Ingles para 4º y 5º

MINISTERIO DE SALUD PBLICA
FACULTAD DE CIENCIAS MDICAS

CELIA SNCHEZ MANDULEY
MANZANILLO-GRANMA
UPDATED CONSULTING BROCHURE FOR ENGLISH FOR

SPECIFIC PURPOSE LESSONS IN THE 4th AND THE 5th YEAR
OF THE MEDICAL CAREER.
FOLLETO DE CONSULTA
AUTHORS:
Joaqun Salgado Santana *

Lainsdel Salgado Barrero **
Merln Ruiz labrandera Len **
Dannier Fleites Martnez **
Michel Nez Lpez **
Bachelor of Education. Assistant Professor.
**
Student from the 4th year of the Medical Career.

2006
INDEX:
Page
Introduction
Hypertension
Myocardial Infarction Heart Attack
Tonsillitis
11
Pneumonia
14
Asthma
16
Duodenal Ulcer
21
Cirrhosis of the Liver
23
Hypothyroidism
27
Appendicitis
29
Pancreatitis
31
Laceration
35
Carcinoma of the Brest Breast Cancer
37
Coma
39
Trichomonas Infection
43
Prostatic Hypertrophy
45
Fracture
48
Placenta Previa
51
Headaches Migraine
53
Pregnancy
56
Colitis
58
Jaundice
62
Tropical Diseases
65
Bibliography
67
INTRODUCTION:
The future formation of graduated from the Medical Sciences at the country
intimately related to the big labours the government does to become itself into
medical potential worldwide, depending fundamentally on knowledge this future
professional be able to acquire and of constant bringing up to dates of
information that there drives regarding his profession which principally, in great
quantity of books, magazines and periodicals, are published in English language
in the main parts of the world .
In Cuba, Medical Superior Teaching introduced, starting from the 1985-86
course changes in the teaching English language, taking this one to the fifth
year of Medical career. This change led to the indisputable technical and
professional elevation of graduated that from this time on comes afterwards
using the language as cultural element that besides and most of all, by means
of the English language he can learn directly about the scientific and technical
development of sciences using it as an instrument of work in the development
of his profession.
The maximum direction of government decided then the specialization of this
teaching, distributing for the first three years the teaching of Basic English and
for the fourth and fifth year of the career, the English for specific purposes that
is, the Medical English which serves to the future professional worker in order
to study, bringing up to date, information and communication of his professional
life in the so-called universal language.
So, medical themes of specialties which are included in the technical formation
of the future health-care professional, are chose, developed and appeared in
Practical Medicine and Practical Surgery textbooks both for the 4th year and in
Medically Speaking textbook for the 5th year of Medical career.
Nowadays, in teaching of English subjects VII, VIII, IX and X for students of 4th
and 5th year of the Medical Sciences career, textbooks taken from editions of
1984, that is, 22 years, are used yet; it denotes in these moments that they
have obsolete information regarding to the scientific advances occurred in
Medicine's sphere.
Included to this, the investments, the high costs of materials, the payments to
rights authors and a great series of inconveniences, make almost impossible to
change the reality of a country that moreover is blocked for the most powerful
potency of the land; for that reasons the changes, although necessary, must be
gradual.
For that reasons, the authors of this work consider necessary to propose this
document in a shape of brochure to increase the power of students'
independent study from the clinical cycle of Medical career, pursuing the
objective to offer a counselling material which contains necessary updated
information about the subjects of study content VII, VIII, IX and X.
The brochure counts with---- sheets of paper where is discussed the updated
information of themes from units that appear in the national software of the
Superior Medical Teaching to the teaching of English language for specific
purposes of 4th and 5th year of Medical career.
The referential themes appear in English language in the same order in which
they are teaching in the years mentioned, offering the student all the necessary
information for the study of theme, departing from the item and the possible
risk factors, mentioning symptoms, signs, lab tests, the differential diagnosis,
the medical treatment, the prophylactic one and the prognosis, all this, in the
order that the students need to do or discuss a case report.
DEFINITION AND CHARACTERISTICS:

Definition:
Hypertension means high blood pressure. It is define as elevation of Systolic
blood pressure above140mmHg (systolic is the "top" number of the blood
pressure measurement, which represents the pressure generated when the heart
beats) and Diastolic blood pressure above over 90mmHg (diastolic is the
"bottom" number of your blood pressure measurement, which represents the
pressure in the vessels when the heart is at rest)
Characteristics:
Types:
Systolic hypertension
Diastolic hypertension
Systodiastolic hypertension (the most common)
CAUSES AND RISK FACTORS:
Risk factors:
The age (the old people)

The race
The inheritance(a family history of the dissease)
Rich diets in sodium
Inactive life-style
The sex
Stress
Being overweight(obesity)
Birth control pills
Tobacco use
Excessive alcohol
Causes:
Essential hypertension(has no identifiable cause).
"Secondary" hypertension (caused by another disorder). This may include:
Adrenal gland tumors
Cushing's syndrome
Glomerulonephritis (inflammation of kidneys)
Renal vascular obstruction or narrowing
Renal failure
Use of medications, drugs, or other chemicals
Oral contraceptives
Hemolytic-uremic syndrome
Henoch-Schonlein purpura
5
Periarteritis nodosa
Radiation enteritis
Retroperitoneal fibrosis
Wilms' tumor
SYMPTOMS AND SIGNS:

(Usually no symptoms are present)
Tiredness
Confusion
Vision changes
Heart failure
Angina-like chest pain (crushing chest pain)
Blood in urine
Nosebleed
Irregular heartbeat
Mild headache
Ear noise or buzzing
Sweating
LABORATORIES TESTS (LAB TESTS):
Chest x-ray
Urinalysis
Blood chemistry (potassium, sodium, creatinine, fasting glucose, total
cholesterol and HDL cholesterol)
Complete blood count (Red Blood Cell Count, Hemoglobin, MCV hematocrit,
White Blood Cell Differential Count, The Platelet Count)
Electrocardiography (EKG)
DIFFERENTIAL DIAGNOSIS:
Cushing's syndrome
Pheochromocytoma
Hyperthyroidism
Hyperaldosteronism
Acute and chronic glomerulonephritis
TREATMENT (MEDICAMENTATION):
Pharmacological treatment:
Medications may include 8 types of medicine used to treat high
blood
pressure; they are:
Diuretics: chlorthalidone, furosemide, hydrochlorothiazide and indapamide
Beta-blockers: atenolol, propranolol, acebutolol, carvedilol, metoprolol,
nadolol, and timolol
6
Calcium channel blockers: nifedipine, verapamil, amlodipine, nicardipine, and

felodipine
Angiotensin-converting enzyme (ACE) inhibitors: benazepril , enalapril,
lisinopril, quinapril, ramipril and trandolapril
Angiotensin II receptor blockers (ARBs): candesartan, irbesartan, losartan,
olmesartan, telmisartan and valsartan
Alpha blockers:doxazosin, prazosin and terazosin
Centrally acting drugs: clonidine and methyldopa
Direct vasodilators: hydralazine and minoxidil
If the blood pressure is very high other Medications may be required such as:
hydralazine, minoxidil, diazoxide, or nitroprusside
PROPHYLACTIC TREATMENT:
Lifestyle changes may help control high blood pressure
Following a Healthy Eating Pattern
Reducing Salt and Sodium in Your Diet
Maintaining a Healthy Weight
Being Physically Active
Limiting Alcohol Intake
Quitting Smoking
Increase fruits, vegetables, and fibers
COMPLICATIONS:
Hypertensive heart disease
Heart attacks
Congestive heart failure
Aortic dissection
Blood vessel damage (arteriosclerosis)
Kidney damage
kidney failure
Stroke
Brain damage
Loss of vision
PROGNOSIS (Expectations):
Hypertension is controllable with treatment. It requires lifelong monitoring, and the treatment may
require adjustments periodically

Definition:
A heart attack (myocardial infarction) occurs when an area of heart
muscle dies or is permanently damaged because of an inadequate
supply of oxygen to that area.
Characteristics:
Most heart attacks are caused by a clot that blocks one of the
coronary arteries
A clot in the coronary artery interrupts the flow of blood and
oxygen to the heart muscle, leading to the death of heart cells in
that area
It is a major cause of sudden death in adults
In many cases the pain may be subtle or even completely absent
(called a "silent heart attack")
The pain typically lasts longer than 20 minutes and is not fully
relieved by rest or nitroglycerine
Causes:
Atherosclerosis
Thrombus
Stress
Spasm
Risk factors:
Smoking
High blood pressure
Too much fat in your diet
Diabetes
Poor blood cholesterol levels, especially high
cholesterol and low HDL ("good") cholesterol.
Male gender
Elderly Age
Heredity
Overweight
LDL
("bad")
SYMPTOMS AND SIGNS:

Chest pain behind the sternum (breastbone). Often, the pain
radiates from your chest, to your arms or shoulder; neck,
teeth, or jaw; abdomen or back
Squeezing or heavy pressure
A tight band on the chest
"An elephant sitting on [your] chest"
Bad indigestion
Tachycardia
Low blood pressure
Cardiac arrythmia
Shortness of breath
Cough
Lightheadedness - dizziness
Fainting
Nausea or vomiting
Anxiety
Sweating, which may be profuse
Feeling of "impending doom"

The following tests may reveal a heart attack and the extent of
heart damage:
Electrocardiogram (ECG) -- single or repeated over several hours
Echocardiography
Coronary angiography
Nuclear ventriculography (MUGA or RNV)
Troponin I and troponin T(proteins involved in muscle contraction)
CPK and CPK-MB
Serum myoglobin
Neumotorax
Acute pancretitis
Dissecting aortic aneurysm
Acute cholecystitis
Acute pericarditis
Diaphragmatic hernia
Pulmonary thromboembolism
Herpes zoster
No Pharmcologic treatment:
Hospitalization is required and possibly intensive care
Various monitoring devices may be necessary. A urinary catheter
may be inserted to closely monitor fluid status
Oxygen is usually given, even if blood oxygen levels are normal
Pharmcologic treatment:
Pain Control Medications:
Nitroglycerin
Morphine
Aspirin
Beta-blockers: Atenolol, Propranolol

Thrombolytic therapy:
Streptokinase
Urokinase
Tissue plasminogen activator
Nitrites: Nitrogycerin, Heparin
ACE Inhibitors: Ramipril, Enalapril, Captopril
Surgery and other Procedures:
Emergency coronary angioplasty
Emergency coronary artery bypass surgery (CABG)
Control your blood pressure
Control total cholesterol levels
Stop smoking if you smoke
Eat a low fat diet rich in fruits and vegetables and low in animal
fat
Control diabetes
Lose weight if you are overweight
Exercise daily or several times a week by walking and other
exercises to improve heart fitness
COMPLICATIONS:
Arrhythmias such as : ventricular tachycardia, ventricular
fibrillation, heart blocks
Cardiogenic shock
Infarct extension
Pericarditis (inflammation around the lining of the heart)
Pulmonary embolism (blood clot in the lungs)
Complications of treatment (For example, thrombolytic agents
increases the risk of bleeding)
The expected outcome varies with the amount and location of
damaged tissue. The outcome is worse if there is damage to the
electrical conduction system (the impulses that guide heart
contraction)

Definition:
Tonsillitis is inflammation of the tonsils due to bacterial or viral
infection.The tonsils' job is to catch germs before they cause
infections in the throat, mouth, or sinuses. Usually, tonsils do their
job well. But sometimes bacteria or viruses get into the tonsils. When
this happens, you have tonsillitis.
Characteristics:
A rapid strep test may also be performed by your physician by
taking a throat swab for a quick diagnosis
The infection may also be present in the throat and surrounding
areas, causing pharyngitis
A culture for the streptococcus bacteria (strep) may be taken
because it is the most common and most dangerous form of
tonsillitis
If the tonsillitis is caused by a virus, antibiotics won't work and
your body will fight off the infection on its own
CAUSES:
The most common is bacterial infection by streptococcus
In second place viral infection
SYMPTOMS AND SIGNS:
Sore throat (Possibly severe and persisting longer than 48
hours)
Tenderness of the jaw and throat
Enlarged and tender of the lymph nodes of the jaw and neck
Reddened and white spots in the mouth and throat
Difficulty swallowing
Headache
Fever, chills
Voice changes
Loss of voice
Vomiting
General malaise
Earache

Hemogram
Eritrosedimentation
Differential white blood cell count
Microbilogic examination of pharynx
A culture of the tonsils(show bacterial infection)
Syphilis
Diphitheria
Pharyngitis
Laryngitis
Sinusitis
Acute otitis media
Infectious mononucleosis
No pharmacological treatment:
Rest
Drink plenty of fluids.
-Especially warm (not hot)
-Bland fluids or very cold fluids may soothe the throat.
-Gargle with warm salt water or suck on lozenges:(containing
benzocaine or similar ingredients) to reduce pain.
Eat smooth foods, including flavored gelatin, soups, icepops, and
applesauce
Avoid hard, crunchy, or spicy foods
Use a cool-mist vaporizer or humidifier in the room where you spend
the most time
Pharmacological Treatment:
Over-the-counter medications may be used to reduce pain and fever
-Do not use aspirin because this may be associated with Reyes
Syndrome
-Use analgesic like duralgin, acetaminophen
Surgery to remove the tonsils (tonsillectomy) may be necessary for
some people
If the cause of the tonsillitis is bacteria(streptococcus):
Antibiotics, Penicillin G(Benzylpenicillin) are given to cure
Avoid people with known tonsillitis or bacterial sore throats, if
susceptible to tonsillitis
COMPLICATIONS:
Bacterial Pharyngitis
Kidney failure
Viral Pharyngitis
Dehydration from difficulty swallowing fluids
Blocked airway from enlarged tonsils
Peritonsillar abscess or abscess in other parts of the throat
Rheumatic fever and subsequent cardiovascular disorders
Post-streptococcal glomerulonephritis
Tonsillitis symptoms usually lessen in 2 or 3 days after treatment
starts. The infection usually is cured by then, but may require more
than on course of antibiotics. Complications of untreated strep
tonsillitis may be severe. A tonsillectomy may be recommended if
tonsillitis is severe, comes back, or does not respond to antibiotics

Definition:
Pneumonia is an inflammation of the lungs caused by an infection.
Many different organisms can cause it, including bacteria, viruses,
and fungi
Characteristics:
Types:
Aspiration pneumonia
Atypical pneumonia
CMV pneumonia
Hospital-acquired pneumonia
Legionella pneumonia
Pneumocystis carinii pneumonia
Pneumonia in immunocompromised host
Viral pneumonia
Walking pneumonia
CAUSES:
Bacterial pneumonias :
The most common pneumonia is Streptococcus pneumoniae
Mycoplasma pneumoniae
Haemophilus influenzae
Staphylococcus aureus
Klebsiella pneumonie
Moraxella catarrhalis
Viral pneumonias:
Respiratory sincytal virus
Parainflenza virus
Influenza A and B
Adenovirus
SYMPTOMS AND SIGNS:

Cough
Bloody sputum
Fever with shaking chills
Pleuritic chest pain
Confusion
Rapid, shallow breathing
Shortness of breath
Headache
Excessive sweating and clammy skin
Loss of appetite(anorexia)
Excessive fatigue
Crackles are heard when listening the chest with a stethoscope

Chest x-ray
Gram's stain and culture of sputum
CBC
Arterial blood gases
CAT scan of the chest
Pleural fluid culture
Pulmonary tubeculosis
Brochiectasis
Pulmonary infarction
Allergic pneumonitis
Cancer of the lung
Atelectasis
Sarcoidosis
Chronic obstructive pulmoary disease in acute phase
Pulmonary congestion
Uremia
No pharmacologic treatment:
Drink plenty of fluids to help loosen secretions and bring up
phlegm
Get lots of rest. Have someone else do household chores
Control your fever with aspirin or acetaminophen. DO NOT give
aspirin to children
Pharmacologic treatment:
If the cause is bacterial, the goal is to cure the infection with
antibiotics:
Penicillin G
Cephalosporin
Vancomycin
If the cause is viral:
Antibiotics will NOT be effective
Symptomatic treatment
Wash patient hands frequently,
Don't smoke
Wear a mask when cleaning dusty or moldy areas
Vaccines can help prevent pneumonia in children, and people with
diabetes, asthma, emphysema, HIV, cancer
COMPLICATIONS:
Empyemae
Lung abcesses
Meningitis
Arthritis
Infective endocarditis
Otitis Media
Pericarditis
Epiglottitis
With treatment, most patients will improve within two weeks. Elderly or debilitated
patients who fail to respond to treatment may die from respiratory failure

Definition
Asthma is an inflammatory disorder of the airways, characterized
by periodic attacks of wheezing, shortness of breath, chest
tightness, and coughing
Characteristics:
Half of the people with asthma develop it before age 10, and most
develop it before age 30
Asthma symptoms can decrease over time, especially in children.
Many people with asthma have an individual and/or family history
of allergies
Others have no history of allergies or evidence of allergic problems
Types:
-Extrinsic asthma:
*Atopic asthma
*Occupational asthma
*Allergic asthma
-Intrinsic asthma
CAUSES:
Inhaled allergens:
Pet dander
Dust mites
Cockroach allergens
Molds
Pollens
Irritants:
Cigarette smoke
Air pollution
Other pollutants
Fumes from burning wood or gas
Others:
Respiratory infections
Exercise
Cold air
Stress
Food
Some drugs(aspirin and other non-steroidal anti-inflammatory

medications (NSAIDS))
SYMPTOMS AND SIGNS:
Usually symptoms:
Wheezing or paroxysmal dyspnea
Cough(with or without sputum)
Shortness of breath(that is aggravated by exercise)
Breathing that requires increased work
Intercostal retractions (pulling of the skin between the ribs when
breathing)
Emergency symptoms:
Difficulty breathing
Bluish color to the lips and face
Anxiety due to shortness of breath
Rapid pulse
Sweating
Decreased level of consciousness (severe drowsiness or confusion)
during an asthma attack
Tightness in the chest
Additional symptoms that may be associated with this disease:
Nasal flaring
Chest pain
Abnormal breathing pattern, in which exhalation (breathing out)
takes more than twice as long as inspiration (breathing in)
Breathing which temporarily stops

Eosinophil count (a type of white blood cell)
Chest x-ray
Allergy skin or blood tests
Arterial blood gas
Peak flow measurements
Lung function tests
Spirometry (forced expiratory volume, or FEV1)
Peak expiratory flow (PEF)
Pulmonary embolism
Pulmonary emphysema
Bronchiolitis
Chronic bronchitis
Cystic fibrosis
Mechanical airway obstruction
Cardiac asthma in left ventricular failure
Vocal cords disorder
Bronchodilators:
Adrenergic bronchodilator:
-Epinephrine
-Isoproterenol
-Salbutamol
-Salmeterol
Aminophylline or theophylline
Anticholinergic:
Atropine
Anisotropine methylbromide
Corticosteroids:
Oral:
-Prednisone
-Prednisolone
Parenteral:
-Methylprednisolone
-Hydrocortisone
Others:
Cromolyn sodium (Intal) or nedocromil sodium
A severe asthma attack requires a special medical evaluation and
may require:
Hospitalization
Oxygen
Intravenous medications
Avoiding known allergens and respiratory irritants
Encasing mattresses and pillows in allergen-impermeable covers
Removing carpets from bedrooms, and by vacuuming regularly
Exposure to dust mites and mold reduced by lowering indoor
humidity
Kept out the animals of the patient's bedroom
Avoiding expossure to:
-Cigarette smoke
-Air pollution
-Industrial dusts
-Irritating fumes
COMPLICATIONS:
Respiratory fatigue
Pneumothorax
Pulmonary failure
Respiratory failure
Status asthmaticus
Atelectasis
Cardiorespiratory arrest
Death
Side effects of the medication used

There is no cure for asthma, though symptoms sometimes

decrease over time. With proper self management and medical
treatment, most people with asthma can lead normal lives
A peptic ulcer is erosion in the lining of the stomach or

duodenum (the first part of the small intestine). The word peptic
refers to pepsin, a stomach enzyme that breaks down proteins. The
word ulcer is defined as a breach in the mucosa of the alimentary
tract that extends through the muscularis mucosa into the
submucosa or deeper. If a peptic ulcer is located in the stomach it is
called a gastric ulcer.

Infection by a bacterium called Helicobacter pylori (H.pylori) (most
common).
Using:aspirin, ibuprofen, or naproxen.
Corticosteroids in high dose.
Drinking alcohol excessively.
Smoking cigarettes and using tobacco.
Psychological stress(It is not clear if this is true).
Zolliger-Ellison syndrome.
A family history of ulcers.
SYMPTOMS AND SIGNS:

Abdominal pain is a common symptom (the pain tends to be
worse at night and occurs usually 1 to 3 hours after meals during
the day.)
Nausea
Vomiting
Weight loss
Fatigue
Dizzy
Lightheaded
Heartburn
Indigestion
Belching or eructation.
Chest pain
Vomiting blood
Bloody or dark tarry stools

An upper GI -- a series of x-rays taken after you drink a substance
called barium
An esophagogastroduodenoscopy (EGD)
Biopsy from the wall of the intestines
Hemoglobin test to check for anemia
Stool guaiac cards to test for blood in your stool or feces
Gastritis
Chronic duodenitis
Hiatal hernia with reflux
Beningn or malignat neoplasm
Parasitism
Gastroduodenal diverticulum
Chronic Pancreatitis
Kidney stone
Biliary dyskinesia
TREATMENT
Treatnmet often involves a combination of medications to kill

the Helicobacter pylori bacteria, reduce acid levels, and protect the
GI tract
The medications may include one or more of the following:
Antibiotics to kill Helicobacter pylori
Acid blockers (like cimetidine, ranitidine, or famotidine)
Proton pump inhibitors (such as omeprazole)
Medications that protect the tissue lining (like sucralfate)
Bismuth (may help protect the lining and kill the bacteria)
If bleeding procedure or the ulcer has caused a perforation, then
surgery may be required
PROPHYLATIC TREATMENT:
Don't smoke or chew tobacco
Limit alcohol
Avoid aspirin, ibuprofen, and naproxen
COMPLICATIONS:
Bleeding internally
Perforation of the intestine
Chemical peritonitis
Bowel obstruction
Shock
Obstruction of the pyloric channel

Death
Peptic ulcers tend to come back if untreated. If patient follow

the treatment instructions from his doctor and take all of his
medications, the Helicobacter pylori infection will be eliminated. The
symptoms will also improve if patient follow some preventive lifestyle
steps

Definition:
Alcoholic liver disease involves an acute or chronic inflammation of
the liver induced by alcohol abuse
Characteristics:
Alcoholic liver disease usually occurs after years of excessive
drinking
Acute alcoholic hepatitis can result from binge drinking, and may
be life-threatening if severe
Malnutrition develops as a result of empty calories from alcohol,
reduced appetite, and malabsorption(inadequate absorption of
nutrients from the intestinal tract)
Alcoholic liver disease does not affect all heavy drinkers, and
women may be more susceptible than men
The hepatitis B virus is probably the most common cause of
cirrhosis worldwid
Nonalcoholic steatohepatitis (NASH). This type of hepatitis appears
to be associated with diabetes, protein malnutrition, obesity,
coronary artery disease, and treatment with corticosteroid
medications
Malnutrition contributes to liver disease
Spider angiomas are small, red spider veins under your skin or
easy bruising
Cirrhosis is the final phase of alcoholic liver disease
Causes:
Chronic alcoholism and hepatitis C are the most common
Alcoholic liver disease
Chronic hepatitis C
Chronic hepatitis B and D
Autoimmune hepatitis
Inherited diseases., hemochromatosis, Wilson's disease,
galactosemia
NASH
Blocked bile ducts
Drugs
Toxins
Infections
Malnutrition
Risk factors:
Excessive alcohol consumption is the single greatest risk factor for
cirrhosis
Chronic infection with hepatitis C or B.
Your sex. More men than women develop cirrhosis, possibly
because men tend to drink more heavily than women do.
Certain inherited diseases.
Drug reactions and exposure to environmental toxins
SYMPTOMS AND SIGNS:
Loss of appetite
Weight loss
Nausea
Jaundice
Abdominal pain and tenderness
Fever
Ascites (fluid collection in the abdomen)
Unintentional weight gain (because of fluid collection)
Mental confusion
Excessive thirst
Dry mouth
Fatigue
Spider angiomas
Loss of interest in sex
Edema(swelling of your legs and feet from retained fluid)
Weakness
Itching
Bleeding from engorged veins in your esophagus or intestines
Abnormally dark or light skin
Redness on feet or hands
Paleness
Tachycardia(when rising to standing position)
Slow, sluggish, lethargic movement
Impaired ability to concentrate
Agitation
Fluctuating mood
Attention deficit
Confusion (encephalopathy):
-Hallucinations
CBC (may show anemia)
Liver function tests
Liver blood tests
Bilirubin test
Liver biopsy(shows alcoholic liver disease)
Ultrasound of the abdomen (ultrasonography)
CT(Computerized tomography) scan abdominal
Magnetic resonance imaging (MRI)
Reticulocyte count
Ferritin
Alpha phetoprotein
DIFFERENTIAL DIAGNOSIS
Primary biliary cirrhosis
Secondary biliary cirrhosis
Cryptogenic cirrhosis
Cardiac cirrhosis
Nutrition is also often a key part of therapy because people with
cirrhosis, and especially alcoholic cirrhosis, are frequently
malnourished
A doctor or dietitian is likely to recommend a high-calorie, nutrientdense dietary plan to help liver cells regenerate
An alcohol rehabilitation program or counseling may be necessary
to break the alcohol addiction
Vitamins(especially B1)
Folic acid
Portal hypertension:
-Blood pressure medications such as beta blockers
Bleeding blood vessels:
-One such procedure, endoscopic variceal band ligation, treats

bleeding in the esophagus
-Sagestake Blakemore(a catheter with a balloon on the end to
compress the veins and stop the bleeding)
-Transjugular intrahepatic portosystemic shunt,
Fluid retention:
-Diuretics
-Severe cases may require paracentesis(a procedure in which large
amounts of fluid are removed through a thin tube inserted in the

abdomen)
Itching:
-Antihistamines
-Cholestyramine(to reduce itching caused by metabolites in the
blood)
Treatments for hepatic encephalopathy:
-Lactulose
-Synthetic sugar(can help lower blood ammonia levels by changing
the type of bacteria in your intestine)
-Antibiotic(to reduce the number of ammonia-producing bacteria in
your intestine)
Liver failure:
-A liver transplant may be the only option for some people

Although liver damage from cirrhosis is irreversible, treatment can
often help prevent further damage and reduce complications
If you drink alcohol, limit consumption to moderate levels
COMPLICATIONS:
Bleeding esophageal varices
Portal hypertension(high blood pressure within the liver)
Hepatic encephalopathy(damage to brain tissue):
-Delirium and Coma.
Weak bones (osteoporosis).
Liver cancer
Liver failure
Ascites
Gallstones
Toxins in the blood or brain
Insulin resistance and type 2 diabetes
Kidney dysfunction and failure
Continued excessive drinking is associated with a shorter life
expectancy. The probable outcome is poor if drinking continues

Definition:
Hypothyroidism is the clinical symdrome that results from a
deficiency of thyroid hormone. In severe hypothy a hydrophilic
mucopolysaccharide substance accumulates in subcutaneous
tissues, causing nonpitting edema referred to as myxedema
Characteristics:
Hypothyroidism is common in adults
Autoimune destruction of the thyroid gland is the most common
cause of thyroid gland failure in adults

Symptoms and signs can be attributed to either deceleration of
cellular metabolic processes

Serum prolactin is increased in moderate to severe primary
hypothyroidism

Primary hypothyroidism:
Adquired:
-Hashimotos thyroiditis
-Idiopatic myxedema
-Cystinosis
Congenital
-Thyroid agenesis
-Thyroid dysgenesis or ectopy
-Antithyroid drugs
Secondary hypothyroidism
Neoplasm
Eosinophilic granuloma
Therapeutic irradiation
Idiopathic hypopituitarism
Tissue resistance to thyroid hormone
SYMPTOMS AND SIGNS:

Weakness
Fatigue
Cold intolerance
Constipation
Weight gain
Snoring
Menorrhagia
Muscle cramps and stiffness
Paresthesias in hands and feet
Eyelid
Facial puffiness
Periorbital edema
Hoarse voise
Dry skin and hair
Bradycardia
Diastolic Hypertension
Delayed deep tendon reflex
Hypothermia
LABORATORY TEST:(Lab test)

T3 suppression test
Serum free T4, T3 and the free T4 index
Total serum thyroid hormone concentration
Serum thyrotropin
Serum thyroglobulin
Basal metabolic rate
Thyroid scan
Thyroid ultrasound
Needle biopsy on aspiration
Chronic renal failure
Nephrotic syndrome
Severe anemia
Euthyroid hypothyroxinemias
Hypoalbuminemia
Hashimotos thyroiditis
TREATMENT:(Medication)
Synthetic preparation of T4 and T3 combination of the two in
purified thyroglobulin
Synthetic preparation of pure T4 (L-Thyroxine)
Evaluated the thyroid gland function
COMPLICATION:
Myxedema coma
Angina
CO2 narcosis
Cardiac arrhythmias associated with hypoxia
Death by myxedema coma
PROGNOSIS:(Expectation)
Is excellent provided that thyroid hormone replacement is

maintained at on appropriate level

Definition:
Appendicitis is an inflammation of the appendix
Characteristics:
The pain of appendicitis usually increases over a period of six to 12
hours
Appendicitis is considered a medical emergency
Appendicitis is the most common acute surgical emergency of the
abdomen
Anyone can get appendicitis, but it occurs most often between the
ages of 10 and 30
Laxatives and pain medications should not be taken
Children are more likely to have a ruptured appendix than adults
are

Causes:
It's not always clear why appendicitis occurs
Fecal stone
Gastrointestinal bacterial or viral infection
Lymphoid hyperplasia (swelling of lymph nodes)
Traumatic injury
Genetics
Risk factor:
Anyone can develop appendicitis, but it most often strikes people
between the ages of 10 and 30
SYMPTOMS AND SIGNS:

Symptoms:
Pain in the abdomen, first around the belly button, then moving
to the lower right area
Nausea and vomiting
Loss of appetite(anorexia)
A low-grade fever that starts after other signs and symptoms
appear
Constipation
An inability to pass gas
Diarrhea
Abdominal swelling
Murphy Triad(Pain in the abdomen, nausea or vomiting and
fever)
Signs:
Blumberg sign
Cope sign
Rovsing's sign
Lennanders sign

Laboratory Tests:
Blood test(CBC)
Blood chemistries: show dehydration and electrolyte disorders
Urinalysis: is used to rule out a urinary tract infection
Imaging tests:
Abdominal X-ray
Ultrasound scan
Computerized tomography (CT) scan
Laparoscopy
Meckels diverticulitis
Ectopic pregnancy
Certain ovarian cysts
Kidney stone
Crohn's disease
Rupture of an ovarian follicle
Pelvic inflammatory disease
Mesenteric lymphadenitis
Gastroenteritis with mesenteric adenitis
Appendectomy:
-Traditional open surgery
-Laparoscopic surgery
Intravenous antibiotics (to prevent a sistemic infection):
-Gentamicin
Only surgical and pharmacologic treatment
COMPLICATIONS:
The most serious complication of appendicitis is peritonitis
Abscess
Gangrene
Bowel obstruction(paralytic ileus)
Septicemia
Pelvic inflamatory disease
Death.
It depends on surgery and circumstances around it.

Definition:
Acute pancreatitis is an inflammation (irritation and swelling) of

the pancreas
Characteristics:
The pancreas is an elongated, tapered gland, located behind the
stomach, that secretes digestive enzymes and the hormones
insulin and glucagon
The disease affects men more often than women
The mechanism that causes pancreatitis is not well known
Pancreatic infections can be fatal without intensive treatment

Causes:
Alcohol abuse
Gallstones
Other gallbladder (biliary) disease
Viral infection ( coxsackie B, mycoplasma pneumonia)
Traumatic injury
Medications (especially estrogens, corticosteroids, thiazide
diuretics)
Abnormal anatomy of the pancreas (pancreas divisum)
Genetic factors (hereditary pancreatitis)
Hypertriglyceridemia
Complications of cystic fibrosis
Abdominal trauma
Cystic fibrosis
Hemolytic uremic syndrome
Kawasaki disease
Mumps
Reye syndrome
Various viral illnesses
Some medications
Risk factor:
Alcohol abuse
Gallbladder disease
Ethnicity
Your sex. (Pancreatitis occurs more frequently in men, possibly
because men are more likely to abuse alcohol than women are)
Cigarettes and other toxins
Genetic mutations
Other medical conditions
SYMPTOMS AND SIGNS:

Abdominal pain that is greatest in the upper abdomen (upper left
quadrant or upper middle of the abdomen)
May be worse after eating or drinking, especially foods with a high

fat content
May be worse after drinking alcohol
Nausea and vomiting
Sweating
Anxiety
Fever
Mild jaundice
Rapid pulse
Dehydration
Low blood pressure
Internal bleeding
Shock
Swollen abdomen
Gaseous abdominal fullness
Abdominal indigestion
Hiccups
Skin rash or lesion
Clay-colored stools

Tests that show release of pancreatic enzymes:
Elevated serum amylase
Elevated urine amylase
Elevated serum lipase
Test that show inflammation of the pancreas:
Abdominal CT scan
Abdominal ultrasound
Abdominal MRI
In other blood tests results:
CBC shows an elevated WBC count
A glucose test may show elevated levels
Serum calcium may be decreased
Acute cholecystitis
Myocardial infartion
Ulcer(duodenal or gastric)
Acute appendicitis
Acute pericarditis
Paralytic ileus
Duodenitis
Pharmacolgic treatment:
Analgesic:
Duralgin
Procaine hydrochloride
Morphine
Restrict pancreatic activity:
Nasogastric suction
Atropine
NPO
If Hypocalcemia:
Calcium sulfate
If infection:
Antibiotics (Penicillin)
Other:
Vitamin(K;E;B)
Insulinotherapy
Surgery:
In the most severe cases, surgery is necessary to remove necrotic,
infected pancreatic tissue
Do not abuse alcohol
Use proper safety precautions to avoid abdominal trauma
Genetic counseling
To reduce the risk of Reye syndrome, avoid aspirin for treatment of
fever in children, especially if they may have a viral illness
Stop smoking
Limit fat
COMPLICATIONS:
Heart failure
Kidney failure
ARDS (adult respiratory distress syndrome)
Ascites, accumulation of fluid in the abdomen
Cysts in the pancreas
Infection
Pseudocysts
Abscess
Respiratory failure
Shock
Bleeding
Malnutrition and weight loss
Diabetes
Drug addiction
Pancreatic cancer

While most cases resolve in a week, some cases develop into

life-threatening illness. The death rate is high with hemorrhagic
pancreatitis or necrotizing pancreatitis and complications such as
liver, heart, or kidney impairment may occur. Recurrences are
common

Definition:
A laceration is a wound thats produced by the tearing of soft
body tissue. This type of wound is often irregular and jagged. A
puncture wound is usually caused by a sharp pointy object such
as a nail, animal teeth, or attack
Characteristics:
A laceration wound is often contaminated with bacteria and debris
from whatever object caused the cut
This type of wound usually does not bleed excessively and can
appear to close up
Puncture wounds are also prone to infection and should be treated
appropriately
Minor lacerations (shallow, small, not bleeding, and clean) may not
require medical attention
Sutures are used for wounds that are deep, keep bleeding, have
jagged edges, or have fat or muscle exposed
Types of wound:
-Open wounds:
*Incisions
*Lacerations
*Abrasions (grazes)
*Puncture wounds
*Penetration wounds
*Gunshot wounds
-Closed wounds:
*Contusions
*Hematoma
*Crushing Injuries
Illnesses that may affect blood clotting (e.g. haemophilia, renal

failure)
Illnesses that cause the immune system to be suppressed
Allergies to antibiotics or local anaesthetics
Dirty, old, or contaminated wounds
Bite wounds or wounds longer than five centimetres (about two
inches), due to high infection rate
SYMPTOMS AND SIGNS:

Bleeding (most important)
Loss of feeling or function below the wound site
Pain
Fever (if patient have infection)

Blood test:
CBC(with differential white cell count)
Eritrosedimentation
Hematocrit
Skin culture(to check for bacteria)
No pharmacology treatment:
Stop the bleeding (use direct pressure to stop the bleeding)
Wash the hands with soap to avoid infection
Look for objects inside the wound
Clean the wound
Get stitches for deep wounds
Cover the wound
Change the dressing
Watch for signs of infection
Pharmacologyc treatment:
Get a tetanus shot
Get analgesic for pain(Duralgine)
Apply an antibiotic(Penicillin)
Surgery
Sutures (Stitches)
Prophylactic treatment:
Keep knives, scissors, firearms, and breakables out of the reach of
children. When children are old enough, teach them to how to use
knives and scissors safely
Keep up-to-date on vaccinations. A tetanus vaccine is generally

recommended every 10 years
COMPLICATIONS:
Wound infection
Hemorrhage shock
gangrenous necrosis
Tetanus(frequently in patient that no have tetanus shot)
Noticeable scaring
Dehiscence (tearing open of incision)
Allergic reaction
It depends on the type of the wound and measures taken;

however, in general is good.

Definition:
It is a malignant epithelial tumor of the breast. All solid lumps
need histological and cytological assessment. Invasive Ductal
Carcinoma of the Breast
Characteristics:
Breast cancer is the most common cancer to affect women
Breast cancer is an uncontrolled growth of breast cells
While cancer is always caused by a genetic "abnormality" (a
"mistake" in the genetic material)
Instead, 90% of breast cancers are due to genetic abnormalities
that happen as a result of the aging process and life in general
Studies show that regular self-exam, combined with an annual
exam by a doctor, improves the chances of detecting cancer early
The laboratory keeps your tissue samples for a long time after
surgery
Stage IB invasive ductal breast carcinoma was confirmed by
lumpectomy

Cause:
The cause of Breast Cancer is unknown
Risk factor:
No breast feeding
Increasing age
Early menarche
Late menopause
Late Pregnancy
Interrupted first pregnancy
Family history of breast cancer
Obesity
Ionizing radiation
Alcohol intake
Oral contraceptive use
SYMPTOMS AND SIGNS:

Benign disorder(a dominant mass- a lump distinctly different from
the surrounding Breast)
Fixation of the mass to the chest
Wall or to the over lining skin
Satellite nodules or ulcers in the skin
Exaggeration of the usual skin markings resulting from lymph
nodes and / or supraclavicular or infraclavicular lymphadenopathy
Skin edema or ulceration
Nipple discharge
Retraction or erosions

Mammography
Needle aspiration
Cystologic evaluations
Excisional biopsy
Ultrasonography
Post-surgical scar
Radial scar
Hematoma
Past trauma to the breast
Inflammatory disease
Acute bacterial mastitis
Chronic mastitis
Fat necrosis
Mammary dysplasia(benign breast disease)
Adenosis
Systic disease
Duct ectasia
Benign tumors
Fibroadenoma
Papilloma
TREATMENT:
Surgery
Radiation
Therapy
Chemotherapy
Eating a balanced diet
Not smoking
Minimizing stress
Exercising regularly
The staging before treatment of the primary tumor depends on
the initial clinical stage of the patient

A state of deep, often prolonged unconsciousness, usually the
result of injury, disease, or poison, in which an individual is
incapable of sensing or responding to external stimuli and
internal needs

Causes:
Shock
Head trauma
Brain infection
Brain inflammation
Poisoning
Diabetic ketoacidosis
Uremia
Risks factors:
Death of mother from pre-eclampsia after delivering child
Diabetes and risk reduction
Diabetes: the simple facts
Heat, a real killer
Lifestyle:
-Inactivity, stress, diet, aging
Behaviors:
-Sex, smoking, alcohol, drugs
Fatal four:
-Obesity, cholesterol, diabetes, hypertension
Diseases:
-HIV, heart, cancer, autoimmune, immunocompromise
Infection:
-Animals, birds, insects, water, travel
Exposures:
-Environment, occupation, sunlight, radiation, chemicals
Medications:
-Contraceptives, steroids
Women's:
-Pregnancy, childbirth, menopause
SYMPTOMS AND SIGNS:

Unconscious
Not respond to painful stimulation
Fever
Jaundice
Hypothermia
Sweating
Spider angiomas
Dyspnea
Confusion
Irregular heartbeat
Hypotension
The symptoms depend of the causes

Blood tests(can detect salt imbalances, low blood sugar)
Urine tests(detect drugs in someone's system or diagnose kidney
disease)
X-ray tests
Cranial CT scan of the brain(may detect a stroke, brain tumor, or

bleeding into or around the brain)
Arterial Blood Gases
Blood Cultures
Alcohol level
Full blood count
Biochemistry
Lumbar puncture
Intracranial:
Vascular:
-Haemorrhage(intracerebral,subarachnoid,subdural and extradural)
-Infarction
Infection:
-Meningitis
-Encephalitis
-Abscess
Tumor:
-Mass effect
-Cerebral edema
Head injury:
-Vascular effects
-Hypoxic encephalopathy
Psychiatric:
-Conversion disorder
-Depression
Extracranial:
Cardiovascular:
-Shock (any cause)
-Severe hypertension
Infection:
-Septicaemia
Metabolic:
-Hormonal insufficiency(Pituitary, Adrenal and Thyroid)
-Hepatic encephalopathy
-Uraemic encephalopathy
Drugs:
-Sedatives
-Analgesics
-Alcohol
-Major tranquillizers
Not pharmacology treatment:
Basic vital functions, such as breathing and blood pressure, are

maintained when possible
A person may need a ventilator, or artificial breathing machine
Oxygen
Fluids given through a tube in a vein(Glucose may be given
through an IV in case the person has low blood sugar)
NPO
nasogastric suction
Pharmacology treatment:
Vitamin(B1 and B6) with nicotine acid
Drugs like:
-Naloxone
-Flumazenilo
Antibiotics(for infection)
Treatment of the intracranial hypertation
Surgery:
Subdural hematoma
Avoiding drug use can prevent cases due to overdose
Proper treatment of diabetes can prevent many cases due to this
cause
Wearing a helmet when riding a motorcycle or bike can prevent
head injuries leading to coma
Prevention is related to the cause
Many cases cannot be prevented
COMPLICATIONS:
Coma as a complication of:
Shock
Stroke
Traumatic Brain Injury
Hypoglycemia
Hypoglycemic attack
Heat stroke
Hypothermia
Kidney failure
Pulmonary embolism
Cryptococcal Meningitis
Eclampsia
Typhoid fever
Uremia
Hyperparathyroidism
Reye's Syndrome
Viral Hemorrhagic Fevers
Most people in a coma are at a high risk of death. A person may stay
in a coma for weeks, months, or even years

Definition:
Trichomoniasis is a common sexually transmitted disease (STD) that
affects both women and men. In women cause a vaginal infection
Characteristics:
The symptoms are more common in women
Is the most common curable STD in young, sexually active women
An estimated 7.4 million new cases occur each year in women and
men
In women the vagina is the most common site of infection
In men the urethra (urine canal) is the most common site of infection
The parasite is sexually transmitted through penis-to-vagina
intercourse or vulva-to-vulva (the genital area outside the vagina)
Contact with an infected partner
Women can acquire the disease from infected men or women, but
men usually contract it only from infected women
The single-celled protozoan parasite, Trichomonas vaginalis
SYMPTOMS AND SINGS:
Most men do not have signs or symptoms:
Irritation inside the penis
Mild discharge
Slight burning after urination or ejaculation
Recurrent urethritis
The symptoms are more common in women:
Frothy
Yellow-green vaginal discharge with a strong odor
Discomfort during intercourse and urination
Irritation and itching of the female genital area

Lower abdominal pain
Small red ulcerations (sores) on the vaginal wall or cervix

Microscopy examination of fresh vaginal secretions
Culture (the most sensitive)
PCR test for T. vaginalis
Papanicolaou (Pap) test
Giemsas stain
Grams method
Johnsons method (Special cultures)
Gonorreha
Garnerella vaginalis
Candidiasis or moniliasis
Clamydia
Both partners should be treated at the same time to eliminate the
parasite
Oral and vaginal:
Metronidazole
Vaginal:
Tinidazole
Clotrimazole
Abstain from sexual contact
To be in a long-term mutually monogamous relationship with a
partner who has been tested and is known to be uninfected
The correctly and consistently use of latex male condoms
COMPLICATIONS:
Urinary infection
Septicemia
Death
The genital inflammation caused by trichomoniasis can increase a
woman's susceptibility to HIV infection if she is exposed to the virus.
Having trichomoniasis may increase the chance that an HIV-infected
woman passes HIV to her sex partner(s)

Definition
The hyrertrophy or enlargement (aumento) of the prostate.Is a
proliferation of both (ambos) epithelial and stromal elements with
resultant in some cases urinary obstruction
Characteritics:
An enlarged prostate is often called benign prostatic hyperplasia (BPH)
or benign prostatic hypertrophy
The gland has grown bigger
Happens to almost all men as they get older
As the gland grows (crecer), it can press on the urethra and
cause urination and bladder problems
An enlarged prostate is often called benign prostatic hyperplasia (BPH)
or benign prostatic hypertrophy
It is not cancer, and it does not raise your risk for prostate cancer
The likelihood of developing an enlarged prostate increases with age
A small amount of prostate enlargement is present in many men over
age 40 and more than 90% of men over age 80
Types:
-So-called transitional and periurethral:
*Hyperplastic
*Nodular hyperplasia
*Glandular hyperplasia
*Stromal hyperplasia
Causes:
The actual cause is unknown
Risk factors:
No risk factors have been identified. Althought many doctors believe
that age is an important risk factor
SYMPTOMS AND SIGNS:
Less than half of all men with BPH have symptoms and most common
ones involve with urination:
-Hesitant
-Interrupted
-Weak stream
-Urgency
-Leakin
-Dribbling
-More frequent urination, especially at night
Slowed or deayed start of the urinary stream
Strong and sudden urge to urinate
Incomplete emptying of his bladder
Needing to urinate two or more times per night

Pain with urination or bloody urine (these may indicate infection)
Incontinence
Digital rectal exam to feel the increase prostate gland

IVP(an x-ray study) to confirm BPH or look for blockage
Urinalisy to check for blood on infection
Urine culture to check to for infection
Cytoscopy
Voiding cytourethrogram
Prostate specific antigen (PSA) blood test to screen for prostate cancer
Urine flow rate
Post- void residual urine test to see how much urine is left in his
bladder after urination
Pressure flow studies to measure the pressure in the bladder as he
urinate
Prostate adenocarcinoma
Blader tumor
urethral narrowness
Blader cervic sclerosis
Prostatitis
Prostatic calculus
Prostatic abscess
Treatment include
"Watchful waiting"
Lifestyle changes
Medication
Surgery
No Pharmacologic treatment
Urinate when you first get the urge. Also, go to the bathroom when
you have the chance, even if you don't feel a need to urinate
Avoid alcohol and caffeine, especially after dinner
Don't drink a lot of fluid all at once. Spread out fluids throughout the
day. Avoid drinking fluids within 2 hours of bedtime
Try NOT to take over-the-counter cold and sinus medications that
contain decongestants or antihistamines. These medications can
increase BPH symptoms
Keep warm and exercise regularly. Cold weather and lack of physical
activity may worsen symptoms
Learn and perform Kegel exercises (pelvic strengthening exercises)
Reduce stress. Nervousness and tension can lead to more frequent

urination
Alpha 1-Blockers (these medications relax the muscles of the bladder
neck, allowing easier urination):
-Doxazosin
-Prazosin
-Tamsulosin
-Terazosin
Antibiotics may be prescribed to treat chronic prostatitis, which may
accompany BPH
Prostate surgery:
Transurethral resection of the prostate (TURP)
Transurethral incision of the prostate (TUIP)
Open Prostatectomy
Photoselective vaporization of the prostate (PVP)
COMPLICATIONS:
Sudden inability to urinate
Urinary tract infections
Urinary stones
Damage to the kidneys
Blood in the urine
Reserved

Definition
If more pressure is put on a bone than it can stand, it will split or break.
A break of any size is called a fracture.
Characteristics
If the broken bone punctures the skin, it is called an open fracture
(compound fracture)
A stress fracture is a hairline crack in the bone that develops because
of repeated or prolonged forces against the bone
Repetitive forces, such as those caused by running, can cause stress
fractures of the foot, ankle, tibia, or hip
Fracture on one side of the bone, causing a bend on the other side of
the bone(Greenstick fracture)
A fracture that results in three or more bone fragments (Comminuted
fracture)
The fracture is at right angles to the long axis of the bone(Transverse
fracture)
Types of fractures:
-Closed or simple fracture
-Open or compound fracture
-Transverse fracture
-Greenstick fracture
-Comminuted fracture
Fall from a height
Some diseases(Osteogenesis imperfecta (OI))
Motor vehicle accidents
Direct blow
Child abuse
Medications:
-Blood pressure pills
-Heart medicines
-Diuretics or water pills
-Muscle relaxers or tranquilizers
Osteoporosis
Overuse sometimes results in stress fractures. These are common
among athletes
SYMPTOMS AND SIGNS:

A visibly out-of-place or misshapen limb or joint
Swelling
Bruising
Bleeding
Intense pain
Numbness and
Tingling
Broken skin with bone protruding
Limited mobility
Inability to move a limb

X-Ray
Blood test:
-CBC(with differential white cell count)
-Eritrosedimentation
-Hematocrit
Culture(to check for bacteria)
Ultrasound
Do not:
Move the person unless the broken bone is stable
Move a person with an injured hip, pelvis, or upper leg unless it is
absolutely necessary
Move a person who has a possible spine injury
Attempt to straighten a bone or change its position unless blood
circulation appears hampered
Try to reposition a suspected spine injury
Test a bone's ability to move
Doctors use casts, splints, pins or other devices to hold a fracture in
the correct position while the bone is healing:
External fixation methods include plaster and fiberglass casts, castbraces, splints and other devices
Internal fixation methods hold the broken pieces of bone in proper
position with metal plates, pins, or screws while the bone is healing
Methods of Immobilization:
Plaster casts
Fiberglass casting
Bracing
Splinting
Traction
Recovery and rehabilitation
Wear protective gear while skiing, biking, roller blading, and

participating in contact sports.(includes helmets, elbow pads, knee
pads, and shin pads)
Teach children how to be safe and look out for themselves
Prevent falls by not standing on chairs, counter tops, or other unstable
objects
Remove throw rugs and electrical cords from floor surfaces
Steps to Prevent Fragile Bones:
-Consume adequate amounts of calcium and vitamin D
-Exercise several times a week
-BMD (bone mineral density) test
-Medications to slow bone loss and reduce fracture risk
COMPLICATIONS:
Hemorrhagae
Anemia
Shock
Coma
It depends on the circumstances and the kind of the fracture.

Definition:
Placenta previa is a condition that may occur during pregnancy when the
placenta implants in the lower part of the uterus and is close to or
covering the cervical opening to the vagina (birth canal)
Characteristics:
Types:
Complete placenta previa
Marginal placenta previa
Lateral placenta previa
Causes:
Scarred endometrium (lining of the uterus)
A large placenta
Abnormal uterus
Abnormal formation of the placenta
Risk factors:
Mother age(more than 35 years)
Multiparity (previous deliveries)
Multiple pregnancy
Previous myomectomy (removal of uterine fibroids through an incision
in the uterus)
Previous C-section (if the scar is low and close to the vaginal cervix
region)
SYMPTOMS AND SIGNS:
Spotting during the first and second trimesters
Sudden, painless, and profuse vaginal bleeding in pregnancy during the
third trimester (usually after 28 weeks)
Uterine cramping occuring with onset of bleeding
Painless bleeding
Pallor
Tachycardia
Hypotension
Vaginal examination:
Confirm the uterus bleeding
The uterus is usually soft and relaxed

An abdominal ultrasound during the second trimester
Transvaginal or transperineal ultrasound
Radioactive isotope
Abdominal MRI
Vaginal varices
Vaginal erosion
Cervical cancer
Retroplacental hematoma
Rupture of uterus in pregnancy
Rupture of previuos vessels
Prophylactic treatment:
This condition is not preventable
The treatment depends on the amount of abnormal uterine bleeding.
Early in pregnancy:
Transfusions may be given to replace maternal blood loss
Medications may be given to prevent premature labor
The most important factor in reducing maternal and infant death rates
Cesarean section is the method for deliverytransfusion
If not complete placenta previa we can use oxytocin for better uterus
dinamic
COMPLICATIONS:
Major hemorrhage (bleeding)
Shock
Death.
Risk of infection
Formation of blood clots (thromboembolism)
Prematurity
Infant is less than 36 weeks gestation, is responsible for about 60% of
infant deaths
Fetal blood loss or hemorrhage may occur
Also occur hemorrhage with surgical entry into the uterus during a Csection delivery
The probable outcome is excellent when the condition is managed
appropriately. This means hospitalizing those at risk who are having
symptoms, and performing C-section delivery

Definition:
A migraine is a type of primary headache that some people get
repeatedly over time also is define as a recurring vascular headache
Characteristics:
The headaches tend to start between the ages of 10 and 46
Migraines are classified :
-Migraine without aura (no warning symptoms)
-Migraine with aura (visual disturbances(that serve as warning sign)
before the headache starts)
-Mixed tension migraine (features of both migraines and tension
headache)
Migraines occur more often in women than men
Pregnancy may reduce the number of migraines attacks
Predisposition to migraine may be inherited
Are worse on one side of the head
Feel throbbing, pounding, or pulsating

Migraine attacks may be triggered by:
History of migraines in the family
Allergic reactions
Stress
Food
Environmental changes
Bright lights
Loud noises
Certain odors or perfumes
Physical or emotional stress
Changes in sleep patterns
Smoking or exposure to smoke
Skipping meals
Alcohol or caffeine
Menstrual cycle fluctuations
Birth control pills
Tension headaches
Foods containing:
-Tyramine (red wine, aged cheese, smoked fish, chicken livers,
figs, and some beans)
-Nitrates ( hot dogs and salami)
Other foods such as: chocolate, banana, citrus, dairy products,
and fermented or pickled foods
SYMPTOMS AND SIGNS:
Symptoms:
Nausea and vomiting
Sensitivity to light or sound
Loss of appetite
Fatigue
Numbness
Tingling
Weakness
Photophobia
Vertigo
Tinnitus
Chills
Polyuria
Sweating
Facial edema
Irritability
Symptoms that may linger even after the migraine has gone away
include:
Feeling mentally dull, like your thinking is not clear or sharp
Increased need for sleep
Warning signs (auras) that can precede a migraine include:
Seeing stars or zigzag lines
Tunnel vision
Temporary blind spot

CBC
Creatinine
urease
EEG
MRI or CT scan
Rarely, a lumbar puncture (spinal tap)
Intracraneal pressure(ICP) monitoring
Cefalea agitata
Subarachnoid hemorrhage
Meningoencephalitis
Temporal arteritis
Hight blood pressure
Intracraneal Hypertension
Brain tumor
Cerebral trauma
Epileptic cephalea
(There is no specific cure for migraine headaches. The goal is to prevent

symptoms by avoiding or altering triggers)
When migraine symptoms begin:
Rest in a quiet, darkened room
Drink fluids to avoid dehydration (especially if you have vomited)
Try placing a cool cloth on your head
Ergots like:
Dihydroergotamine
Ergotamine with caffeine (Cafergot)
Triptans:
Sumatriptan (Imitrex)
Rizatriptan (Maxalt)
Almotriptan (Axert)
Frovatriptan (Frova)
Zolmitriptan (Zomig)
Isometheptene (Midrin):
Stronger pain relievers (narcotics)
If patient get at least three headaches per month, can be use drugs like:
Beta-blockers such as propranolol (Inderal)
Anti-depressants, including tricyclics like amitriptyline (Elavil)
Anti-convulsants such as valproic acid (Depacon, Depakene)
Calcium channel blockers such as verapamil
Avoid smoking, caffeine, and alcohol
Exercise regularly
Get enough sleep each night
Learn to relax and reduce stress
COMPLICATIONS:
Stroke
Some patients responds differently to treatment. Others have rare
headaches that require little to no treatment. However some patients
require the use of several medications or even occasional hospitalization
SYMPTOMS AND SIGNS:

Tender, swollen breasts or nipples
Fatigue
Slight bleeding or cramping
Nausea with or without vomiting
Food aversions or cravings
Frequent urination
Headaches
Constipation
Mood swings
Faintness and dizziness
Raised basal body temperature
Abdominal Pain or Cramping
Backache
Breast Changes
Contractions
Congestion and Nosebleeds
Gas
Gum and Teeth Changes
Hair Changes
Heartburn and Indigestion
Hemorrhoids
Leg Cramps
Shortness of Breath
Skin Changes
Sleeping Difficulties
Swelling

Before 14 weeck:
Blood tests
Urine tests
Blood pressure checks
Serology
Glucose Screen
Group B Strep
Hematocrit
Hemoglobin electrophoresis
Feces wastes
Maternal Blood Screening
Since 14 to 24 weeck:
Ultrasound
Blood tests
Urine tests
Hematocrit
Serology
Alfa-phetoprotein
Since 24 to 37 weeck:
Blood tests
Urine tests
Ultrasound
TREATMENT:
Do:
Take a prenatal vitamin or folic acid supplement
Maintain a healthy weight
Exercise regularly, with your health care provider's OK
Eat healthfully
Manage stress and any chronic health conditions
See your health care provider for regular prenatal checkups
Talk to your health care provider about any medications you're taking
Things to Avoid:
Alcohol
Smoking
Marijuana
Drugs and Herbs
Abuse
Mercury
Hazardous Substances
Avoid Rodents
Stress
COMPLICATIONS:
Anemia
Depression During Pregnancy
Gestational Diabetes
Hyperthyroidism and Hypothyroidism
The Postpartum Blues
Postpartum Depression
Preeclampsia(High Blood Pressure)
Preexisting Diabetes
Preterm Labor
Infection(Bird Flu, Varicella, Rubella, Salmonellosis, Toxoplasmosis and
Cytomegalovirus)
Placental Complications(Placental Abruption,Placenta Accreta, Placenta
Increta, Placenta Percreta and Placenta Previa)
Amniotic Fluid Complications(Oligohydramnios and Polyhydramnios)
Loss Ectopic(Pregnancy and Molar Pregnancy)

Generally good.

Definition:
Ulcerative colitis is an ulceroinflammantory disease affecting the colon
but limited to the mucosa and submucosa. The word colitis is an
inflammation of the large intestine (colon). Also ulcerative colitis is
defined as a chronic, episodic, inflammatory disease of the large
intestine and rectum characterized by bloody diarrhea
Characteritics:
Ulcerative colitis begins in the rectum and sometimes involving the
entire colon
Ulcers form where inflammation has killed the cells that usually line the
colon, then bleed and produce pus
When the inflammation occurs in the rectum and lower part of the
colon it is called ulcerative proctitis
If the entire colon is affected it is called pancolitis
If only the left side of the colon is affected it is called limited or distal
colitis
Ulcerative colitis can occur in people of any age, but it usually starts
between the ages of 15 and 30, and less frequently between 50 and 70
years of age
It affects men and women equally
Clinical Forms:
Light
Moderate
Severe

Causes:
Ulcerative colitis
Crohn's colitis
lymphocytic colitis
Collagenous
Ischemic colitis
History of radiation to the large bowel
Risk factors:
Previous aortic surgery with inadvertent damage to the artery supplying
the colon
History of stroke
Low blood pressure

Diabetes
Abdominal radiation exposure
History of peripheral vascular disease
Respiratory infections
Stress
Family history of ulcerative colitis
Jewish ancestry
SYMPTOMS AND SIGNS:

Abdominal pain and bloody diarrhea(most common)
Anemia
Fatigue
Weight loss
Loss of appetite
Rectal bleeding
Loss of body fluids and nutrients
Skin lesions
Joint pain
Growth failure (specifically in children)
Dehydration
Abdominal bloating
Increased intestinal gas
Bloody stools
Abdominal sounds (borborygmus)
Fever
Tenesmus
Nausea and vomiting
Joint pain

Laboratory:
Hemogram
Eritrosedimentation
Total proteins
Electrolytes in blood
Fosfatasa alkaline
Feces wastes
CRP (C-reactive protein)
Endoscopy:
Sigmoidoscopy
Colonoscopy
Angiography showing a vascular (blood vessel) lesion
Imaging:
Abdominal x-ray
Biopsies show changes related to inflammation
Barium enema
Abdominal CT scan
Abdominal MRI

Crohns disease
Diverticular disease
Cancer
No Pharmacology treatment:
Hospitalization: Occasionally, symptoms are severe enough that a person
must be hospitalized
Stable diet with supplements of vitamins
Pharmacology Therapy:
Aminosalicylates
Sulfasalazine
Olsalazine
Mesalamine
Balsalazide
Corticosteroids:
Prednisone
Methylprednisone
Hydrocortisone
Immunomodulators:
Azathioprine
6-mercapto-purine (6-MP)
Cyclosporine A
Surgery
Ileostomy
Ileoanal anastomosis
Awareness of risk may allow early diagnosis and treatment Absolute
prevention may not be possible
COMPLICATIONS:
Local:
Toxic megacolon
Abscesses perianales
Rectal prolapse
Hemorrhoids
Perforation of the colon
Cancer of colon
Massive hemorrhage
Extraintestinal :
Multiform erythema
Arthritis periferica
Anemia
Iritis
Pericarditis
Cancer of the vias biliary
Complications of corticosteroid therapy
The course of the disease generally varies, with remissions and
exacerbations over a period of years. Sometimes ulcerative colitis can be a
fulminant (quickly progressing) disease. A permanent and complete cure
is unusual
The risk of colon cancer increases in each decade after ulcerative colitis is
diagnosed

Definition
Jaundice is a condition produced when excess amounts of bilirubin
circulating in the blood stream dissolve in the subcutaneous fat (the layer
of fat just beneath the skin), causing a yellowish appearance of the skin
and the whites of the eyes. Also is defined as a yellow color in the skin,
the mucous membranes, or the eyes. The yellow pigment is from bilirubin,
a byproduct of old red blood cells
Characreristics
Jaundice can be caused by:
-Too many red blood cells retiring
-The liver being overloaded or damaged
-The inability to move processed bilirubin from the liver through the
biliary tract to the gut
Jaundice is even more common in premature babies
Physiologic jaundice is the name for normal jaundice commonly seen in
healthy babies
Pathologic jaundice is the name given when jaundice presents a health
risk, either because of its degree or its cause
Newborn jaundice is caused by high levels of bilirubin in the blood, which
gives an infant's skin and eyeballs a yellowish tinge
It arises for many reasons, including:
Blood incompatibilities
Blood diseases
Genetic syndromes
Hepatitis, cirrhosis
Bile duct blockage
Other liver diseases
Infections
Medication

In babies include:
Glucose-6-phosphate dehydrogenase deficiency
Infections, including urinary tract infection and sepsis
Congenital cytomegalovirus (CMV) infection
Congenital toxoplasmosis
Congenital syphilis
Congenital herpes
Congenital rubella
Congenital hypothyroidism
Thalassemia
In children include:
In
Newborn jaundice (physiologic jaundice)

Breastfeeding jaundice
Breast milk jaundice
Viral hepatitis (hepatitis A-E)
Hemolytic anemia
Disorders present since birth that cause problems processing
bilirubin (Gilbert's syndrome or Crigler-Najjar syndromes)
Biliary atresia
Malaria
adults include:
Blocked bile ducts (by infection, tumor or gallstones)
Viral hepatitis (hepatitis A-E)
Drug-induced cholestasis
Drug-induced hepatitis (hepatitis triggered by erythromycin sulfa
drugs, antidepressants, rifampin, steroids, tolbutamide,
testosterone)
Biliary stricture
Alcoholic liver disease (alcoholic cirrhosis)
Cancer of the pancreas
Primary biliary cirrhosis
Ischemic hepatocellular jaundice
Intrahepatic cholestasis of pregnancy
Hemolytic anemia
Chronic active hepatitis
Malaria
SYMPTOMS AND SIGNS:
Yellow color of the skin
Pruritus
Anorexia
Bradycardia
Hypotension
Asthenia
Insomnia or agrypnia
Hemeralopia
Hemorrhagic jaundice
Poor feeding
Lethargy
Blood serum bilirubin(elevated blood serum bilirubin level)
Liver function tests and cholesterol
Prothrombin time
Complete blood count
Ultrasound of the abdomen

Liver biopsy
Urine and fecal urobilinogen
Hepatitis
Erytrobastois fetalis(Hydrops Fetalis)
Leptospirosis
Crigler-Najjar syndrome
Neonatal Hiperbilirrubinemia
Gilberts syndrome
Cholestasis
Rotors syndrome
Breast milk jaundice
Dubin-Johnson syndrome
Treatment is usually not necessary
Keep the baby well-hydrated with breast milk or formula
Encourage frequent bowel movements by feeding frequently
(Bilirubin is what gives stool their brown color)
The eyes are protected from the light
In the most severe cases of jaundice, an exchange transfusion is
required(the patient blood is replaced with fresh blood)
Intravenous immunoglobulin is very effective at reducing the
bilirubin levels to safe ranges
Feed babies frequently and don't let them become dehydrated
Early identification and treatment of jaundice will usually prevent
kernicterus, whatever the cause
In newborns, some degree of jaundice is normal and probably not
preventable
COMPLICATIONS:
Rare, but serious, complications from high bilirubin levels
include:
Kernicterus -- brain damage from very high bilirubin levels
Deafness
Cerebral palsy
The jaundice usually resolves without treatment within 1 to 2

weeks
In different tropical regions of the world, there are great

quantities of tropical diseases; one of them, which is very
common, is Malaria.

Definition
Malaria(parasitic disease) is a severe infectious illness
characterised by fever, chills, and sweating(diaphoresis)
Characteristics:
Malaria can also be transmitted congenitally (from a mother to her
unborn baby)
Malaria can be transmitted by blood transfusions
Malaria can be carried by mosquitoes in temperate climates, but
the parasite disappears over the winter
The disease is a major health problem in much of the tropics and
subtropics
The CDC estimates that there are 300-500 million cases of malaria
each year, and more than 1 million people die
It presents a major disease hazard for travellers to warm climates
In some areas of the world, mosquitoes that carry malaria have
developed resistance to insecticides
The parasites have developed resistance to antibiotics

Malaria is caused by a parasite:
Plasmodium vivax
oval
malariae
falciparum
That is transmitted from one human to another by the bite of
infected Anopheles mosquitoes
SYMPTOMS AND SIGNS:

Sequential chills
Fever
Sweating or diaphoresis
Headache
Nausea and vomiting
Muscle pain
Anemia
Stools
Bloody
Jaundice
Convulsion
Coma
Enlarged liver
Enlarged spleen

Microscopy
Antigen Detection
Polymerase Chain Reaction (PCR)
Serology
Immunofluorescence (IFA)
Enzyme-Linked Immunosorbent Assay (ELISA)
Drug Resistance Tests
Hepatitis
Dengue
Leptospirosis
Hepatic abscess
Typhoid fever
Urinary infection
Recurrent fever
P.Falciparum:
Quinine sulphate or quinine dihydrochloride more:
-Pyrimethamine
-Sulfadiazine
-Tetracycline
-Clindamycin
P.Malariae and P. Falciparum:
Chloroquine phosphate or Chloroquine hydrochloride
P.Malariae and P. Oval:
Chloroquine phosphate or Chloroquine hydrochloride more

Primaquine phosphate
COMPLICATIONS:
Liver failure
Kidney failure
Destruction of blood cells (hemolytic anemia)
Meningitis
Rupture of the spleen and subsequent massive hemorrhage
The outcome is expected to be good in most cases of malaria
with treatment, but poor in Falciparum infection with
complications
BIBLIOGRAPHY
American Collage of Legal Medicine. Legal Medicine. Fifth

Edition. Mosby, inc. USA, 2001.
Diccionario Terminolgico de Ciencias Mdicas. Ministerio de
Cultura. Editorial Cientfico-Tcnica. La Habana, 1978.
Glosario de Trminos Mdicos. Centro Nacional de Informacin
de Ciencias Mdicas. La Habana, 1980.
Henry S. Berman, M.D, et al. Practical Medicine. Primera
Edicin Cubana. Edicin revolucionaria. La Habana, 1988.
Henry S. Berman, M.D, et al. Practical Surgery. Primera Edicin
Cubana. Edicin revolucionaria. La Habana, 1988.
http://www.nih.gov/icd/od/foia/index.htm
http://www.nlm.nig.gov/medlineplus/pregnancy.html
http://www.nlm.nih.gov/medlineplus/ency/article/003432.htm
http://www.nlm.nih.gov/medlineplus/encyclopeia.html
http://www.nlm.nih.gov/medlineplus/gruginformation.html
http://www.nlm.nih.gov/medlineplus/healthtopics.html
http://www.nlm.nih.gov/medlineplus/mplusdictionary.html
Kenneth N. Anderson, et. al. Mosbys Medical Dictionary. Fifth
Edition. Mosby- Year Book, inc. USA, 1998.
Macdonald Critchley. Butterworths Medical Dictionary. Second
Edition. Ministerio de Cultura. Editorial Cientfico-Tcnica. La
Habana, 1986.
Roca Goderich, Reinaldo, et. al. Temas de Medicina Interna. Cuarta
Edicin. Editorial Ciencias Mdicas. La Habana, 2002.
P. L. Sandler. Medically Speaking. Primera Edicin Cubana.
Edicin Revolucionaria. La Habana, 1987.
Vinay Kumar, M.D., et. al. Basic Pathology. Sixth Edition. W. B.
Saunders Company, 1997.

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MINISTERIO DE SALUD PBLICA

FACULTAD DE CIENCIAS MDICAS

UPDATED CONSULTING BROCHURE FOR ENGLISH FOR

Joaqun Salgado Santana *

Bachelor of Education. Assistant Professor.

Student from the 4th year of the Medical Career.

Myocardial Infarction Heart Attack

Cirrhosis of the Liver

Carcinoma of the Brest Breast Cancer

DEFINITION AND CHARACTERISTICS:

The age (the old people)

SYMPTOMS AND SIGNS:

Calcium channel blockers: nifedipine, verapamil, amlodipine, nicardipine, and

DEFINITION AND CHARACTERISTICS:

SYMPTOMS AND SIGNS:

LABORATORIES TESTS (LAB TESTS):

Beta-blockers: Atenolol, Propranolol

DEFINITION AND CHARACTERISTICS:

LABORATORIES TESTS (LAB TESTS):

DEFINITION AND CHARACTERISTICS:

SYMPTOMS AND SIGNS:

LABORATORIES TESTS (LAB TESTS):

DEFINITION AND CHARACTERISTICS:

Some drugs(aspirin and other non-steroidal anti-inflammatory

SYMPTOMS AND SIGNS:

LABORATORIES TESTS (LAB TESTS):

There is no cure for asthma, though symptoms sometimes

DEFINITION AND CHARACTERISTICS:

A peptic ulcer is erosion in the lining of the stomach or

CAUSES AND RISK FACTORS:

SYMPTOMS AND SIGNS:

LABORATORIES TESTS (LAB TESTS):

Treatnmet often involves a combination of medications to kill

Obstruction of the pyloric channel

Peptic ulcers tend to come back if untreated. If patient follow

DEFINITION AND CHARACTERISTICS:

-One such procedure, endoscopic variceal band ligation, treats

amounts of fluid are removed through a thin tube inserted in the

-A liver transplant may be the only option for some people

DEFINITION AND CHARACTERISTICS:

Hypothyroidism is common in adults

Autoimune destruction of the thyroid gland is the most common

cause of thyroid gland failure in adults

cellular metabolic processes

CAUSES AND RISK FACTORS:

SYMPTOMS AND SIGNS:

LABORATORY TEST:(Lab test)

Needle biopsy on aspiration

Cardiac arrhythmias associated with hypoxia

Death by myxedema coma

Is excellent provided that thyroid hormone replacement is

DEFINITION AND CHARACTERISTICS:

CAUSES AND RISK FACTORS:

SYMPTOMS AND SIGNS:

LABORATORIES TESTS (LAB TESTS):

It depends on surgery and circumstances around it.

DEFINITION AND CHARACTERISTICS:

Acute pancreatitis is an inflammation (irritation and swelling) of