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Type A personality traits this type of personality tends to experience more stress arrhythmia 4279 diagnosis purchase norvasc 2.5 mg amex. Over a period of years blood pressure medication edarbyclor order genuine norvasc line, the vessels become hardened (sclerotic) and lose elastic ity, a contributing factor in arteriosclerosis (arterio = artery, sclero = hardened, osis = condition of). Sclerotic (hardened) vessels are also more likely to form thrombi and to rupture, which can cause damage or death to the involved organs. Blood pressure screening is very important in di agnosing hypertension before the cardiovascular system is damaged. A random blood pressure of greater than 140/90 might be physiologic; thus, screening with frequent blood pressure readings under varied conditions is needed to confirm the diagnosis. Because the left ventricle works harder to pump blood, it is the area most often affected, leading to left ventricle hypertrophy (muscle enlargement). The vascular system, or blood supply, to the left ventricle does not increase with this enlargement of muscle, so this extra tissue does not have adequate blood supply, often leading to bouts of angina or chest pain due to ischemia. Treatment of hypertension depends on the degree of hypertension and the number of risk factors involved. If blood pressure is extremely high, antihypertensive medications might be prescribed immediately. If hypertension is discovered in a milder form, lifestyle changes or reduction of risk factors might be the initial treatment. A low-salt, low-fat diet; stress-reducing exercise; and smoking cessation might solve the problem (see Healthy Highlight feature "Prevention of Hypertension and Cardiovascular Disease"). If this treatment is ineffective or inadequate, the individual might be placed on diuretic medications. If further control is needed, other antihyper tensive medications can be prescribed. Patient compliance with hypertension treatment is often a factor in addressing this chronic disease. The Centers for Disease Control and Prevention (2015) suggests that lifestyle changes, such as those listed in the following Healthy Highlight, can aid in prevention of hypertension and cardiovascular disease. In general, men are at risk if their waist measurement is greater than 40 inches, and women are at risk if their waist measurement is greater than 35 inches. Regular physical activity-at least 30 to 60 minutes most days of the week-can lower blood pressure by 4 to 9 mm Hg often within a few weeks. Even moderate activity for 10 minutes at a time, such as walking and light strength training, can help. Eating a diet that is rich in whole grains, fruits, vegetables, and low-fat dairy products and limits saturated fat and cholesterol can lower blood pressure by up to 14 mm Hg (see Complementary and Alternative Therapy feature "Including Healthy Fat in the Diet"). Daily intake of sodium should be 1,500 to 2,300 mg per day depending on age and health. If possible, choose low-sodium alternatives of the foods and beverages you normally buy. Potato chips, frozen dinners, bacon, and processed lunch meats are high in sodium. But that protective effect is lost if too much alcohol is consumed-generally more than one drink a day for women and men older than age 65, or more than two a day for men age 65 and younger. Drinking more than a moderate amount can raise blood pressure by several points and reduce the effectiveness of high blood pressure medications. On top of all the other dangers of smoking, the nicotine in tobacco products can raise blood pressure by 10 mm Hg or more for up to an hour. Inhaling smoke from others (secondhand smoke) increases risk of health problems, including high blood pressure and heart disease. Keep all physician follow-up appointments to assure medications and activities are effective. Encouragement and support with self-care, physician visits, and exercise programs may improve chances of success. Arteriosclerosis is a group of diseases that are characterized by a loss of elasticity and a thickening of the artery wall.

The virus is shed in the feces pulse pressure with cardiac tamponade cheap norvasc 5mg mastercard, and the affected individual does not become a carrier of the disease blood pressure medication dry mouth cheap 2.5 mg norvasc amex. A vaccine is available and is recommended for those trav eling or living in a high-risk area. Another major concern is the fact that individuals can unknowingly become carriers of the virus and carry it for years or even a lifetime. Carriers are not only a threat to others, but also are at high risk for developing chronic hepatitis and cirrhosis. However, it is now known that saliva, urine, feces, and semen can spread the virus, which also qualifies it as a sexually transmitted disease. Pregnant women or nursing women need to be particularly careful about taking any dietary supplements. Source: National Center for Complementary and Integrative Health (2016) Copyright 2019 Cengage Learning. Interestingly, those who become more jaundiced are more likely to have a good recovery than those who are less jaundiced. Other symptoms include malaise, anorexia, myalgia (myo = muscle, algia = pain), fever, and abdominal pain. Dark-colored urine and clay- or light-colored stools are related to the inability of the liver to form normal bile. General treatment includes adequate rest and good nutrition, which are essential for all types. The most serious complications with hepatitis are development of chronic hepatitis and fulminant hep atitis. Chronic hepatitis develops in one out of four cases and often leads to cirrhosis of the liver. Fulmi nant hepatitis is acute liver failure that causes extensive necrosis of liver tissue. Symptoms include a high fever, hemorrhages from the skin and mucous membranes, confusion, and stupor. Prevention of hepatitis involves good hygiene and special care when handling needles and body secretions. Other activities that aid in prevention include: chronic, irreversible, degenerative disease also known as end-stage liver disease. This change in structure and function of the liver cells leads to impaired blood flow and altered function of the liver. It also can be idiopathic or the end result of other diseases such as chronic hepatitis and congestive heart failure. Symptoms usually do not appear until serious structural and functional changes in the liver tissue have occurred. If symptoms occur, they are usually mild and nonspecific and might include loss of appetite, nausea, indigestion, weakness, and weight loss. As the disease progresses, the abnormal scar tissue alters blood flow through the liver and leads to a variety of complications such as blood backing up in the hepatic portal vein. The relationship of the liver, the hepatic portal system, and the digestive system is as follows: Avoiding excessive alcohol consumption. The purpose of the hepatic portal system is to carry venous blood from the spleen and digestive Copyright 2019 Cengage Learning. For example, if an individual consumes a meal with an alcoholic beverage, these nutrients are absorbed into venous blood in the small intestine and transported to the liver to be filtered, detoxified, and stored. Nutrients are filtered, metabolized, stored, and released as needed into the systemic circulation by the liver. Complications of severe cirrhosis can If the liver is obstructed for any reason, blood will back up in t his portal system. Varicosities Portal hypertension causes varicosities (varicose veins) of the veins of the digestive system organs. Other sites of varicosities include the rectum (hemorrhoids) and anterior abdominal wall. Splenomegaly Portal hypertension also causes increased pressure on the organs that are connected to or drained by the portal system.

Such distinctions are not absolute heart attack 50 buy norvasc overnight delivery, as some diseases may be mainly organ specific in most cases but demonstrate systemic involvement in some individuals blood pressure erratic order generic norvasc online. As well, organ-specific autoimmune symptomatologies are often part of systemic autoimmune disease. It should be emphasized that almost every organ can be afflicted with autoimmune disease. Immunity Is Usually Depressed in Patients with Autoimmune Diseases People suffering from systemic autoimmune disorders have reduced immune responses to exogenous antigens. This observation is independent of immunosuppressive treatments they may be receiving. It is almost as if an immune system that is obsessed with responding to self cannot do its real job of defending against infection. The antibodies found in systemic autoimmune disease patients have all of the characteristics of mature, high-affinity immune responses. There are antibodies present against multiple epitopes on complex autoantigens, supporting the idea that the original autoantibody response was indeed antigen driven and not due to a fortuitous cross-reaction or an aberrancy in immune regulation. Autoantibodies Autoantibodies can be detected in normal individuals and may not cause disease. Other autoantibodies can transfer disease manifestations when given to experimental animals. For most autoimmune diseases, the inference that autoantibodies or autoreactive T cells are the cause of pathology is made based on the presence of autoantibodies or T cells in affected tissue, often together with complement components. Even today, there is debate about the relative importance of humoral versus cellular immunity for many autoimmune diseases. For others, it has been difficult to incriminate specific antigens, or the antigenic spectrum of certain autoimmune diseases may be highly complex. Autoantibodies Predate Disease Onset Patients with systemic lupus and rheumatoid arthritis generally have significant levels of disease-specific autoantibodies in their sera years before the disease began to manifest clinically. Thus, at least in these instances, autoimmunity precedes disease, and autoantibodies most likely play causative roles in pathogenesis. Autoantibody Specificities Are Skewed the specificities of disease-related autoantibodies are not easily predictable. Of the thousands of proteins present in the nucleus, only a few are targets of autoantibodies. There is some evidence that the degree of molecular disorder positively correlates with autoantigenicity. In the United States, it appears to be more common and severe in blacks and Hispanics, although socioeconomic factors may in part be responsible. Nearly 90% of cases are in women of childbearing age, as many as 1 in 700 of whom may have this disease. Instead, susceptibility to lupus results from the sum of small effects of multiple genes. In the past two decades, at least 17 genetic linkages have been established and independently confirmed. There are also at least 20 independent genetic effects (polymorphisms) identified and confirmed that are risk factors in lupus. Cytokines the cytokine network is also abnormal in lupus and reflects (1) the systemic inflammatory status and (2) an ongoing antigen-driven autoimmune response. Ultraviolet irradiation and viral infections are two established environmental factors. For example, a typical lupus onset is a patient presenting to the clinic with malar rash and arthritis after prolonged exposure to the sun. Both factors are thought to operate by inducing a form of proinflammatory cell death. Other factors such as cigarette smoking, heavy metals, solvents, pesticides and exogenous estrogens have been implicated, but definitive proof is lacking. The female predilection becomes less pronounced outside the reproductive age range.

For instance arteria testicularis discount 5mg norvasc amex, bone marrow biopsy is performed by boring a needle into the bone of the iliac crest of the hip to obtain tissue that is prepared and microscopically examined blood pressure ranges pediatrics buy norvasc 5 mg visa. Lymph node biopsy can be performed to determine functioning of the marrow, detect anemias, and diagnose neoplasms. Any disorders of the blood-forming organs (spleen, bone marrow, and lymph nodes) can lead to secondary disorders of this system. The individual suffering from anemia commonly is pale or has a condition of pallor. Facial paleness can be difficult to determine, but further examination of the mucous membranes of the mouth and conjunctiva of the eyes will reveal definite paleness. Anemic individuals are weak and suffer from fatigue due to poor oxygenation of muscle tissue. For simple cases, a history and physical examination along with blood tests measuring the level of hemoglobin, hematocrit, iron, folic acid, and vitamin B12 assist in diagnosis. Microscopic examination of the size a nd shape of the red cells also provides further clues to the type of anemia. More complicated anemias, or those caused by chronic disease, might need further testing, including urine analysis, stool sampling, endoscopy, colonoscopy, and bone marrow biopsy. Red cell mass is important because it directly affects the amount of hemoglobin available (oxygen-carrying potential). Too much red cell mass is called erythrocytosis, the most common type of which is a condition called polycythemia. There are more than 400 types of anemia; the three most common types are related to deficiency of iron, folic acid, and vitamin B12. For instance, if the cells are broken down (hemolyzed) too soon, this can lead to a decrease in cell number; if cells are not formed quickly enough to replace the worn cells, the number of circu lating cells will be low. If cells are formed abnormally, their ability to carry oxygen can be impaired because important because treatment is directed at the cause. Some anemias can be cured, whereas others, such as sickle cell anemia, are not curable. Eating a healthy diet including foods high in iron and B complex vitamins will prevent deficiency anemias. Eating healthy overall includes such tips as opting for healthy fats like olive oil or nuts, eating more oily fish such as sardines or tuna, limiting cholesterol, including vegetables and fruit at every meal, and eating more whole grains. In addition to these healthy eating tips, including more iron rich foods in the diet for individuals with iron deficiencies might reduce the need to take supplements. Foods rich in iron include spinach, beef or chicken liver, clams, mussels, or oysters, sardines, turkey, beef, veal, ham, perch or salmon. Individuals who are vegetarian can increase their iron intake by eating more legumes, nuts, and greens. Iron deficiency anemia can be due to a loss of iron, such as from chronic blood loss, or to an inadequate intake of iron such as from low dietary intake of iron. Chronic blood loss can be due to bleeding hemorrhoids, gastrointestinal bleeding, and heavy or prolonged menstrual flow. Iron deficiency anemia is commonly seen in females during times of increased iron demand as occur during pregnancy and breastfeeding. During their menstrual years, females often have iron loss due to a combination of menstruation and inadequate dietary intake of iron. Symptoms previously described in t he anemia section pertain here as well, but, briefly, include pallor, weakness, fatigue, and dyspnea. Deficiency can also occur during times of high folic acid need such as those associated with infancy and pregnancy. Symptoms can include fatigue, weight loss, abdominal pain, black or bloody stools, and chest pain. Deficiency of folic acid c an be related with blood tests indicating low levels of hemoglobin, iron, or both assist in diagnosis of an iron deficiency. For cases caused by bleeding, further tests include looking for the presence of blood in urine and stool samples. Bone marrow biopsy is seldom needed but also will show abnormally large red cell size. If there are no complications to treatment, folic acid levels are usually restored to normal within two months. This last cause of deficiency is the most common and is also called pernicious anemia.