AtoZ Diseases

What is this Condition?

Hypogonadism results from decreased androgen production in men. which may impair sperm production and cause infertility, and inhibit the development of normal secondary sex characteristics. The symptoms of androgen deficiency depend on the person’s age at onset.

What Causes it?

Primary (hypergonadotropic) hypogonadism results from damage to testicular structures, specifically the Leydig cells, which secrete testosterone, and the seminiferous tubules, which produce sperm. The pituitary gland responds to this damage by secreting more gonadotropins to try to maintain sperm production. Primary hypogonadism occur, in persons with Klinefelter’s syndrome, Reifenstein’s syndrome, Turner’s syndrome, and Sertoli-cell-only syndrome.

Secondary (hypogonadotropic) hypogonadism results from impairment of a complex hormonal regulatory mechanism between the pituitary gland and hypothalamus that reduces gonadotropin secretion. Secondary hypogonadism occurs in persons with hypopituitarism isolated follicle-stimulating hormone deficiency, isolated luteinizing hormone deficiency, Kallmann’s syndrome, and Prader-Willi syndrome.

Depending on the person’s age at onset, hypogonadism may cause eunuchism (complete gonadal failure) or eunuchoidism (partial failure).

What are its Symptoms?

Symptoms vary with the specific cause of hypogonadism. In a chile some characteristic findings include delayed closure of the epiphyses (ends of long bones) and immature bone age; delayed puberty; infantile penis and small, soft testicles; below-average muscle development and strength; fine, sparse facial hair; scant or absent underarm, pubic and body hair; and a high-pitched, effeminate voice. In an adult hypogonadism diminishes the sex drive and potency and causes regression of secondary sex characteristics.

How is it Diagnosed?

An accurate diagnosis requires a detailed history, a physical exam, and hormonal studies. Chromosomal analysis may determine the specific cause. Testicular biopsy and semen analysis determine sperm production, identifY impaired sperm formation, and assess low levels of testosterone.

How is it Treated?

Treatment depends on the underlying cause and may consist of hormone replacement, especially with testosterone, methyltestosterone, or human chorionic gonadotropin for primary hypogonadism and with human chorionic gonadotropin alone for secondary hypogonadism. Fertility cannot be restored after permanent testicular damage. However, eunuchism resulting from pituitary-hypothalamic dysfunction can be corrected when administration of gonadotropins stimulates normal testicular function.

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What do Doctors call this Condition - Dermatophytosis

What is this Condition?

Tinea is a fungal infection that may affect the scalp (tinea capitis), body (tinea corporis), nails (tinea unguium), feet (tinea pedis), groin (tinea cruris), and bearded skin (tinea barbae). Tinea infections are common in the United States. With effective treatment, the cure rate is very high, although about 20% of infected people develop chronic tinea.

What Causes it?

Tinea infections are caused by the fungi Trichophyton, Microsporum, and Epidermophyton. Transmission can occur directly through contact with infected lesions or indirectly through contact with contaminated articles, such as shoes, towels, or shower stalls.

What are its Symptoms?

Lesions vary in appearance and duration.

Tinea of the Scalp

This type of fungal infection mainly affects children and is characterized by small, spreading papules on the scalp, causing patchy hair loss with scaling. These papules may progress to inflamed, pus-filled lesions.

Tinea of the Body

This tinea infection produces flat lesions on the skin at any site except the scalp, bearded skin, or feet. These lesions may be dry and scaly or moist and crusty; as they enlarge, their centers heal, producing the classic ring-shaped appearance that gives this infection the common name ringworm

Tinea of the Nails

Infection typically starts at the tip of one or more toenails (fingernail infection is less common) and produces gradual thickening, discoloration, and crumbling of the nail, with buildup of debris under it. Eventually, the nail may be destroyed completely.

Tinea of the Feet

This tinea infection, commonly known as athlete’s foot, causes scaling and blisters between the toes. Severe infection may lead to inflammation, with severe itching and pain on walking. A dry, scaly inflammation may affect the entire sole.

Tinea of the Groin

Commonly known as jock itch, this infection produces red, raised. sharply defined, itchy lesions in the groin that may extend to the buttocks, inner thighs, and external genitalia. Warm weather and tight clothing encourage fungus growth.

Tinea of Bearded Skin

This uncommon infection affects the bearded area of the face in men.

How is it Diagnosed?

To confirm tinea infection, scrapings from lesions are examined under a microscope. Other diagnostic procedures include Wood’s light examination (which is useful in only about 5% of cases of tinea of the scalp) and culture of the infecting organism.

How is it Treated?

Tinea infections usually respond to topical agents, such as ketoconazole cream. Other antifungals used to treat tinea include Naftin, Loprox, Lamisil, Halotex, and Tinactin. Topical treatments should continue for 2 weeks after lesions resolve. Alternatively, the doctor may prescribe the oral drug Fulvicin, which is especially effective in tinea infections of the skin, hair, and nails.

Supportive measures include applying open wet dressings, removing scabs and scales, and applying drugs known askeratolytics to soften and remove lesions of the heels or soles.

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What is this Condition?

A nosebleed may be a primary disorder or may result from another condition. In children, bleeding generally originates in the anterior nasal septum and tends to be mild. In adults, it s most likely to originate in the posterior septum and can be severe. Nosebleeds are twice as common in children as in adults.

What Causes it?

A nosebleed usually occurs after an injury, such as a blow to the nose. nose picking, or insertion of a foreign body into the nose. Less commonly, it occurs as a complication of nasal polyps or acute or chronic infections, such as sinusitis or rhinitis, which cause congestion and eventual bleeding of the capillary blood vessels. It may also result from inhalation of chemicals that irritate the nasal mucosa.

Factors that predispose a person to nosebleeds include use of blood­thinning drugs (called anticoagulants), high blood pressure, chronic aspirin use, high altitudes and dry climates, sclerotic vessel disease. Hodgkin’s disease, certain cancers, scurvy, vitamin K deficiency, rheumatic fever, blood disorders (hemophilia, purpura, leukemia, and anemias), and a bleeding disorder called hemorrhagic telangiectasia.

What are its Symptoms?

Blood oozing from the nostrils usually originates in the anterior nose and is bright red. Blood from the back of the throat originates in the posterior area and may be dark or bright red (and is often mistaken for hemoptysis, expectorated blood that is usually a sign of a respiratory disease). A nosebleed generally occurs only in one nostril, except when it’s caused by a blood disorder or severe injury. In a severe nosebleed, blood may seep behind the nasal septum and may appear in the middle ear and in the corners of the eyes.

Associated symptoms depend on the severity of bleeding. Moderate blood loss may cause light-headedness, dizziness, and slight respiratory difficulty. Severe bleeding causes low blood pressure, rapid and bounding pulse, difficulty breathing, and pallor. Bleeding is considered severe if it lasts longer than 10 minutes after pressure is applied and may cause blood loss as great as 1 liter per hour in adults.

How is it Diagnosed?

Although simple observation confirms a nosebleed, inspection with a bright light and nasal speculum is necessary to locate the site of bleeding. The doctor may also order blood tests to evaluate blood count and clotting ability.

When making a diagnosis, the doctor must check for an underlying disorder that may cause nosebleed, especially disseminated intra­vascular coagulation (a condition marked by bleeding at multiple sites within the body) and rheumatic fever. Bruises or concomitant bleeding elsewhere probably indicates a blood disorder.

How is it Treated?

For anterior bleeding, the doctor will recommend applying a cotton ball saturated with epinephrine to the bleeding site and applying external pressure to the nose. The doctor may then cauterize the bleeding site with electrocautery or silver nitrate stick. If these measures don’t control the bleeding, petrolatum gauze nasal packing may be inserted.

For posterior bleeding, the doctor will insert gauze packing through the nose or postnasal packing through the mouth, depending on the bleeding site. (Gauze packing generally remains in place for 24 to 48 hours; postnasal packing, for 3 to 5 days.) An alternative method, the nasal balloon catheter, also controls bleeding effectively. The doctor may also prescribe antibiotics if packing must remain in place for longer than 24 hours.

If local measures fail to control bleeding, additional treatment may include supplemental vitamin K. A person with severe bleeding may require blood transfusions and surgery to close off a bleeding artery.

What can a Person with Nosebleeds do?

• To control a nosebleed, sit upright. Then press the soft portion of. the nostrils against the septum continuously for 5 to 10 minutes. Apply an ice collar or cold, wet compresses to the nose. If bleeding continues after 10 minutes of pressure, notify the doctor. Breathe through your mouth. Don’t swallow blood, talk, or blow your nose.

• Know that a nosebleed usually looks worse than it is.

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What is this Condition?

An infection of the lower genitourinary tract, trichomoniasis affects about 15% of sexually active women and 10% of sexually active men. It occurs worldwide. In women, the condition may be acute or chronic. Recurrence is minimized when sexual partners are treated as well.

What Causes it?

The infecting organism, Trichomonas vaginalis, causes the disease in women by infecting the vagina, the urethra, and, possibly, the endocervix, Bartholin’s glands, Skene’s glands, or the bladder. In men, it infects the lower urethra and, possibly, the prostate gland, seminal vesicles, or epididymis.

Use of oral contraceptives, pregnancy, bacterial overgrowth, cervical or vaginal lesions, or frequent douching may predispose a woman to trichomoniasis.

Trichomoniasis is usually transmitted by sexual intercourse; less often, by contaminated douche equipment or moist washcloths.

What are its Symptoms?

Approximately 70% of women - including those with chronic infections - and most men with trichomoniasis have no symptoms. In women, acute infection may produce various signs, such as a gray or greenish yellow, possibly frothy vaginal discharge with an unpleasant odor. Other effects include severe itching, redness, swelling, tenderness, painful intercourse, painful urination, urinary frequency and, occasionally, postcoital spotting, excessive menstrual bleeding, or painful menstruation.

Such symptoms may persist for a week to several months and may be more pronounced just after menstruation or during pregnancy. If trichomoniasis is untreated, symptoms may subside but the infection persists.

In men, trichomoniasis may produce mild to severe transient urethritis, possibly with painful urination and urinary frequency.

How is it Diagnosed?

Direct microscopic examination of vaginal or seminal discharge and examination of clear urine specimens may reveal the infecting organism. A physical exam of the vagina and cervix may reveal signs of illness.

How is it Treated?

The treatment of choice for trichomoniasis is oral Flagyl to both sexual partners. Oral Flagyl may not be safe during the first trimester of pregnancy. Sitz baths may be used to help relieve symptoms.

After treatment, both sexual partners must have a follow-up exam to check for residual signs of infection.

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What is this Condition?

Cardiovascular disease ranks fourth (after infection, toxemia, and hemorrhage) among the leading causes of maternal death. The physiologic stress of pregnancy and delivery is often more than a compromised heart can tolerate and often leads to death of the mother and child.

Approximately 1 % to 2% of pregnant women have heart disease, but the incidence is rising because current medical treatment allows more women with rheumatic heart disease or congenital defects to reach childbearing age. With careful management, the prognosis for pregnant women with cardiovascular disease is good. Decompensation (the heart’s failure to maintain adequate circulation) is the leading cause of maternal death. Infant mortality increases with decompensation, because uterine congestion, insufficient oxygenation, and the elevated carbon dioxide content of the blood not only endanger the fetus, but also frequently cause premature labor and delivery.

What causes it?

More than 80% of pregnant women who develop cardiovascular complications have a history of rheumatic heart disease. In the rest, these complications stem from congenital defects (10% to 15%) or coronary artery disease (2%).

The diseased heart is sometimes unable to meet the normal increased demands of pregnancy, which include a 25% increase in cardiac output (the amount of blood pumped by the heart per minute), a 40% to 50% increase in plasma volume, increased oxygen requirements, retention of salt and water, weight gain, and alterations in hemodynamics during delivery. This physiologic stress often leads to decompensation. The degree of decompensation depends on the woman’s age, the duration of heart disease, and the functional capacity of her heart at the outset of pregnancy.

What are its Symptoms?

The woman with cardiovascular disease during pregnancy will have distended neck veins, diastolic murmurs, moist crackles heard at the base of the lungs, an enlarged heart, and irregular heartbeats. Other typical symptoms may include bluish skin discoloration, pericardial friction rub, and pulse irregularities.

Decompensation may develop suddenly or gradually. As it progresses, the woman may experience swelling, increasing shortness of breath on exertion, palpitations, a smothering sensation, and coughing up blood.

How is it Diagnosed?

Exam findings, including unusual heart sounds, irregular heartbeats, and an enlarged heart, suggest cardiovascular disease. To determine the extent and cause of the disease, an electrocardiogram, echocardiogram, or phonocardiogram may be performed. X-rays show heart enlargement and congestion in the lungs. Cardiac catheterization should be postponed until after delivery, unless surgery is necessary.

How is it Treated?

The goal of therapy is to prevent complications and minimize the strain on the mother’s heart, primarily through rest. This may require periodic hospitalization for women with moderate heart dysfunction or with symptoms of decompensation, toxemia, or infection. Older women or those with previous episodes of decompensation may require hospitalization and bed rest throughout the pregnancy.

Drug therapy, when necessary, will use the safest possible drugs in the lowest possible dosages to minimize harm to the fetus. Diuretics and drugs that increase blood pressure, blood volume, or cardiac output should be used with extreme caution. If an anticoagulant is needed, heparin is the drug of choice. Digoxin (also known as Lanoxin) and common antiarrhythmics, such as Cardioquin and Procan SR, are often required. The preventive use of antibiotics is reserved for women who are susceptible to endocarditis.

A therapeutic abortion may be considered for women with severe heart dysfunction, especially if decompensation occurs during the first trimester. Women hospitalized with heart failure usually follow a regimen of digoxin, oxygen, rest, sedation, diuretics, and restricted intake of sodium and fluids. If these measures fail to improve symptoms, heart surgery may be necessary. During labor, the woman may require oxygen and an analgesic for relief of pain and apprehension without adversely affecting the fetus or herself. Depending on which procedure would be less stressful for the woman’s heart, delivery may be vaginal or by cesarean section.

Bed rest and medications already instituted should continue for at least 1 week after delivery because of a high incidence of decompensation, cardiovascular collapse, and maternal death during the early puerperal period.

Breast-feeding is undesirable for women with severe cardiovascular disease because it increases fluid and metabolic demands on the heart.

What can a Pregnant Woman with Cardiovascular Disease do?

Get plenty of rest and control your weight to decrease the strain on your heart. To prevent vascular congestion, limit your fluid and sodium intake. Take supplementary folic acid and iron to prevent anemia.

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What do Doctors call this Condition - Coal worker’s pneumoconiosis, coal miner’s disease, miner’s asthma, anthracosis, anthracosilicosis

What is this Condition?

A progressive lung disease, black lung occurs in two forms. Simple black lung is characterized by small opaque areas in the lung. In complicated black lung, also known as progressive massive fibrosis, masses of fibrous tissue occasionally develop in the lungs.

The risk of developing black lung depends on the duration of exposure to coal dust (usually 15 years or longer), the intensity of exposure (dust count, particle size), the location of the mine, the silica content of the coal (anthracite coal has the highest silica content), and the worker’s susceptibility. Incidence of black lung is highest among anthracite coal miners in the eastern United States.

The prognosis varies. Simple asymptomatic disease is self-limiting, although progression to complicated black lung is more likely if black lung begins after a relatively short period of exposure. Complicated black lung may be disabling, resulting in severe respiratory and heart failure .

What Causes it?

Black lung is caused by the inhalation and prolonged retention of coal dust particles. Simple black lung may cause focal emphysema (permanent dilation of small airways). Simple disease may progress to complicated black lung, involving one or both lungs. In this form of the disease, fibrous tissue masses enlarge and coalesce, causing gross destruction of structures in the lungs.

What are its Symptoms?

Simple black lung causes no symptoms, especially in nonsmokers. Symptoms appear if complicated black lung develops and include shortness of breath on exertion and a cough that occasionally produces inky-black sputum. Other features of black lung include increasing shortness of breath and a cough that produces milky, gray, clear, or coal-flecked sputum. Recurrent lung infections produce yellow, green, or thick sputum.

Complications include pulmonary hypertension, an enlarged heart, and tuberculosis. In cigarette smokers, chronic bronchitis and emphysema may also complicate the disease.

How is it Diagnosed?

The person’s history reveals exposure to coal dust. A physical exam shows a barrel chest, hyperresonant lungs with diminished breath sounds, wheezes, and other abnormal lung sounds. In simple black lung, chest X-rays show small opacities, which may be present in all lung zones but are more prominent in the upper lung zones; in complicated black lung, one or more large opaque areas are seen.

Pulmonary function studies help to evaluate the person’s breathing capacity. In addition, arterial blood gas studies provide information about the amount of oxygen and carbon dioxide in the blood.

How is it Treated?

The goal of treatment is to relieve respiratory symptoms, to manage oxygen deficiency, and to avoid respiratory tract irritants and infections. Treatment also includes careful observation for tuberculosis symptoms.

Respiratory symptoms may be relieved through therapy with drugs that widen the breathing passages (such as Theo-Dur or Aminophyllin), steroids (oral Orasone or an aerosol form), or Nasalcrom aerosol. Chest physical therapy techniques, such as controlled coughing, combined with chest percussion and vibration, help remove secretions.

Other measures include increased fluid intake (at least 3 quarts [liters] every day) and respiratory therapy techniques. In severe cases, it may be necessary to administer oxygen by mask if the person has chronic oxygen deprivation, or by mechanical ventilation. Respiratory infections require antibiotics.

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What is this Condition?

Genital herpes is a viral infection that causes acute inflammation of the genitalia. The first episode usually is self-limiting but may cause painful genital symptoms or even disease of the body as a whole. After the initial episode, the virus remains dormant in the body, causing recurrent outbreaks. These recurrences, which tend to be milder, may be triggered by stress, illness, and overexposure to sunlight.

What Causes it?

The usual cause of genital herpes is infection with herpes simplex virus type 2. Typically, the disease spreads through sexual intercourse, oral ­genital sexual activity, kissing, and hand-to-body contact. Pregnant women may pass the infection to their newborns during vaginal delivery.

What are its Symptoms?

About 3 to 7 days after a person is infected with herpes simplex virus. fluid-filled blisters appear, usually on the cervix and possibly on the labia, skin around the rectum, external genitalia, or vagina of the woman and on the penis or foreskin of the man. Blisters may also appear on the mouth or anus. Usually painless at first, the blisters soon erupt into painful ulcers with yellow oozing centers. Often, the lymph glands located along the top of the thigh become tender.

During the initial infection, the person may also have fever, a general ill feeling, painful urination and, in women, a white vaginal discharge.

How is it Diagnosed?

The doctor diagnoses genital herpes by examining the person and taking a history. Lab tests may show characteristic antibody and cell findings. The diagnosis is confirmed if the virus appears in fluid from blisters, or is implicated in tests that identifY specific antigens.

How is it Treated?

The drug Zovirax is effective against genital herpes. The doctor will prescribe oral Zovirax for people with first-time infections or frequent recurrences. Some people take it daily for prevention; used daily, it reduces the frequency of recurrences by at least 50%. People hospitalized with severe genital herpes and those with weak immune systems who have potentially life-threatening herpes infection may receive intravenous Zovirax.

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