Can peng chapter 11 presentation
- 1. The presence of sugar or glucose in the urine - glycosuria Causes Types Symptoms Potential complications Diagnosis and treatment Prevention strategies 1
- 2. 2 The most common causes of glucose in urine Web photos retrieved from https://www.medindia.net/patients/patientinfo/glycosuria.htm, http://intranet.tdmu.edu.ua/data/kafedra/internal/chemistry/classes_stud/en/pharm/prov_pharm/ptn/3/05.%20INVESTIGATION%20OF%20CATA BOLISM%20AND%20BIOSYNTHESIS%20OF%20GLYCOGEN.htm, https://www.sott.net/article/316427-Its-not-cancer-after-all-Doctors- reclassify-thyroid-tumor, and http://www.medpractitioners.com/liver-cirrhosis/. • High sugar diet: Consuming high sugar diet can raise the blood glucose past the threshold that the kidneys can properly reabsorb. • Diabetes mellitus (undamaged): The lack of insulin in the blood elevates the glucose levels. The excess blood glucose levels make it difficult for the kidneys to properly reabsorb the glucose back into the bloodstream, leading to some excretion in the urine. • Hyperthyroidism: Overproduction of thyroid hormones can cause decreased absorption of glucose that is then leaked from the filtrate and passed into the urine. • Liver cirrhosis: This disease affects carbohydrate metabolism, resulting in high blood glucose levels in the blood that exceed the renal threshold and cause glucose excretion in urine.
- 3. 3 The most common causes of glucose in urine • Emotion: Fear, anger, and anxiety can cause the release of adrenaline, which promotes the breaking down of carbohydrates to produce energy for a “flight or fight” reaction. Consequently, a temporary rise in blood sugar levels occurs, which and potentially an increase in urine glucose as well. Such an event results in temporary rise in blood sugar levels, which can exceed the renal threshold and an increase in urine glucose. • Pregnancy: Increased renal blood flow decreases the renal threshold, thus eliminating more sugar in the urine. • Raised intracranial pressure: Sometimes glycosuria can be seen in patients with increased intracranial pressure and other brain lesions, due to the activation of the sympathetic nervous system and the consequent alterations in carbohydrate metabolism. Web photo retrieved from https://us.hellomagazine.com/healthandbeauty/health-and-fitness/2017022036768/how-to-exercise-during-pregnancy/
- 4. 4 Other possible causes of glycosuria Web photo retrieved from https://www.medindia.net/patients/patientinfo/glycosuria.htm • Renal tubular disease (with reduced renal threshold and reduced glucose reabsorption) • Kidney infections • Post-gastrectomy • Interstitial nephritis • Hereditary tyrosinaemia • Glucose-galactose malabsorption in the intestine • Wilson’s disease • Cystinosis • Heavy metal poisoning (lead, mercury, etc.) • Certain drug usage (cephalosporins, penicillins, nitrofurantoin, methyldopa, tetracycline, lithium, carbemazepine, phenothiazines, steroids, and thiazides)
- 5. 5 Types • Alimentary glycosuria: A condition due to high sugar diet. • Benign glycosuria: A rare, inherited condition in which the filtering system of the kidneys allows sugar to pass into the urine. It usually has no other symptoms. Type A: Most common type of glycosuria where there is a decline in both renal glucose threshold and maximal glucose reabsorption rate. Type B: The rate of reabsorption is normal but there is a decline in the renal threshold. Type O: Glucose reabsorption does not happen in the kidneys, resulting in lots of glucose excreted through urine. The serum glucose, glucose tolerance, and insulin level are normal.
- 6. 6 Symptoms Web photo retrieved from https://www.medindia.net/patients/patientinfo/glycosuria.htm • High urine glucose level with a lot of white blood cells and proteins • Renal pain • Difficulty in passing urine • Frequent urination • High blood sugar levels • Infections • Fever • Abdominal pain • Excessive hunger • Fatigue • Unexplained weight loss • Slower healing of wounds • Excessive thirst
- 7. 7 Potential complications • Cardiovascular (heart attack, stroke, high cholesterol, and hypertension) • Vision issues • Nerve irritability and damage • Tingling sensation in hands and feet Web photo retrieved from https://www.thedoctorasky.com/arrest-and-stroke/
- 8. 8 Diagnosis Urine glucose level Test Result mg/dL mmol/L Note Trace Glucose in urine 100 5.55 The trace amount of glucose in the urine suggests a high blood sugar. Glucose 1+ 250 11.1 The patient has lost 250 mg/dL of glucose via urine. Glucose 2+ 500 27.75 The patient has lost 500 mg/dL of glucose via urine. Glucose 3+ 1000 55.5 The patient has lost more than 1000 mg/dL of glucose via urine. Glucose 4+ 2000 111 The patient has lost over 2000 mg/dL of glucose via urine. The glucose level in a urine sample can be measured through a dipstick test which employs the glucose-oxidase/peroxidase reaction to specifically screen for glucose.
- 9. 9 Web photo retrieved from https://lifeinthefastlane.com/investigations/urinalysis/ Urinalysis - a dipstick test • Glycosuria may not always indicate high blood glucose levels. • Renal glycosuria may show negative in blood glucose tests but positive in glucose urine.
- 10. 10 Treatment Glycosuria is not necessarily a serious or life-threatening condition. • Find the cause of glycosuria to determine if the condition is chronic or acute. • Manage diabetes, hyperthyroidism, and kidney function to help reduce excretion of glucose in urine. • Use medications such as dapagliflozin and canagliflozin to lower blood sugar levels in patients with type 2 diabetes mellitus. Web photo retrieved from https://www.medindia.net/patients/patientinfo/glycosuria.htm
- 11. 11 Prevention strategies – live a healthy and active lifestyle Web photo retrieved from https://health.spectator.co.uk/regular-running-may-change-brain-works/ • Monitor diet and consume less sugar • Conduct regular checkups for health status and any pre-existing conditions such as diabetes and hyperthyroidism
- 12. Condition of excessive calcium in the blood, hypercalcemia 12 Causes Signs and symptoms Diagnosis Treatment Prevention strategies
- 13. 13 The most common causes of excessive blood calcium Web photos retrieved from https://www.sterlingcare.com/resources/resources/diseases-and-conditions-library/view/understanding- hyperparathyroidism/ and http://www.sensipar.com/whats-secondary-hpt/ • Hyperparathyroidism, an overproduction of parathyroid hormone (PTH), which is more common in women over 50 • Benign tumors such as parathyroid adenoma • Malignant tumors/cancers, especially lung cancer and breast cancer • Immobilization over a long period of time • Kidney failure • Overactive thyroid (hyperthyroidism) or excessive thyroid hormone intake • Certain medications such as the thiazide diuretics • Inherited kidney or metabolic conditions • Excessive vitamin D levels from vitamins, excessive dietary calcium, or from diseases that may result in excess vitamin D production
- 14. 14 Signs and symptoms Web photos retrieved from https://www.istockphoto.com/vector/peptic-ulcer-disease-stomach-ulcer-or-gastric-ulcer-gm645454524-117094053 and https://www.medicinenet.com/kidney_stones/article.htm Cardiovascular conditions • Higher levels of calcium in the blood. • Abnormal heart rhythms Moans (gastrointestinal conditions) • Constipation • Nausea • Vomiting • Loss of appetite • Abdominal pain • Peptic ulcer disease Stones (kidney-related conditions) • Kidney stones • Flank pain • Frequent urination
- 15. 15 Signs and symptoms Web photos retrieved from http://www.dailymail.co.uk/health/article-2056905/At-GPs-told-MUST-check-brittle-bones-victory-osteoporosis- campaigners.html and http://www.coloradoarthritis.com/osteoperosis-treatment-englewood.html Groans (psychological conditions) • Confusion • Dementia • Memory loss • Depression Bones and muscles (musculoskeletal conditions) • Muscle weakness • Bone aches and joint pains • Osteoporosis (fragile bones) • Decreased bone density • Spontaneous fractures or deformities • Curving of the spine and loss of height
- 16. 16 Diagnosis • Hypercalcemia is easy to be diagnosed as the calcium level in a blood sample can be easily measured. The normal range of the blood calcium is 8.6-10.3 mg/dL. • To identify the causes of hypercalcemia needs a detailed history and physical examination, including further blood tests (such as a PTH level and vitamin D level), urine evaluation, X-rays, and other imaging procedures. Web photo retrieved from https://www.healththoroughfare.com/disease/high-levels-calcium-blood-dont-always-indicate-cancer/2520
- 17. 17 Treatment • It the blood calcium is elevated to a critically high level to cause severe, dangerous symptoms, the patient needs hospitalization and the use of hydration, steroids, or even dialysis. Intravenous medications can be used to lower calcium. • If the hypercalcemia is modest, treatment with medications can be administered on an outpatient basis. • If the underlying cause is hyperparathyroidism (particularly from an adenoma), there are certain criteria to determine if a surgery is necessary, including the absolute calcium level, a history of kidney stones or other calcium-related complications, and the amount of calcium seen in a 24-hour urine collection. Web photo retrieved from https://www.youtube.com/watch?v=6a3DptpfLmc
- 18. 18 Prevention strategies Web photo retrieved from https://www.medindia.net/patientinfo/hypercalcemia.htm / • Hypercalcemia cannot be prevented. • Early detection is essential for normalization of blood calcium levels and early definition of the cause. • Special attention is required for any known family history of hypercalcemia or hyperparathyroidism
- 19. 19 References 1. Glycosuria (glucose in urine) symptoms, causes, and potential complications, https://www.belmarrahealth.com/glycosuria-glucose-urine-symptoms-causes- potential-complications/. 2. Glycosuria, https://www.medindia.net/patients/patientinfo/glycosuria.htm. 3. Hypercalcemia (Elevated Calcium Levels), https://www.medicinenet.com/hypercalcemia/article.htm.
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Editor's Notes
- #5: alimentary glycosuria.