47 Differential Diagnosis for PT: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary
Myasthenia Gravis (MG): Unknown cause; block or destruction of acetylcholine receptor (neurological autoimmune) • Symptoms: muscles around the eyes are commonly affected first; this causes drooping of the eyelid (ptosis) and double vision Guillain-Barre: Demyelinating disease affecting peripheral nerves; cause is unknown; may be triggered by immune reaction to myelin • Follows infectious illness • Symptoms ○ Rapid progressive parathesis/weakness ○ Symmetrical ○ Affects lower extremities ○ Decreased deep tendon reflexes (DTR’s) • Two-thirds of patients recover • Diagnosed by lumbar puncture, nerve biopsy Multiple Sclerosis (MS): Most common demyelinating disease that affects 20- to 40-year-olds. It is most common in colder climates. Pathogenesis of MS is unknown, causing lesions (plaques) in central nervous system (CNS) white matter. • Vision-related MS symptoms ○ Blurred vision or double vision (diplopia) ○ Loss of vision in one eye ○ Moving or “jumping” field of vision • Irregular sensations as MS symptoms ○ Altered sensations, such as itching, burning, parasthesia ○ Electrical shock sensations in the neck and spine ○ Weakness in an arm or leg ○ Feeling heavy ○ Dizziness or vertigo • Diagnosis: Neurological exam, magnetic resonance imaging (MRI), cerebrospinal fluid tests, and/or immunoglobulin G test Rheumatoid Arthritis (RA): Chronic, systemic, inflammatory disorder of unknown etiology. RA affects women two to three times more than men and it is typically seen in 20- to 40-year- olds. • Hormonal implications/environmental trigger: Infection, E. coli (antibodies in synovial fluid)
○ Gay, bisexual, other men who have sex with men (MSM), and young Black MSM are most affected ○ By race, Black Americans face the most severe burden of HIV ○ Most new HIV infections in women are from heterosexual contact (84%) • Symptoms ○ Flulike illness within three to six weeks after exposure (acute HIV syndrome) ○ Fever ○ Headache ○ Fatigue ○ Nausea ○ Diarrhea ○ Enlarged lymph nodes Autoimmune Disorders • Inability to distinguish self from antigens • Autoantibodies are produced, causing tissue damage • Causes: Genetics, sex hormones, viruses, stress, or environment • Chemotherapy: Dampen the activity of IS rather than kill abnormal cells ○ To minimize side effects, doses are lower than those used to treat cancer • Gene: Chromosome 17, named NALP1 ○ Gene known to control IS that serves to alert body to viral and bacterial attacks ○ Could be a new target of autoimmune diseases Hashimoto’s Thyroiditis (HT): Most common cause of hypothyroidism (destruction of gland) • Symptoms: fatigue, depression, sensitivity to cold, weight gain, muscle weakness and cramps, dry hair, constipation, goiter, asymptomatic Graves’ Disease (hyperthyroidism): Caused by an antibody-mediated autoimmune reaction, making gland produce too much hormone; trigger for this reaction is still unknown • Symptoms: weakness, bulging eyes, shaky hands, asymptomatic, diagnosis for HT and Graves’ disease is a blood test for thyroid- stimulating hormone (TSH), heat sensitivity
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