 842,100 of 50 million people have a diagnosis of COPD.
Signs and symptoms
O Dyspnea
O Rhonchi, decreased intensity of breath sounds, and prolonged expiration on physical
examination
O Airflow limitation on pulmonary function testing that is not fully reversible and most often
progressive.
O tachypnea, a rapid breathing rate
O wheezing sounds or crackles in the lungs heard through a stethoscope
O breathing out taking a longer time than breathing in
O enlargement of the chest, particularly the front-to-back distance (hyperaeration)
O active use of muscles in the neck to help with breathing
O increased anteroposterior to lateral ratio of the chest (i.e. barrel chest).
auses
The primary risk factor for COPD is chronic tobacco smoking. Ìn the United States, 80 to
90% of cases of COPD are due to smoking. Exposure to cigarette smoke is measured in pack-
years, the average number of packages of cigarettes smoked daily multiplied by the number of
years of smoking. The likelihood of developing COPD increases with age and cumulative
smoke exposure, and almost all life-long smokers will develop COPD, provided that smoking-
related, extra pulmonary diseases (cardiovascular, diabetes, cancer) do not claim their lives
beforehand. Others include occupational exposures, air pollution and genetic factors.
Treatment
COPD is not a reversible condition, but treatment can slow its progression (smoking cessation
being the most important).
O Medical treatment
O Behavioral treatment
O Surgical treatment

Lung cancer
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the
lung. Ìf left untreated, this growth can spread beyond the lung in a process called metastasis
into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung,
known as primary lung cancers, are carcinomas that derive from epithelial cells. Worldwide,
lung cancer is the most common cause of cancer-related death in men and women, and is
responsible for 1.3 million deaths annually, as of 2004.The most common symptoms are
shortness of breath, coughing (including coughing up blood), and weight loss.
Signs and symptoms
O dyspnea (shortness of breath)
O hemoptysis (coughing up blood)
O chronic coughing or change in regular coughing pattern
O wheezing
O chest pain or pain in the abdomen
O cachexia (weight loss), fatigue, and loss of appetite
O dysphonia (hoarse voice)
O clubbing of the fingernails (uncommon)
O dysphagia (difficulty swallowing).
auses
The main causes of any cancer include carcinogens (such as those in tobacco smoke),
ionizing radiation, and viral infection. This exposure causes cumulative changes to the DNA in
the tissue lining the bronchi of the lungs (the bronchial epithelium). As more tissue becomes
damaged, eventually a cancer develops.
Treatment
Treatment for lung cancer depends on the cancer's specific cell type, how far it has
spread, and the patient's performance status. Common treatments include palliative care,
surgery, chemotherapy, and radiation therapy.





Tubercuosis
Tubercuosis, MT, or T (short for tubercle bacillus) is a common and in many cases
lethal infectious disease caused by various strains of mycobacteria, usually Mycobacterium
tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body.
Ìt is spread through the air when people who have an active MTB infection cough, sneeze, or
otherwise transmit their saliva through the air. Most infections in humans result in an
asymptomatic, latent infection, and about one in ten latent infections eventually progresses to
active disease, which, if left untreated, kills more than 50% of its victims.
Symptoms
Symptoms include chest pain, coughing up blood, and a productive, prolonged cough
for more than three weeks. Systemic symptoms include fever, chills, night sweats, appetite
loss, weight loss, pallor, and fatigue
ause
The main cause of TB, Mycobacterium tuberculosis (MTB), is a small aerobic non-
motile bacillus. High lipid content of this pathogen accounts for many of its unique clinical
characteristics. Ìt divides every 16 to 20 hours, an extremely slow rate compared with other
bacteria, which usually divide in less than an hour. Since MTB has a cell wall but lacks a
phospholipid outer membrane, it is classified as a Gram-positive bacterium. However, if a
Gram stain is performed, MTB either stains very weakly Gram-positive or does not retain dye
as a result of the high lipid and mycolic acid content of its cell wall. MTB can withstand weak
disinfectants and survive in a dry state for weeks. Ìn nature, the bacterium can grow only within
the cells of a host organism, but M. tuberculosis can be cultured in vitro.
Treatment
Treatment for TB uses antibiotics to kill the bacteria. Effective TB treatment is difficult,
due to the unusual structure and chemical composition of the mycobacterial cell wall, which
makes many antibiotics ineffective and hinders the entry of drugs. The two antibiotics most
commonly used are isoniazid and rifampicin. However, instead of the short course of
antibiotics typically used to cure other bacterial infections, TB requires much longer periods of
treatment (around 6 to 24 months) to entirely eliminate mycobacteria from the body. Latent TB
treatment usually uses a single antibiotic, while active TB disease is best treated with
combinations of several antibiotics, to reduce the risk of the bacteria developing antibiotic
resistance. People with latent infections are treated to prevent them from progressing to active
TB disease later in life.

ystic Fibrosis
ystic fibrosis (also known as F or mucoviscidosis) is a common recessive genetic
disease which affects the entire body, causing progressive disability and often early death.
The name cystic fibrosis refers to the characteristic scarring (fibrosis) and cyst formation
within the pancreas, first recognized in the1930s. Difficulty breathing is the most serious
symptom and results from frequent lung infections that are treated with, though not cured
by, antibiotics and other medications. A multitude of other symptoms, including sinus
infections, poor growth, diarrhea, and infertility result from the effects of CF on other parts of
the body.
Signs and Symptoms
The hallmark symptoms of cystic fibrosis are salty tasting skin, poor growth and poor
weight gain despite a normal food intake, accumulation of thick, sticky mucus, frequent chest
infections and coughing or shortness of breath. Males can be infertile due to congenital
absence of the vas deferens. Symptoms often appear in infancy and childhood, such asbowel
obstruction due to meconium ileus in newborn babies. The causes of growth failure are multi-
factorial and include chronic lung infection, poor absorption of nutrients through the
gastrointestinal tract, and increased metabolic demand due to chronic illness.
auses
CF is caused by a mutation in the gene cystic fibrosis transmembrane conductance
regulator (CFTR). The most common mutation, AF508, is a deletion (A) of three nucleotides

that results in a loss of the amino acid phenylalanine (F) at the 508th (508) position on the
protein. This mutation accounts for two-thirds (66-70%) of CF cases worldwide and 90 percent
of cases in the United States; however, there are over 1,500 other mutations that can produce
CF. Although most people have two working copies (alleles) of the CFTR gene, only one is
needed to prevent cystic fibrosis. CF develops when neither allele can produce a functional
CFTR protein. Thus, CF is considered an autosomal recessive disease.
Treatment
The cornerstones of management are proactive treatment of airway infection, and
encouragement of good nutrition and an active lifestyle. Management of cystic fibrosis
continues throughout a patient's life, and is aimed at maximizing organ function, and therefore
quality of life. At best, current treatments delay the decline in organ function.

         

            

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