pathology
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| Ankylosing Spondylitis | Systemic condition characterized by inflammation of the spine and the larger peripheral joints
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| Ankylosing Spondylitis | Males are at two to three times greater risk than females with peak onset observed between 20-40 years of age
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| Ankylosing Spondylitis Clinical presentation | initially includes recurrent and insidious onset of back pain, morning stiffness, and impaired spinal extension
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| Diabetes Mellitus (Type 1) | Insulin is functionally absent due to the destruction of the beta cells of the pancreas, where the insulin would normally be produced
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| Diabetes Mellitus (Type 1) Starts in children | ages four years or older, with the peak incidence of onset coinciding with early adolescence and puberty
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| Diabetes Mellitus (Type 1) Common symptoms include | polyuria, polydipsia, polyphagia, nausea, weight loss, fatigue, blurred vision, and dehydration
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| Duchenne Muscular Dystrophy | X-linked recessive trait manifesting in only male offspring while female offspring become carriers
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| Duchenne Muscular Dystrophy Clinical presentation | includes waddling gait, proximal muscle weakness, toe walking, pseudohypertrophy of the calf, and difficulty climbing stairs
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| Duchenne Muscular Dystrophy | There is usually rapid progression of this disease with the inability to ambulate by ten to twelve years of age with death occurring as a teenager or less frequently in the 20ʼs
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| Human Immunodeficiency Virus (HIV) Primary risk factors for contracting HIV include | unprotected sexual relations, intravenous drug use or mother to fetus transmission
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| Human Immunodeficiency Virus (HIV)Patients may actually be | “symptom free” for one to two years post infection or may exhibit flu-like symptoms including rash and fever
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| Human Immunodeficiency Virus (HIV) | Leading cause of death for patients with the virus is kidney failure secondary to the extended drug therapies
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| Juvenile Rheumatoid Arthritis (JRA) | Autoimmune disorder found in children less than 16 years of age that occurs when the immune cells begin to attack the joints and organs causing local and systemic effects throughout the body
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| Girls have a higher incidence of | JRA and are most commonly diagnosed as toddlers or in early adolescence
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| Clinical symptoms JRA include | persistent joint swelling, pain, and stiffness
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| Osteoporosis Metabolic bone disorder | where the rate of bone resorption accelerates while the rate of bone formation slows down
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| Osteoporosis Patients may complain of | low thoracic or lumbar pain and experience compression fractures of the vertebrae
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| Osteoporosis Bone mineral density test accounts for | 70% of bone strength and is the easiest way to determine osteoporosis
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| Reflex Sympathetic Dystrophy Increase in sympathetic activity | causes a release of norepinephrine in the periphery and subsequent vasoconstriction of blood vessels resulting in pain and an increase in sensitivity to peripheral stimulation
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| Reflex Sympathetic Dystrophy | Affects all age groups, but is most likely found in individuals 35-60 years of age with females being three times more likely to be affected than males
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| Reflex Sympathetic Dystrophy Patients experience | intense burning and chronic pain in the affected extremity that eventually spreads in a proximal direction
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| Rheumatoid Arthritis | Systemic autoimmune disorder of the connective tissue that is characterized by chronic inflammation within synovial membranes, tendon sheaths, and articular cartilage
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| Rheumatoid Arthritis Incidence is | three times greater in females than males and is diagnosed most frequently between 30-50 years of age
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| Rheumatoid Arthritis Blood work assists | with the diagnosis of rheumatoid arthritis through evaluation of the rheumatoid factor, white blood cell count, erythrocyte sedimentation rate, hemoglobin, and hematocrit values
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| Systemic Lupus Erythematosus | Connective tissue disorder caused by an autoimmune reaction in the body
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| Systemic Lupus Erythematosus Females are | at greater risk than males with the most common age group ranging from 15-40 years of age
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| Systemic Lupus Erythematosus Clinical presentation includes | a red butterfly rash across the cheeks and nose, a red rash over light exposed areas, arthralgias, alopecia, pleurisy, kidney involvement, seizures, and depression
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| Type 1 Diabetes Mellitus (DM) | This form of diabetes occurs when the pancreas fails to produce enough or any insulin.
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| Type 1 Diabetes Mellitus (DM) Symptoms include | a rapid onset of symptoms, polyphagia, weight loss, polyuria, polydipsia, blurred vision, dehydration, and fatigue.
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| Treatment Type 1 Diabetes Mellitus (DM) includes | exogenous insulin injections that are required to maintain proper glucose blood levels and avoid complications.
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| Proper nutritional management is also required for blood glucose control. | Insulin pumps may be indicated for continuous administration of insulin.
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| Since there is no cure for type 1 DM at this time the goal is to | control the regulation of blood glucose levels. This form of diabetes is normally diagnosed in childhood.
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| Type 1 Diabetes Mellitus (insulin-dependent, juvenile diabetes) Onset: | usually less than 25 years of age
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| Type 1 Diabetes Mellitus (insulin-dependent, juvenile diabetes) | Abrupt onset
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| Type 1 Diabetes Mellitus (insulin-dependent, juvenile diabetes) | 5-10% of all cases
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| Type 1 Diabetes Mellitus (insulin-dependent, juvenile diabetes) Etiology: | destruction of islet of Langerhans cells secondary to possible autoimmune or viral causative factor
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| Type 1 Diabetes Mellitus (insulin-dependent, juvenile diabetes) Insulin production: | very little or none
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| Type 1 Diabetes Mellitus (insulin-dependent, juvenile diabetes) | Ketoacidosis can occur
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| Type 1 Diabetes Mellitus (insulin-dependent, juvenile diabetes) Treatment includes | insulin injection, exercise and diet
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| Type 2 Diabetes Mellitus (DM) This form of diabetes occurs when | the body cannot properly respond to insulin. Obesity is found to contribute to this condition by increasing insulin resistance.
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| Symptoms Type 2 Diabetes Mellitus (DM)are relatively the same as with type 1, however, | ketoacidosis does not occur since insulin is still produced. Treatment of type 2 diabetes includes blood glucose control through diet, exercise, oral medications or insulin injections when necessary
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| . There has been an increase in children diagnosed with | type 2 diabetes secondary to a rise in childhood obesity.
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| Type 2 Diabetes Mellitus (DM)Onset: | usually older than 40 years of age
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| Type 2 Diabetes Mellitus (DM) | Gradual onset
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| Type 2 Diabetes Mellitus (DM)90-95% | of all cases
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| Type 2 Diabetes Mellitus (DM)Etiology: | resistance at insulin receptor sites usually secondary to obesity; ethnic prevalence
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| Type 2 Diabetes Mellitus (DM)Insulin production: | variable
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| Type 2 Diabetes Mellitus (DM) | Ketoacidosis will rarely occur
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| Type 2 Diabetes Mellitus (DM)Treatment includes | weight loss, oral insulin, exercise, and diet
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| Rehabilitation Considerations for Patients with Diabetes Mellitus Must be | familiar with symptoms of excessive pharmacological treatment
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Avoid treatments that exacerbate the condition
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Peripheral neuropathies
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Small vessel angiopathy
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Tissue ischemia and ulceration
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Impaired wound healing
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Tissue necrosis and amputation
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Acute metabolic changes
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Sudden hypoglycemia
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Inconsistent management of insulin intake
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Diet and physical activity
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| Rehabilitation Considerations for Patients with Diabetes Mellitus | Proper skin care and shoe evaluation
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| Hypothyroidism | This condition occurs when there are decreased levels of thyroid hormones in the bloodstream.
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| Hypothyroidism deficiency slows | the processes within the body and symptoms may include fatigue, weakness, decreased heart rate, weight gain, constipation, delayed puberty, and retarded growth and development.
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| Common causes of hypothyroidism are | Hashimotoʼs thyroiditis or an underdeveloped thyroid gland. Treatment includes oral thyroid hormone replacement therapy.
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| Hypothyroidism | Depression and/or anxiety, increased lethargy, fatigue, headache, slowed speech, slowed mental function, impaired short-term memory
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| Hypothyroidism | Proximal muscle weakness, carpal tunnel syndrome, trigger points, myalgia, increased bone density, cold intolerance, paresthesias
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| Hypothyroidism | Dyspnea, bradycardia, CHF, respiratory muscle weakness, decreased peripheral circulation, angina, increase in blood pressure and cholesterol
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| Hypothyroidism | Anorexia, constipation, weight gain, decreased absorption of food and glucose
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| Hypothyroidism | Infertility, irregular menstrual cycle, increased menstrual bleeding
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| Hyperthyroidism | This condition occurs when there are excessive levels of thyroid hormones in the bloodstream.
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| Symptoms Hyperthyroidism can include | an increase in nervousness, excessive sweating, weight loss, decrease in blood pressure, bulging eyes, myopathy, chronic periarthritis, and an enlarged thyroid gland.
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| Treatment Hyperthyroidism may include | pharmacological intervention, radioactive iodine, and surgery.
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| Hyperthyroidism | Tremors, hyperkinesis, nervousness, increased DTRs, emotional lability, insomnia, weakness, atrophy, fatigue
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| Hyperthyroidism | Chronic periarthritis, heat intolerance, flushed skin hyperpigmentation, increased hair loss
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| Hyperthyroidism | Tachycardia, palpitations, increased respiratory rate, decrease in blood pressure, arrhythmias
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| Hyperthyroidism | Hypermetabolism, increased appetite, increased peristalsis, nausea, vomiting, diarrhea, dysphagia
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| Hyperthyroidism | Polyuria, infertility, increased first trimester miscarriage, amenorrhea
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| Rehabilitation Considerations for Patients with Thyroid Dysfunction | Must be familiar with symptoms of excessive pharmacological treatment
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| Rehabilitation Considerations for Patients with Thyroid Dysfunction | Avoidance of treatments that exacerbate the condition
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| Rehabilitation Considerations for Patients with Thyroid Dysfunction | Avoid cardiovascular stress to eliminate secondary complications from hypotension, goiter, and Gravesʼ disease
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| Rehabilitation Considerations for Patients with Thyroid Dysfunction | Avoid exercise in a hot aquatic or gym setting due to heat intolerance (Gravesʼ disease)
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| Rehabilitation Considerations for Patients with Thyroid Dysfunction | Close monitoring of vital signs
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| Rehabilitation Considerations for Patients with Thyroid Dysfunction | Effects of radioiodine therapy
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| Rehabilitation Considerations for Patients with Thyroid Dysfunction | Recognize reduced exercise capacity and fatigue
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| Rehabilitation Considerations for Patients with Thyroid Dysfunction | Risk of rhabdomyolysis (hypothyroidism)
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