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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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