Major Diseases

Disorders of Sleep

Sleep disturbances include too much sleep (hypersomnolence or excessive daytime sleepiness), insufficient or poor-quality sleep (insomnia), and abnormal behavior during sleep Insomnia is usually causedby psychological or psychiatric disorders, shift work and other environmental causes, pain and so on, and will not be discussed further.

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Schizophrenia

Schizophrenia is a psychosis characterised by delusions, hallucinations and lack of insight. Acute schizophrenia may present with disturbed behaviour, marked delusions, hallucinations or with insidious social withdrawal and other so-called negative symptoms and less obvious delusions and hallucinations.

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Depression

Major depressive disorder has a prevalence of 5% in the general population. It is a major cause of disability and suicide. If combined with a medical condition,depression magnifies disability, diminishes adherence to medical treatment and rehabilitation, and may even shorten life expectancy.

Symptoms of depressive disorders

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Mood disorders

Mood or affective disorders include:

• unipolar depression: one or more episodes of low mood

• bipolar disorder

episodes of elevated mood
interspersed with episodes of depression

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Vertigo

Vertigo is defined as an abnormal perception of movement of the environment or self, and occurs because of conflicting visual, proprioceptive and vestibular information about a person’s position in space.

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Migraine

Migraine usually appears before middle age; it affects about 20% of females and 6% of males at some point in life. Some patients assume that migraine is a term encompassing any severe headache but it has a characteristic Cluster headache is strikingly periodic, featuring runs of identical headaches beginning at the same hour for weeks at a time (the eponymous ‘cluster’).

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Headache

Headache is common and causes considerable worry, but rarely represents sinister disease. The causes may be divided into primary or secondary, and most patients, whether presenting in clinic or as emergencies, have primary syndromes.

The tempo of evolution of headache is critical; sudden-onset headache ,maximal immediately, is always a ‘red flag’ and should prompt rapid assessment in hospital for possible subarachnoid hemorrhage or other sinister causes, even though only 10–25% of patients harbour
serious pathology.

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Urinary tract infection

Urinary tract infection (UTI) is the term used to describe acute urethritis and cystitis caused by a microorganism. It is a common disorder accounting for 1–3% of consultations in general medical practice. The prevalence of UTI in women is about 3% at the age of 20, increasing by about 1% in each subsequent decade.

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Tuberculosis

• Massive haemoptysis
• Cor pulmonale
• Fibrosis/emphysema
• Atypical mycobacterial infection
• Aspergilloma
• Lung/pleural calcification
• Obstructive airways disease
• Bronchiectasis
• Bronchopleural fistula

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