Description and Possible Medical Problems
Your two kidneys are workhouse organs that work in tandem with the urinary system to remove fluid and waste products from your tissues and blood. When they begin to malfunction in some way, it’s frequently due to an underlying illness such as high blood pressure, diabetes, heart failure, primary kidney disease, or a side effect of a particular medication.
Treatment
To diagnose a kidney ailment positively, your doctor will administer a number of tests, including a urinalysis to test the composition of the urine, a blood test to determine the amount of urea and nitrogen that is excreted through the kidneys (also called a BUN test), and perhaps an X ray or an intravenous pyelogram (IVP), which provides a clear picture of the kidneys on an X ray.
Because any abnormalities in the kidneys can cause permanent damage to the organs if they’re not treated, your physician will want to begin treatment right away. And since the kidneys often begin to malfunction because of a medical problem elsewhere in the body, your doctor’s recommended course of treatment will depend on what she determines to be the primary cause.
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Description and Possible Medical Problems
If you see a person who is visibly confused and sweating and is suffering from heart palpitations, and if you know for a fact that he is diabetic, you should call 911 for assistance right away. The cause is probably hypoglycemia, or a blood sugar level that is too low. If the level gets even lower or is not treated immediately, it can lead to a loss of consciousness.
If you’re not sure the person has diabetes, check for an ID bracelet or a dog tag that identifies her as a diabetic.
Treatment
Ask for advice from the emergency dispatch operator He may tell you that if the person can sit up slightly and is able to swallow liquid without choking, you can try to give her some sips of orange juice or sugary syrup while you wait for the paramedics to arrive. There are some diabetics who keep an emergency supply of glycogen ready for just such an emergency.
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Weight gain in an elderly person can be a sign of water accumulation, especially if it’s accompanied by shortness of breath, an inability to lie flat at night, and swollen ankles. An increase in weight in an elderly person can lead to heart failure. I tell elderly patients who have had heart failure in the past to weigh themselves in the early morning after they urinate. I also tell them that if their weight is up two or three pounds over the course of several days and they have some of the other signs of heart failure I’ve mentioned, they should call me so I can advise them on proper treatment. Sometimes, if their other signs aren’t serious, I’ll tell them just to take another water pill; other times, however, I’ll ask them to come in to see me.
In addition, weight loss that’s due to body water can be an indication of heart problems, and I give my patients with weight loss these same guidelines.
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The following lists include the routine exams and procedures physicians generally recommend for adults age 40-64 and 65 and older every 1-3 years. Obviously, they are not exhaustive, and much depends on a person’s medical history and other individual circumstances. However, the information presented will serve as a good guide to the typical periodic checkup.
Screening
Physical Exam
High-risk groups. Complete skin exam for persons with a family or personal history of skin cancer, frequent occupational or recreational exposure to sunlight, or clinical evidence of premalignant lesions.
Complete oral cavity exam for persons who use tobacco or drink excessive amounts of alcohol or those with suspicious symptoms or lesions detected through self-examination.
Palpitation for thyroid nodules fot persons with a history of upper-body radiation therapy.
Auscultation for carotid bruits for persons who have risk factors for cerebrovascular or cardiovascular disease (e.g., hypertension, smoking, coronary artery disease, atrial fibrillation, diabetes), neurological symptoms, or a history of cerebrovascular disease.
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Depressive symptoms.
Suicide risk factors: recent divorce, separation, unemployment, depression, alcohol or other drug abuse, serious medical illnesses, living alone, or recent bereavement.
Abnormal bereavement.
Signs of physical abuse or neglect.
Malignant skin lesions.
Peripheral arterial disease for persons over age 50, smokers, and persons with diabetes mellitus.
Tooth decay, gingivitis, loose teeth
The recommended schedule for the above exams and procedures applies only to the periodic visit itself. The frequency of the individual preventive services listed in this section is left to the clinician’s discretion as dictated by past medical and family history.
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