In this assignment I will be looking at the nature of two named physiological disorders. I will explain its sign and symptoms and access possible difficulties involved in the diagnosis of the disorders from their signs and symptoms. The two physiological disorders are coronary heart disease and breast cancer. Coronary heart disease: Coronary heart disease is the build-up of plaque such as cholesterol and other fatty substances within the coronary arteries causing a reduced or no supply of oxygen to the heart. The process of plaque lining the coronary arteries is called arteriosclerosis. Coronary heart disease can be caused and triggered by many different factors. These include: Smoking; lifetime smoking roughly doubles your risk of developing heart disease because the chemicals in tobacco get into the bloodstream from the lungs and they damage the blood vessels and other parts of the body.
It is one of the leading causes of cardiovascular disease; High blood pressure; the blood pressure can become dangerous the higher it gets. An increased of blood pressure is an increase of the force of blood against the walls of the arteries and the higher the blood pressure the higher the likelihood the walls of the arteries can become damaged. This can lead to stiffness of the arteries making them less flexible which can lead to the build-up of cholesterol, even after being used on cells the extra gets deposited inside the artery wall lining which can lead to atherosclerosis and this can occur from unhealthy diet intake.
Your blood pressure and cholesterol level are also important. All people aged over 40 should have a cardiovascular health risk assessment’ usually available at your GP surgery. If you have a high risk of developing cardiovascular disease, treatment to reduce high blood pressure (hypertension) and/or cholesterol may be advised. Physical activity like exercising helps reduce blood pressure and the likelihood of obesity; Diabetes, people with diabetes have the same risk of developing heart disease as a person who has had a heart attack but who doesn’t have diabetes; obesity, obese individuals are more likely to have high blood pressure, diabetes and high blood fats. If your blood vessel are narrow due to a build-up of atheroma or if the symptoms of coronary heart disease cannot be controlled using medication, surgery may be needed to open up or replace the blocked arteries in severe cases heart transplants may even be needed if the heart is too damaged to function after a serious build-up of plaque or after a heart attack.
Breast cancer: Breast cancer is the serious disorder that is very common amongst both men and women in today’s day and age. In the UK about 1 in 8 women develop breast cancer at some stage of their life and also it is the most common frequently investigated cancer in quality of life studies. The breasts and every other part of our body is made up of millions of individual cells normally they would function to multiply and grow in an orderly way the body has implicated, however in cancer this process goes wrong and dysfunctional cells begin to multiply rapidly and uncontrollably. It has not been proven why exactly the breast cancer is caused however there are many risk factors that are associated with breast cancer which if taken into consideration can help reduce the risk of the likelihood of getting breast cancer.
Some of the risk factors: obesity and alcohol abuse; if a woman loses weight and limits alcohol intake, her risk of developing breast cancer may diminish; age, it is most common for women to develop breast cancer at an older age particularly women who have been through menopause and are over the age of 50; and some studies also have shown that diet and vitamins play a role in breast cancer risk the use of antiperspirants containing specific chemicals and environmental chemical use are also uncertain risk factors; previous breast cancer if you have previously has breast cancer you are at higher risk of obtaining and developing the disease again, this can be either in the same breast or in the other one; Alcohol, studies have showed that women who drink alcohol on a daily basis are more likely to develop diseases than those who do not drink at all. If you are concerned about a history of breast cancer in your family you should see GP and they will want to take a family history.
Before seeing your GP it is a good idea to try to find out who in your family has been diagnosed with breast cancer at what age they were diagnosed ad their exact blood relationship to you. On the basis of the family history, it is usually possible for your GP to access your risk as either near-normal, moderate or high. If your risk is moderate or high then if you wish you may be referred to be a doctor who is specialist for further assessment and counselling. There are many treatments of breast cancer, the seriousness and the type of cancer will result in what type of treatment is chemotherapy. Chemotherapy is given to advanced stage of breast cancer. And it is a nurse role to educate the women receiving chemotherapy about the names of drugs and they are administered and their side effects. P2- Explain the signs and symptoms related to two named physiological disorders. Coronary heart disease
The main symptom of coronary heart disease is angina. Angina is chest pain that occurs when the blood supply to the muscles of the heart is restricted. It usually happens because the arteries supplying the heart become hardened and narrowed. This can be a mild, uncomfortable feeling similar to indigestion. However, a severe angina attack can cause a painful feeling of heaviness or tightness, usually in the centre of the chest which may spread to the arms, neck, jaw, back or stomach. It is often triggered by physical activity or stressful situations. Symptoms usually pass in less than 10 minutes and can be relieved by resting or using a nitrate tablet or spray. If your arteries become completely blocked, it can cause a heart attack. A heart attack can cause severe pain in the centre of your chest, which may feel like very bad digestion or you can have mild pain and feel unwell.
Symptoms can happen suddenly but sometimes the pain can develop more slowly. Symptoms include: a feeling of heaviness, squeezing or crushing in the centre of your chest, feeling dizzy, feeling breathless and feeling sick or vomiting. The symptoms of a heart attack can be similar to indigestion. A heart attack can happen at any time, including while you are resting and if heart pains last longer than 15 minutes it may be the start of a heart attack. Unlike angina the symptoms of a heart attack are not usually relieved using a nitrate tablet or spray.
Heart failure can also occur in people with coronary heart disease when the heart becomes weak to pump blood around the body which can cause fluid to build up in the lungs that makes it increasingly difficult to breathe. The most common signs and symptoms of heart failure are shortness of breath or trouble breathing; fatigue; and swelling in the ankles, feet, legs, stomach and veins in the neck. All of these symptoms are the result of fluid build-up in your body. When symptoms start, you may feel tire and short of breath after routine physical effort like climbing stairs. Breast cancer
The usual first symptom is a painless lump in the breast. Most breast lumps are fluid-filled cysts or fibro adenomas which are benign. Benign neoplasms are often the complication of fibrocystic hyperplasia and common in young women between 18-25 years and rare after the age of 50. However, you should always see a doctor if a lump develops as the breast lump may be cancerous. Other symptoms which may be noticed in the affected breast include: Changes in the size or shape of a breast
Dimpling or thickening of some of the skin on a part of a breast The nipple becoming inverted (turning in)
Rarely a discharger occurring from a nipple (which may be blood-stained) A rare type of breast cancer, causing a rash around the nipple, which can look similar to a small patch of eczema Rarely, pain in a breast. Pain is not a usual early symptom but many women develop painful breasts and this is not usually caused by cancer. P3- Describe the investigation that are carried out to enable the diagnosis of these physiological disorders? Coronary Heart Disease require many tests and investigations before a diagnosis can be made such as electrocardiogram which is also known as (ECG) is one of the most widely used tests for detecting heart problems with the help of this that regulates the heart cycle of contraction and relaxation.
A number of electrodes (small, sticky patches) put on your arms, legs and chest. It’s important to have an electrocardiogram as part of an initial evaluation for any individual who is suspected of or diagnosed with coronary heart disease the test is likely to be repeated periodically to find out the occurrence of heart examinations. In some cases you may have an exercise ECG test or stress test; this is when an ECG recording is taken while you are exercising. If you experience pain while exercising, the test can help identify whether your symptoms are caused by angina which is usually due to CHD. Blood tests pick up abnormalities that influence how well the heart working e.g. they can detect raised levels of cholesterol, which may lead to CHD, abnormal levels of thyroid hormones which can affect the heart muscle cells are damaged in a heart attack. You may need to have a number of blood tests to monitor the activity of the heart; these may include cardiac enzyme tests which can show whether there has been recent damage to the heart muscle. An X-ray may be used to look at the heart, lungs and chest wall and this can help rule out any other conditions that may be causing your symptoms.
If your doctor feels you are risk of CHD, they may carry out a risk assessment. This involves asking about your medical and family history, your life style and blood test as I’ve already mentioned. If you have CHD you’re GP or practice nurse can tell you what your ideal weight is in relation to your build and height. Body mass index will be measured. You also need to regular exercise to make your heart and blood circulatory system more efficient, lower your cholesterol level, and also keep your blood pressure at a healthy level Breast Cancer has many investigations that take place before a diagnosis can be made such as a Biopsy is when a sample is taken of lump or abnormal area the biopsy sample is then analysed in a laboratory and the cells are examined this allows the doctors to see exactly what type of cancer it is and whether it’s likely to grow slowly or more quickly.
There are many types of biopsies that can be used including core needle biopsy, blood tests and fine needle aspiration and excision biopsy. Scans can measure the size of the cancer and whether it has spread to other parts of the body or nearby this is called staging the cancer. Once the type and stage of the cancer is known the doctors can discuss with the individual how best to treat them. The different types of scans that can be used include ultrasounds, mammograms and magnetic resonance imaging (MRI); ultrasound is an imaging technique that used sound waves to create a picture of the breast tissue. It is generally used as a test to a mammogram an ultra sound is the best way to check whether the lump is a solid or filled with fluid a mammogram is one of the most important tools to diagnose breast cancer.
It is a breast X-Ray which helps to detect breast cancer, even before there are any obvious signs and symptoms. In the UK, women between 50 and 70 are invited to have a mammogram every three years as part of a national breast screening programme. The procedure is very safe and it doesn’t make more than 20 minutes there is some discomfort and pain in the breasts when the breast is pressed on an upper and lower plate. MRI imaging technology used in the diagnosis of cancer unlike a mammogram that uses X-Rays to get the images of the breast, MRI use magnets and radio waves to create 3D images of the breast tissue.
Sometimes a dye is injected in to the individuals arm cancer cells need a large amount of blood supply for their growth and the MRI shows where and whether the dye is concentrated in certain areas indicating cancer cells and the picture it appears as a white dark background. Having investigations for a breast problem can be a worrying and stressful time. The staff in the clinic will know that you want results as soon as possible and your specialist may be able to tell you what they think the outcome might be. However, the results of all the investigations you’ve had are usually needed before you can be given more detailed information. The clinic will let you know how and when you’ll get your results.
M1- Assess possible difficulties involved in the diagnosis of the disorders from their signs and symptoms. There are many possible difficulties that can be involved in the diagnosis of coronary heart disease and one of them is ECG. Even though an ECG is an important test for detecting heart problems it isn’t advisable to have an ECG done every year because there are two reasons for this. The first is that there isn’t yet evidence that routine screening actually improves long-term health outcomes. Secondly, ECGS provide too many false-positive tests, especially in women leading to unnecessary additional tests and too many false-negative tests which lead to missed abnormalities. However, this advice could change in the future depending on new evidence from the clinical trials. People who are older or out of shape have arthritis, lung disease, vascular disease or other medical conditions or those who cannot exercise enough to undergo the exercise tolerance test take a pharmacologic stress test.
In place of exercise patients are given medications that increase the hearts need for blood, allowing doctors to detect blockages that obstruct the supply of blood. However, the test is considered safe for most people. Problems that can be involved in the diagnosis of breast cancer can include many women finding having a mammography to be uncomfortable or even painful but this is normally just for a short time. However some women may find that the pain or soreness lasts for a few days. Mammograms can sometimes show an abnormal area in the breast that is later found not to be a cancer when further tests are carried out. This is known as a false-positive result. It takes a lot of time to get the results for further tests and it can be a very worrying time and some women may continue to feel anxious even after they’ve been told they don’t have breast cancer (negative result).
About 1 in 10 women who have breast screening will have an abnormal result and be asked to go for further tests. The tests may include more mammograms, ultrasound scans or biopsies of the breast tissue which can cause pain or scarring. Most of the women asked back for further tests won’t have breast cancer. 1 or 2 mammograms to be takes again for various reasons including the following; The x-ray picture is blurred and cannot be read by the doctor; there is some kind of equipment failure for example the machine that processes the x-ray films breasts down however this is very rare.
The mammogram missed part of the breast and it needs to be retakes so that the whole breast can be seen. Although mammography is the most effective and reliable way of detecting breast cancer early, it is not always perfect. A breast cancer may not be detected by mammogram because some cancers are very difficult to see on the x-ray and the person reading the x-ray may miss the cancer. This will happen very rarely no matter how experienced the person reading the x-ray is. So, to reduce the risk of a cancer being missed all mammograms are looked at by two people.
http://www.patient.co.uk/health/preventing-cardiovascular-diseases http://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Symptoms.aspx http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs.html http://www.breastcancercare.org.uk/breast-cancer-information/breast-awareness/referral-breast-clinic/mammogram-ultrasound-scan-core-biopsy-fna