Differential Diagnosis for Physical Therapy: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary 123
○ Lymph nodes: Contain lymphocytes/ macrophages that filter foreign substances (antigens) ○ Spleen: Chief site for filtering antigens and reservoir for cellular elements ○ Tonsils: Masses of lymphoid tissue filter circulating lymph of antigens that enter the body through the mouth and nose ○ Peyer’s patches: Located in intestinal wall Immune Disorders • Allergies: Abnormal hypersensitivity that takes place when an allergen is introduced → body fights invaders and produces antibodies (IgE) • Anaphylaxis: Systemic manifestation of immediate hypersensitivity; vasodilatation occurs • AIDS/HIV ○ More than 1.2 million people in U.S. living with HIV infection; one in eight are unaware of their infection ○ 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
○ 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 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
○ 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
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