Differential diagnosis- Hematological and Endocrine disorders

Question	Answer
Define Hemochromatosis	An autosomal recessive hereditary disorder characterized by excessive iron absorption by small intestine
Define Anemia	An abnormality of quality or quantity of blood
Define Sickle-cell Disease	Refers to a group of inherited, autosomal recessive disorders in which RBCs are crescent/sickle shaped instead of biconcave
Define Hemophilia	A bleeding disorder inherited as sex-linked autosomal recessive trait, abnormality of plasma clotting proteins
Define Thrombocytopenia	An increase in number of circulating platelets, caused by inadequate platelet production from bone marrow & spleen
An increase in INTRAvascular fluid will lead to...	CHF, increased pulse, & increased respiration
A decrease in INTRAvascular fluid will lead to...	Decreased BP, increased pulse & increased respiration
An increase in EXTRAvascular fluid will lead to...	Edema, Ascites, Pleural Effusion
A decrease in EXTRAvascular fluid will lead to...	Decreased skin turgor & fatigue
Define Upper Urinary Tract Infection	An infection of the urinary tract located at kidney & ureters
Define Lower Urinary Tract	An infection of urinary tract located at bladder & urethra
Define Functional Incontinence	Person has normal urine control but is unwilling or has difficulty reaching toilet in time bc of muscle/joint dysfuntion or environmental barriers
Define Stress Incontinence	Loss of urine due to activities that increase intraabdominal pressure such as coughing, lifting, or laughing
Define Urge Incontinence	The sudden unexpected urge to urinate & the uncontrolled loss of urine; often related to reduced bladder capacity, detrusor instability, or hypersensitive bladder
Define Overflow Incontinence	The constant leaking of urine from a bladder that is full but unable to empty
List Reasons for Overflow Incontinence	Anatomic obstruction (ie-prostate enlargement) Neurogenic bladder (ie-SCI)
Define Interstitial Cystitis	Complex, chronic disorder characterized by inflamed or irritated bladder wall
Define Pyelonephritis	an infectious, inflammatory disease involving the kidney parenchyma and renal pelvis
Define Dialysis Dysequilibrium	Result of drastic changes at beginning of dialysis; S&S include nausea, vomiting, drowsiness, HA, & seizures
Define Dialysis Dementia	Result of chronic tx; S&S include cerebral dysfunction, speech difficulties, mental confusion, seizures & occasionally death
PT Role in Management of pt receiving Dialysis...	Record vitals while pt exercising Do NOT take BP at shunt site Avoid trauma to peritoneal catheters
Define Type I Diabetes	Decrease in size & number of Islet cells of pancreas resulting in inadequate production of insulin
Define Type II Diabetes	Characterized by a gradual increase in peripheral insulin resistance with an insulin-secretory defect that varies in severity
In which type of Diabetes are pts considered Insulin Dependent?	Type I Diabetes
Which type of Diabetes are pt's at risk for if they are obese adults?	Type II Diabetes
Signs of Hyperglycemia	CNS changes: irritability, HA, blurred vision, slurred speech, difficulty concentrating, confusion, incoordination Sympathetic: diaphoresis, pallor, piloerection, tachycardia, shakiness, hunger
List Classic Signs & Symptoms of DM	Hyperglycemia, Glycosuria, Polyuria, Polydipsia, Polyphagia & wt loss, fatigue
Clinical signs & symptoms of Hyperglycemia	CNS changes; confusion, diminished reflexes, paresthia,Fruity odor to breath, weakness, complaint of thirst, rapid weak pulse, rapid deep inspirations
What is the leading cause of blindness in ages 20-74?	Diabetes
What is the leading cause of non-traumatic LE amputation and End-stage Renal disease?	Diabetes
A pt with DM should NOT exercise when...	Blood glucose levels are high (at or near 250mg/dL) OR Urine test is positive for ketones
What is considered the most common pathological hormone deficiency?	Hypothyroidism
Define Cretinism	Congenital Hypothyroidism
Symptoms of Hyperthyroidism	Nervousness, Hyperreflexia, wt loss, hunger, heat intolerance, palpitations, bounding pulse, tachycardia, diarrhea, increase metabolic processes, possible exercise intolerance
Symptoms of Hypothyroidism	Wt gain, increased appetite, lethargy & fatigue, Low BP, cold intolerance, dry skin & hair, goiter, possible exercise intolerance/exercise induced myalgia, reduced CO
Define Acromegaly	Result of increased & unregulated growth hormone (GH) production, usually cause by GH-secreting pituitary tumor
Signs & Symptoms of Acromegaly	Acral growth;enlargement of facial bone structure, enlarged hands & feet; visceral outgrowth macroglossia, enlarged heart mm, thyroid, liver, kidney; insulin antagonism, nitrogen retention, increased risk colon polyps/tumor
Adrenal Hypofunction is also referred to as...	Addson's Disease
Excessive production of Androgens is also known as...	Adrenal Virilism
Excessive secretion of Glucocorticosteroids is also known as...	Cushing's Syndrome
Excessive Aldosterone production is known as...	Hyperaldosteronism
Define Adrenal Crisis	Medical Emergency: characterized by profound asthenia, severe pains in abdomen, lower back, legs, peripheral vascular compromise & eventual renal shutdown
Signs & Symptoms of Adrenal Virilism	Hirsutism, baldness, acne, deepening of voice, amenorrhea, atrophy of uterus, clitoral hypertrophy, decreased breast size increased muscularity (occurs in men & women)
Signs & Symptoms of Cushing's Syndrome	"moon face" & "buffalo hump", muscle wasting & weakness, truncal obesity, HTN, thin/atrophic skin with poor wound healing, osteoporosis, glucose intolerance, psychiatric disturbances
List common clinical causes for fluid & electrolyte imbalances	Burns, surgery, DM, malignancy, acute alcoholism, socioeconomic status, dehydration, edema, fatigue, BP changes, CHF
PT role in Complex Disorders (CRPS, Fibromyalgia etc.)	Increase function, improve sleep thru relaxation techniques, energy conservation, ergonomic education, decrease pain & fatigue, soft-tissue & joints mobs, carefully controlled, graded exercises, lifestyle modifications esp to reduce stress