Urticaria – Causes, Types, Signs and Symptoms
Definition:
It is an intense itching disorder marked by formation of wheals.
Causes:
(A) General—(l) Allergy — food, drugs, parasites, inhalants etc. (2) Focal sepsis—otitis media, dental sepsis, sinusitis etc. (3) Psychogenic stress. (4) Physical agents—cold, trauma, stings, hot etc. (5) hereditary factors.
(B) Local—(1) Bites as of nettles, caterpillars, bed-bug etc.. (2) Injection of A.T.S., or penicillin etc.
(C) Idiopathic (unknown)
Types :
(1) Physical urticaria—develops after physical pressure or irritation. (2) Chronic—when urticaria persists for more than 6 weeks. (3) Solar—occurs after exposure to s n during summer months. (4) Cold—develops in association with cold wind or cold food or drinks. (5) Aquagenic— occurs in contact with water. (7) Cholinergic— after exercise, hot bathe emotional changes etc.
Psoriasis and Warts (Verruca)
Definition:
Psoriasis is a common chronic inflammatory skin disease marked by circumscribed dry erythematous scaly macules affecting chiefly the extensor surfaces of the body.
Aetiology:
The exact aetiology is not known. The Probable factors are disturbed fat metabolism, hormonal imbalance, septic 1ocus anywhere in the body, allergy, anxiety states, hereditary influences etc. It occurs in both sexes and all ages.
Clinical Features :
(1) Affects usually extensor surfaces of the body. (2) Dry, well defined erythematous macules, papules are present (3) A candle grease like scale can be repeatedly produced even from the non scaling lesion. (4) Complete removal of a scale produces pin..point bleeding. Itching may be slight or moderate. (5) The felon may develop along the scratch lines. This is called Kebner’s Phenomenon (6) the lesions may heal in the centre thus forming rings.
Prognosis:
In case of proper treatment the prognosis is favourable.
Pleural effusion – Signs, Symptoms, Diagnosis, Treatment and Investigations
Definition:
Collection of exudative serous fluid inside the pleural sac is known as Pleural Effusion.
Aetiology:
(1) Tubercular focus in the lungs or pleura.
(2) Rheumatism
(3) Lobar and bronchopneumonia
(4) Infarction of the lung.
(5) Bronchogenic carcinoma.
(6) Trauma.
(7) Viral infection Clinical Features: Onset is usually insidious.
Symptoms:
(I) History of dry pleurisy may be present.
(2) Chest pains or felt heavier.
(3) Dyspnoea.
(4) Fever, anorexia, weakness, fatigue etc. may be present.
Signs
(1) Temperature 101°F or above (2) Pulse— tachycardia (3) Distressed on exertion. (4) Hurried respiration. (5) Cyanosis may be present. (6) On examination of chest :—( a) Inspection of illness and restricted movement on the affected side. Shift of the mediastinum to the opposite side. (b) Palpation diminished expansion on the affected side; the cardiac apex is moved away from the fluid. (c) Percussion—Stony dullness over the effusion, above the fluid level a high-pitched note may be elicited. Obliteration of Traube’s space: if left sided effusion. (D) Auscultation breath sound and vocal resonance: absent or diminished. Bronchial breathing at the level of pleural effusion due to relaxed lung,
Pyelonephritis – causes, symptoms, diagnosis and treatment
Definition:
Chronic inflammation of the parenchyma and pelvis of the kidney.
Aetiology :
escherichia coil is mostly the causative organism.
Associated factors are
(l) Inadequately treated acute pylonephritis. (2) tertiary obstruction due to—(a) calculus. (b) stricture. (c) prostatic disease. (3) Statis in bladder due to-—(a) cystocele. (b) paraplegia, tabes dorsalis etc. (4) Renal tuberculosis (5) Prolonged ingestion of phenacetin.
Pathology
Pathology May be unilateral or bilateral. Macroscopically there would be scarring; of varying degree with reduction in size of kidney. Patchy fibrosis with lymphocytic infiltration, tubular atrophy, periglomerular fibrosis and disappearance of nephron are the microscopic picture.
Clinical features
(1 ) tiredness, lassitude, ill health. (2) Repeated attacks of fever with pain in lumbar region. (3) Dysuria may he present. 4) Sometimes malnutrition or uraemic symptoms may be present. (5) P/R— Prostatic obstruction and cystocele may be present. (6) In late stage, uremia may &ot in.
Polycystic kidney – causes, symptoms, treatment
Definition:
It is a hereditary disorder in which kidneys are completely cystic with intra-renal parenchyma almost completely obliterated.
Type:
The commonest type is adult polycystic kidney disease has autosomal dominant inheritance and manifests at any age, infantile polycystic disease is a rare developmental anomaly, invariably bilateral and has autosomal recessive inheritance.
Clinical Features:
(1) Bilateral renal swelling in a man with o without dragging pain in the loin ( sometimes pain in renal angles). (2) Haematuria. (3) Uraemic symptoms. (4) Slowly progressive hypertension. (5) Kidneys palpable with nodular surface. (6) When renal failure occurs, polyuria with urine of fixed specific gravity. (7) Urine: Low specific gravity with albumin and a few casts, (8) I.V.P. Attenuated and elongated (spider leg) calyces with terminal clubbing or cupping
Causes:
(1) Uraemia. (2) Cerebrovascular accident. (3) Cardiac failure.