The field of internal medicine is very comprehensive and important, as it is the department where the diseases usually apply with their first complaints and are directed to the relevant special fields after all the necessary evaluations are made. Laboratory tests such as blood analysis, urinalysis, stool analysis, radiological examinations (computerized tomography, ultrasonography, magnetic resonance imaging, x-ray, etc.), electrocardiography, and endoscopy are performed on patients who apply to the internal medicine unit. After the evaluations, treatment procedures are applied or the patients are referred to the relevant units for more detailed evaluation and treatment methods. Patients often apply to the internal medicine unit with complaints arising from infectious diseases, hypertension, high cholesterol, lung diseases, respiratory tract infections, blood diseases, diabetes, gastrointestinal system diseases, and rheumatic diseases.
Infectious Diseases
Infectious diseases are defined as diseases caused by microorganisms such as viruses, bacteria, fungi, and parasites. Infectious diseases can occur spontaneously in people’s bodies or they can be transmitted between people through air, contact, and water. iruses are microorganisms that cannot reproduce without entering a living organism. Covid-19, influenza, laryngitis, acute bronchitis, hepatitis, measles, meningitis, and the common cold are diseases caused by viruses. Bacteria are single-celled microorganisms that often cause infections in the urinary tract and respiratory tract. They can be treated with the use of antibiotics. Fungi cause infections that usually settle in the same areas of the human body and present with typical lesions. Parasites cause infections with symptoms such as weakness, fatigue, loss of appetite, and diarrhea. Parasites survive by using mosquitoes, tapeworms, worms, lice, and humans as hosts.
Influenza is an infectious disease that causes respiratory tract infection with difficulty in breathing and fever. Influenza is an infectious disease that causes respiratory tract infection with difficulty in breathing and fever. Meningitis, hepatitis disease is an infectious disease that develops due to the elevation of the substance called bilirubin in the blood. Tuberculosis is a bacterial disease that is transmitted from animal to human, often with pain, fever, and loss of appetite. Diarrhea is a disease often transmitted through drinking water.
Although individuals with infectious diseases vary depending on the type and cause of the infection, they usually apply to the clinic with symptoms such as fever, fatigue, diarrhea, and coughing. When the patients are evaluated, the presence of complaints such as dyspnea (shortness of breath), headache, fever, sudden cough, sudden visual disturbances, and redness are questioned.
In infectious diseases, the diagnosis is made with the help of clinical examination and microbiology laboratory tests. Among the laboratory tests, blood analysis, urinalysis, stool analysis, mucous sample, and cerebrospinal fluid obtained by lumbar puncture are frequently used methods.
Treatment of infectious diseases may differ depending on the microorganism causing the infection. Antibiotic treatment is applied to bacterial infections. While antifungal drugs are used in infections caused by fungi, antiparasitic drugs are used in diseases caused by parasites. For the treatment of some infectious diseases, the patient’s medical follow-up is considered important as well as the use of medication. Some infections that are recommended to be treated as inpatients are meningitis (inflammation of the cerebral cortex), gastroenteritis (inflammation of the digestive system), hepatitis (inflammation of the liver), pneumonia, and nosocomial infections.
Diabetes Mellitus
Diabetes mellitus is defined as a higher than normal blood sugar level. High blood sugar is due to the body not producing enough insulin or not using the produced insulin. Insulin is an important hormone that balances blood sugar. Insulin hormone is produced in the cells called insula (islet) in the tail part of the pancreas and released into the body and takes its name from the insula cells. Diabetes is seen in two different types, type 1 and type 2. Type 1 diabetes is a disease that develops due to insufficient insulin production. Type 2 diabetes is characterized by the body’s resistance to the use of insulin, despite the presence of a sufficient amount of insulin in the body. In Type 1, Type 1, and Type 2 diabetes, hyperglycemia (higher than normal blood sugar) is observed, regardless of the cause.
Individuals with diabetes usually apply to the clinic with complaints of weakness, fatigue, urine production more than normal, and constant hunger. Fatigue is felt because the cells cannot meet enough nutrients and energy due to insufficient or not using insulin.
Complications due to diabetes can lead to serious problems with the progression of the disease. The disease often affects the vessels in the toes, causing trophic disorders. Complications in the eye in the advanced stages of the disease can lead to vision problems. Diabetes increases the risk of heart disease by causing systemic changes. n addition, damage to nerve cells, such as the vessels in the feet, causes the clinical picture called “diabetic foot”.
Diabetes is diagnosed by the blood glucose measurement method. Blood glucose measurement includes fasting blood glucose and postprandial blood glucose measurements. Treatment of diabetes is mainly aimed at balancing blood sugar. Type 1 diabetes patients are usually followed up with insulin therapy. Insulin that cannot be produced by the pancreas is given to the body by injection. Type 2 diabetes patients are followed up with the use of antidiabetic drugs. In type 2 diabetes patients, blood sugar is always high and cells are resistant to insulin use. Type 2 diabetes may occur due to genetic predisposition, sedentary life, obesity, and stress. Patients are advised to control their blood sugar, make dietary arrangements, pay attention to regular physical activity, and avoid smoking.
Cholesterol
Cholesterol is a type of lipid produced by all cells in the body and found in the blood. Since cholesterol has a water-soluble structure, it is not possible to self-distribute into the body. Therefore, it uses the lipoproteins produced by the liver as carriers. There are two types of lipoproteins, low-density lipoproteins (LDL) and high-density lipoproteins (HDL).
Low-density lipoproteins provide systemic transport of cholesterol in the blood. High-density lipoproteins transport cholesterol to the tissues and liver. Excess cholesterol in the bloodstream causes it to form plaques by accumulating on the vessel walls. Plaques formed in the vessel wall cause narrowing of the vessel lumen and occlusion in advanced stages. Low-density cholesterol accumulating in the arterial wall hardens the arterial walls, reducing their flexibility and narrowing their lumen, which is called atherosclerosis. The cholesterol deposits that cause atherosclerosis are called atherosclerotic plaques. Atherosclerotic plaques can break up with the effect of blood flow in the artery and mix with the blood. Atherosclerotic plaques that participate in the systemic circulation may circulate throughout the body and create risk factors for many organs.
If atherosclerotic plaques remain stuck in any artery in the circulation, blocking the blood flow in the artery, it can lead to circulatory disorders in the organs or parts of the organs fed by that artery. High-density cholesterol ensures that low-density cholesterol in the circulation is directed to the liver and removed from the body. Removal of low-density cholesterol from the body reduces the risk of atherosclerotic plaque forming.
The normal value of total cholesterol should be below 200 mg/dl. Higher-than-normal cholesterol levels are usually associated with a sedentary lifestyle, obesity, and genetic factors. Some risk factors are known that increase the risk of high cholesterol. Inactivity or lack of regular exercise causes low-density cholesterol to increase and high-density cholesterol to decrease. Accordingly, the exercise habit of the person is directly related to the risk of atherosclerotic plaque formation.
Consuming animal fats and trans fats can lead to increased cholesterol levels. Diabetes and obesity are important factors that cause an increase in cholesterol. High blood sugar causes a decrease in high-density lipoprotein and an increase in very-low-density lipoprotein.
Lifestyle changes are recommended primarily in the treatment of patients diagnosed with high cholesterol. Elimination of risk factors can improve the patient’s cholesterol. In addition, medical treatment that lowers cholesterol can be applied when necessary.