Myasthenia gravis
• Concept and Etiology: How does the disease affect the endocrine and neural body systems
in particular? How does it deviate from the definition of health discussed in Module One?
• Myasthenia gravis is an autoimmune disorder that attacks the communication
between the nerve and the muscles, causing muscles to become weak. The
antibodies can block the protein muscle-specific receptor tyrosine kinase or
lipoprotein-related protein 4. However, there are some people that have the disease
without these antibodies, which is known as seronegative (Mayo Clinic, 2021). It
typically occurs in young woman aged 20-30, or older males age 50 or older. (John
Hopkins Medicine, n.d.)
• Classification: How is the disease classified?
• Myasthenia gravis is a prototypic autoimmune disease caused by antibodies to the
acetylcholine receptor (AChR) leading to weakness of the ocular, bulbar,
respiratory, axial, and limb muscles (Hehir & Silvestri, 2018).
• Clinical Manifestations (Symptoms and Signs): What are the symptoms and signs of the
disease or disorder? Be sure you understand the difference between symptoms (subjective)
and signs (objective).
• Signs
• Drooping eye lids
• Facial muscle involvement, i.e., a smile looking more like a snarl
• Short of breath
• Paralysis
• Symptoms
• Weakness
• Trouble swallowing
• Fatigue
• Hoarseness/ voice changes
• Diagnostic Tests: What are some additional diagnostic tests that can be done to illuminate
the diagnosis? For example, when you injure your ankle, they take an X-ray to determine
if it is broken or sprained.
• Some diagnostic tests that can be performed to evaluate for myasthenia’s gravis
are nerve conduction and single-fibre EMG. Blood test to test for the presence of
acetylcholine receptor antibodies can be tested for, a Tension test can evaluate
baseline muscle strength. They may also perform a CT or MRI scan of the chest to
check for a thyroid tumour (Signs-and-Symptoms.org, 2017).
Concept and Etiology: A goiter is the irregular growth of the thyroid gland. Goiter disease
affects the endocrine and neural body systems because when the body has hypothyroidism, the
body makes too little of the thyroid hormones T3 and T4, which control a person's metabolism.
Hereditary factors may cause goiters. Risk factors for the development of a goiter include female
sex, age over 40 years, inadequate dietary intake of iodine, residence in an endemic area, and a
family history of goiter. It deviates from the definition of health discussed in Module One because
goiter can change a person's overall state of physical, mental, and social well-being, because the
disease can cause a person to be fatigued, irritable, and sleeping disorders and lack sleep can really
change a person's health and attitude.
Classification: A simple goiter may be classified as either an endemic (colloid) goiter or a sporadic
(nontoxic) goiter.
Clinical Manifestations (Signs and Symptoms):
The main and most obvious sign of goiter is a swelling and lumps or nodules at the base of the
neck.
The main symptoms of goiter include:
• Swelling in the front of the neck, just below the Adam's apple
• A feeling of tightness in the throat area
• Hoarseness (scratchy voice)
• Neck vein swelling
• Dizziness when the arms are raised above the head
Other less common symptoms may include:
• Difficulty breathing (shortness of breath)
• Coughing
• Wheezing (due to squeezing of the windpipe)
• Difficulty swallowing
Some people who have a goiter may also have hyperthyroidism or overactive thyroid. Symptoms
of hyperthyroidism can include:
• An increased resting pulse rate
• Rapid heartbeat
• Diarrhea, nausea, vomiting
• Sweating without exercise or increased room temperature
• Shaking
• Agitation
Diagnostic Tests: Several tests can be used to diagnose and evaluate goiter, including:
• Physical exam: Your doctor may be able to tell if the thyroid gland has grown by feeling
the neck area for nodules and signs of tenderness.
• Hormone test: This blood test measures thyroid hormone levels, which tell if the thyroid
is working properly.
• Antibody test: This blood test looks for certain antibodies that are produced in some
forms of goiter
• Ultrasound of the thyroid: Ultrasound of the thyroid reveals the gland's size and finds
any nodules.
• Thyroid scan: This imaging test provides information on the size and function of the
gland. A small amount of radioactive material is injected into a vein to produce an image
of the thyroid on a computer screen.
• CT scan or MRI (magnetic resonance imaging) of the thyroid: If the goiter is very
large or spreads into the chest, a CT scan or MRI is used to measure the size and spread of
the goiter.
Concept and Etiology
• Meningitis is the inflammation of the meninges, usually caused from an infection. The
meninges are important to the human body because it covers and protects the brain and
spinal cord.
• Meningitis deviates from the definition of health due to bacteria entering the bloodstream
causing headaches, speech problems, vision problems, possible blindness, epilepsy,
seizures, memory loss and deafness. Severe Meningitis can lead to limb amputation due to
tissue damage.
Classifications
• Acute Bacterial Meningitis- Bacteria that’s spread from one person to another. Can be life
threatening
• Viral Meningitis- Bacterial that’s spread virally. Most common
o Types of Meningitis
▪ Bacterial Meningitis
▪ Viral Meningitis
▪ Parasitic Meningitis
▪ Fungal Meningitis
▪ Non-Infectious Meningitis
▪ Amoebic Meningitis
• Clinical Manifestations (Symptoms and Signs): What are the symptoms and signs of
the disease or disorder? Be sure you understand the difference between symptoms
(subjective) and signs (objective)
Clinical Manifestations
• Signs
o Fever
o Confusion
o Vomiting
o Stiff Neck
o Bulging Fontanelle (occurs when fluid builds up in the brain)
o Decreased consciousness
o Rash
• Symptoms
o Chills
o Nausea
o Photophobia (Fear and sensitivity to light)
o Headaches
o Agitation
Diagnostic Tests
• Throat Culture: test that finds germs, bacteria’s and fungus that causes infections
• Lumbar puncture with CSF analysis: testing of the Cerebrospinal Fluid
• Polymerase Chain Reaction Test: testing of the peripheral blood samples
• Head CT: X-Ray of the brain
Concept and Etiology: Cushing’s syndrome is a hormonal disorder caused by irregular cortisol
levels in the body. Cortisol is sometimes called the “stress hormone” because it helps your body
respond to stress. Cortisol also helps
• maintain blood pressure
• regulate blood glucose
• reduce inflammation
• turn the food you eat into energy
The adrenal glands, two small glands on top of your kidneys, make cortisol (National Institute of
Diabetes and Digestive and Kidney Diseases, 2019). Cushing’s deviates from the definition of
health as the hormones are not regular, causing illness in the body. Sometimes Cushing’s
syndrome can be caused by taking glucocorticoid medications.
Classification: Cushing’s syndrome is classified as adrenocorticotropic hormone (ACTH)-
dependent or ACTH-independent. ACTH-dependent Cushing’s syndrome accounts for 80%–85%
of cases. ACTH-independent Cushing’s syndrome accounts for 15%–20% of endogenous
Cushing’s syndrome in adults; 90% are unilateral adrenal tumors. (Feelders et al., 2015)
Clinical Manifestations: Cushing’s sometimes maybe hard to detect as some patients may not have
symptoms. However, those who have symptoms usually have
• Irregular periods
• Facial hair (in women)
• Erectile dysfunction (in men)
• Weight gain
• Round and fatty lump between shoulders
• Weak muscles and easy bruising.
Diagnostic Tests: Testing for Cushing’s are:
• 24-hour Urine
• Petrosal sinus sampling0test that can help determine if the cause is pituitary, samples are
taken from the pituitary gland (petrosal sinuses)
• CT or MRI scans of the patient’s pituitary and adrenal glands
• Saliva test
References
Feelders, R., Sharma, S., & Nieman, L. (2015). Cushing’s syndrome: epidemiology and
developments in disease management. Clinical Epidemiology, 281.
https://doi.org/10.2147/clep.s44336
National Institute of Diabetes and Digestive and Kidney Diseases. (2019, March 15). Cushing’s
Syndrome | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases; US
Department of Health & Human Services. https://www.niddk.nih.gov/health-
information/endocrine-diseases/cushings-syndrome
https://www.meningitis.org/meningitis/after-effects
https://www.meningitisnow.org/meningitis-explained/after-meningitis/after-effects-of-
septicaemia/
https://www.cdc.gov/meningitis/index.html
Goiter: Causes, risk factors, symptoms, diagnosis & treatment. Cleveland Clinic. (2019, February
5). Retrieved November 18, 2021, from https://my.clevelandclinic.org/health/diseases/12625-
goiter.
Thyroid goiter. UCLA Endocrine Center. (n.d.). Retrieved November 18, 2021, from
https://www.uclahealth.org/endocrine-center/thyroid-goiter.
Hehir, M. K., & Silvestri, N. J. (2018). Generalized Myasthenia Gravis: Classification, Clinical
Presentation, Natural History, and Epidemiology. Neurol Clinic. Doi: 10.1016/j.ncl.2018.01.002
John Hopkins Medicine. (n.d.). Myasthenia Gravis. Retrieved November 17, 2021, from John
Hopkins Medicine: https://www.hopkinsmedicine.org/health/conditions-and-diseases/myasthenia-
gravis
Mayo Clinic. (2021, June 22). Myasthenia gravis. Retrieved from Mayo Clinic:
https://www.mayoclinic.org/diseases-conditions/myasthenia-gravis/symptoms-causes/syc-
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Signs-and-Symptoms.org. (2017). Myasthenia Gravis Signs and Symptoms. Retrieved from Signs-
and-Symptoms.org: https://www.signs-and-symptoms.org/myasthenia-
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a,Choking%209%20Paralysis%2010%20Hoarseness%20or%20Changing%20Voice
