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Psoriasis, unspecified
Pathophysiology
Immunological triggers provoke a discharge of a large number of leukocytes to the dermis and epidermis; the epidermis becomes infiltrated by activated T cells inducing the proliferation of keratinocytes, and then an unregulated inflammatory process occurs along with the ejection of various cytokines (Mahajan & Handa, 2013).
Symptoms and Signs
Psoriatic rashes on the skin, sudden occurrence of scaly areas of redness, pain, itching, joint pain without visible changes on the skin, rash developing after a recent pain in the joints.
Lab and Diagnostic Tests
As a rule, the diagnosis is established based on a typical clinical picture. To exclude a fungal infection, especially if the foot or hand is injured, microscopic examination of skin samples for the presence of fungal cells may be required (Mahajan & Handa, 2013).
Urolithiasis (N21.8)
Pathophysiology
The most common cause of urolithiasis in adult patients is an intravesical obstruction which can be caused by prostatic hyperplasia or prostate cancer in men, stricture of the urethra (after trauma, surgery, inflammation), etc.; whereas the mechanism of stone formation is associated with the impossibility of complete bladder emptying, stagnation, and concentration of residual urine leading to precipitation of salt crystals (Gould, VanMeter, & Hubert, 2014).
Symptoms and Signs
Impaired urination with frequent urges during movement, interruption of the urine stream or acute retention of the outflow, urinary incontinence due to a stone stuck in the narrow neck of the bladder.
Lab and Diagnostic Tests
Urine analysis allows identifying the microflora and its sensitivity to the selection of antibacterial therapy. Ultrasound of the bladder helps to see the stones as hyperechoic formations with an acoustic shadow.
Nephrolithiasis (N20.0)
Pathophysiology
The pathophysiological process is multifactorial and complex, yet important premises for the onset of the disease are the change in kidney function caused by a disorder in the regulation of blood circulation and impaired lymph flow; due to imbalance between colloids and crystalloid urine, the salts begin to precipitate and crystallize (Sakhaee, Maalouf, & Sinnott, 2012).
Symptoms and Signs
Blunt pain in the lumbar region, renal colic, severe sweating, as well as increased frequency of urination.
Lab and Diagnostic Tests
Ultrasound and roentgenology, general and biochemical analysis of blood and urine. In nephrolithiasis, micro-constrains (sand), depleted renal epithelial cells, and erythrocytes can be found in the patient’s urine (Sakhaee et al., 2012).
Urolithiasis (N20.1)
Pathophysiology
Calculus of the ureter usually develops on the background of chronic urethritis, prostatitis, prostate adenoma; fistulas, diverticula of the urethra, stricture of the urethra; urolithiasis; mineral metabolism disorders, inadequate diet, dehydration, urinary tract infections (Gould et al., 2014).
Symptoms and Signs
Severe pain, difficulty urinating, weakening of the urine stream, hematuria.
Lab and Diagnostic Tests
Palpation and the gynecological assessment are the major diagnostic methods. An ultrasound test of the bladder allows visualizing the hyperechoic formation of the urethra (through an acoustic shadow). A general urine test is also performed: macro- or microhematuria and the symptoms of inflammation can be determined (Gould et al., 2014).
Insomnia (G47.00)
Pathophysiology
Insomnia may be due to physiological predisposition, psychogenic disorders, diseases of the nervous system and internal organs; neuroses and neurosis-like conditions (psychosis, depression, panic disorders, etc.); somatic diseases that cause night pain, dyspnea, heart pain, respiratory disorders; organic lesions of the central nervous system (stroke, schizophrenia, brain tumors, etc.) (Dunphy, Winland-Brown, Porter, & Thomas, 2015).
Symptoms and Signs
Pre-somnological and post-somnological disorders; reduced daily activity, impaired memory, and attention; aggravation of chronic conditions.
Lab and Diagnostic Tests
Diagnosis is based on the patient’s complaints. Polysomnography is recommended if the disorder is followed by a respiratory impairment or if the medical treatment is ineffective.
References
Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care: The art and science of advanced practice nursing. Philadelphia: F.A. Davis Company.
Gould, B. E., VanMeter, K. C., & Hubert, R. J. (2014). Pathophysiology for the health professions. St. Louis, MO: Elsevier Saunders.
Mahajan R., & Handa, S. (2013). Pathophysiology of psoriasis. Indian Journal of Dermatology, Venereology and Leprology, 79, 1-9. doi:10.4103/0378-6323.115505
Sakhaee, K., Maalouf, N. M., & Sinnott, B. (2012). Kidney stones 2012: Pathogenesis, diagnosis, and management.The Journal of Clinical Endocrinology and Metabolism, 97(6), 1847–1860. Web.
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