- •Ministry of Public Health of Ukraine
- •Basic Symptoms and Syndromes in Diseases of Cardiovascular System.
- •Syndrome of cardiovascular failure
- •Etiology
- •Classification of heart failure
- •Classification of heart failure according n.D. Strazhesko and V.H. Vasilenko
- •Classification of heart failure according to New York Heart Association New York Heart Association Functional Classification (nyha)
- •Clinical features
- •Additional methods of examination
- •Acute heart failure Acute left ventricular failure
- •Cardiac asthma
- •Pulmonary edema
- •Additional methods of examination
- •Acute left atrial heart failure
- •Acute right ventricular heart failure
- •Etiology
- •Clinical features
- •Additional methods of examination
- •Chronic heart failure Chronic left ventricular heart failure
- •Etiology
- •Clinical features
- •Additional methods of examination
- •Chronic left atrial heart failure
- •Chronic right ventricular heart failure Etiology
- •Clinical features
- •Additional methods of examination
- •Syndrome of vascular failure
- •Syndrome of a syncope
- •Clinical features
- •Syndrome of collapse
- •Etiology
- •Clinical features
- •Syndrome of shock
- •Classification according to etiology
- •Clinical features
- •Additional methods of examination
- •Literature
- •Acute rheumatic fever
- •Etiology
- •Pathogenesis
- •Classification
- •The Jones Criteria for Rheumatic Fever, Updated 1992
- •Clinical features
- •Additional methods of examination
- •Literature
- •Contents heart valvular diseases
- •Mitral regurgitation
- •Etiology
- •Disorders of hemodynamics
- •Clinical features
- •Additional methods of examination
- •Mitral stenosis
- •Etiology
- •Disorders of hemodynamics
- •Clinical features
- •Additional methods of examination
- •Literature
- •Contents aortic stenosis
- •Etiology:
- •Disorders of hemodynamics
- •Clinical features
- •Additional methods of examination
- •Aortic regurgitation
- •Etiology
- •Disorders of hemodynamics
- •Clinical features
- •Additional methods of examination
- •Literature
- •Syndrome of the arterial hypertension
- •2. Endocrine hypertension:
- •3. Hemodynamic hypertension:
- •4. Neurogenic hypertension:
- •Clinical features
- •Essential hypertension
- •Etiology
- •Clinical features
- •Additional methods of examination
- •Literature
- •Ischemic heart disease
- •Etiology and pathogenesis
- •Classification of ischemic heart disease (ihd)
- •Stable angina
- •Clinical features
- •Canadian Cardiovascular Society classification of stable angina
- •Additional methods of examination
- •Acute coronary syndrome
- •Clinical features
- •Additional methods of examination
- •Unstable angina
- •Braunwald classification system for unstable angina (ua)
- •Intensity of treatment
- •Myocardial infarction
- •Clinical features
- •Additional methods of examination
- •Optimal time for estimation of myocardial markers of necrosis
- •Dynamic of laboratory markers of myocardial infarction
- •Sudden cardiac death
- •Clinical features
- •Literature
- •Chronic obstructive pulmonary disease (copd)
- •Classification of Chronic Obstructive Pulmonary Disease by Severity
- •Clinical features
- •Additional methods of examination
- •Chronic bronchitis Chronic bronchitis is chronic inflammation of the bronchi and bronchioles. Etiology
- •Pathogenesis. On chronic bronchitis occurs development of classic pathogenetic triad:
- •Clinical features
- •Additional methods of examination
- •Bronchial asthma
- •Etiology
- •Classification
- •Clinical features
- •Additional methods of examination
- •Syndrome of bronchium obstruction (bronchospastic syndrome)
- •Additional methods of examination
- •Syndrome of increased airiness of the pulmonary tissue
- •Additional methods of examination
- •Bronchiectasis
- •Etiology
- •Pathogenesis
- •Clinical features
- •Additional methods of examination
- •Literature
- •Pneumonia
- •Classification
- •Acute lobar pneumonia
- •Additional methods of examination
- •Bronchopneumonia (focal pneumonia)
- •Clinical features
- •Tumors of the lungs
- •Clinical features
- •Literature
- •Pleurisy
- •Dry pleurisy
- •Etiology
- •Pathogenesis
- •Clinical features
- •Additional methods of examination
- •Pleurisy with effusion
- •Etiology
- •Pathogenesis
- •Clinical features
- •Additional methods of examination
- •Syndrome of fluide accumulation in the pleural cavity
- •The main causes of pleural fluid accumulation
- •Classification
- •Clinical features
- •Additional methods of examination
- •Syndrome of air accumulation in the pleural cavity
- •Clinical features
- •Additional methods of examination
- •Respiratory insufficiency
- •Literature
- •Syndrom of functional dyspepsia
- •Classification
- •Clinical features
- •Chronic gastritis
- •Etiology
- •Classification
- •Clinical features
- •Additional methods of examination
- •Peptic ulcer disease (Gastric and Duodenal Ulcer)
- •Etiology
- •Pathogenesis
- •Cinical features
- •Additional methods of examination
- •Complications
- •Irritable bowel syndrome
- •Clinical features
- •Literature
- •Syndrome of bile ducts dyskinesia (dysfunctional bile tract disorders)
- •Classification
- •Clinical features
- •Additional methods of examination
- •Chronic cholecystitis
- •Clinical features
- •Additional methods of examination
- •Cholangitis
- •Etiology
- •Pathogenesis
- •Classification
- •Clinical features
- •Additional methods of examination
- •Jaundice
- •Etiology
- •Pathogenesis
- •Additional methods of examination
- •Literature
- •Classification
- •II. Classification by grade or by stage:
- •Pathological anatomy
- •Clinical features
- •Additional methods of examination
- •Etiology
- •Clinical features
- •Additional methods of examination
- •Syndrome of portal hypertension
- •Classification
- •Hepatic insufficiency
- •Literature
- •Glomerulonephritis
- •Classification
- •Etiology
- •Acute glomerulonephritis
- •Clinical features
- •Additional methods of examination
- •Chronic glomerulonephritis (nephritic form)
- •Clinical features
- •Additional methods of examination
- •Chronic glomerulonephritis (hypertensive form)
- •Clinical features
- •Additional methods of examination
- •Chronic glomerulonephritis (mixed form).
- •Clinical features
- •Additional methods of examination
- •Chronic glomerulonephritis (latent form)
- •Clinical features
- •Additional methods of examination
- •Pyelonephritis
- •Pathogenesis
- •Infectious agents may be transmitted by contact, hematogenous or lymphatic ways in obligatory presence of urodynamic abnormalities. Acute pyelonephritis
- •Clinical features
- •Additional methods of examination
- •Chronic pyelonephritis
- •Clinical features
- •Additional methods of examination
- •Syndrom of chronic renal failure
- •Etiology
- •Pathogenesis
- •Classification of chronic renal diseases (nkf, usa)
- •Clinical features
- •Additional methods of examination
- •Literature
- •Syndrome of anemia
- •Classification
- •Iron deficiency anemia
- •Etiology
- •Vitamin b12 deficiency anemia
- •Hemolytic anemia
- •Classification of hemolytic anemias
- •Additional methods of examination
- •Complete Blood Count (cbc)
- •Normal wbc count
- •Complete Blood Count (cbc)
- •Literature
- •The main methods of laboratory diagnostics of hemorrhagic syndromes
- •Tests for plasma factors involved in coagulation and fibrinolisis
- •Hemorrhagic syndrome
- •Etiology
- •Pathogenesis
- •Clinical feature
- •Additional methods of examination
- •Hemophilia b (Christinas' disease)
- •Clinical feature
- •Additional methods of examination
- •Additional methods of examination
- •Literature
- •Eucosis (Hemoblastosis)
- •Classification of hemoblastosis
- •Acute myeloblastic leukemia
- •Etiology
- •Pathogenesis
- •Clinical features
- •Additional methods of examination
- •Chronic myelocytic leukemia
- •Etiology
- •Pathogenesis
- •Clinical features
- •Additional methods of examination
- •Chronic lymphocytic leukemia
- •Etiology
- •Pathogenesis
- •Clinical features
- •Additional methods of examination
- •Literature
- •Diabetes mellitus
- •Etiological classification of glycemia disorders
- •Classification according to clinical feature
- •Etiology and pathogenesis of insulin dependent diabetes mellitus
- •Etiology and pathogenesis of insulin nondependent diabetes mellitus
- •Clinical features
- •Comparative clinical features of iddm and niddm
- •Hypoglycemia
- •Clinical features
- •Diabetic ketoacidosis
- •Clinical feature
- •Objective examination
- •Additional methods of examination
- •Hyperosmolar non-ketotic coma
- •Clinical features
- •Additional methods of examination
- •Additional methods of examination dm
- •Hyperthyridism
- •Etiology
- •Pathogenesis
- •Clinical feature
- •Additional methods of examination
- •Hypothyroidism
- •Etiology
- •Pathogenesis
- •Clinical features
- •Additional methods of examination
- •Literature
- •Contens
Diabetes mellitus
Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbances of carbohydrate, fat, metabolism resulting from defects of insulin secretion, insulin action, or a combination of both. There are two types of diabetes mellitus: insulin dependent diabetes mellitus (IDDM) called type I diabetes and non-insulin dependent diabetes mellitus (INDDM) called type 2 diabetes.
Etiological classification of glycemia disorders
Type 1 (β-cell destruction, usually leading to absolute insulin deficiency)
Autoimmune
Idiopatic
Type 2 (may range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with or without insulin resistance)
Other specific type
- Genetic defects of β-cell function;
- Genetic defect in insulin action;
- Diseases of the exocrine pancreas: pancreatitis, trauma/pancreatectomy, neoplasia, cystic fibrosis.
Endocrinophaties: Cushing's syndrome, acromegaly, phaeochromocytoma, hyperthyroidism
Drug or chemical-induced: cortisone, anti-depressant drugs, beta-blockers, thiazide, infections: cytomegalovirus.
Uncommon forms of immune-mediated diabetes.
Other genetic syndromes sometimes associated with diabetes: Down's syndrome, Friederich's ataxia, Klinefelter`s syndrome, Wolfram's syndrome.
Gestational diabetes.
Classification according to clinical feature
Severity of diabetes:
- mild (I degree), - moderate (II degree),
severe (III degree).
Compensation state:
compensated,
subcompensated,
decompensated.
Complications:
- ketoacidotic coma, hyperosmolar coma, lactacidotic coma, hypoglycemic coma;
microangiopathy - retinopary, nephropaty;
macroangiopathy,
neuropathy.
The type I diabetes, it is due to a lack of endogenous pancreatic insulin production, whereas in type 2 diabetes, the rising blood glucose results from a combination of genetic predisposition, unhealthy diet, physical inactivity, and increasing weight with a central distribution resulting in complex pathophysiological processes.
Etiology and pathogenesis of insulin dependent diabetes mellitus
The precise cause is still unknown in both main types of diabetes, nevertheless the etiology is considered as interaction of environmental factors with a genetic susceptibility. The pattern of these factors differs in IDDM and NIDDM.
Insulin dependent diabetes mellitus has polygenic genetic predisposition. Recently the role of genetic factor has finally proved as principal reason on development diabetes mellitus. Over 50 % of the heritability is contributed by the HLA class II genes which determines immune responsiveness and located in 6 chromosome being the marker of the predisposition to the autoimmune damage pancreatic islet insulin-secreting cells, witch becomes insulin-auto-antibodies. Selective destruction of beta cells occurs. In clinical expression of the disease an important role have environmental factors. Viral infections can induce diabetes by two pathogenic mechanisms: destruction of the pancreatic beta cells by direct cytolysis result from possessing tropism to the Langergans' islet (German measles, Coxsackie B4 virus, virus of hepatitis B, epidemic parotitis and cytomegalovirus); induction of an autoimmune destructive process results from infections.
In modern diabetology the following stage of pathogenesis are offered:
The I stage is genetic predisposition, by presence of certain antigens of`HLA-system, and also genes 10 and 11 chromosomes.
The II stage is initiation of autoimmune process in beta-cells under influencing of pancreotroping viruses, cytostaties and other unknown factors.
The III stage is the stage of active immune processes with formation of antibodies to beta-cells, to insulin and by development of autoimmune insulitis.
The IV stage is progressive declining of secretion of insulin, by the stimulated glucose (I phase of secretion of insulin).
The V stage is clinical overt diabetes. This stage develops, in case of destruction and death of 85 90 % beta-cells.
The VI stage is complete destruction of beta-cells, complete absence of secretion of insulin and C-peptide.
Type I diabetes characterized by deficiency of insulin due to destructive lesions of pancreatic beta-cells; usually progresses to the stage of absolute insulin deficiency. Typically, it occurs in young subjects with acute onset with typical symptoms of diabetes together with weight loss and propensity to ketosis, but type 1 diabetes may occur at any age, sometimes with slow progression. People, who have antibodies to pancreatic beta-cells such as glutamic-acid-decarboxylase (GAD), arc likely lo develop either typical acute-onset or slow-progressive insulin-dependent diabetes. Today antibodies to pancreatic β-cells are considered as a marker of type 1 diabetes, although such antibodies are not detectable in all patients.