Menopause
i.How do you confirm menopause?+
Onset of menopause occurs usually around the age 50. But in some cases, it may start as early as mid-40’s, or may not start until a woman reaches her late 50’s. If a woman has not had a menstrual period for a year, it is generally accepted that she has reached menopause. In some cases, the doctor may recommend a diagnostic test to check blood levels for follicle-stimulating hormone (FSH) and estrogen (estradiol), because FSH levels increase and estradiol levels decrease with the onset of menopause
ii.What are different stages and early signs of menopause?+
The timing of symptoms varies significantly in menopause, where they might occur at the onset or in some cases may start even years before a womans final menstrual periods. While in some cases, women may experience symptoms for months or years after the onset of menopause.
Symptoms include irregular periods, vaginal dryness, mood swings, hot flashes, night sweats and weight gain
There are three stages of menopause:
- Stage1: Perimenopause - 3-5 year period before menopause when estrogen and hormone levels begin to drop.
- Stage2: Menopause - refers to the specific event, when a woman has missed her periods for 12 consecutive months (in the absence of other obvious reasons).
- Stage3: Postmenopause - includes all the years beyond menopause.
iii.How long are you in perimenopause?+
The average length of perimenopause is 4 years, but in some cases this stage may last for only a few months or continue for even up to 10 years. Perimenopause ends when a woman has gone 12 months without having her period
iv.What test you must do to check for menopause?+
To diagnose menopause or perimenopause, doctor may suggest blood test to check follicle stimulating test (FSH) level, as menopause causes FSH levels to rise. Under certain circumstances, doctor may also suggest for thyroid function test to determine the thyroid-stimulating hormone level, as it causes similar symptoms to those seen in menopause.
Asthma
i.What are the major signs and symptoms of asthma?+
The most common problem for an asthma patient is chronic airway inflammation and excessive airway sensitivity to various triggers that makes breathing difficult. When the airways come into contact with a trigger, the airways become inflamed (they are filled with mucus, and swell and narrow).
This results in difficulty in breathing, shortness of bread, increased airway secretion and a combination of various other allergic symptoms. Other asthma symptoms include coughing (especially at night), wheezing, shortness of breath, chest pain.
Triggers are different for different individuals. The most common triggers are breathing polluted air, inhaling irritants such as perfume and cleaning products, allergies such as molds, dust, etc.
ii.What is exercise induced asthma? How to get diagnosed with it?+
Exercise-induced asthma is a category of asthma that happens that occurs because of exercise. The muscle bands around your airways are sensitive to changes during exercise and react by contracting, which narrows the airway. This results in difficulty in breathing.
To diagnose, doctor may suggest lung function test (also known as pulmonary function test i.e., PFT) and can give some exercise challenges to measure your breathing before, during and after exercise.
iii.Can exercise help to reduce asthma?+
Exercise has many benefits when it comes to managing asthma. An exercise program helps to maintain a healthy weight, which reduces the severity of asthma symptoms. Before starting exercise program, asthma patient should consult a doctor to understand safety of the exercises for his/her case and also get suggestions on some safe exercise activities as per his/her health condition.
iv.How asthma can get diagnosed?+
To diagnose menopause or perimenopause, doctor may suggest blood test to check follicle stimulating test (FSH) level, as menopause causes FSH levels to rise. Under certain circumstances, doctor may also suggest for thyroid function test to determine the thyroid-stimulating hormone level, as it causes similar symptoms to those seen in menopause.
- Spirometry
- Peak airflow
- FeNO test (exhaled nitric oxide)
- Provocation test
Polycystic Ovarian Disease (PCOD)
i.What are the main causes of Polycystic Ovarian Disease?+
Presently, the exact cause of Polycystic Ovarian Disease (PCOD) is unknown. But as per researchers and health care providers, genetic and environmental factors together with obesity, hormonal issues, and ovarian and hormonal dysfunctions contribute to the development of PCOD.
ii.What does the doctor check to confirm the diagnosis of PCOD?+
To diagnose PCOD, doctor usually will have to go through the patient's medical history, symptoms and the menstrual cycle pattern. In addition, doctor needs to perform physical exams to check excess body hair and high blood pressure. Doctor will usually also suggest further tests that include blood tests, insulin and hormonal tests, pelvic ultrasound to confirm (PCOD)
iii. Can polycystic ovarian disease be treated?+
There is no cure yet, but there are many options available to reduce or eliminate the symptoms associated with polycystic ovarian disease (PCOD). Different medicines are available that can treat symptoms such as irregular periods, acne, excessive hair and elevated blood sugar.
Fertility treatments are also available to help women with polycystic ovarian disease in conceiving a child. Losing atleast 5% excess weight, can help women ovulate more regularly and reduce other PCOD symptoms.
iv.Is natural conceiving possible with PCOD?+
It is possible to conceive naturally with PCOD, on instances by only following proper diet and lifestyle. There are few natural ways to conceive with PCOD which includes weight loss, proper diet (consume good fats like coconut oil, use olive oil), use herbs and natural supplements to regulate ovulation and menstruation, practice lunaception and exercise. These therapies can be useful for treating PCOD-related fertility.
Chronic Kidney Disease (CKD)
i.What are the major signs and symptoms of chronic kidney disease?+
Before experiencing any chronic kidney disease (CKD) symptoms, a person can lose upto 90% of their kidney functions. Many of the times, people may not face any CKD symptoms until it is advanced. Signs of advancing CKD include swelling of feet and ankles, high blood pressure (hypertension), chest pain, persistent itching, muscle twitching and cramps, changes in urination, etc.
ii.Having frequent urination? Check if something is wrong with your kidneys?+
Frequent urination is a major symptom of advanced chronic kidney problem. However, frequent urination is often a symptom of a bladder dysfunction as well. For this condition, doctor can determine the difference by performing blood and urine tests, and in addition to that sometimes require an X-ray or USG (ultrasonography).
iii.What are the test to diagnose chronic Kidney disease?+
For kidney disease diagnosis, doctor may suggest certain tests such as:
- Blood test: to assess the level of waste products, such as creatinine and urea in blood
- Urine tests: to reveal abnormalities that point to chronic kidney failure and help to identify the cause
- Imaging tests: to assess kidney structure and size
- Removing a sample of kidney tissue for testing (biopsy):to determine the actual cause, a sample of kidney tissue is removed through kidney biopsy
iv.What is GFR? What is normal GFR level?+
Kidneys filters blood and on an average it filters about 180 liters of blood daily in a normal person. During filtration, urine is formed in the small tubules of the kidneys. In a normal human being, about 125 cc of this initial urine is formed in each minute. This is called glomerular filtration rate (GFR). It is the best test to measure kidney function level as it also determines kidney disease stage. It can be calculated from the results of a renal function test, which also includes serum creatinine test.
Normal GFR ranges from 90 to 120 mL/min/1.73 m2. Older people will have lower than normal GFR levels, because GFR decreases with age. When GFR level is less than 60 for three months or more, it can be said that chronic kidney disease (CKD) is present.
Dialysis
i.How long can a person survive with and without dialysis?+
Life expectancy can vary depending upon patient health conditions and how well he follows the treatment plan. Expected survival for patient on dialysis is 5-10 years, however, many patients can live well on dialysis for 20 or even 30 years. These wide fluctuations depend on patient’s age, nutritional status, and presence of other co-existing disease conditions like heart disease, cancer, etc.
Patients who have been on dialysis for atleast six months and who have made the decision to stop dialysis treatment can survive on an average for a period of 10 days. However, this means some will live a short time and some may live for weeks.
ii.Is it painful to have dialysis?Check if something is wrong with your kidneys?+
The dialysis treatment itself is painless, but there might be some discomfort when the needles are put into fistula or graft. In hemodialysis, if needle stick is bothering any patient then they can ask for numbing (pain suppressing) medicine. Patient might also have a few painful muscle cramps during hemodialysis, especially if a patient has gained a lot of fluid weight between treatments. But the care team can help patient to manage the cramps and ensure that it does not happen again.
In peritoneal dialysis (PD), abdominal pain can be a major sign of an infection called peritonitis. Patients who undergo peritoneal dialysis with a cycler machine can have pain at the end of a drain cycle. But doctors and healthcare management team can help patients learn different ways to prevent these problems.
iii. What are the common side effects of dialysis?+
Low blood pressure is one of the most common side effects of hemodialysis. It can be caused by the drop in fluid levels during dialysis. Other side effects are sepsis (blood poisoning), muscle cramps, itchy skin, etc.
Peritoneum (peritonitis) bacterial infection is the common side effect of peritoneal dialysis. It can be caused if the dialysis equipment is not kept clean. If there are bacteria on the equipment, they can spread to the peritoneum (thin layer of tissue that lines the inside of the abdomen).
iv.What is considered as high creatinine level? What are the symptoms of high creatinine level?+
Creatinine levels play a major role in assessing kidney function. Elevated creatinine level signifies impaired kidney function. Most men with normal kidney have approximately 0.6 to 1.2 mg/dL of creatinine. While most women with normal kidney have between 0.5 to 1.1mg/ dL. When creatinine levels reaches 5.0 or more in adults may indicate severe kidney impairment.
Some of the most common causes of elevated creatinine levels include diabetes, high blood pressure, urinary tract infections, and kidney functions.
Cardiac Diseases
i.Am I at risk of heart disease?+
If you have a family history of heart disease or other cardiovascular risk factors such as high cholesterol, diabetes, obesity or smoking, these factors can increase risk for heart disease. These cardiovascular factors may be different for men and women. For instance, men are more likely to have chest pain, while women are more likely to have other symptoms along with chest discomfort, such as short breath, nausea.
ii.How do you know if you are having cardiac problem? Can you have any symptoms before heart attack?+
Many of the times, people may not face any cardiac related symptoms until it is advanced. But if a person have pain or pressure in the center of chest that spreads upto throat or jaw, it could be sign of cardiac related problems. Irregular heartbeat is also a major sign of having cardiac problem.
There are many risk factors that contribute to having a heart attack, including high cholesterol, obesity, excessive alcohol consumption, high blood pressure, stress.
iii.What should I do to prevent cardiac disease?+
There are many ways to prevent cardiac disease by adopting a healthy lifestyle this include manage stress, regular exercise, stay at a healthy weight, eat a healthy diet, get regular health screening for blood pressure, cholesterol levels, diabetes. If any of these issues are identified early and proper treatment is initiated, it can help prevent cardiac disease in the longer run.
iv. What are the screening and diagnostic tests for cardiac diseases?+
Key screening tests for monitoring cardiovascular health include blood pressure, fasting lipoprotein profile (cholesterol, LDL, VDL, HDL, triglyceride), body weight and blood glucose.
After completing physical examination and blood tests, doctor may suggest additional noninvasive test for heart disease that include
- Electrocardiogram (ECG)
- Holter monitoring (to detect heart rhythm irregularities)
- Echocardiogram
- Stress test
- Cardiac catheterization
- Cardiac computerized tomography (CT) scan
- Cardiac magnetic resonance imaging (MRI)
Thyroid Disorders
i.What are the common developing symptoms of hypothyroidism and hyperthyroidism?+
Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones to meet the needs of the body. Hence it causes symptoms related to a slow metabolism. Major symptoms associated with hypothyroidism are muscle weakness, constipation, weight gain, elevated blood cholesterol level, joint pain.
In hyperthyroidism, body produces excessive amount of thyroid hormones. Hence it causes symptoms related to a high metabolism. Major symptoms include sudden weight loss, rapid heartbeat, and increased appetite.
ii.Why thyroid is common in women?+
Women are having problems with thyroid gland 3-10 times more, than men. Women are very sensitive to any hormonal changes and hence react sharper than the calm male body.
The most common cause of hyperthyroidism in women is the autoimmune condition known as Graves’ disease (where antibodies target the gland and cause it to speed up hormone production) this leads to overactivity of the thyroid gland. Graves’s disease is most common in women over the age of 20.
iii.How do you get diagnosed for thyroid problems?+
To diagnose thyroid problems, doctor may do physical examination by knowing patient medical history and can suggest different blood tests which includes thyroid stimulating hormone (TSH) test, T3 test and T4 (thyroxine) test.
iv.What are the complications along with thyroid, if it remains untreated?+
If it remains untreated, it can cause severe disease like heart problems, increase cholesterol level, infertility, mental health issues and myxedema (which causes swelling of tissues, increase fluid around heart and lungs).
Gastric disorders
i.What are the common gastrointestinal disorders?<+
Common gastrointestinal / digestive problems includes heartburn, diarrhea, peptic ulcer disease, gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), etc.
ii.What are the common signs of digestive problems?+
Common signs and symptoms of digestive problems are indigestion, constipation, bloating, gas, bleeding, nausea and vomiting, swallowing problems, pain in the belly, stomach pain, stomach cramps and weight gain or loss
iii.What are the causes of upset stomach?+
Stomach can be upset due to food poisoning, overeating, overdrinking, eating greasy spicy or fatty foods, and eating too fast or eating on the run.
Lifestyle factors like high emotional stress, smoking, motion sickness while travelling, too much alcohol or caffeine can also cause upset stomach.
iv.Which diagnostic tests are available for gastric problems?+
Blood tests like CBC, liver function test, Helicobacter pyroli and pancreatic enzyme test to diagnose bacterial or parasitic infection, celiac disease and exact cause of diarrhoea.
Stool analysis to assess the overall health of gastrointestinal tract and is recommended in case of indigestion, constipation, diarrhea, malabsorption, IBS and IBD.
Endoscopy, abdominal ultrasound, CT scan and MRI to examine the internal digestive organs.
Hair loss
i. Does nutritional deficiency cause hair loss?;+
There is a strong connection between nutritional deficiency and hair loss. Some nutritional deficiencies can cause hair loss. Hairs are only as healthy as the diet. If food is not properly digested and body is not getting the right nutrients, this can impact hair structure and hair growth.If diet lacks certain nutrients like Vitamin D, Protein, Vitamin A, etc. for an extended period of time, it can cause hair follicles cells to stop working properly.
ii. What are the common causes of hair loss?+
Hair loss is very common and can occur due to a combination of factors such as severe stress, genetics, illnesses like thyroid disease and anemia, nutritional changes, hormonal changes related to puberty, pregnancy and menopause, or side effects of medication (like chemotherapy).
iii. What are the early signs and symptoms of alopecia? Can it be cured? +
Hair loss associated with alopecia is unpredictable and random. The most prominent symptom is patchy hair loss. Hair usually falls out in round patches, mainly from the scalp. Any site of hair growth may be affected, including beard and eyelashes. Other signs are itchy scalp, hair growth stops, severe hair loss, thinning hair etc. Currently there is no cure for alopecia, there are some treatments and medications that can be suggested by doctor to improve and stimulate regrowth of hairs.
Lifestyle factors like high emotional stress, smoking, motion sickness while travelling, too much alcohol or caffeine can also cause upset stomach.
iv.How can I diagnose my hair fall?+
Hair fall can be diagnosed in two ways; first way is by hair analysis, where doctor can diagnose with the sample of hair and examine it under microscope. Second way to diagnose hairfall is by undergoing blood tests, including tests for specific condition, such as thyroid.
Back Pain
i. What are the symptoms associated with back pain that you should never ignore?;+
The symptoms of back pain which should be taken into consideration are pain down the legs, swelling in the back, pain reaches below knees, weakness in one or both legs, intense and constant pain in back that gets worse in night, onset following trauma such as a fall or a blow of back, and loss of bowel or bladder control, sharp and localized pain in neck, inability to stand straight without having pain in lower back, pain accompanied with fever. .
ii. Why should you have blood test for back pain?+
Routine blood tests help in finding the cause of back pain in some situation when it is induced due to infections such as lupus and other inflammatory diseases or genetic disease such as HLA -B27.
iii. How long does it take to heal lower back pain?+
In most of the cases, the back pain is acute or short term that persists for few days to few weeks. It tends to resolve by its own or with some medication without loss of residual function. Sub-acute low back pain persists for 4-6 weeks and chronic pain stays for more than 6 weeks. It can be healed with medication but generally it is observed that after a year, patient may again face back pain while in some cases, it can be cured permanently.
iv. What can cause severe back pain? What precaution should be taken?+
Back pain is caused by poor posture, lifting heavy objects, falls, prolonged sitting, highly physical jobs, obesity, sleep disorders, sitting/ standing for long hours, over stretching, strain in neck forward due to driving or working on computers, long driving sessions, wearing high heels and tight clothing.In order to prevent it, do exercise regularly, take some breaks from sitting and standing postures, and avoid getting stuck in the above mentioned causes
Newborn Screening
i. How is the newborn screening done?;+
Newborn screening is usually done with a blood test 24 to 48 hours after a baby is born. In some conditions, second blood test is performed at a check-up appointment with the baby's pediatrician when baby is 1 to 2 weeks old. Nurse will take few drops of blood from baby's heel and hospital will send the blood samples to newborn screening lab. Newborn screening is a part of standard care, parents do not need to request to have the test done
ii. How long does it take to get the results of new born screening?+
Testing time varies from type and number of tests done as a part of new born screening. For blood tests, results are usually ready within one week of sample collection. If results indicate any further need of testing, the results will likely be available within a couple of days. Physician will be notified right away and he will contact further, if any tests are required or there is delay in results.
iii. Which tests included in newborn screening tests?+
Newborn screening tests varies by hospital and is subject to change, many hospitals currently do the basic and necessary screening tests. All newborns undergo hearing screening and some other tests as suggested by the doctor. Some common tests that doctors suggest as part of new born screening are as follows:.
- Phenylketonuria (PKU)
- Congenital hypothyroidism
- Galactosemia
- Sickle cell disease
- Cystic Fibrosis
- Severe combined immunodeficiency (SCID)
Obesity
i. What are the common causes of obesity?;+
Number of factors can play role in obesity or weight gain, but it is generally caused by eating too much and / or a sedentary lifestyle. If a high amount of energy is consumed, mainly fat and sugar, and if that is not burned through exercise or physical activity, much of the surplus energy will be stored in body in the form of fat. Some other factors that cause obesity are environmental factors, genetics, hormone problems, stress and emotional factors.
ii. What are the risks associated with obesity?+
There are many risks associated with obesity and is an open-door to a number of preventable disease and conditions including heart disease, type 2 diabetes, high blood pressure, stroke, breathing problems, chronic back pain and osteoarthritis. These cumulatively increases the risk of pre-mature death from cardiovascular disease (heart attacks, heart failure)
iii. Can preventive measures decrease the risk of obesity? +
If a person is able to maintain a healthy body weight, eat a well-balanced diet and exercise regularly than it can help to decrease the risk of obesity. Preventing obesity is important because once fat cells form they remain in the body forever. .
If there are chances of obesity due to genetics, early diagnosis can help a person to reduce the level of risk.
iv. Which tests are important to undergo for individuals with obesity?+
Simple method of diagnosing obesity is through BMI. If BMI falls in the obese range, some tests can be performed after consulting the doctor. There are number of tests that are important to analyze a person's overall risk factors if there is obesity. Some common blood tests should be done which includes cholesterol test, liver function test, fasting sugar test and a thyroid test. If there is higher risk, heart test can also be done after consulting the physician.
Alcohol side effects
i. Am I an alcoholic? What is the difference between casual drinking and alcoholism?;+
There are many signs which signify whether a person is alcoholic or not. Person starts losing interest in things that were once enjoyed, addiction to drink over health issues, extreme mood swings, need to drink first in the morning, failure to control the amount of alcohol consumptions are some indications of an alcoholic person. There is an enormous difference between casual drinking and alcoholism. Casual drinking is done occasionally within a limit and not frequently, while alcoholism is allied with drinking in excess, too often and even in unhealthy situations.
ii. What is GGT test for liver? What does their higher level mean?+
Gamma-glutamyl transferase (GGT) test measures amount of GGT in the body which detects liver damage and alcohol. GGT is a liver enzyme, which help other molecules to move around the body. Higher level of GGT indicates possibility of liver damage. Also a person with higher level of GGT has more than 1.5 fold risk of cardiovascular disease in comparison to people with normal levels of GGT.
iii. How long does alcohol stay in my system – urine, blood and breathe?+
Alcohol stays in urine for 12-36 hours, depending on how much it is consumed. It takes around 1 hour to break down 1 unit of alcohol in the blood. Alcohol can be identified up to 24 hours after the last drink, in a breath test.
iv. How does alcoholism damage liver? Does it affects kidneys also?+
Liver can handle small amount of alcohol at given time. Liver requires water to function but excessive drinking or regular drinking will make it hard for liver to find water from other sources. Too much fat can be formed, which may cause fatty liver disease. There are also many associated risks, if liver stop functioning properly. Kidney filters harmful element from blood and keep right amount of water in the body. When alcohol is present in blood it kidneys cannot filter the blood properly resulting improper elimination of waste. Thus drinking in excess damages kidney and can cause abnormal blood pressure and kidney related disease.
Stroke
i. Can mini-stroke be diagnosed? Does it shows up on MRI?;+
Mini stroke is also referred as transient ischemic attack (TIA) that occurs when blood flow stops for some time. Symptoms of mini-stroke last up to 24 hours, in some cases it lasts for only 1 to 2 hours. It can be diagnosed through MRI even if symptoms of mini-stroke are temporary. MRI should be done as quickly as possible to diagnose.
ii. What all diagnostic tests are there to determine the effects of stroke?+
Doctors first perform CT scan, series of X-rays or head MRI to diagnose whether there is bleeding in the brain. Accordingly, other tests are done like ECG, blood tests, CBC, Blood sugar, Liver and kidney function tests, Electrolytes and prothrombin time to check how much time it takes to clot the blood.
iii. Is it possible to detect if a person has had stroke?+
Yes, it is possible to detect if a person knows the symptoms of a stroke. Person with risk of stroke will have unclear speech, speak wrong words, will not able to walk properly, weakness will be observed. These are some common signs that can identify stroke, but silent stoke is hard to realize till the time it cause damage in the brain.
iv. Can stroke occur in young age also?+
Generally 2/3rd of strokes happen in the people over 65, but even younger people can be at risk. Stroke risk increase with age but anyone at any age can have a stroke. Sometimes obesity, high blood pressure, diabetes and heart disease can form a reason for stroke at younger age. It is always better to recognize the symptoms of stroke irrespective of age.
Diabetes
i. What are the early signs of diabetes?;+
Early signs of diabetes are minor and many people do not realize that they are suffering from diabetes. Following are some early signs for both the types of diabetes:
- Hunger and Fatigue
- Blurred vision
- Frequent urination and getting thirsty
- Dry skin and have more infection than usual
ii. Can diabetes be tested at home? Are there any risks associated with home testing?+
Diabetes can be tested at home by using home blood glucose monitors to manage the condition on regular basis. Glucose meter are simple to use, there are no such risks associated with home testing. If the person is testing for the first time, it is better to opt for proper diagnosis test in hospital or clinic.
iii. What is the normal range for blood sugar?+
Normal range for blood sugar of a healthy person is between 72 to 108mg/dL, when fasting and it should be up to 140mg/dL after 2 hours of eating. For people with diabetes, normal range for blood sugar level before meal is 80 to 130 mg/dL and under 140 to 199 mg/L after meal.
iv. Can diabetes be properly tested with single blood test?+
A1C test which is sometimes called HbA1c or hemoglobin A1c is used to diagnose type 2 diabetes and prediabetes alone in combination of with other diabetes tests. This single test allows a doctor to determine the level of blood sugar in the body for normal diabetic patient and gives a better result. It is always better to be recommended by doctor first.
v. What are the signs of sudden fluctuation of my sugar level? What should be immediate action?+
Person with sudden fluctuation will start feeling vertigo and nausea, severe pain in feet and feeling of weakness will also be observed. It is advisable to have digital glucometer at home to identify high / low sugar level immediately. Immediate physician consultation is recommended in such cases.
Fever
i. What is the normal body temperature and what is the temperature during fever?;+
The average normal body temperature is 98.6oF (37oC), which can vary upto 1oF (0.6oC) above or below the normal temperature throughout the day. Any body temperature above the normal range is generally considered as fever. However, medically, a person is not considered to have a significant fever until the temperature is above 100.4oF (38oC).
ii. How can I detect my fever without thermometer?+
During fever, there is a temporary increase in body temperature. On putting your head on your forehead if it feels hot to touch, you may have fever. In fever even the skin on entire body may feel hot. Signs such as body ache, flushed complexion, fatigue, chills, dehydration, and loss of appetite are also an indication of fever.
iii. How do I get fever, what all can be the reasons behind my fever?+
There are can several reasons which can cause fever – infection from bacteria, virus, parasites and fungi; reaction to certain medication or immunization, chronic conditions associated with inflammation such as rheumatoid arthritis, severe trauma including surgery and during certain types of cancer.
iv. What all diagnostic tests are there to detect fever?+
Common diagnostic tests like Complete Blood Count (CBC), Urine routine and microscopic examination (Urine R/M) and a blood culture test to detect fever.Further, there are specific tests for specific fever types like Widal’s test for typhoid fever, dengue test for dengue fever, Mantoux test for tuberculosis, etc. The tests required for this will vary significantly depending on the locality, seasonality, etc. as the cause of fever keeps changing based on this.
Infertility
i. How can someone know if she/he is infertile?;+
The first and very common sign is inability to achieve a pregnancy. If age of couple is below 40 years, and if they have been trying to conceive for long without success, it can be sign of infertility. .There are physical, imaging and blood tests which gives the accurate reason for not conceiving. Some of the pathological tests like hormone test, sperm count etc. followed by a physical examination with a doctor can help clearly diagnose the infertility in men or women.
ii. What all diagnostic tests are there for infertility?+
There are different diagnostic test for men and women apart from physical examination.
Tests for Men:
Semen Analysis: Lab will analyze semen specimen to understand if men produce enough healthy sperm
Hormone testing: a blood test to determine the level of testosterone and other male hormones
Testicular biopsy: may be performed to identify abnormalities contributing to infertility
Other tests: Doctor may suggest few imaging tests, genetic tests to evaluate the abnormalities
Test for Women:
Hormonal testing: a blood test measures whether woman is ovulating, the quality and quantity of the eggs available for ovulation, levels of ovulatory hormones, as well as pituitary hormones that control reproductive processes
Imaging test like ultrasound, diagnosis surgeries like laparoscopy is very good to understand abnormality with uterus and fallopian tube
iii. What can be the possible reasons behind someone’s infertility?+
Various factor are there which causes infertility like ovulation disorder, hormonal imbalance, polycystic ovarian disorder (PCOD), blocked fallopian tubes, endometriosis poor egg health, very low or very high body weight in women. While in men, low sperm count and poor sperm health are the major reasons. Poor life style, excessive body weight, excessive stress can lead the major reasons of infertility in both men and women.
Bone Health
i. What is a bone density test? What does it actually represent?;+
A bone density test is the only test which diagnose osteoporosis, as it helps to estimate the density of your bones. It is also called as bone mass measurement test which helps doctor to make recommendation to help you protect your bone. A bone density test will tell you normal bone density, low bone density (osteopenia) or osteoporosis. Lower bone density increases the risk of breaking a bone.
ii. What is a healthy bone mineral density?+
BMD, bone mineral density is reflecting the strength of bone and represents the calcium content. Bone mass/ density always changes throughout your life. You start build up bone mass in young age and you will start losing it as you get older. .Bone mass is usually expressed in a scores. A Z-score of anything between -1 and 1 is normal, a Z-score between -1 and -2.5 means you have low bone mineral density and a Z-score of -2.5 or lower means you have osteoporosis.
iii. What all diagnostic tests are there for osteoporosis?+
To diagnose osteoporosis, bone mass density (BMD) test needs to perform. It is most commonly performed using dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry.
Apart from these, hormonal deficient test is required to perform because low bone mass and an increased risk of developing the disease, is menopausal or due to hormone-deficiency in women. Other diagnostic imaging tests that may be done to measure BMD and to detect osteoporosis include CT scans (computerized tomography), X-rays, and ultrasounds.
iv. What is the correlation between vitamin D, calcium and healthy bones?+
Nutritional Deficiency
i. Why vitamin B12 deficiency is common and how does it affect on body?;+
Vitamin B12, an essential micronutrient, plays a crucial role in the formation of red blood cells and maintaining the health of the nerve tissue. Vitamin B12 deficiency is common in Indian due to vegetarian diet that lacks eggs and milk product.
Deficiency of vitamin B12 would lead to megaloblastic anemia, which is a type of anemia that often produces fatigue and tachycardia (rapid heart rate), and sometimes dizziness. It causes a range of symptoms, such as fatigue, forgetfulness and tingling of the hands and feet.A person with vitamin B12 deficiency would be at risk of dementia (memory loss), depression, stroke, myelopathy (spinal cord disease). Other associated diseases can be thyroid disorders and multiple sclerosis.
ii. What all diagnostic tests are there for nutritional deficiency?+
A vitamin blood test measures the amount of a specific vitamin in your blood. Your personal level of that vitamin is then compared to a reference range that defines healthy levels of that nutrient in your body.
Major vitamin tests includes Vitamin A, E, B12, D, beta carotene. There are tests to measure Iron, folic acid, electrolyte for various minerals. Calcium test helps to measure level of calcium in body to assess general health or for parathyroid conditions
iii. What are the symptoms of nutritional deficiency?+
Calcium and Iron deficiency can cause muscle cramps coarse hair, psoriasis etc. Magnesium can cause muscle contraction and cramps, abnormal heart rhythms, anxiety, high blood pressure. Zinc deficiency can result in low immunity, mouth ulcer, Coarse, brittle, thinning hair, skin problems, stretchmark.
iv. Does the chances of nutritional deficiency increases with age?+
Yes, adults tend to eat fewer calories, due to decreased appetite and activity levels. This decrease in caloric intake can also lead to deficient levels of vitamins and minerals.
Acne
i. What causes acne?;+
Acne is chronic inflammatory skin condition causes spots and pimples, especially on the face, shoulders, back, neck, chest, and upper arms. It generally occurs during puberty period. Pimples grow when the follicles of skin pores get blocked, and oil builds up under the skin.
Other reasons are hormonal changes, emotional stress, menstruation, and use of some greasy cosmetics.
ii. How can severe acne be treated fast?+
For severe acne, you must visit doctor or dermatologist. You may be prescribed with oral antibiotics to reduce bacteria and fight inflammation. Along with that you may prescribed topical creams (medicine) to apply on your acne. .
iii. When should I see a dermatologist for acne treatment?+
Acne is common condition that occurs during puberty. It gets severe when over the counter treatment doesn’t work, and you start noticing its spread and scars. One should definitely consult a dermatologist if all OTC remedy stop working, one should also consult a doctor if he/she has cystic acne which causes pitted facial scars, if he/she has some inflammatory condition like irregular periods, hormonal imbalances etc. which makes the condition worse.
iv. Which are the diagnostic test that dermatologists recommend for acne?+
Dermatologist recommend bacterial test in which microbiological examination and culture of acne spot is performed. Hormonal test can be performed like testosterone, SBHG, free androgen index, prolactin, cortisol, dexamethasone suppression test. Ultrasound test is performed to analyses ovarian cysts and tumors on the ovary and adrenal gland.
Lactose Intolerance
i. How can milk allergy be tested?;+
For milk allergy, you will be asked detail question about signs and symptoms, they ask you to keep a detail diary of food and to eliminate milk and again add back in diet to see the reaction.
Doctor generally recommend two test, a skin test and blood test. However blood test is more accurate than skin test. In skin test, your skin is pricked and exposed to small amounts of the proteins found in milk. If you're allergic, you develop a raised bump (hive) at the test location on your skin. While a blood test can measure your immune system's response to milk by measuring the amount of immunoglobulin E (IgE) antibodies in your blood.
ii. How can a person find out if he / she is lactose intolerant?+
A person can find that he/she has problem with milk or milk product if the symptoms are there within 30 minutes of milk consumption. Symptoms are abdominal bloating, pain or cramps, diarrhea, flatulence or gas, nausea which may accompanied by vomiting. Accurate diagnosis of lactose intolerance is through lab test suggested by doctors. .
iii. What all food items should be avoided by a lactose intolerant person?+
Lactose intolerance is the inability to digest and absorb lactose, the natural sugar found in milk and milk products. All pure milk products like milk, yogurt, cream, butter, ice cream and cheese should be avoided depending on severity of the condition. Other food products in which milk is also used as an ingredient should also be avoided. For example breads and baked goods, pancake mixes, ready-to-eat breakfast cereals, instant soups, candy, cookies, salad dressings, deli meats etc.
iv. Can a person suddenly become lactose intolerant?+
Theoretically a person can become lactose intolerant at any stage of life. But it is commonly diagnose in early stage of life in teenage or in early adult hood. Lactose intolerance is caused by a deficiency in the enzyme lactase in the inner lining of the GI wall, which can develop at any stage of life. For this you should start tracking the food you consume and check what exactly cause the problem.
Pregnancy
i. How early can a home pregnancy test detect pregnancy?;+
One should opt home pregnancy test after 8 to 10 days of missed periods. Home pregnancy test is very sensitive test which detects the presence of hCG (human chorionic gonadotropin), a pregnancy hormone. The development of this hormone may vary in each pregnancy. Hence, it is advisable to perform home pregnancy test after 8 to 10 days of missed period.
ii. Which pregnancy tests does doctors use?+
There are two common test which doctors recommend, Urine tests and Blood tests. Urine test is performed with use of home pregnancy kit at home or at doctor’s clinic. If it gives positive result, doctor recommend blood test and sonograms. Blood tests are to confirm pregnancy as early as 10 days after a missed period. Blood test will also have beta hCG which measures exact amount of pregnancy hormone (hCG) in your blood.
iii. When does the pregnancy symptoms start appearing?+
Pregnancy symptom start appearing early from 5th week to latest by 8th week of conception. The first sign of pregnancy is usually a missed period. The most common symptoms to follow are nausea, vomiting, fatigue, frequent urination, and breast tenderness and swelling. Symptoms like morning sickness, feeling exhausted, and mood swings are also there. It varies with each pregnancy.
iv. What all diagnostic tests must be done during pregnancy?+
Some of the mandatory diagnostic test during pregnancy are ultrasound test and blood tests. Blood sugar test must be performed during the pregnancy for screening of assesses your risk for gestational diabetes. CBC and thyroid test are suggested based on requirement. Urine test is recommended in each trimester to check the bacteria, kidney function, level of protein and glucose level.
Cancer
i. What are the early signs of cancer?+
Symptoms like coughing-up blood, persistent headaches, unexplained loss of weight or appetite, chronic pain in bones, persistent fatigue, nausea and vomiting, persistent low grade fever and repeated instances of infection may also indicate presence of some form of cancer.
ii.Do blood tests detect cancer?+
Complete blood count (CBC) can show cancer cells, proteins or other substances made by cancer. It also gives an idea to doctors how well the organs are functioning and if they have been affected by cancer.
iii.How cancer screening is done?+
Screening tests helps to find cancer at an early stage, before the symptoms appear. When abnormal tissue or cancer is found early, it may be easier to treat or cure. By the time symptoms appear, the cancer may have grown and spread. This can make the cancer harder to treat or cure. Screening tests are done when a person has no cancer symptoms.
iv. What types of cancer screening tests are available?+
- Colonoscopy, sigmoidoscopy and high sensitivity fecal occult blood tests (FOBTs) for colorectal cancer
- Low dose helical computed tomography for lung cancer
- Mammography for breast cancer
- Pap test and human papillomavirus (HPV) testing for cervical cancer
- Alpha-fetoprotein (AFP) blood test for liver cancer
- Carcinoembryogenic antigen (CEA) for colon cancer
- Carbohydrate antigen 125 (CA-125) associated with ovarian cancer
- Carbohydrate antigen 19.9 (CA-19.9) for cancers of digestive tract
- Beta-human chorionic gonadotropin (ß-HCG)
Allergies
i. Is there a blood test for allergy? Which other diagnostic tests are there for allergy?+
A blood test along with skin allergy test can detect a patient’s sensitivity to common inhalants or food. Blood test detect and measure the amount of allergen specific antibodies like IgE against it. Allergy blood test may be referred as immunoassay tests. Skin test has three different ways depending which test doctor prefer, including scratch test where doctor will mark and label areas on your skin with a pen and place a drop of a potential allergen on each of those spots. Next, they'll scratch the outer layer of your skin to let the allergen in. Doctor performs intradermal test where they inject a small amount of allergen just under your skin. Patch test in which doctor could put an allergen on a patch and then stick that on your arm or back to understand the reaction.
ii.How do doctors find out what a person is allergic to?+
Doctors can ask you several questions to assess what actually triggers the allergy. They check few symptoms like runny nose, cold, itchy watery eyes, skin rashes and can ask you about your food intake. Doctor recommend skin test, blood test or food elimination tests to understand with what person is allergic to.
iii.Is allergy seasonal?+
Not all allergies are seasonal, but if you are experiencing sneeze and cough, or your nose and eyes itch and are runny during certain times of the year, seasonal allergies can be the reason. Different people experience seasonal allergy in different seasons, and can be prevented by avoidance of getting exposure of certain weather conditions.
iv.What is Elimination test for food allergy? +
Food Elimination test along with blood and skin test helps to diagnose food allergy. Doctor usually suggest this test along with maintaining food diary and duration of this test would be two to four weeks. During this period, patient will have to avoid the suspect foods while the doctor monitors symptoms. It should be undertaken with doctor’s supervision.
Arthritis
i.What all diagnostic tests are there to detect arthritis?+
There are several tests to confirm the diagnosis, and assess the possible and severity of arthritis condition.
Blood tests like CBC, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), liver function test and kidney function test to confirm the diagnosis. Imaging tests like X-ray, MRI, CT and ultrasound to detect inflammation and its severity.
Other tests like synovial fluid analysis and urine tests could also be recommended by the doctor.
ii.How can a person identify whether he is suffering from arthritis or not?+
Pain, stiffness and swelling in joints tend to indicate a patient that he could be suffering from arthritis.
iii. In which parts of the body can arthritis occur?+
Arthritis can occur in knees; hips; wrist, hands and fingers; shoulder; back and neck; elbows; ankles; foot, heel and toes.
iv.How do you get rid of arthritis pain?+
Doctors generally prescribe NSAIDs and other painkillers, topical painkillers in form of creams, gels and patches.
Wearing right footwear and avoiding heels also helps in the condition.
Some people prefer acupuncture test.
Systemic Lupus Erythematosus
i.What are the first signs and symptoms of lupus?+
The first signs and symptoms of lupus are as follows:
- Fatigue
- Unexplained fever
- Skin rash or lesions
- Hair loss
- Swollen and painful joints
- Pulmonary issues
- Gastrointestinal problems
ii.What are the different types of lupus?+
There are four different types of lupus:
- Systemic Lupus Erythematosus (SLE) – most common form of lupus and is more serious than the other 3 forms. SLE can affect many parts of a person’s body, including kidneys, heart, lungs, brain, blood and skin
- Discoid (cutaneous) - Discoid form of lupus only affects the skin and causes rashes. These rashes may be anywhere but are usually found on the face, neck and scalp. This type of lupus does not affect any of the internal body organs
- Drug-induced lupus (DIL) - occurs after a person takes certain types of medication. The symptoms are similar to systemic lupus, but they usually disappear when the medicine is stopped. Symptoms are typically gone within six months, however the Antinuclear Antibody (ANA) test (used to help diagnose lupus) may stay positive for years
- Neonatal lupus - In rare cases, the newborn of a mom with lupus or another autoimmune disease may have neonatal lupus. This condition can cause skin rashes, anemia or liver problems. Symptoms usually go away after a few months and don’t cause permanent damage
iii.Who usually gets lupus?+
People of African, Asian and Native American descent are more likely to develop lupus as compared to Caucasians. Although, it can occur in both men and women, most of people diagnosed with SLE are women.
iv.Can women with lupus have healthy pregnancies?+
Pregnancy is possible in most patients with lupus. However, complications are frequent; all patients must be considered high risk. In pregnancy or planned pregnancy, referral for specialty care is always appropriate. Patients with antiphospholipid antibody are at risk for pregnancy loss; patients with anti-Ro/SSA and anti-La/SSB antibodies are at risk for delivering a child with neonatal lupus.
Coagulation
1. What is a coagulation disorder?+
Coagulation disorders are disruptions in the body's ability to control blood clotting, an essential function of the body designed to prevent blood loss. The most commonly known coagulation disorder is hemophilia, a condition in which a critical component of blood coagulation is missing, causing individuals to bleed for long periods of time before clotting occurs.
ii.What can cause coagulation disorder?+
It can be caused by reduced levels or absence of blood-clotting proteins. Factors like genetic disorders such as hemophilia and von Willebrand's disease, can cause a reduction in clotting factors.
iii.What are the treatment options for people with coagulation disorder?+
It can be treated with factor replacement therapy which involves injecting clotting factor concentrates into the bloodstream. These injections can prevent or control excessive bleeding. It can also be treated by frozen plasma transfusions if there is need of more clotting factors.
iv. What are causes of coagulation disorder?+
- Low platelets
- Vitamin K deficiency
- Side effects from certain medications
Sexually Transmitted Diseases (STDs)
1. How do I know if I have an STD??+
Many STDs do not show any signs or symptoms, and those that do often display symptoms that mimic other illnesses. It is important to get tested, so that a person knows his status and does not unknowingly transfer STDs to others. To complicate matters more, a person can have multiple STDs at once, making it very tough to diagnose without testing. .
ii.I have never had sex, can I have an STD?+
Yes, a person can get STDs even if he is virgin. Some STDs spread by sharing needles, from unsterilized tattooing equipment, from kissing, or skin-to-skin contact. Sometimes, STDs affect areas of skin apart from sexual organs. For example, herpes can spread by kissing or shedding skin cells that contain it.
iii.Is there a cure for STDs?+
Some STDs have a cure, while others do not. Human Papillomavirus (HPV) is preventable via vaccine if the immunization is received prior to getting it. Sexually transmitted diseases that are caused by bacteria are curable, especially when treated early on. Bacterial STDs include trichomoniasis (trich), chlamydia, gonorrhea and syphilis. Viral STDs are currently not curable, but all viral STDs have some sort of treatment available. Viral STDs include HIV/AIDS, herpes simplex 1, herpes simplex 2, and HPV.
iv.If I had unprotected sex, when can I get STD tested?+
It can take days or weeks after exposure for the bacteria or virus to be in the body at a level noticeable by testing. It is recommended to get retested in case you initially got tested too soon.
v.Will an STD affect a women’s pregnancy/baby? +
STDs transmitted to fetus during pregnancy may cause mild to life threatening conditions in the baby. Pre-pregnancy testing for sexually transmitted diseases is highly recommended to prevent transmissible diseases of the newborn.
Anemia
1. At what levels of hemoglobin are people considered anemic?+
This varies with gender and age.
- Hemoglobin (Hgb) and hematocrit values are both used to define anemia. These lab values are obtained from a complete blood count (CBC) test. This is performed at a caregiver's office
- Normal range of hemoglobin values for adult men is 14.0 g/dL to 17.4 g/dL. For non-pregnant women, values are 12.3 g/dL to 15.3 g/dL
- World Health Organization defines anemia as less than 12 g/dL for non-pregnant women and less than 13 g/dL for men
ii. Are some types of anemia inherited?+
Some types of anemia are due to inherited or genetic defects like:
- Sickle cell anemia
- Thalassemia (or Cooley's anemia)
- Fanconi’s anemia
iii.What is iron deficiency anemia and can I correct it by changing my diet?+
Iron deficiency anemia develops after the body has a low level of iron for a long time. Foods from animal origin such as beef, chicken, and pork, are good sources of iron. Foods rich in Vitamin C include citrus, bell pepper, strawberries, spinach and cantaloupe. In some cases, iron supplements may be needed in order to correct the iron deficiency. In the case of poor absorption, extra iron may have to be given directly into the vein through a needle.
iv.Why are adolescents prone to iron deficiency?+
During adolescence, there is rapid increase in height and weight and sexual maturation. Also for adolescent girls, menstruation begins - leading to blood loss each month. To cope with these additional demands, there is an increased requirement of iron.