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  • Abdomen Acute
  • Abdominal Infarction
  • Abdominal Pain
  • Abdominal Pain Chronic
  • Abdominal Pain-Lower Abdomen
  • Abdominal Pain-Upper AbdomenAbdominal
  • Absence Seizure
  • Abuse-Psychological, Physical, Or Sexual
  • Acoustic Neuroma
  • Acromegaly
  • Acute Appendicitis, Unspecified
  • Acute Intermittent Porphyria (AIP)
  • Acute Renal Failure
  • Acute Stress Disorder
  • Addison's Disease
  • ADHD Adult
  • ADHD-Sleep Disorder Related To ADHD
  • Adjustment Disorder
  • Adrenal Disease
  • Adrenal Disease-Cushing's
  • Adrenal Insufficiency-Addison's Disease
  • Adult ADHD (ADD)
  • Agoraphobia
  • AIDS-Acquired Immune Deficiency Syndrome
  • Akathisia
  • Akathisia Medication-induced
  • Alcohol Abuse
  • Alcohol Dependence
  • Alcohol Dependence In Remission
  • Alcohol Use Disorder
  • Alcohol-Flush-Aldehyde Dehydrogenase Deficiency
  • Aldehyde Dehydrogenase Deficiency
  • Alopecia Areata
  • Alopecia Secondary To Childbirth
  • Alopecia Universalis
  • Alopecia-Male Pattern Baldness
  • Alopecia-Medication-induced
  • Alopecia-Telogen Effluvium
  • Alopecia-Traction
  • Alport Syndrome
  • Aluminum Toxicity
  • Alzheimer's
  • Alzheimer's Dementia
  • Amnestic Disorder
  • Amphetamine Abuse
  • Amphetamine Dependence
  • Amphetamine Dependence In Remission
  • Amyloidosis
  • Amyotrophic Lateral Sclerosis
  • Amyotrophic Lateral Sclerosis (ALS)
  • Anemia
  • Aneurysmal Subarachnoid Hemorrhage
  • Angina Pectoris
  • Angina Unstable
  • Ankylosing Spondylitis
  • Anorexia Nervosa
  • Anorgasmia
  • Antisocial Personality Disorder
  • Anxiety Disorder
  • Anxiety Disorder Due To Another Medical Condition
  • Anxiety-Agoraphobia
  • Anxiety-Organic
  • Anxiety-PTSD (Post-traumatic Stress Disorder)
  • Anxiety-Specific Phobia
  • Aortic Aneurysm
  • Appendicitis
  • Appendicitis-Acute, Unspecified
  • Arrhythmia
  • Arsenic Toxicity
  • Arthritis
  • Arthritis-Cervical
  • Arthritis-Osteoarthritis
  • Arthritis-Rheumatoid
  • Asperger's Syndrome
  • Asthma
  • Atonic Seizure
  • Atypical Depression
  • Auditory Hallucinations
  • Auriculotemporal Nerve Syndrome
  • Autoimmune Hepatitis
  • Avitaminosis
  • Avoidant Personality Disorder
  • B12 Deficiency
  • Bacterial Preexisting Heart Conditions
  • Balance-Disequilibrium-Benign Positional Vertigo
  • Balance-Disequilibrium-Cerebellar Disease
  • Balance-Disequilibrium-Friedreich's Ataxia
  • Balance-Disequilibrium-Labyrinthitis-Acute
  • Balance-Disequilibrium-Vertigo-Central
  • Balance-Disequilibrium-Vertigo-Medication-induced
  • Balance-Disequilibrium-Vertigo-Peripheral
  • Balance-Disequilibrium-Vertigo-Toxin-induced
  • Balance-Disequilibrium-Vestibular-Neuritis
  • Balding-Alopecia Areata
  • Balding-Alopecia Secondary To Childbirth
  • Balding-Alopecia Universalis
  • Balding-Alopecia-Male Pattern
  • Balding-Alopecia-Medication-induced
  • Balding-Alopecia-Traction
  • Balding-Telogen Effluvium
  • Barbiturate -use
  • Barbiturate Abuse
  • Barbiturate Dependence
  • Benzodiazepine Abuse
  • Benzodiazepine Dependence
  • Benzodiazepine Dependence In Remission
  • Benzodiazepine Use
  • Bereavement
  • Bile Duct Obstruction
  • Binge Eating Disorder
  • Bipolar
  • Bipolar Disorder
  • Bipolar Irritability
  • Bipolar-Atypical Depression
  • Bipolar-Dissociative Disorder
  • Bipolar-Dissociative Identity Disorder
  • Bipolar-Irritability
  • Bipolar-Kleptomania
  • Bipolar-Pathological Gambling
  • Bipolar-SAD (Seasonal Affective Disorder)
  • Bladder Disorder
  • Bladder Disorder, Unspecified
  • Bladder Disorder-Unspecified
  • Bladder-Incomplete Bladder Emptying
  • Bladder-Incontinence-Unaware
  • Bladder-Incontinence-Urge Incontinence
  • Bladder-Incontinence-Urinary Stress Incontinence
  • Bladder-Urinary Urgency
  • Bleeding Disorder
  • Blood In The Urine
  • Blood-Anemia
  • Blood-Bleeding Disorder
  • Blood-Epistaxis
  • Blood-Hematemesis
  • Blood-Hematochezia
  • Blood-Hematuria
  • Blood-Hemochromatosis
  • Blood-Hemoptysis
  • Blood-Melena
  • Blood-Polycythemia
  • Blood-Sickle Cell Anemia
  • Blood-Thrombocytopenia
  • Body Dysmorphic Disorder
  • Body Fluid Change
  • Borderline Personality Disorder
  • Boron Toxicity
  • Bowel-Constipation
  • Bowel-Diarrhea
  • Bowel-Diverticulitis
  • Bowel-Diverticulosis
  • Bowel-Essential Palatal Tremor
  • Bowel-Food Allergy
  • Bowel-Gastritis
  • Bowel-Gastroenteritis
  • Bowel-Hiatal Hernia
  • Bowel-Lactase Deficiency
  • Bowel-Nutrition-Gluten-Celiac Disease
  • Bowel-Nutrition-Lactose Intolerance
  • Bowel-Nutrition-Malabsorption
  • Bowel-Nutrition-Malnutrition
  • Bowel-Nutrition-Tropical Sprue
  • Bowel-Pain-Abdomen
  • Bowel-Pain-Abdomen-Acute
  • Bowel-Pain-Abdomen-Chronic
  • Bowel-Pain-Abdomen-Infarction
  • Bowel-Pain-Abdomen-Lower
  • Bowel-Pain-Abdomen-Upper
  • Bowel-Pain-Abdomen-Visceral
  • Bowel-Pain-Abdomen-Viscus-Perforation
  • Bowel-Pain-Erosive Esophagitis
  • Bowel-Pain-Heartburn-GERD
  • Bowel-Pain-IBS
  • Bowel-Pain-Obstruction
  • Bowel-Pain-Peritonitis
  • Bowel-Pain-PUD (Peptic Ulcer Disease)
  • Bowel-Pain-Regional Enteritis
  • Bowel-Pain-Ulcer
  • Bowel-Pain-Ulcer-Gastric
  • Bowel-Pain-Ulcer-Small Intestine-Duodenal
  • Bowel-Pain-Ulcer-Zollinger-Ellison Syndrome
  • Brain Dementia-Amnestic Disorder
  • Branchial Neuralgia
  • Bronchiectasis
  • Bronchitis
  • Bruxism (teeth Grinding)
  • Bulimia
  • Caffeine Dependence
  • Caffeine Intoxication
  • Caffeine-induced Sleep Disorder
  • Cancer
  • Cancer-Bladder
  • Cancer-Breast
  • Cancer-Cervical
  • Cancer-Colon
  • Cancer-Esophageal
  • Cancer-Gastrointestinal
  • Cancer-Kidney
  • Cancer-Leukemia
  • Cancer-Leukoplakia
  • Cancer-Lung
  • Cancer-Lymphoma
  • Cancer-Malignant Neoplasm: Mouth, Unspecified
  • Cancer-Medullary Thyroid Carcinoma
  • Cancer-Melanoma
  • Cancer-Mouth
  • Cancer-Multiple Myeloma
  • Cancer-Ovarian
  • Cancer-Pancreatic
  • Cancer-Pituitary
  • Cancer-Prostate
  • Cancer-Renal Cell Carcinoma
  • Cancer-Skin
  • Cancer-Stomach
  • Carbon Monoxide Poisoning
  • Carcinoid
  • Cataract
  • Cerebellar Disease
  • Cervical Spondylosis
  • Charcot-Marie-Tooth Disease
  • Charles Bonnet Syndrome
  • Chlamydia Infection
  • Choledocholithiasis
  • Cholesteatoma
  • Chorea Gravidarum
  • Chronic Daily Headache
  • Chronic Fatigue Syndrome
  • Chronic Kidney Failure (CKD)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Chronic Pain
  • Chronic Renal Failure
  • Circadian Rhythm Sleep Disorder
  • Cluster Headache
  • Cocaine Abuse
  • Cocaine Dependence
  • Cocaine Dependence In Remission
  • Coital Cephalgia
  • Coital Cephalgia-dull Type
  • Coital Cephalgia-explosive Type
  • Coital Cephalgia-postural Type
  • Collagen Vascular Disease
  • Conduct Disorder
  • Congestion-Drug-induced
  • Congestive Heart Failure
  • Congestive Heart Failure (CHF)
  • Constipation
  • Conversion Disorder
  • COPD
  • Costochondritis
  • Cranial Nerve Palsy
  • Creutzfeldt-Jakob
  • Creutzfeldt-Jakob Disease
  • Crohn's Disease Or Regional Enteritis
  • Cushing's Disease
  • Cystic Fibrosis
  • Cystitis
  • Cystitis, Unspecified
  • Deep Vein Thrombosis
  • Dehydration
  • Delirium
  • Delirium-Aneurysmal Subarachnoid Hemorrhage
  • Delirium-Lewy Body Dementia
  • Delirium-Postconcussion Syndrome
  • Delirium-Traumatic Brain Injury
  • Delusional Disorder
  • Delusional Disorder-erotomanic
  • Delusional Disorder-jealousy
  • Delusional Erotomania
  • Delusional Jealousy
  • Dementia
  • Dementia Amnestic Disorder
  • Dementia NOS
  • Dementia Vascular
  • Dementia-Alzheimers
  • Dental-Poor Fitting Dentures
  • Dental-Poor Hygiene
  • Dependent Personality
  • Depersonalization Disorder
  • Depression
  • Depression-Bereavement
  • Dermatopolymyositis
  • Diabetes Insipidus
  • Diabetes Mellitus
  • Diarrhea
  • Disease Of The Small Intestine, Unspecified
  • Disease Of Anus And Rectum, Unspecified
  • Disease Of Biliary Tract, Unspecified
  • Disease Of Intestine, Unspecified-Colon Proximal
  • Disease Of Intestine, Unspecified-Small Intestine
  • Disease Of Stomach And Duodenum, Unspecified
  • Disease Of The Proximal Colon, Unspecified
  • Disequilibrium-Benign Paroxysmal Positional Vertigo (BPPV)
  • Disequilibrium-Central Vertigo
  • Disequilibrium-Cerebellar Disease
  • Disequilibrium-Friedreich\'s Ataxia
  • Disequilibrium-Labyrinthitis Acute
  • Disequilibrium-Vertigo-Medication-induced
  • Disequilibrium-Vertigo-Peripheral
  • Disequilibrium-Vertigo-Toxin-induced
  • Disequilibrium-Vestibular Neuritis
  • Disorder Of Brain, Unspecified-Brainstem Or Pons
  • Disorder Of Brain, Unspecified-Hemisphere
  • Disorder Of The Brainstem Or Pons, Unspecified
  • Disorder Of The Cerebral Hemisphere, Unspecified
  • Disorder-Body Dysmorphic
  • Disorder-Impulse Control
  • Disorder-Intermittent Explosive
  • Disruptive Behavior Disorder
  • Disruptive-Conduct Disorder
  • Dissociative Disorder
  • Dissociative Identity Disorder
  • Dissociative-Depersonalization Disorder
  • Diuretic-induced Hypokalemia
  • Diverticulitis
  • Diverticulosis
  • Drug Induced Edema
  • Dry Mouth
  • Dyspareunia
  • Dysthymia
  • Early Morning Awakening
  • Eating Disorder
  • Eating Disorder, Medication-induced
  • Eating Disorder-Binge
  • Eating-Anorexia Nervosa
  • Eating-Bulimia
  • Eating-Laxative/Diuretic Abuse
  • Eating-Obesity
  • Eating-Reactive Hyperphagia
  • Eating-Weight Gain-Drug-induced
  • Edema
  • Edema-Drug Induced
  • Electrolytes-Magnesium-Hypomagnesemia
  • Electrolytes-Potassium Deficiency
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Empty
  • Endocrine Disease-Adrenal
  • Endocrine-Adrenal Disease
  • Endocrine-Adrenal Insufficiency-Addison's Disease
  • Endocrine-Adrenal-Cushing's
  • Endocrine-Adrenal-Hyperaldosteronism
  • Endocrine-Carcinoid
  • Endocrine-Diabetes Mellitus
  • Endocrine-Diabetes Mellitus-Hypoglycemia
  • Endocrine-Gout
  • Endocrine-Hyperparathyroidism
  • Endocrine-Hyperparathyroidism - Primary Type
  • Endocrine-Hyperparathyroidism - Tertiary Type
  • Endocrine-Hypogonadism
  • Endocrine-Hypoparathyroidism-reversable
  • Endocrine-Hypopituitarism
  • Endocrine-Hypothyroidism
  • Endocrine-Metabolic Syndrome
  • Endocrine-Pancreatic Disease
  • Endocrine-Pancreatitis
  • Endocrine-Pheochromocytoma
  • Endocrine-Pituitary Adenoma
  • Endocrine-Porphyria Acute Intermittent
  • Endocrine-Thyroid-Hyper
  • Endocrine-Thyroid-Hypo
  • Enuresis
  • Enuresis/Bedwetting
  • Epilepsy-Seizure-Absence (petit Mal)
  • Epistaxis
  • Erectile Dysfunction
  • Erosive Esophagitis
  • Erythema-Drug Induced
  • Essential Palatal Tremor
  • Essential Tremor
  • Estrogen Related Hair Growth
  • Excessive Daytime Sleepiness
  • Exhibitionism
  • Eye-Cataract
  • Eye-Glaucoma
  • Factitious Disorder
  • Fainting
  • Fatigue
  • Fatigue-Chronic Fatigue Syndrome
  • Fatigue-Myasthenia Gravis
  • Female Orgasmic Disorder
  • Female Pattern Baldness
  • Female Sexual Arousal Disorder
  • Fetishism
  • Fibromyalgia
  • Fluid-Dehydration
  • Fluid-Polydipsia Psychogenic
  • Fluid-Polydipsia Secondary
  • Fluid-Weight Change
  • Flush-Aldehyde Dehydrogenase Deficiency
  • Flushing
  • Flushing Of Skin Due To A Spinal Cord Lesion Above T6
  • Flushing Of The Skin
  • Flushing-Drug Induced
  • Flushing-Gustatory Flushing Syndrome
  • Flushing-Harlequin Syndrome
  • Flushing-Mastocytosis
  • Flushing-VIPoma
  • Folic Acid Deficiency
  • Food Allergy
  • Friedreich\'s Ataxia
  • Frotteurism
  • Gallbladder Disease
  • Gallbladder Disease-choledocholithiasis
  • Gastric Or Peptic Ulcer
  • Gastritis
  • Gastroenteritis
  • Gastroesophageal Reflux Disease (GERD)
  • Gender Identity Disorder
  • Generalized Anxiety Disorder
  • Giant Cell Arteritis
  • Gingivitis
  • Glaucoma
  • Glomus Tumor (paraganglioma)
  • Glomus Tumors
  • Gluten-Celiac Disease
  • Gonorrhea
  • Gout
  • Guillain-Barre Syndrome
  • Gustatory Flushing Syndrome
  • Hair-Alopecia-Male Pattern Baldness
  • Hair-Balding-Alopecia Areata
  • Hair-Balding-Alopecia Medication-induced
  • Hair-Balding-Alopecia Secondary To Childbirth
  • Hair-Balding-Alopecia Universalis
  • Hair-Balding-Alopecia-Telogen Effluvim
  • Hair-Balding-Alopecia-Traction
  • Hair-Estrogen Related Hair Growth
  • Hair-Female Pattern Baldness
  • Hair-Tinea Capitis
  • Hair-Trichotillomania
  • Hallucination
  • Hallucination-Gustatory
  • Hallucinations
  • Harlequin Syndrome
  • Head Trauma
  • Head-Trauma To Scalp
  • Headache
  • Headache-Chronic Daily Headache
  • Headache-Cluster Headache
  • Headache-coital Cephalgia
  • Headache-Coital Cephalgia -dull Type
  • Headache-Coital Cephalgia -explosive Type
  • Headache-Coital Cephalgia -postural Type
  • Headache-Hemicrania Continua
  • Headache-Medication Overuse
  • Headache-Migraine
  • Headache-Migraine Probable
  • Headache-Migraine Status
  • Headache-Migraine With Aura
  • Headache-Migraine Without Aura
  • Headache-Migraine-Retinal
  • Headache-Psychogenic
  • Headache-sinus
  • Headache-Tension
  • Hearing
  • Hearing Problem
  • Hearing-Medication-induced Loss
  • Hearing-Meniere's Disease
  • Hearing-Tinnitus
  • Hearing-Traumatic Tinnitus
  • Heart Cardiac
  • Heart Disease
  • Heart-Angina
  • Heart-Angina - Emergency
  • Heart-Arrhythmia
  • Heart-Bacterial Endocarditis
  • Heart-CHF
  • Heart-Claudication-Intermittent
  • Heart-claudication-Neurogenic
  • Heart-HCM
  • Heart-MI
  • Heart-Mitral Stenosis
  • Heart-Pericarditis
  • Heavy Smoker
  • Heavy Tobacco Smoker
  • Hematemesis
  • Hematochezia
  • Hematuria
  • Hemicrania Continua
  • Hemochromatosis
  • Hemoptysis
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatitis D
  • Hepatitis E
  • Hepatitis G
  • Hepatolenticular Degeneration-Wilson's Disease
  • Heroin Abuse
  • Heroin Dependence
  • Heroin Dependence In Remission
  • Hiatal Hernia
  • Hip Pain
  • Histrionic Personality
  • HIV Infection
  • Homicide
  • Huntington's Disease
  • Hyperaldosteronism
  • Hypercalcemia
  • Hypercholesterolemia
  • Hyperhidrosis-Idiopathic
  • Hyperparathyroidism
  • Hyperparathyroidism - Primary Type
  • Hyperparathyroidism - Tertiary Type
  • Hyperprolactinemia
  • Hypersomnia
  • Hypertension
  • Hyperthyroidism
  • Hypertriglyceridemia
  • Hypertrophic Cardiomyopathy
  • Hypoactive Sexual Desire
  • Hypoactive Sexual Desire Disorder
  • Hypochondriasis
  • Hypoglycemia
  • Hypogonadism
  • Hypokalemia
  • Hypokalemia
  • Hypokalemia-Diuretic-induced
  • Hypomagnesemia
  • Hypoparathyroidism
  • Hypoparathyroidism-reversable
  • Hypopituitarism
  • Hypothyroidism
  • Hypothyroidism
  • Idiopathic Hyperhidrosis
  • Impulse Control Disorder
  • Incomplete Bladder Emptying
  • Incontinence-stress Type
  • Incontinence-unaware Type
  • Incontinence-Urge
  • Incontinence-urge Type
  • Increased Intracranial Pressure
  • Infection-AIDS
  • Infection-Creutzfeldt-Jakob
  • Infection-Gonorrhea
  • Infection-HIV
  • Infection-Lyme Disease
  • Infection-Malaria
  • Infection-Rheumatic Fever
  • Infection-Syphilis
  • Infection-Urinary Schistosomiasis
  • Infection-Viral Infection
  • Inferior Temporal Lobe Seizure
  • Inflammatory Disease Of Uterus, Unspecified
  • Inhalant Abuse
  • Inhalant Dependence In Remission
  • Initial Insomnia
  • Insomnia
  • Insomnial-Early Morning Awakening
  • Intermittent Claudication
  • Intermittent Explosive Disorder
  • Intracranial Pressure - Increased
  • Involuntary Emotional Expression Disorder (IEED)
  • Iron Deficiency
  • Irritable Bowel Syndrome (IBS)
  • Kidney Disease
  • Kidney Stone
  • Kidney-Alport Syndrome
  • Kidney-Chronic Renal Failure
  • Kidney-Diabetes Insipidus
  • Kidney-Pyelonephritis
  • Kidney-Renal Failure
  • Kidney-Renal-Failure-Acute
  • Kidney-Uremia
  • Kleine-Levin Syndrome
  • Kleptomania
  • Knee Pain
  • Labyrinthitis Acute
  • Lactase Deficiency
  • Lactose Intolerance
  • Laxative/Diuretic Abuse
  • Lead Toxicity
  • Learning Disorder
  • Leukoplakia
  • Lewy Body Dementia
  • Liver Cirrhosis
  • Liver Disease
  • Liver Disease - Cirrhosis
  • Liver Disease-autoimmune Hepatitis
  • Liver-Cirrhosis-billary
  • Liver-Common Bile Duct Obstruction
  • Liver-Hepatitis B
  • Liver-Hepatitis C
  • Liver-Hepatitis D
  • Liver-Hepatitis E
  • Liver-Hepatitis G
  • Liver-Hepatolenticular Degeneration-Wilson's Disease
  • Liver-Viral Hepatitis
  • LSD Abuse
  • LSD Dependence
  • LSD Dependence In Remission
  • Lung-Asthma
  • Lung-Bronchiectasis
  • Lung-Bronchitis
  • Lung-COPD
  • Lung-Pleurisy
  • Lung-Pneumonia
  • Lung-Pulmonary Embolism
  • Lung-TB
  • Lupus Erythematosus
  • Lupus Erythematosus-Drug Induced
  • Lyme Disease
  • Magnesium-Hypomagnesemia
  • Malabsorption
  • Malaria
  • Male Orgasmic Disorder
  • Malignant Neoplasm Of Mouth, Unspecified
  • Malnutrition
  • Malnutrition-Gluten-Celiac Disease
  • Manganese Toxicity
  • Marijuana Abuse
  • Marijuana Dependence
  • Marijuana Dependence In Remission
  • Mastocytosis
  • Medication Overuse Headache
  • Medication-induced Eating Disorder
  • Medication-induced Erythema
  • Medication-induced Flushing
  • Medication-induced Hearing Loss
  • Meiges Syndrome
  • Melena
  • Meniere's Disease
  • Menopause
  • Menopause-Drug Induced
  • Menopause-early
  • Menopause-Perimenopause
  • Menopause-Postmenstrual Duress
  • Menopause-surgical
  • Mental Retardation
  • Meprobamate Abuse
  • Meprobamate Dependence
  • Meprobamate Dependence In Remission
  • Meprobamate Use
  • Mercury Toxicity
  • Mescaline Abuse
  • Mescaline Dependence
  • Mescaline Dependence In Remission
  • Metabolic Syndrome
  • Metal Toxicity-Aluminum
  • Metal-Aluminum
  • Metal-Arsenic
  • Metal-Boron
  • Metal-Lead
  • Metal-Mercury
  • Metal-Selenium
  • Metal-Tellurium
  • Metal-Zinc
  • Middle Insomnia
  • Migraine Headache
  • Migraine Headache-probable
  • Migraine Headache-retinal
  • Migraine Headache-status
  • Migraine Headache-with Aura
  • Migraine Headache-without Aura
  • Mitral Valve Stenosis
  • Movement Disorder
  • Movement-Akathisia-Neuroleptic-induced
  • Movement-ALS
  • Movement-Chorea Gravidarum
  • Movement-CTD-Polymyalgia Rheumatica
  • Movement-Dermatopolymyositis
  • Movement-Essential Tremor
  • Movement-Guillain-Barre Syndrome
  • Movement-Huntington's
  • Movement-Myoclonus
  • Movement-Parkinson's
  • Movement-Parkinsonism
  • Movement-Tardive Dyskinesia
  • Movement-Tic Disorder
  • Movement-Tourette's Disorder
  • Movement-Transient Tic Disorder
  • Multiple Sclerosis
  • Myasthenia Gravis
  • Myocardial Infarction
  • Myoclonic Seizure
  • Myoclonus
  • Narcissistic Personality
  • Narcolepsy
  • Nasal Congestion-Rebound Congestion
  • Neurodermatitis
  • Neurofibromatosis
  • Neurofibromatosis-I
  • Neurofibromatosis-II
  • Neurogenic Claudication
  • Neuroleptic Malignant Syndrome
  • Neuropathies
  • Night Eating Syndrome
  • Night Sweats
  • Nightmare Disorder
  • Nocturia
  • Nonadherence
  • Nonne-Milroy's Disease
  • Nose Bleed
  • Nutrition-Iron Deficiency
  • Nutrition-Lactose Intolerance
  • Nutrition-Malabsorption
  • Nutrition-Malnutrition
  • Nutrition-Thiamine B1 Deficiency
  • Nutrition-Tropical Sprue
  • Nutrition-Vitamin-Avitaminosis
  • Nutrition-Vitamin-B12 Deficiency
  • Nutrition-Vitamin-B5-Pantothenic Acid Deficiency
  • Nutrition-Vitamin-B6-Pyridoxine Deficiency
  • Nutrition-Vitamin-B9-Folic Acid Deficiency
  • Nutrition-Vitamin-D Deficiency
  • Obesity
  • Obsessive-compulsive Disorder (OCD)
  • Obstruction Intestinal
  • Obstruction-Common Bile Duct
  • OCD
  • OCD Personality
  • OCD-medication Induced
  • Olfactory Hallucinations
  • Opioid Abuse
  • Opioid Dependence
  • Opioid Dependence In Remission
  • Optic Neuritis
  • Oral Cancer
  • Oral Facial Dystonia
  • Oral-Dry Mouth
  • Oral-Gingivitis
  • Orgasmic Disorder
  • Orgasmic Disorder-Female
  • Orgasmic Disorder-males
  • Orthostasis
  • Osteoporosis
  • Other And Unspecified Lesions Of Oral Mucosa
  • Overactive Bladder
  • Pain Abdominal Chronic
  • Pain Abdominal Infarction
  • Pain Disorder
  • Pain Disorder Due To Anatomical And Psychological Conditions
  • Pain Disorder-Psychiatric
  • Pain Disorder-Psychological & General
  • Pain-Abdomen-Acute
  • Pain-Abdominal
  • Pain-Abdominal-Localized To The Lower Abdomen
  • Pain-Abdominal-Localized To Upper Abdomen
  • Pain-Abdominal-Perforation Of Viscus
  • Pain-Abdominal-Visceral
  • Pain-Bowel-Obstruction
  • Pain-Branchial Neuralgia
  • Pain-Chronic Pain
  • Pain-Costochondritis
  • Pain-Erosive Esophagitis
  • Pain-Gastric Ulcer
  • Pain-Heartburn-Gastroesophageal Reflux Disease
  • Pain-Hip
  • Pain-Irritable Bowel Syndrome (IBS)
  • Pain-Peptic Ulcer Disease (PUD)
  • Pain-Peritonitis
  • Pain-Thalamic Central Pain Syndrome
  • Pain-Ulcer
  • Pain-Ulcer-Duodenal
  • Pain-Ulcer-Zollinger-Ellison Syndrome
  • Pancreatic Disease
  • Pancreatic Disease Unspecified
  • Pancreatitis
  • Panic Attacks
  • Panic Disorder
  • Pantothenic Acid Deficiency
  • Paranoid Personality
  • Paraphilia
  • Parkinson's Disease
  • Partial Seizure
  • Partial Seizures
  • Partialism
  • Pathological Gambling
  • Pathological Gambling-medication Induced
  • PCP Dependence
  • PCP Dependence In Remission
  • Pedophilia
  • Pedophilia Exclusive
  • Pedophilia Limited To Incest
  • Pelvic And Perineal Pain
  • Pelvic Inflammatory Disease
  • Pelvic Inflammatory Disease (PID)
  • Perforation Of Viscus
  • Pericarditis
  • Perimenopause
  • Periodic Limb Movement Disorder
  • Peripheral Neuropathy
  • Peripheral Vascular Disease
  • Peripheral Vascular Disease (PVD)
  • Peritonitis
  • Personality Avoidant
  • Personality Disorder
  • Personality-Antisocial
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  • PSY-Learning Disorder
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  • PSY-OCD
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  • PSY-Panic Disorder
  • PSY-Pyromania
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  • PSY-Schizophrenia-Delusional Disorder
  • PSY-Schizophrenia-Delusional Disorder-erotomanic
  • PSY-Schizophrenia-Delusional Disorder-jealousy
  • PSY-Schizophrenia-Schizoaffective Disorder
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  • PSY-Shared Psychotic Disorder
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  • Psychiatric-Abuse-Psychological, Physical, Or Sexual
  • Psychiatric-ADHD
  • Psychiatric-Anxiety Disorder
  • Psychiatric-Anxiety-Agoraphobia
  • Psychiatric-Anxiety-Organic Anxiety
  • Psychiatric-Anxiety-PTSD
  • Psychiatric-Anxiety-Social Phobia
  • Psychiatric-Depression
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  • Psychiatric-Disorder-Body Dysmorphic
  • Psychiatric-Disruptive Behavior Disorder
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  • Psychiatric-Dissociative-Depersonalization Disorder
  • Psychiatric-Impulse-control Disorder
  • Psychiatric-Pain Disorder
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  • Psychiatric-Sleep Disorder Related To ADHD
  • Psychiatric-Somatic-Conversion Disorder
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  • Pulmonary Embolism
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  • Restless Leg Syndrome-neuroleptic Induced
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  • Sjogren's Syndrome
  • SLE
  • SLE-Drug Induced
  • Sleep Apnea
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  • Sleep Terror Disorder
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  • Sleep-Restless Legs Syndrome
  • Sleep-Sleep Apnea
  • Sleep-Sleep Disorder
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  • Sleep-Sleep Disorder Related To Blindness
  • Sleep-Sleep Disorder Related To Chronic Fatigue Syndrome
  • Sleep-Sleep Disorder Related To Down's
  • Sleep-Sleep Disorder Related To GERD
  • Sleep-Sleep Disorder Related To Myopathy
  • Sleep-Sleep Disorder Related To Nocturnal Headaches
  • Sleep-Sleep Disorder Related To Nocturnal Seizures
  • Sleep-Sleep Disorder Related To Spasticity
  • Sleep-Sleep Disorder Related To Tourette's
  • Sleep-Sleep Terror Disorder
  • Sleep-Sleepwalking
  • Sleep-Substance-induced Hypersomnia
  • Sleep-Substance-Substance Induced Sleep Disorder
  • Sleepwalking
  • Social Phobia (Social Anxiety)
  • Somatic-Conversion Disorder
  • Somatization
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  • Somatoform Disorder
  • Spinal Cord Lesions Above T6
  • Stevens-Johnson Syndrome Or Toxic Epidermal Necrolysis
  • Stevens-Johnson Toxic Epidermal Necrolysis
  • Stress
  • Stress-Acute Stress Disorder
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  • Stroke
  • Stroke
  • Stroke - Lateral Hypothalamus
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  • Stroke-Transient Ischemic Attack (TIA)
  • Stuttering
  • Substance Abuse
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  • Substance Induced Sleep Disorder
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  • Substance-Opioid Abuse
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  • Substance-PCP Abuse
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  • Substance-Peyote Abuse
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  • Substance-Psilocybin Abuse
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  • Substance-Psilocybin Dependence In Remission
  • Substance-Sedatives-hypnotics Abuse
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  • Multiple myeloma

    Multiple myeloma is a progressive blood cancer of the class of white blood cells in the bone marrow called plasma cells.

    The immune system, white blood cells, and development of plasma cells

    Certain white blood cells (part of the immune system which helps protect the body from infection and disease) leave the bone marrow and mature in other parts of the body. Some of these immune cells develop into plasma cells when the immune system needs them to fight foreign invaders that cause infection and disease.

    Plasma cells and the production of antibodies

    The plasma cells, when presented with molecules from the infecting agent, produce proteins called  antibodies that move throughout the body via the bloodstream to help the body fight infection by foreign agent (e.g. bacteria and viruses). Each type of plasma cell responds to only one specific foreign invader by making a large amount of a specific antibody to fight that invader. Once a particular plasma cell commits to fighting a particular invader, it makes antibody only for that specific invader, and it cannot make antibody for any other type of invader. However, because in normal conditions the body makes many types of plasma cells, the body has plenty of plasma cells to mount a defense to any invader.

    Abnormal plasma cells and multiple myeloma

    In multiple myeloma, a group of abnormal plasma cells multiplies, elevating the number of plasma cells to a higher than normal level. These abnormal plasma cells are called myeloma cells. People with multiple myeloma have an abnormally large number of identical plasma cells, and they make too much of one type of antibody causing a number of serious medical problems.

    Myeloma cells tend to collect in the bone marrow and in the hard, outer part of bones.

    Plasmacytomas and multiple myelomas

    Sometimes myeloma cells collect in only one bone, forming a single mass, or tumor. These solitary tumors are called a plasmacytoma. However, in most cases the myeloma cells collect in many different bones, and the disease is called multiple myeloma.

    Myeloma-induced bone changes 

    As myeloma cells increase in number, they erode and weaken bones, and cause hypercalcemia and diffuse osteoporosis (thinning of the bones), usually in the pelvis, spine, ribs, and skull. 

    An X-ray of the skull of a person with multiple myeloma taken from the side, and showing multiple "punched-out" holes (typical findings of multiple myeloma). 
    The arrow is pointing at one of the larger holes.

    Myeloma and hypercalcemia

    When bones are damaged, calcium is released into the blood, and too much calcium in the blood (hypercalcemia) can cause loss of appetite, nausea, thirst, fatigue, muscle weakness, restlessness, and confusion. 

    Myeloma and immune dysfunction

    The disease also interferes with the function of bone marrow and the immune system, because myeloma cells prevent the bone marrow from forming normal plasma cells and other white blood cells that are important to the immune system. This interference in normal immune cell production can lead to impaired production of normal immunoglobulin with a subsequent increased susceptibility to bacterial infection.

    Myeloma and Serum protein electrophoresis

    Serum protein electrophoresis is a test that allows the globulins to be characterized further, by separating them according to their physical properties.  The serum is placed on a gel, and an electrical current is applied.  The globulins migrate across the gel based on their charge and size, and a pattern emerges (see the graph below). 

    The figure below shows a typical, normal electrophoresis pattern. 
    Albumin, a serum protein, appears on the left.  The next five components (the globulins) appear and are labeled alpha 1, alpha 2, beta 1, beta 2, and gamma.  The gamma fraction is where the antibodies are found.  

    Infectious and/or inflammatory conditions will cause an increase in globulins, and when electrophoresis is performed, the pattern will still look like that in  the graph above, although the gamma peak might be a little bit larger.

    If, however, the electrophoresis reveals a very tall, narrow peak in the gamma region (see the graph below), it suggests that multiple copies of an identical antibody have been produced by one particular subset or “clone” of cells.  This narrow peak is called a “monoclonal spike”, meaning one (“mono”) clone (“clonal”) is responsible for the pattern seen. The most common cause of this pattern is multiple myeloma. 

    Myeloma-induced anemia

    Myeloma cells also crowd out newly forming red blood cells from the bone marrow causing anemia. and people with anemia feel unusually tired or weak.

    Myeloma-induced kidney dysfunction

    People with multiple myeloma may have serious problems with their kidneys because the excess antibody proteins and excess calcium can prevent the kidneys from filtering and cleaning the blood properly.

    Symptoms of myeloma

    In the earliest stage of the disease, there may be no symptoms, but when symptoms do occur, people frequently have bone pain, often in the back or ribs. 

     

    bone              

    People also may have broken bones, weakness, fatigue, weight loss, or repeated infections. When the disease is advanced, symptoms may include nausea, vomiting, constipation, problems with urination, and weakness or numbness in the legs.

    Epidemiology of multiple myeloma

    Fortunately, multiple myeloma is an uncommon cancer, but it is the most common primary bone cancer. It accounts for 1 percent of all cancers, and it is rarely seen in people under 40 years of age. Fewer than 3 percent of cases occur in people younger than 40 years of age. Multiple myeloma tends to be more common in men than women, and it is twice as common in people of African descent as it is in people of European descent.

    Map showing ovarian cancer death rates in 2004 with the lowest rates represented as light yellow to the highest rates represented by dark red. Gray represents no data available

    Multiple myeloma is an incurable but treatable disease. If you feel you are suffering from multiple myeloma, then see a health care provider immediately. 

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