Introduction to Common Medical Conditions

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Module 1: Introduction to Common Medical Conditions

Glucose Insulin and Diabetes Every cell in the body needs energy to function

Muscles needenergy to contract

Primary source of energy is glucose

Glucose is delivered to cells via blood stream

Glucose needs insulin, insulin needs to bind with insulin receptors so the glucose can be

taken up by the cell

Insulin produced in pancreas

Glucose will not be able to enter the insulin receptors if the pancreas does not produce

enough insulin, this is known as type 1 diabetes (no energy)

Insulin is produced by pancreas however the insulin receptors are desensitized, this is known

as type 2 diabetes (too much sugar causes damage to body)

Managing type 1 diabetes: Inject insulin

Blood Sugar Levels Blood Sugar Concentration glucose
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Glucose Concentration Conversion 80 MG/DL

Decilitre = 1/10th

Litre

80*10 = 800mg

Milligrams 1/1000th

= 1 gram

0.8 G/L

0.8*5 = 4 grams per human (Average glucose) Approx. 1 tsp. per human being

A1C Levels Red blood cells carries oxygen

Haemoglobin makes red blood cells red

Haemoglobin and Glucose can bind to each other, this is known as glycated haemoglobin

(Haemoglobin A1C) A1C Levels measuring the % of Haemoglobin

Average 4-6%

> 7 or 8% is considered high (considered more blood sugar than a normal person)

120 day lifespan of Haemoglobin


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Heart Disease and Heart Attacks Heart pumps blood and takes blood in from the rest of the body.

Blue gets pumped to lungs and becomes oxygenated which goes back to the heart and gets

pumped round the rest of the body as it is now oxygenated.

Arteries provide blood to the heart, are the ones that get clogged. (Left Coronary Arteries)

Left Coronary Arteries (LCA) Right Coronary Arteries (RCA)

Plaques are formed to the arteries (lipids and fat and dead white blood cells)

Formation of plaque is called atherosclerosis, narrows the vessel, disrupting the blood flow

Schema is the deprivation of blood flow downstream known as coronary artery disease/

heart disease

Heart disease is one of the causes to Heart failure

Heart failure means it is failing to provide the needs for the person, not providing adequate

function for the person

Angina Pectoris, strangling feeling in the chest (chest pain) Symptom of heart disease

If plaque is unstable it can rupture (turbulent blood flow may stimulate the rupture) thisbecomes highly thrombogenic (causes blood clots due to ruptured plaque)

This obstructs blood flow, this will stop cells downstream getting oxygen causing them to die

known as infarction (heart tissue begins to die) **PRIMARY CAUSE OF HEART ATTACK**

Cardiac Arrest is actual dying of a heart Enough of an infarction causes it to die from

oxygen depravation

Heart attack (myocardial infarction) is not a cardiac arrest,

Arterial Thrombo-emboli and Thromboembolisms Blood clots can form on ruptured plaque

Thrombosis is the process of Thrombus (blood clots) forming

Embolus is the term of anything that can float around in the blood and can lodge and

restrict blood flow.

Thrombo-Emboli is clotted material around the released plaque

Thromboembolism is the blocking of a blood vessel by a particle that has broken away from

a blood clot at its site of formation

Stenosis, ischemia and heart failure Stenosis the narrowing of a blood vessel

The narrowing blood vessel restricts blood supply, this leads to loss of function

Ischemia restricting blood supply

The restricted blood supply to the muscle means that the muscle is not getting enough

oxygen leads to heart failure

Heart failure leads to Coronary Artery Disease

Coronary Artery Disease, Coronary Heart Disease and Heart Failure lead to the same thing


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Strokes A rapid loss of brain function

Ischemic StrokeLack of blood flow to particular tissues, occurring in a blood vessel in a

brain, also known as cerebral infarctions

87% of strokes are Ischemic

Haemorrhagic Stroke A situation where a blood vessel breaks

13% of strokes are Haemorrhagic

Normal Colon Tissue Histology Study of tissues

Colon is a piece of the large intestine removed

Mucosa is the lining that makes the mucus, keeps the lining of it from drying out

Two main cells: Goblet cell

Goblet cellsfunction is to secrete mucin, which dissolves in water to form mucus. They use

both apocrine and merocrine methods for secretion.

Hyperplasia in Colon Tissue Hyperplasia means too much growth caused by an irritant

Colon Dysplasia Abnormal Growth and development in colon cells.

Colon cancer generally develops from colon polyps.

Dysplasia can be identified during a colonoscopy.

Neoplasia is the abnormal proliferation of cells.

Prior to Neoplasia, cells often undergo an abnormal pattern of growth, such

as metaplasia or dysplasia.

However, metaplasia or dysplasia does not always progress to Neoplasia.

The growth of neoplastic cells exceeds that of the normal tissues around it.

Cancerous colon tissue Diagnosis of colorectal cancer can be made by barium enema or by colonoscopy with biopsy

confirmation of cancer tissue

Benign tumours are not cancer. They can usually be removed and, in most cases, they do

not come back. Most important, cells from benign tumours do not spread to other parts ofthe body. Benign tumours are rarely a threat to life.

Malignant tumours are cancer. Cancer cells can invade and damage tissues and organs near

the tumour. Also, cancer cells can break away from a malignant tumour and enter the

bloodstream or lymphatic system. This is how cancer spreads from the original (primary)

tumour to form new tumours in other parts of the body. The spread of cancer is called

metastasis.


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Adequacy of the Lateral Cervical Spine X-Ray Adequate view: see from the first vertebra down to the junction of 7th cervical vertebra and

the 1st

thoracic vertebra

Thoracic vertebrae compose the middle segment of the vertebral column, between the

cervical vertebrae and the lumbar vertebrae

Swimmers view: Raise one arm up and lower the other arm

Injury for C7 could lead to paralysis as the spinal cord is behind it

Assessing Alignment of the Lateral Cervical Spine (neck) X-ray Examine the alignment of the columns of the cervical spine. The AVBL, PVL and SLL should

have a smooth curve no steps or discontinuities.

Anterior vertebral body line (AVBL)

Posterior vertebral line (PVL)

Spinolaminar Line (SLL)

Spinal Process tips

Cervical Spine Protection in Airway Management (not a substitutefor formal training)

Airway is blocked e.g. Tongue falls back when conscious as the muscle relaxes

Head tilt, chin liftPulling the tongue out of the way, flexing the neck

** Avoid for trauma victims as it could cause injury **

Jaw thrust Grasping the mandible forward, used for trauma victims

Insert a plastic tube to create a passageway directly into the lungs.


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Introduction to the Endocrine System Hormones are chemical messengers from one part of the body to the other

Hormones go through the blood stream

Small molecules derived from amino acids

Endocrine hormones work from a far distance

Paracrine hormones regionally active, small distance

Autocrine hormones work from a very small distance, right next to that cell

Pituitary gland, master gland creates hormones that work on other organs TSH.

TSH goes to the thyroid glands (regulate metabolism, hunger)

Pituitary gland also makes ACTH for Adrenal gland (sits above of the kidney) (regulates

glucose, metabolism)

Pituitary gland also makes LH Testicles (Testosterone) and FSH Ovaries (Oestrogen)

Pancreas creates insulin


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Bacterial Meningitis (Not viral or parasitic meningitis) Principles of antibiotic choice

1. Site cerebral fluid

Altered stage of consciousness e.g. very sleepy or irritable, lethargic (coma) Fever

Meningeal signs

> Stiff neck

> Seizures

> Abnormal movements/posture

> Asymmetry (reflexes/strengths)

Diagnosis Cerebral Spinal Fluid (CSF)

Lumbar puncture

High White Blood Cells (>0) 1~2000

Low glucose (


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Precocious Puberty

Females start from the age of 10 breasts

10.5 hair

12-13 period

Precocious puberty before the age of 8

Males start from 11.5 testes

12.5 hair

15 mature

Precocious puberty before the age of 9

Variability

Genetics

Over nutrition > high BMI, high growth, increase puberty

Concerns

Final height

Social

Visit

Address parental concerns

Childhood Growth

Ritual of the Bedside Exam

Physical exam Fremitus

Patient Identity

Systemic Thinking About Cancer Small changes in temperature and gravity e.g. eggs to chicken

Cancering to healthing

Study: Breast cancer placebo, osteoporosis

cancers love bone

Phenotype, what it looks like

Phenotype vs Genotype

Vitamin C and the Limeys

Inflammation


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Documents

Introduction to Common Medical Conditions