ELDER TIP Because their thirst mechanism functions less effectively, older adults may not report polydipsia, a hallmark of diabetes in younger adults.
In ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome, dehydration may cause hypovolemia and shock. Wasting of glucose in the urine usually produces weight loss and hunger in type 1 diabetes, even if the patient eats voraciously.
Long-term effects of diabetes may include retinopathy, nephropathy, atherosclerosis, and peripheral and autonomic neuropathy. Peripheral neuropathy usually affects the hands and feet and may cause numbness or pain. Autonomic neuropathy may manifest itself in several ways, including gastroparesis (leading to delayed gastric emptying and a feeling of nausea and fullness after meals), nocturnal diarrhea, impotence, and orthostatic hypotension.
Because hyperglycemia impairs the patient’s resistance to infection, diabetes may result in skin and urinary tract infections (UTIs) and vaginitis. Glucose content of the epidermis and urine encourages bacterial growth.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Pancreatitis:
Signs and Symptoms
(Professional Guide to Diseases (Eighth Edition))
Epigastric pain close to umbilicus, vomiting, abdominal rigidity, decreased bowel activity, mottled skin, low-grade fever, crackles in lung bases, left pleural effusion, malaise
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Pancreatic cancer:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
The most common features of pancreatic cancer are weight loss, abdominal or low back pain, jaundice, and diarrhea. Other generalized effects include fever, skin lesions (usually on the legs), and fatigue. (See Types of pancreatic cancer, page 88.)
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Malignant spinal neoplasms:
Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))
Extramedullary tumors produce symptoms by pressing on nerve roots, the spinal cord, and spinal vessels; intramedullary tumors, by destroying the parenchyma and compressing adjacent areas. Because intramedullary tumors may extend over several spinal cord segments, their symptoms are more variable than those of extramedullary tumors.
The following clinical effects are likely with all malignant spinal cord neoplasms:
❑Pain — Most severe directly over the tumor, radiates around the trunk or down the limb on the affected side and is unrelieved by bed rest. It may worsen when lying down or with straining, coughing, or sneezing. Pain can be diffuse, occurring over all extremities. Generally, it progressively worsens and isn't relieved by medication.
❑ Motor symptoms — Asymmetric spastic muscle weakness, decreased muscle tone, exaggerated reflexes, and a positive Babinski's sign. If the tumor is at the level of the cauda equina, muscle flaccidity, muscle wasting, weakness, and progressive diminution in tendon reflexes are characteristic.
❑ Sensory deficits — Contralateral loss of pain, temperature, and touch sensation (Brown-Séquard's syndrome). These losses are less obvious to the patient than functional motor changes. Caudal lesions invariably produce paresthesias in the nerve distribution pathway of the involved roots.
❑Bowel and bladder symptoms — Urine retention is an inevitable late sign with cord compression. Early signs include incomplete emptying or difficulty with the urine stream, which is usually unnoticed or ignored. Cauda equina tumors cause bladder and bowel incontinence due to flaccid paralysis.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Diabetes mellitus:
Signs and symptoms
(Handbook of Diseases)
Diabetes may begin dramatically with ketoacidosis in type 1 or insidiously. Its most common symptom is fatigue, from energy deficiency and a catabolic state. However, many patients with type 2 diabetes may be asymptomatic.
Insulin deficiency or resistance causes hyperglycemia, which pulls fluid from body tissues, causing osmotic diuresis, polyuria, dehydration, polydipsia, dry mucous membranes, and poor skin turgor. In ketoacidosis and hyperglycemic hyperosmolar nonketotic state, dehydration may cause hypovolemia and shock. Wasting of glucose in the urine usually produces weight loss and hunger in uncontrolled type 1 diabetes, even if the patient eats voraciously.
Long-term effects
In diabetes, long-term effects may include retinopathy, nephropathy, atherosclerosis, and peripheral and autonomic neuropathy.
Peripheral neuropathy usually affects the hands and feet and may cause numbness or pain. Autonomic neuropathy may manifest itself in several ways, including gastroparesis (leading to delayed gastric emptying and a feeling of nausea and fullness after meals), nocturnal diarrhea, impotence, and postural hypotension.
Because hyperglycemia impairs the patient’s resistance to infection, diabetes may result in skin and urinary tract infections and vaginitis. Glucose content of the epidermis and urine encourages bacterial growth.
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Source: Handbook of Diseases, 2003
Pancreatitis:
Signs and symptoms
(Handbook of Diseases)
In many patients, the first and only symptom of mild pancreatitis is steady epigastric pain centered close to the umbilicus. Examination of the abdomen reveals muscle guarding or tenderness. If there’s seepage of bloody exudate from the pancreas, periumbilical bruising (Cullen’s sign) and bruising of the flanks (Turner’s syndrome) may occur. The pain usually begins as a gradually increasing midepigastric pain reaching its maximum intensity several hours after the beginning of the illness. With pancreatitis resulting from alcohol ingestion, the pain begins 12 to 48 hours after an episode of binge drinking. Nausea and vomiting commonly accompany the abdominal pain. However, a severe attack causes extreme pain, persistent vomiting, abdominal rigidity, diminished bowel activity (suggesting peritonitis), right or left pleural effusion, or elevation of the left half of the diaphragm.
Severe pancreatitis may produce extreme malaise and restlessness, mottled skin, tachycardia, and diaphoresis. Hypotension, hypovolemia, hypoperfusion, sepsis, and shock may ensue. Pulmonary complications, secondary pancreatic infections (such as pancreatic abscess or infected pancreatic necrosis) and, later, pancreatic pseudocyst may also occur. The proximity of the inflamed pancreas to the bowel may cause ileus. Renal failure may occur because of severe hypovolemia.
If pancreatitis damages the islets of Langerhans, complications may include diabetes mellitus and enzyme deficiency. (See Chronic pancreatitis, page 602.)
Fulminant pancreatitis causes massive hemorrhage and total destruction of the pancreas, resulting in diabetic acidosis, shock, or coma.
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Source: Handbook of Diseases, 2003
Pancreatic cancer:
Signs and symptoms
(Handbook of Diseases)
The most common features of pancreatic cancer are weight loss, anorexia, abdominal or low back pain, jaundice, diarrhea, steatorrhea, fluid and electrolyte imbalances, and bleeding tendencies. If the islets of Langerhans are affected, signs and symptoms of diabetes may be present. (See Types of pancreatic cancer, page 598.)
Other signs and symptoms include fever, skin lesions (usually on the legs), and emotional disturbances, such as depression, anxiety, and premonition of fatal illness.
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Source: Handbook of Diseases, 2003
Pancreatic Pseudocyst:
Pancreatic Pseudocyst - signs & symptoms
(The 5-Minute Pediatric Consult)
- Abdominal pain
- Abdominal mass
- Abdominal tenderness
- Nausea and vomiting
- Weight loss
- Jaundice
- Abdominal distention:
- In many situations, there are no clinical signs that are seen.
- Clinical signs may be secondary to complications:
- Jaundice in hepatobiliary obstruction
- Lower limb edema in compression of inferior vena cava
- Ascites in peritonitis
- Pleural effusion
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Source: The 5-Minute Pediatric Consult, 2008
Pancreatitis:
Pancreatitis - signs & symptoms
(The 5-Minute Pediatric Consult)
- Upper abdominal pain:
- Usually epigastric with radiation to the back
- May have some relief of pain on stooping forward
- Aggravated by food intake
- Fever:
- Low-grade fever
- High-grade fever is usually due to infection.
- Nausea and vomiting common:
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Source: The 5-Minute Pediatric Consult, 2008
Article Excerpts About Symptoms of Pancreatic cancer:
Pancreatic cancer is sometimes called a "silent disease"
because early pancreatic cancer often does not cause symptoms .
But, as the cancer grows, symptoms may include:
(Source: excerpt from What You Need To Know About Cancer of the Pancreas: NCI)
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