Congenital Disorders

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Down Syndrome

Genetic, has 47 chromosomes instead of the usual 46, mild to severe retardation with characteristic facial features and distinctive physical abnormalities

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Down Syndrome Symptoms:

Sm head, with a flat back skull Slant to the eyes; flat nasal bridge Sm low-set ears Sm mouth with a protruding tongue Sm weak muscles Short hands w/stubby fingers; deep horiz. crease across the palm Exaggerated space btwn the big and little toes

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Down Syndrome Diagnosis and Prevention:

Prenatally via ultrasound, blood tests and/or amniocentesis or during the neonatal period; no prevention

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Down Syndrome Etiology:

Have extra chromosome number 21 (trisomy 21). Occurs in 1 to 650 births and more to woman over age 35.

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Down Syndrome Treatment:

No known cure; treatment plan is individual and includes a multidimensional approach to maximize the development of motor and mental skills.

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Cerebral Palsy (CP)

most common crippler of children; congenital or acquired, bilateral or unilateral paralysis from damage to CNS

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Cerebral Palsy Symptoms and Signs:

Infant has difficulty with sucking and swallowing Muscles may be floppy or stiff When infant is lifted from behind, the legs may be difficult to separate and they may cross their legs

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Spastic CP

Hyperactive reflexes or rapid muscle contractions Scissor gait by walking on the toes and crossing one foot over the other 70% of cases

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Athetoid CP

Involuntary muscle movements, especially during stress Reduced muscle tone Difficulty with speech 20 % of cases

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Ataxic CP

Lack of control over voluntary movements Poor balance and wide gait Visual and auditory deficits Seizure activity Mental retardation

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Cerebral Palsy Patient Screening:

Suspected during routine well-baby or well-child visits

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Cerebral Palsy Etiology:

Stems from inadequate blood or oxygen supply to the brain during fetal development, during the birth process or in early childhood until about 9 years of age. More common in premature infants and in male babies.

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Cerebral Palsy Diagnosis and Prevention:

Made from a clinical picture and neurologic examination findings. Prevention in head injury or brain infection in prenatal, perinatal and neonatal periods.

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Cerebral Palsy Treatment:

No cure; goal of treatment is to minimize the handicap by providing every possible therapeutic measure to help the child reach their potential.

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Cerebral Palsy Prognosis:

Brain damage can't be reversed; therefore there is no cure for CP.

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Spina Bifida

Group of malformations of the spine in which the posterior portion of the bony canal containing the spinal cord is completely or partially absent.

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Spina Bifida Occulta

The posterior arches of the vertebrae, commonly in the lumbosacral area, fail to fuse, but there is no herniation of meninges or spinal cord. Usually there is no spinal cord or spinal nerve involvement.

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Spina Bifida Symptoms and Signs:

Without displacement of the cord or the meninges it is asymptomatic. Evidence of neural tube defect dimpling, a tuft of hair or hemangioma over the site where the vertebrae have not completely fused.

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Spina Bifida Patient Screening:

Discovered during the newborn examination.

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Spina Bifida Etiology:

Congenital anomaly is unknown, but it has been associated with exposure t ionizing radiation during the early uterine life. Reduced levels of Vitamin A and folic acid during pregnancy may contribute.

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Spina Bifida Diagnosis and Prevention:

Maternal blood levels of AFP measured Ultrasound Postnatal physical examination Prevention is unknown; avoiding exposure to ionizing radiation is wise

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Spina Bifida Treatment:

Surgery to repair the defect if the child becomes symptomatic with neurologic problems

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Spina Bifida Prognosis:

Prognosis is good.

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Hydrocephalus

Abnormal enlargement of the head due to the amount of CSF increased and it's circulation is blocked. "Water on the brain"

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Hydrocephalus Symptoms and Signs:

Fontanelles befin to bulge Sutures of the skull separate Scalp veins become distended Head circumference increases Infant has a high pitched cry, is irritable and projectile vomit Downward displacement of the eyes Abnormal muscle tone of the legs

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Hydrocephalus Patient Screening:

Detected during newborn examination by measuring the head circumference and plotting on a growth chart

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Hydrocephalus Etiology:

A large amount of CSF accumulates in the skull, causing increased intracranial pressure. It may be caused by a lesion within the system or by a congenital structural defect. Intracranial hemorrhage

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Hydrocephalus Diagnosis and Prevention:

Made through clinical picture, physical examination, and radiographic skull studies. MRI and CT No known prevention for congenital form; good prenatal care, preventing infections and injury to head during childhood

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Hydrocephalus Treatment:

Placing a shunt in the ventricular or subarachnoid spaces to drain off the excessice CSF

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Hydrocephalus Prognosis:

Varies depending on the extent; most children can function normally in society

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Congenital Cardiac Defects

Developmental anomalies of the heart or the great vessels of the heart and present at birth

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Acyanotic Defects

Oxygenated blood does not mix with deoxygenated blood and the infant usually maintains a fairly normal pink skin color. Cyanosis is not prevalent.

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Ventricular Septal Defect

Most common congenital cardiac disorder, ventricular septal defect (VSD), it's an abnormal opening btwn the RT and LT ventricles.

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Patent Ductus Arteriosus (PDA)

Results when the ductus fails to functionally close.

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Coarctation of the Aorta

Characterized by a narrowed aortic lumen, causing a partial obstruction of the flow of blood through the aorta.

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Atrial Septal Defect (ASD)

An abnormal opening between the right and left atria.

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Tetralogy of Fallot

Most common cyanotic cardiac defect, it's a combo of 4 congenital heart defects: VSD, pulmonary stenosis, dextroposition of the aorta and right ventricular hypertrophy

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Transposition of the Great Arteries

The aorta and the pulmonary artery are reversed, resulting in two closed-loop circulatory systems.

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Cleft Lip (harelip)

Congenital birth defect consisting of one or more clefts in the upper lip.

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Cleft Palate

A birth defect in which there is a hole in the middle of the roof of the mouth (palate).

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Cleft Lip and Palate Etilogy and Prevention:

The failure in embryonic development of the fetus. 1 in 10,000 births. No prevention for this deformity.

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Congenital Pyloric Stenosis

A gastric obstruction associated with narrowing of the pyloric sphincter at the exit of the stomach.

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Congenital Pyloric Stenosis Symptoms:

Infant has episodes of projectile vomiting, after feedings and gails to gain weight. Symptoms usually begin at 2 to 3 weeks of age.

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Congenital Pyloric Stenosis Etiology and Diagnosis:

Slight hereditary tendency, but exact cause is unknown. Diagnosed from the history and pt's physical condition, upper GI x-ray and ultrasound of the pylorus.

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Congenital Pyloric Stenosis Treatment and Prevention:

Surgical intervention in which the constricted pylorus is incised and sutured to relieve the obstruction. No prevention known.

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Cystic Fibrosis

An autosomal recessive inherited disorder, is a chronic dysfunction the gene called cystic fibrosis transmembrane conductance regulator (CFTR) that affects multiple systems. Most common fatal genetic disease.

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Cystic Fibrosis Symptoms and Signs:

Attacks the lungs and digestive system, producing thick and sticky mucus that accumulates and blocks glandular ducts. Sinus infections and diarrhea.

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Cystic Fibrosis Etiology and Diagnosis:

Inherited and transmitted as an autosomal recessive trait. Genetic testing and sweat test.

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Cystic Fibrosis Treatment and Prognosis:

Considered fatal and treatment is supportive measures to help lead a normal life and prevent pulmonary infections.

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Bronchopulmonary Dyplasia (BPD)

serious, chronic lung disease, results after and insult to the neonate's lungs; may be sequela to IRDA, lung infection or extreme prematurity; lungs are hard, stiff and hard to ventilate

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BPD Symptoms and Signs:

Periods of dyspnea Tachypnea Wheezing Cyanosis Nasal Flaring Sternal Refractions O2 saturation and heart rate decreases

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Infant Respiratory Distress Syndrome (IRDS)

patient suffers acute hypoxemia caused by infiltrates within the alveoli

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BPD Diagnosis and Treatment:

Observation Chest X-ray Oxygen and CO2 levels tested Atrial blood gases tested Replacement of the damaged alveoli Supplemental O2 therapy Diuretics and Antiinflammatory drugs

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Laryngomalacia

obstructive airway condition; infant exhibits respiratory stridor that is louder on inspiration

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Tracheomalacia

obstructive airway condition; infant exhibits respiratory stridor that is louder on expiration

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Bronchomalacia

means 'floppiness' of some part of the bronchi. Patients present with noisy breathing and/or wheezing. There is collapse of a main stem bronchus on exhalation.

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Laryngo, Tracheo and Bronchomalacia Diagnosis:

Chest X-Ray CT Laryngoscopy Bronchoscopy

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Retinopathy of Prematurity

or Retrolental Fibroplasia; is an abnormal growth of the blood vessels in the retinas of the infant's eyes

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Retinopathy Symptoms and Signs:

occurs most often in infant's before 28 weeks, no visible symptoms

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Retinopathy Diagnosis and Treatment:

Diagnosed by ophthalmologist using a ophthalmoscope Most mild forms resolve without treatment Laser treatment

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Necrotizing Entercolitis (NEC)

is an acute inflammatory process cuased by ischemic necrosis of the mucosal lining of the small intestine, large intestine or both

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NEC Symptoms and Signs:

Feeding intolerance Abdominal distention Bile-colored emesis Diarrhea Blood in Stool Lethargy Decreased or absent bowel sounds

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NEC Diagnosis and Treatment:

Etiology is inknown Observation of feeding patterns or activity level Respiratory difficulties Abdominal distention and tenderness CBC and stool cultures Feedings stopped and feeding tube placed

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Croup

is an acute, severe inflammation and obstruction of the respiratory tract

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Croup Symptoms and Signs:

Hoarseness Fever Harsh, high-pitched cough Stridor during inspiration

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Croup Diagnosis and Treatment:

Blood and Throat Cultures Laryngoscopy X-Rays of airway Treated symptomatically, steroids, increased fluid intake, antibiotics

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Adenoid Hyperplasia

is an abnormal enlargement of the lymphoid tissue located in the space above the soft palate of the mouth, causing a partial breathing blockage

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Adenoid Hyperplasia Symptoms, Diagnosis and Treatment

Mouth-breathing and snoring Lateral pharyngeal x-ray and nasopharyngoscopic exam Adenoidectomy

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Asthma

a chronic reversible obstructive disease caused by increased reactivity of the tracheobronchial tree to stimuli

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Asthma Symptoms and Signs:

Productive or nonproductive cough Wheezing Rapid pulse Pallor Profuse perspiration "Tight chest"

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Asthma Diagnosis:

Pulmonary function test X-ray Intradermal skin test to identify inhalant and food allergies Blood test (CBC with differential leukocyte count

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Asthma Treatment:

Medical management Immunotherapy Allergy shots Steroid injections Inhalation therapy Hospitalization

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Bronchiolitis

an inflammation of the bronchioles, the smallest air passages of the lungs, which is usually caused by viruses, such as RSV

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Bronchiolitis Symptoms and Signs:

Cough and nasal congestion Wheeze Tachypnea Respiratory distress Apnea

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Bronchiolitis Diagnosis:

Pt History Physical examination Chest X-ray Rapid RSV testing Viral culture from the nasopharynx

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Bronchiolitis Treatment:

Supportive care Nebulizer treatment Supplemental oxygen IV fluids, if necessary Intubation/Ventilator until the infection runs course

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Neuroblastoma

a cancer of the sympathetic nervous system, it's the 3rd most common childhood malignancy; arises from primitive sympathetic ganglion cells

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Neuroblastoma Symptoms ans Signs:

Abdominal mass Abdominal pain or fullness Anemia Bone pain Fever Hypertension Weight loss "Raccoon Eyes"

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Neuroblastoma Diagnosis:

Measurement of urine serum catecholamine levels Electrolytes, kidney and liver function Biopsy of the mass Chest X-ray Chest and head CT

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Neuroblastoma Treatment:

Surgical removal Chemotherapy Autologous hematopoietic stem cell rescue

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Chickenpox

a highly contagious, acute viral infection; systemic disease with superficial cutaneous lesions

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Chickenpox Symptoms and Sign:

Lesions that progress to papules then to vesicles that form crusts May experience fever, malaise and anorexia Possible bacterial infection, viral pneumonia, conjunctival ulcers and Reye syndrome Itchy

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Chickenpox Diagnosis and Treatment:

History of exposure and the presence of characteristic cutaneous eruptions Soda baths Calamine lotion Acetaminophen for fever and pain Antiviral drugs

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Developmental Dysplasia of the Hip

an abnormal development of the hip joint that ranges from an unstable joint to dislocation of the femoral head from the acetabulum

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Developmental Dysplasia of the Hip Symptoms:

Asymmetric folds of the thigh Shortening of the femur when the knees and hips are flexed at right angles

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Developmental Dysplasia of the Hip Diagnosis:

Abnormal signs, including positive Ortolani and Barlow maneuvers, may be detected at birth. Physical examination and ultrasound

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Developmental Dysplasiaof the Hip Treatment:

After femur head is returned to its proper position in the acetabulum, the legs are held in place by a Pavlik harness, a splint, or a cast

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Hypertrophic Cardiomyopathy

a congenital disorder, occurs when a portion of the heart muscle thickens without any apparent cause; major cause of sudden cardiac death in young athletes who have appeared to be completely healthy

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Hypertrophic Cardiomyopathy Symptoms and Signs:

First sign is collapse of a seemingly healthy young athlete Chest pain Syncope Hypertension Palpitations SOB Fatigue

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Hypertrophic Cardiomyopathy Diagnosis:

Autopsy Drop in blood pressure Family history Holter monitor Electrocardiogram (ECG) X-ray MRI Genetic test

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Hypertrophic Cardiomyopathy Treatment:

Beta-Blockers Calcium Channel Blockers Pacemaker Implantable Cardioverter-Defribillator (ICD) Surgical myectomy

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Common Variable Immunodeficiency (CVID)

an acquired B-cell deficiency that results in decreased antibody production and/or function

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CVID Symptoms and Signs:

History of chronic or recurrent infections, such as pneumonia, bronchitis, sinusitis, otitis media Gastrointestinal (GI) disease Lymphadenopathy, splenomegaly and hepatomegaly Chronic lung disease and granulomatous disease Autoimmune disorders

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CVID Etiology and Diagnosis:

has 2 peaks of incidence: 1 btwn ages 18 to 25 and smaller peak btwn 1 to 5 years History of repeated and chronic infections lead to investigation of immunoglobulin levels and T-cell quantities

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Common Variable Immunodeficiency (CVID) Treatment:

aimed at preventing infections and implementing early treatment with appropriate antibiotic administration when infections occur

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Severe Combined Immunodeficiency (SCID)

is a group of disorders that result from a disturbance in the development and function of the T cells with or without B cells

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Severe Combined Immunodeficiency (SCID) Symptoms:

Severe, recurrent infrections with bacteria, viruses, fungi and protozoa; chronic diarrhea; and failure to thrive Occurs by the age of 3 to 6 months Common infections: Pneumocystis Pneumonia and Persistent Mucocutaneous Candidiasis

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SCID Etiology and Diagnosis:

2 types: X-linked and autosomal recessive; both lead to defects in stem cell differentiation into B cells and T cells Routine newborn screen Immunoglobulin levels measured Antibody titers measured #'s of T cells and B cells measured

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Severe Combined Immunodeficiency (SCID)Treatment:

Bone marrow transplant (BMT) Gene therapy

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Pernicious Anemia

is caused by chronic atrophic gastritis resulting in decreased gastric production of hydrochloric acid and a shortage of intrinsic factor

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Pernicious Anemia Symptoms:

Sore tongue Weakness Tingling and numbness in the extremities Lips, tongue and gums appear pale whereas the sclera and skin appear slightly jaundiced

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Pernicious Anemia Etiology and Diagnosis:

90% of pts have anti-parietal antibodies, which can be cytotoxic to the parietal cells Lab and blood tests Schilling test Bone marrow test

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Pernicious Anemia Treatment:

Injection of Vitamin B12 for life Blood replacement Supportive measures

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Idiopathic Thrombocytopenic Purpura (ITP)

is a acquired disorder that results from an isolated deficiency of platelets

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ITP Symptoms :

Inability of blood to clot Spontaneous hemorrhages in the skin, mucous membranes or internal organs Petechiae Ecchymoses Nosebleeds GI bleeding Menorrhagia Hematuria Easy bruising

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ITP Etiology and Diagnosis:

Considered idiopathic (of unknown cause) Causes of thrombocytopenia ruled out first Complete CBC analysis and peripheral blood smear

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Idiopathic Thrombocytopenic Purpura (ITP) Treatment:

Corticosteroid administration IVIG may be administered to increase platelet count Anemia needs to be corrected with blood transfusion Vitamin K administration Splenectomy last resort

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Systemic Lupus Erythematosus (SLE)

is a chronic, inflammatory autoimmune disease characterized by unusual autoantibodies in the blood that target tissues of the body

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SLE Symptoms and Signs:

inflammation of the skin, joints, nervous system, kidneys, lungs and other organs. Butterfly rash or erythema Photosensitivity

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Systemic Lupus Erythematosus (SLE) Diagnosis:

Blood and urine tests Chest x-ray and echocardiogram Biopsy of kidney tissue

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Systemic Lupus Erythematosus (SLE) Treatment:

Anti-inflammatory drugs Corticosteroids Immunosuppressive agents

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Scleroderma

a chronic, progressive disease characterized mostly by sclerosis of the skin, scarring of certain internal organs

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Scleroderma Symptoms and Signs:

Characterized by sclerosis and shrinking of the skin and certain internal organs (GI tract, heart, lungs and kidneys) Skin becomes taut, firm and edematous Skin feels tough and leathery, may itch Pigmented patches Swelling, stiffness, joint pain

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Scleroderma Etiology and Diagnosis:

Cause is unknown, appears to be autoimmune disease Complete history and physical exam Lab testing including Scl-70 and centromere antibodies Blood tests and urinalysis CAT of the chest and right heart catheterization

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Scleroderma Treatment:

No specific treatment Treatment is directed to area of body affected Physical therapy for muscle strength

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Sjogren Syndrome

is an autoimmune disease that features inflammation in moisture-secreting glands; resulting in dryness in the affected areas

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Sjogren Syndrome Etiology and Diagnosis:

Genetic factors seem to play a role; most are female Screened for medication side effects, autoimmune thyroid disease, RA, SLE, sarcoidosis and scleroderma Schirmer testing for dry eyes Lower lip biopsy to check lymphocytes Blood test

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Sjogren Syndrome Treatment:

Is directed toward relieving symptoms Increasing fluid intake, chewing gum, oral sprays Prednisone and/or antimalarial medications

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Rheumatoid Arthritis (RA)

is a chronic, inflammatory, systemic disease that affects the joints

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RA Symptoms and Signs:

Inflammation and edema of the synovial membranes surrounding a joint Joint deformity Pain Joint stiffness

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RA Diagnosis:

Is based on a review of the symptoms, pt and FH, physical exam, x-rays and blood tests that check elevated levels of rheumatoid factor CBC Synovial fluid analysis Serum protein electrophoresis ESR Citrulline antibody Antinuclear antibody titer

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RA Treatment:

Reduction in inflammation and pain Preservation of joint function Prevention of joint prevention Anti-inflammatory medications Corticosteroids

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Multiple Sclerosis (MS)

is an inflammatory disease of the central nervous system; attacks the myelin sheath, causing scarring that debilitates the nerves

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MS Symptoms and Signs:

Weakness or numbness in 1 or more limbs Optic neuritis Loss of vision in one eye Diplopia Unsteady gait Vertigo Difficulty with urinating, leading to UTIs

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MS Diagnosis:

Challenging to diagnose Physical exam in early stages MRI Determined by eliminating other possible causes Exam of CSF

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MS Treatment:

Acute attacks are treated with corticosteroids Immunosuppressive therapies Biologic medications Treated systemically

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Myasthenia Gravis

is a chronic, progressive neuromuscular disease that is caused by autoantibodies to the acetylcholine receptor at nerve synapses

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Myasthenia Gravis Symptoms and Signs:

Extreme muscular weakness (without atrophy) Progressive fatigue Drooping eyelids Diplopia Difficulty with talking , chewing and swallowing

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Myasthenia Gravis Diagnosis:

Physical examination is done that aims to test for fatigability of different muscle groups Tensilon test EMG

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Myasthenia Gravis Treatment:

Treatment is symptomatic and supportive Anticholinesterase drugs Mestinon Corticosteroids

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Cushing Syndrome

is a condition of chronic hypersecretion of the adrenal cortex, which results in excessive circulating cortisol levels

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Cushing Syndrome Symptoms and Signs:

Fatigue Muscular weakness Weight Gain Changes in body appearance Moon Face Thin skin, bruise easy Stretch marks

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Cushing Syndrome Diagnosis:

Physical appearance: moon face, buffalo hump and gross obesity of the trunk Urinalysis CT or MRI

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Cushing Syndrome Treatment:

Treatment depends on cause of the over secretion of cortisol; if tumor is cause, surgical removal or radiation of the tumor in the pituitary gland or adrenal gland

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Hypoparathyroidism

is the condition in which the secretion of parathyroid hormone (PTH) by the parathyroid glands is greatly reduced

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Hypoparathyroidism Symptoms:

Hypocalcemia Numbness and tingling of fingertips, toes, ears or nose followed by muscular spasms or twitching of the hands and feet Tetany Emotional changes, irritability, confusion

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Hypoparathyroidism Diagnosis:

Blood studies ECG Clinical picture of neuromuscular hyperexcitability

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Hypoparathyroidism Treatment:

Calcium replacement therapy with vitamin D for life

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Hyperparathyroidism

is a condition caused by overactivity of 1 or more of the 4 parathyroid glands and results in the overproduction of PTH

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Hyperparathyroidism Symptoms:

Muscle weakness Atrophy GI pain Nausea Low back pain Renal calculi Bone tenderness Arthritis type of pain Easy fracturing of bones

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Hyperparathyroidism Treatment:

Varies with the cause and is highly individualized Parathyroid surgery Reduce blood serum calcium levels by medication

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Hyperparathyroidism Diagnosis:

X-ray Bone density test

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Hypothyroidism

a very common condition, refers to state in which thyroid hormone production is below normal

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Hypothyroidism Symptoms:

Fatigue Cold intolerance Constipation Dry, flaky skin

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Hypopituitarism

is a condition caused by a deficiency or absence of any of the pituitary hormones, produced by the anterior pituitary lobe

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Hypopituitarism Symptoms:

Stomach pain, decreased appetite, nausea, vomiting, constipation Excessive thirst and urination Fatigue and/or weakness Anemia Headache and dizziness Sensitivity to cold Weight loss or weight gain

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Hypopituitarism Diagnosis:

Medical evaluation to detect partial or selective hormone deficiencies Contributors are history of head trauma, previous radiation or surgical procedure to the gland or nearby tissue

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Hypopituitarism Treatment:

Age, severity and type of deficiency and underlying cause determine the source of treatment Replacement therapy with hormonal supplements

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Diabetes Insipidus

is a disturbance of water metabolism resulting in extreme thirst and excessive secretion of dilute urine

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Diabetes Insipidus Symptoms:

Extreme thirst Excretion of an excessive amount of diluted urine Unexplained fussiness or inconsolable crying Trouble sleeping Fever Vomiting Diarrhea Delayed growth Weight loss

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Diabetes Insipidus Diagnosis:

Water deprivation test Urinalysis Magnetic resonance imaging (MRI)

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Diabetes Insipidus Treatment:

Vasopressin injections Nasal spray Oral desmopressin acetate (DDAVP) Thiazide diuretics

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Goiter

refers to any enlargement of the thyroid gland usually evidenced by a swelling in the neck

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Goiter Symptoms:

Asymptomatic in early stages Usually female Difficulty swallowing Dyspnea Weight loss Heat intolerance Tachycardia Anxiety Increased sweating

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Goiter Etiology and Diagnosis:

Results from a shortage of iodine in diet Exam of neck Blood studies indicate thyrotropin levels Measurement of radioactive iodine uptake by the thyroid gland Thyroid ultrasonography

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Goiter Treatment:

A drop per week of saturated solution of potassium iodide Adding iodine to diet Avoidance of goitrogenic drugs or food Thyroid hormone T4

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Graves Disease

a condition of primary hyperthyroidism, occurs when the entire thyroid gland hypertrophies, resulting in a diffuse goiter and an overproduction of thyroid hormones

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Graves Disease Symptoms:

Increased metabolism and multisystem changes Rapid heartbeat and palpitations Nervousness Excitability Insomnia Excessive appetite, but loses weight Profuse perspiratio Muscular weakness Tremor Loss of hair Outward protrusion of eyes

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Graves Disease Diagnosis:

Clinical picture and history Serum T3,and T4 levels are tested Thyroid scan

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Graves Disease Treatment:

Reduce the formation and secretion of thyroid hormone Antithyroid drugs Radioactive iodine therapy Thyroidectomy

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Hypoglycemia

is an abnormally low glucose level of the blood

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Hypoglycemia Symptoms:

Sweating Nervousness Weakness Hunger Dizziness Trembling Headache Palpitations Confusion Visual disturbances Stupor Coma Drunkenness behavior

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Hypoglycemia Diagnosis:

Physical exam Check blood glucose level

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Hypoglycemia Treatment:

Intravenous infusion of glucose Hormone glucagon given A complex carbohydrate and protein snack Modified diet

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Hashimoto Thyroiditis

Aka Chronic Lymphocytic Thyroiditis A chronic disease of the immune system that attacks the thyroid gland

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Hashimoto Thyroiditis Symptoms:

Gradual and and painless lumpy enlargement of the thyroid gland Pressure in the neck Difficulty swallowing Sensitivity to cold Weight gain Fatigue Depression Mental apathy

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Hashimoto Thyroiditis Diagnosis:

Thyroid gland needle biopsy Radioactive iodine uptake scan

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Hashimoto Thyroiditis Treatment:

Lifelong replacement of thyroid hormones

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Diabetes Mellitus (DM)

is a chronic disorder of carbohydrate, fat and protein metabolism caused by inadequate production of insulin by the pancreas or faulty use of insulin by the cells

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DM Symptoms and Signs:

Increased thirst Frequent urination Extreme hunger Unexplained weight loss Presence of ketones in the urine Fatigue Irritability Blurred vision Slow-healing sores Frequent infections, such as gums or skin infections and vaginal infections

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DM Diagnosis:

Patient History Assessment for cardinal symptoms At least 2 positive tests of fasting blood plasma glucose, presence of glucose and acetone in the urine Blood insulin test Eye exam for retinopathy

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DM Treatment:

Normalize blood glucose Well-balanced diet Insulin administration Oral medication Exercise Blood and urine testing Hygienic measures

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Gestational Diabetes

is a condition of damaged ability to process carbohydrate that has its onset during pregnancy

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Gestational Diabetes Symptoms:

Polyuria Polydipsia Polyphagia

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Gestational Diabetes Diagnosis:

Routine prenatal urine glucose test Fasting blood glucose determination Glucose tolerance tests Glycated hemoglobin tests

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Gestational Diabetes Treatment:

Eat balanced meals Exercise Check blood sugar levels Monitor fetal growth and well-being Take diabetes medication and insulin shots

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