Approach to Chest Pain Differential diagnosis of chest pain

Chest pain or chest discomfort  may occur due to some minor illness or may be due to some serous illness, or may be an emergency condition.   chest pain   Causes of serious chest pain – Acute ischemic heart disease, or aortic coronary syndrome, Aortic dissection, Tension pneumotherix, Pulmonary pneumothorex, Pulmonary embolism. The different condition […]

Diabetic Nephropathy and Renal complications of DM (Diabetes Mellitus)

Diabetic nephropathy (DN) Renal Long-Term complications of DM (Diabetes Mellitus) Diabetic nephropathy (DN) is responsible for high morbidity and mortality. DN is associated with diabetic retinopathy and hy­perglycemia. DN is due to the effect of growth factors, Angiotensin Il, endothelin, AGEs. A high body mass index (BMI) has been associated with an increased risk of […]

Ophthalmologic Complications of DM (Diabetes Mellitus)

Chronic Long-Term Ophthalmologic Complications of DM (Diabetes Mellitus) Blindness – occurs due to progressive diabetic Ret­inopathy and macular oedema. Diabetic retinopathy may be non-proliferative and proliferative. Diabetic retinopathy (DR) is one of the most important causes of visual loss worldwide, and is the principal cause of impaired vision in patients between 25 and 74 years […]

Some Facts about Glucocorticoid & Major side effects

Facts about Glucocorticoid & Hypermineralocorticoidism Major side effects Definition : [Gr. gleukos, sweet (new wine), + L. cortex, + Gr. eidos, form, shape] A general classification of adrenal cortical hormones that are primarily active in protecting against stress and in affecting protein and carbohydrate metabolism. The most important glucocorticoid is cortisol (hydrocortisone). Isolated glucocorticoid deficiency It […]

Pheochromocytoma Clinical Features Diagnosis Treatment

All about Pheochromocytoma Clinical Features Diagnosis Treatment Definition A tumor derived from neural crest cells of the sympathetic nervous system that is responsible for about 0.1% to 2% of all cases of hypertension. Catecholamine-secreting tumors that arise from chromaffin cells of the adrenal medulla and the sympathetic ganglia are referred to as “pheochromocytomas” and “extra-adrenal […]

Diabetes mellitus Types,Causes,Symptoms and Diagnosis

Diabetes mellitus Overview Types Causes,Symptoms with Diagnosis Diabetes mellitus is a group of metabolic disorders with hyperglycemia. Glucose intolerance is characterized by hyperglycemia resulting from defects in glucose and fat metabolism. Overt diabetes is classified as type 1 (T1DM), type 2 (T2DM), and gestational (GDM) A chronic metabolic disorder marked by hyperglycemia. Diabetes mellitus (DM) […]

Metabolic,Insulin Resistance Syndrome X Causes Symptoms

INSULIN RESISTANCE SYNDROMES or Syndrome X Overview (metabolic syndrome)- consists of : Insulin resistance Hypertension Dyslipidemias Obesity – central Endothelial dysfunction Accelerated cardiovascular disease. The co-occurrence of metabolic risk factors for both type 2 diabetes and CVD (abdominal obesity, hyperglycemia, dyslipidemias, and hypertension) suggested the existence of a “metabolic syndrome”  . A similar profile can […]

Diabetic Ketoacidosis (DKA) Acute Complications Of Diabetes Mellitus

ACUTE COMPLICATIONS OF DIABETES MELLITUS (DKA) DKA is characterized by the triad of hyperglycemia, anion gap metabolic acidosis, and ketonemia. Metabolic acidosis is often the major finding. The serum glucose concentration is usually greater than 500 mg/dL (27.8 mmol/L) and less than 800 mg/dL (44.4 mmol/L)  . However, serum glucose concentrations may exceed 900 mg/dL […]

Hyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM

HYPERGLYCEMIC HYPEROSMOLAR STATE (HHS) hyperosmolar hyperglycemic state (HHS, also known as nonketotic hyperglycemia) and Diabetic ketoacidosis (DKA) are of the most serious acute complications of diabetes. hyperosmolar hyperglycemic state (HHS, also called nonketotic hyperglycemia) In HHS, there is little or no ketoacid accumulation, the serum glucose concentration frequently exceeds 1000 mg/dL (56 mmol/L), the plasma […]

Chronic Long-term Complications Of Diabetes Mellitus

CHRONIC COMPLICATIONS OF DIABETES MEL­LITUS COMMON DISEASES DUE TO DM HYPERGLYCEMIA AND MICROVASCULAR DISEASE — Hyperglycemia is an important risk factor for the development of microvascular disease in patients with type 2 diabetes, as it is in patients with type 1 diabetes. Chronic Long-term complications result in morbidity and mor­tality. Children and adolescents with type 2 […]

Grave’s disease Causes and Treatment

Grave’s disease Grave’s disease is thyrotoxicosis, common in females, associated with high iodine intake, occurring between 20 – 50 years of age. Grave’s ophthalmopathy Besides the signs of thyrotoxicosis, there is Grave’s ophthalmopathy. decreased extraocular muscle mobility, and corneal injury, periorbital edema, periorbital and conjunctival inflammation, Ophthalmopathy associated with hyperthyroidism with the clinical characteristics of […]

Thyrotoxic crisis or Thyroid storm

Thyrotoxic crisis or thyroid storm It is a life-threatening hyperthyroidism with fever, seizures, coma, vomiting, diarrhoea, jaundice. A rare but often life-threatening medical emergency resulting from untreated hyperthyroidism Death can occur due to cardiac failure, arrhythmias, hyperthermia. Thyrotoxic crisis Symptoms include : — and fingernails may separate from the nail bed (Plummer’s nails). Cardiovascular findings […]

Thyroid Goiter

GOITER of THYROID Acute thyroiditis is an inflammatory condition of thy­roid due to suppurative infection. enlarged thyroid gland may be caused by thyroiditis, benign thyroid nodules, malignancy, iodine deficiency, or any condition that causes hyperfunction or hypofunction of the gland Types of GOITER aberrant goiter: A supernumerary goiter. acute goiter: A goiter that grows rapidly. […]

Adrenal Gland Steroids

Adrenal Gland Diseases 9V7GZUQ7PBG5 The adrenal cortex produces 3 steroids: 9V7GZUQ7PBG5  9V7GZUQ7PBG5 1. Glucocorticoids 2. Mineralocorticoids 3. Adrenal androgens The function of these steroids are: 1. Glucocorticoids – modulate intermediary me­tabolism and immune responses of the body. 2. Mineralocorticoids – Regulate blood pressure, vascular volume and electrolytes. 3. Adrenal androgens are responsible for second­ary sex […]


LABORATORY TESTS FOR ADRENAL FUNCTION · Tests of pituitary adrenal responsiveness. · Suppression tests -are measurement of target hormone response after suppression of its tropic hormone. · Stimulation tests · Plasma ‘Levels of ACTH and angiotensin II. · Measurement of urinary free cortisol · Measurement of urinary creatinine · Measurement of plasma and urinary level […]

Aldosteronism Clinical features Causes and Treatment

Aldosteronism   Clinical features Causes and Treatment definition Aldosteronism is a syndrome with hypersecretion of mineralocorticoid aldosterone. Primary aldosteronism is excessive aldosterone production due to disease of adrenal glands. It is also called nodular hyperplasia or idiopathic hyperaldos­teronism. Nonsuppressible (primary) hypersecretion of aldosterone is a underdiagnosed cause of hypertension. There is hypokalemia, diastolic hypertension, extra […]

Growth and Development Disorders GHD Diagnosis Treatment

DISORDERS OF GROWTH AND DEVELOPMENT Growth is dependent on GH, IGF, sex steroids, thy­roid hormones, paracrine growth factors and cytokines. Growth also requires caloric energy, amino acids, vi­tamins and trace metals. Short stature results due to intrinsic and extrinsic factors which impair growth. Growth  GHD Causes may be : Most common cause of GHD in children […]

ACTH and TSH DEFICIENCY Diagnosis with Treatment

ACTH DEFICIENCY ACTH SYNTHESIS — POMC also contains the sequences for other hormonal peptides, including the melanocyte-stimulating hormones (MSHs) lipotropins (LPHs), and beta-endorphin (beta-END) ACTH is synthesized as part of a large precursor (241 amino acids in humans) called proopiomelanocortin (POMC). Adrenal insufficiency secondary to ACTH defi­ciency is due to : · glucocorticoid withdrawal after […]

Cushing’s Syndrome Symptoms Causes and Treatment

Cushing’s Syndrome Causes, Symptoms, Diagnosis, and Treatment Cushing’s disease is a hormone disorder caused by high levels of cortisol in the blood disease in which there is ex­cess ACTH secretion, by pituitary adenomas. Cushing’s syndrome is the signs and symptoms that result from prolonged exposure to excessive glucocorticoid hormones. Cushing’s disease: Cushing’s syndrome hormone disorder  […]

Diabetes Insipidus (DI) Causes Diagnosis and Treatment

Diabetes insipidus (DI) Disorders of Neurohypophysis  The neurohypophysis or posterior pituitary gland is made up of nerve tissues originating in su­praoptic and paraventricular nuclei of hypothala­mus. It produces 2 hormones: 1. AVP or arginine vasopressin, also known as antidiuretic hormone (ADH). 2. Oxytocin AVP acts on renal tubules to absorb the water back into the […]

SIADH or Syndrome of inappropriate ADH (AVP)

SIADH or Syndrome of inappropriate ADH (AVP) There is excessive secretion of AVP resulting in pas­sage of decreased volume of highly concentrated urine. There is water retention and decrease in plasma so­dium and plasma osmolarity. It is called dilutional hyponatraemia. It may be asymptomatic or there may be headache, confusion, anorexia, nausea, vomiting, coma and […]

Myxedema coma Diagnosis and Treatment

Myxedema coma  This is a state of hypothyroidism with altered con­sciousness or coma, sometimes seizures. There may be hypothermia. It is common in the elderly, and precipitated by seda-‘ tives, antidepressants, pneumonia, CHF, MI, cere­brovascular accidents. marked by neurological dysfunction, by respiratory depression, and by lowered body temperature, blood pressure, blood sugar, and serum sodium. […]

Hyperthyroidism or THYROTOXICOSIS Causes, Symptoms and Diagnosis

Thyrotoxicosis is a state of thyroid hormone excess. Hyperthyroidism is excessive thyroid function. Hyperthyroidism or thyrotoxicosis defines a spectrum of clinical findings consistent with thyroid hormone excess. Causes of Thyrotoxicosis Primary hyperthyroidism · Grave’s disease · Toxic multinodular goitre · Toxic adenoma · Thyroid carcinoma · Iodine excess (Jod-Basedow phenomenon) · Subacute thyroiditis · Drugs […]

Glycogen Storage Diseases von Gierke disease, Andersen’s disease, McArdle’s disease

Glycogen Storage Diseases Carbohydrate metabolism provides energy for meta­bolic functions of cell. Metabolism of glucose generates ATP by glycolysis and oxidative phosphorylation. Any one of several heritable diseases characterized by the abnormal storage and accumulation of glycogen in the tissues, esp. in the liver Dietary sources of glucose: · Polysaccharide (starch) · Disacchride (lactose, maltose, […]

Anterior Pituitary Hormones and Disorders

Disorders of Anterior PituitaryHormones The anterior pituitary is called the master gland be­ , it regulates the function of most other endocrine organs. The anterior pituitary gla’nd produces 6 major hor­mones. 1, Prolactin (PRL) 2. Growth hormone (GH) 3. Adrenocorticotropin hormone (ACTH) 4. Luteinizing hormone (LH) 5. Follicle stimulating hormone (FSH) 6. Thyroid stimulating hormone […]

Hypopituitarism Diagnosis and Treatment

PRESENTATIONS OF HYPOPITUITARISM This depends on the hormones which are deficient. GH deficiency causes growth disorder and abnor­mal body structure. Gonadotrophin deficiency causes infertility, men­strual and sexual dysfunction and loss of secondary sexual characteristics in men. TSH and ACTH deficiency cause growth retarda­tion, hypothyroidism, adrenal insufficiency. Mineralo­corticoid action is retained. PRL(prolactin) deficiency causes failure of […]

Chronic pancreatitis Causes Symptoms Diagnosis and Treatment

Chronic pancreatitis Diseases Symptoms Diagnosis and Treatment Chronic pancreatitis Pregentation · Abdominal pain · Steatorrhea. A form of pancreatitis that results from repeated or massive pancreatic injury, marked by the formation of scar tissue, which leads to malfunction of the pancreas Irreversible: Progressive destruction of the pancreas Results in both exocrine and endocrine deficiencies Pain, […]

Rheumatoid Arthritis Causes Symptoms Diagnosis and Treatment

Rheumatoid Arthritis Causes Symptoms Diagnosis and Treatment Rheumatoid Arthritis Rheumatoid arthritis is a chronic multisystem disease. There are systemic manifestations. There is persistent inflammatory synovitis. chronic systemic disease marked by inflammation of multiple synovial joints,Involves peripheral joints symmetrically. There is damage of cartilage and bone. Patients typically complain of joint stiffness in the morning rather […]

Systemic Sclerosis Classification Prognosis and Complications

Systemic Sclerosis (Scleroderma) Systemic Sclerosis Classification Epidemiology Pathology Prognosis and Complications It is a chronic multisystem disorder. There is thickening of the skin due to accumula­tion of connective tissue affecting the structure and function of gastrointestinal system (GIT), lungs, heart, kidneys and other organs. There is vascular damage, and other immune processes resulting in damage […]

Systemic Sclerosis Diagnosis Symptoms Treatment Management

 Diagnosis Systemic Sclerosis — Scleroderma (systemic sclerosis [SSc]) is a chronic disease of unknown cause characterized by diffuse fibrosis of skin and visceral organs and vascular abnormalities History Raynaud phenomenon is frequently the initial complaint. Skin thickening, “puffy hands,” and gastroesophageal reflux disease (GERD) are often noted early in the disease process. Systemic Sclerosis Physical […]

Vasculitis Syndrome Causes Differential Diagnosis Symptoms and Treatment

Vasculitis Syndrome Vasculitis is a disease of blood vessels with in­flammation and damage. Vasculitis may be a disease of the blood vessels itself or it may be secondarily affected due to a systemic disease. destruction of blood vessel walls, with subsequent aneurysm formation, bleeding, thrombosis, or ischemia in the various vascular beds and organs Differential […]

Sarcoidosis Causes Diagnosis Symptoms and Treatment

Sarcoidosis It is a chronic, multisystem disorder of unknown cause. chronic multisystem disease of unknown etiology, characterized by noncaseating (hard) granulomas and lymphocytic alveol, Sarcoidosis is a noninfectious, multisystem granulomatous disease of unknown cause, commonly affecting young and middle-aged adults. Almost any other organ may be involved, including liver, spleen, lymph nodes, heart, and CNS. […]

Amyloidosis Symptoms Diagnosis Prognosis and Treatment

Amyloidosis Amyloidosis is deposition of insoluble amyloid fibrils in extracellular spaces of organ and tis­sues due to abnormal protein folding. metabolic disorders resulting from the insidious deposition of protein-containing fibrils (amyloid) in tissues, diseases characterized by extracellular deposition of insoluble protein fibrils in organs and tissues clinical manifestations of amyloidosis are enormously varied, and the […]

Toxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment

Toxic Hepatitis and Drug Induced Hepatitis Diagnosis and Treatment Toxic Hepatitis and Drug Induced Hepatitis Injury to liver may occur due to drugs and toxins in­haled, eaten, chewed, or swallowed. The metabolism of drugs by the liver and the mechanisms by which drugs might injure the liver are discussed separately Drug-induced liver injury (also called […]

Chronic Hepatitis Classification viral hepatitis Clinical features and Treatment

Chronic Hepatitis Classification viral hepatitis Clinical features and Treatment Chronic Hepatitis Chronic hepatitis is a liver disorder with inflam­mation and necrosis persisting for more than 6 months. Chronic hepatitis may be mild, non-progressive, or severe, or may lead to cirrhosis. Chronic hepatitis may be of three types: · Chronic viral hepatitis · Chronic drug-induced hepatitis […]

Alcoholic Liver Disease Diagnosis CAGE criteria and Treatment

Alcoholic Liver Disease Diagnosis CAGE criteria and Treatment Alcoholic Liver Disease Alcoholic liver disease is involvement of the liver due to chronic and excessive alcohol intake. There is a spectrum of clinical and laboratory findings in patients with alcoholic liver disease, ranging from asymptomatic fatty liver to alcoholic hepatitis to end-stage liver failure with jaundice, […]

Cirrhosis and COMPLICATIONS of CIRRHOSIS with Treatment

Cirrhosis and COMPLICATIONS of CIRRHOSIS with Treatment Cirrhosis Cirrhosis means there is irreversible liver dam­age with extensive fibrosis, and formation of re­generative nodules. There is hepatocyte necrosis with nodular regenera­tion of liver parenchyma. characterized pathologically by liver scarring with loss of normal hepatic architecture and areas of ineffective regeneration Cirrhosis represents a late stage of […]

Alcoholic Cirrhosis Clinical features Physical findings Treatment

Alcoholic Cirrhosis Clinical features Physical findings Treatment ALCOHOLIC CIRRHOSIS This results from chronic alcohol ingestion and may follow alcoholic fatty liver and alcoholic hepatitis. It is also called Laennec‘s cirrhosis, and micronodular cirrhosis. Chronic hepatitis C infection worsens alcoholic hepa­titis leading to alcoholic cirrhosis. Alcoholic Cirrhosis Clinical features · It may be symptomless · There […]

Biliary Cirrhosis (Primary and Secondary) Symptoms Diagnosis and Treatment

Biliary Cirrhosis (Primary and Secondary) Symptoms Diagnosis and Treatment BILIARY CIRRHOSIS Biliary cirrhosis occurs due to injury or prolonged obstruction of intrahepatic or extrahepatic biliary sys­tem. There is destruction of liver cells and progres­sive fibrosis with biliary obstruction. In primary biliary cirrhosis there is intrahepatic bile ductules obstruction. progressive jaundice, consequences of impaired bile excretion, […]

Post Hepatitis and Cryptogenic Cirrhosis Cardiac, Cirrhosis, Metabolic, Hereditary, Drug Related Cirrhosis

Post Hepatitis and Cryptogenic Cirrhosis Cardiac, Cirrhosis, Metabolic, Hereditary, Drug Related Cirrhosis POST HEPATITIC AND CRYPTOGENIC CIRRHOSIS Post hepatitis or post necrotic cirrhosis may follow any chronic liver disease. Cryptogenic cirrhosis is cirrhosis of unknown etiol­ogy. POST HEPATITIC Cirrhosis Etiology · Cirrhosis may follow viral hepatitis B or C. · It is especially common in […]

Portal Hypertension Clinical Features Symptoms Diagnosis and Treatment

Portal Hypertension Clinical Features Symptoms Diagnosis and Treatment Portal Hypertension Normal pressure in portal vein is 5-10 mmHg. Vascular resistance in hepatic sinusoids is low. Increased pressure in the portal vein caused by an obstruction of the flow of blood through the liver. Portal hypertension is found in diseases such as cirrhosis, Portal hypertension is […]

VARICEAL BLEEDING Clinical features Diagnosis and Treatment

VARICEAL BLEEDING Clinical features Diagnosis and Treatment VARICEAL BLEEDING It results from portal systemic venous collaterals when portal hypertension is more than 12 mmHg. Clinical features,: There is painless hematemesis, tachycardia and even shock. VARICEAL BLEEDING Differential diagnosis : Peptic ulcer and gastritis. Endoscopy is done for proper diagnosis. Variceal bleeding is serious emergency patients […]

Pancreatitis (inflammatory disease of pancreas) Signs and Symptoms Diagnostic Tests

Pancreatitis (inflammatory disease of pancreas) Signs and Symptoms Diagnostic Tests Pancreatic Diseases Pancreatitis is inflammatory disease of pan­creas Various presentations of Pancreatitis : · Hypertriglyceridemia · Vitamin B12 malsorption · Hypercalcemia · Hypocalcemia · Hyperglycemia · Ascites · Pleural effusion · Chronic abdominal pain. Pancreatitis Prognosis: Several techniques are used to determine how well (or how […]

Hyperbilirubinemia Classification Types Symptoms Examination

Hyperbilirubinemia Classification Types Symptoms Examination Hyperbilirubinemia Hyperbilirubinemias are conditions where the serum bilirubin is high. An excessive amount of bilirubin in the blood; the condition is seen in any illness causing jaundice, including diseases in which the biliary tree is obstructed, and those in which blood formation is ineffective Pediatrics:In newborns, high bilirubin levels due […]

Some Important Values-Ideal Body Values

Some Important Values- Ideal Body Weight, Body Surface Area, Alveolar-Arterial Gradient, Creatinine Clearance Ideal Body Weight Most healthy infants and children grow in a predictable fashion, following a typical pattern of progression in weight, length, and head circumference. Growth velocity, the change in growth over time, is a more sensitive index of growth than is […]

We would like to keep you updated with special notifications.