In humans the respiratory tract is

the part of the anatomy that has to

do with the process of respiration.

The respiratory tract is divided into

3 segments:

 Upper respiratory tract: nose and

nasal passages, paranasal
sinuses, and throat or pharynx
 Respiratory airways: voice box or
larynx, trachea, bronchi, and
bronchioles
 Lungs: respiratory bronchioles,
alveolar ducts, alveolar sacs, and
alveoli
Gas exchange

Most of the respiratory tract

exists merely as a piping
system for air to travel in the
lungs; alveoli are the only part
of the lung that exchanges
oxygen and carbon dioxide
with the blood.
Upper Respiratory Tract
Infections

Lower Respiratory Tract

Infections
The respiratory tract is a
common site for infections.
Upper respiratory tract
infections are probably the
most common infections in
the world.
Pharyngitis is an inflammation of the
throat or pharynx. In most cases it is
painful and the initial infection can
extend for a lengthy time period, and is
often referred to as a sore throat.

Acute pharyngitis can result in very

large tonsils which cause trouble
swallowing and breathing. Some cases
are accompanied by a cough or fever.

Most acute cases are caused by viral

Infections (40%–60%), with the
remainder caused by bacterial
infections, fungal infections, or irritants
such as pollutants or chemical substances.
 Upper Respiratory
Infection: inflamed
mucous membranes of
the throat
◦ Caused by Group A -
hemolytic streptococci
(Streptococcus pyogenes)
◦ Virulence factors:
resistance to phagocytosis
 Streptokinases: lyse fibrin
clots
 Streptolysins: cytotoxic to
tissue cells, RBCs, and
protective leukocytes
 Transmission:
◦ person to person by direct contact
with saliva or nasal discharge.
◦ Most people do not get group A strep
infections from casual contact with
others, but a crowded environment
like a dormitory, school, or an
institutional setting can make it easier
for the bacteria to spread.
◦ A person becomes sick within 3 days
after being exposed to the germ.
◦ Once people become infected, they
can pass the infection to others for up
to 2 to 3 weeks even if they don't
have symptoms.
◦ After 24 hours of antibiotic treatment,
a person will no longer spread the
bacteria to others.
 throat may be red with white patches
 trouble swallowing
 have tender swollen glands (lymph nodes)
on the sides of your neck, toward the front
 Usually the tonsils are red and enlarged
 may also have white craters or specks of
pus on your tonsils or your tonsils may be
covered with a gray or white coating.
headache
 abdominal (lower stomach) pain
 fever
 general discomfort, uneasiness, or ill
feeling
 loss of appetite and nausea
 muscle pain
 joint stiffness
 rash
 Diagnosis:
◦ Throat swab
◦ Rapid test
 Indirect agglutination
diagnostic tests
 Use microscopic latex
particles coated with Abs
against group A
streptococci.
 Negative tests are double
checked by culturing
organism
 Rx: 10 days of treatment with an
antibiotic such as penicillin.
◦ stay home for at least 48 hours, until
the antibiotics have had a chance to
work. It's typical to be contagious for
about 24 hours after you start
treatment. By the third day you should
be feeling much better.
◦ If you stop taking your antibiotics too
soon, bacteria can remain in your
throat, your symptoms may come back,
and you could be contagious for up to
21 days.
◦ No treatment or incomplete treatment
of strep throat also increases your risk
of complications, such as rheumatic
fever (which can cause permanent
damage to your heart), scarlet fever,
blood infection, or kidney disease.
acute epiglottis

acute rheumatic fever

acute glomerulonephritis
 A very rapidly progressive infection
causing inflammation of the epiglottis (the
flap that covers the trachea) and tissues
around the epiglottis that may lead to
abrupt blockage of the upper airway and
death.

 The infection is usually caused by bacteria

and is contracted through the respiratory
tract. Subsequent downward extension
produces what is called cellulitis with
marked inflammation of the epiglottis and
nearby structures.

 The inflamed epiglottis mechanically

obstructs the airway; the work of breathing
increases, and the retention of carbon
dioxide and hypoxia (low oxygen) may
result. Clearance of secretions is also
impaired. These factors may result in fatal
asphyxia within a few hours.
 An inflammatory disease that may develop
two to three weeks after a Group A
streptococcal infection (such as strep
throat or scarlet fever).
 It is believed to be caused by antibody
cross-reactivity and can involve the heart,
joints, skin, and brain.
 Acute rheumatic fever commonly appears
in children between ages 5 and 15, with
only 20% of first time attacks occurring in
adults.
 It gets its name for its similarity in
presentation to rheumatism.
 Some patients develop significant carditis
which manifests as congestive heart
failure.
 This requires the usual treatment for heart
failure: diuretics and digoxin.
 Unlike normal heart failure, rheumatic
heart failure responds well to
corticosteroids.
 Causes renal failure
 Occurs after infection with
Streptococcus pyogenes.
 It typically occurs 10–14 days after
a skin or pharyngeal infection with
this bacterium.
 Patients present with signs and
symptoms of glomerulonephritis.
 Diagnosis is made based on these
findings in an individual with a
history of recent streptococcal
infection.
 Streptococcal titers in the blood
(antistreptolysin O titers) may
support the diagnosis.
 Strep throat or other
infections of nose and
throat, can progress to
otitis media
 Most frequent in early
childhood
 Affects 85% of children
under the age of 3
years.
 An untreated infection can travel
from the middle ear to the nearby
parts of the head, including the
brain.
 Although the hearing loss caused
by otitis media is usually
temporary, untreated otitis media
may lead to permanent hearing
impairment.
 Persistent fluid in the middle ear
and chronic otitis media can
reduce a child's hearing at a time
that is critical for speech and
language development.
 Children who have early hearing
impairment from frequent ear
infections are likely to have
speech and language disabilities.
◦ unusual irritability
◦ difficulty sleeping
◦ tugging or pulling at one or both
ears
◦ fever
◦ fluid draining from the ear
◦ loss of balance
◦ unresponsiveness to quiet
sounds or other signs of
hearing difficulty such as sitting
too close to the television or
being inattentive
 Prevention:
◦ children who are cared for in group
settings, as well as children who live
with adults who smoke cigarettes,
have more ear infections. Therefore, a
child who is prone to otitis media
should avoid contact with sick
playmates and environmental tobacco
smoke.
◦ Infants who nurse from a bottle while
lying down also appear to develop
otitis media more frequently.
◦ Children who have been breast-fed
often have fewer episodes of otitis
media.
◦ Research has shown that cold and
allergy medications such as
antihistamines and decongestants are
not helpful in preventing ear
infections.
◦ Even though studies have shown
that up to 80% of acute ear
infections will clear up on their
own without medical treatment,
the standard therapy for acute
otitis media remains antibiotics.
◦ Even after effective antibiotic
treatment, 40% of children may
retain noninfected residual fluid in
the middle ear that can cause
some temporary hearing loss. This
may last for 3 to 6 weeks after the
initial antibiotic therapy
◦ The duration of acute otitis media
is variable. There may be
improvement within 48 hours even
without treatment. Treatment with
antibiotics for a week to 10 days is
usually effective.
 Diphtheria is an acute bacterial
disease that usually affects the
tonsils, throat, nose or skin. It is
extremely rare in the United
States.
 Diphtheria is most common where
people live in crowded conditions.
Unimmunized children under 15
years of age are likely to contract
diphtheria. The disease is often
found among adults whose
immunization was neglected, and
is most severe in unimmunized or
inadequately immunized
individuals.
◦ Gram-positive
◦ Pleomorphic
◦ Non endospore forming
◦ Non motile
◦ Used to say that it looked
like Chinese characters
 Causative Agent:
Cornybacterium diptheriae
 Transmission: Diphtheria is
transmitted to others through
close contact with discharge
from an infected person s
nose, throat, skin, eyes and
lesions
 There are two types of
diphtheria. One type involves
the nose and throat, and the
other involves the skin.
Characterized by:
◦ Fever
◦ Headaches
◦ Sore throat
◦ Tiredness
◦ Eventual formation of a
pseudomembrane that covers
throat and nasal passages
 RBCs
 WBCs
 Bacterium
 Epithelial cells – organism has
begun to destroy. Membrane
inbedded in tissue

◦ Symptoms usually appear two to
four days after infection, with a
range of one to ten days
◦ Symptoms include sore throat, low-
grade fever and enlarged lymph
nodes located in the neck. Skin
lesions may be painful, swollen and
reddened.
◦ People who are infected with the
diphtheria germ may be contagious
for up to two weeks, but seldom
more than four weeks. If the patient
is treated with appropriate
antibiotics, the contagious period
can be limited to less than four
days.
 The toxin, or poison, caused by the
bacteria can lead to a thick coating in
the nose, throat, or airway
(pseudomembrane).
 C. diphtheriae will only produce the
clinical Sx, if transformed by a
bacteriophage.
 This pseudomembrane is gray or
black and can cause breathing
problems and difficulty in
swallowing.
 In more advanced stages, the patient
may have difficulty breathing or
swallowing, complain of double
vision, have slurred speech, or even
show signs of going into shock (pale,
cold skin; rapid heartbeat; sweating;
and an anxious appearance).
◦ Preventing diphtheria depends almost
completely on immunizing children with
the combined
diptheria/tetanus/pertussis (DTP or
Dtap) vaccine and non-immunized
adults with the diphtheria/tetanus
vaccine (DT).
◦ Most cases of diphtheria occur in
people who haven't received the vaccine
at all or haven't received the entire
course.
◦ The immunization schedule calls for
DTP or DTaP vaccines at 2, 4, and 6
months of age, with booster doses
given at 12 to 18 months and then at 4
to 6 years.
◦ Booster shots should be given every 10
years after that to maintain protection.
◦ International studies have shown that a
significant percentage of adults over 40
years of age are not adequately
protected against diphtheria and
tetanus.
 Incubation:
The incubation period for diphtheria
is 2 to 4 days, although it can range
from 1 to 6 days.
 Contagiousness:
Diphtheria is highly contagious. It is
easily passed from the infected
person to others through sneezing,
coughing, or even laughing. It also
can be spread to others who pick up
tissues or drinking glasses that have
been used by the infected person.
 People who have been infected by
the diphtheria bacteria can infect
others for up to 4 weeks, even if they
don't have any symptoms.
 Tx:
◦ Treatment consists of immediate
administration of diphtheria
antitoxin and antibiotics.
◦ Antibiotic treatment usually renders
patients non-infectious within 24
hours.
 Vaccine:
◦ Diphtheria vaccine is usually
combined with tetanus vaccine and
acellular pertussis vaccine to form a
triple vaccine known as DTaP. This
vaccine should be given at two,
four, six and 15-18 months of age,
and between four and six years of
age. A combination of tetanus
vaccine and diphtheria vaccine (Td)
should be given every 10 years to
maintain immunity.
◦ Unless immunized, children and
adults may repeatedly be infected
with the disease.
Infections of the Lungs

Pneumonia

Whooping Cough

Tuberculosis
Inflamation of lung with accompanying
fluid build up

Much of pneumonia seen clinically is

caused by viruses.

Streptococcus pneumoniae causes

about 90% of all bacterial pneumonia
cases.
◦ Organism is Gram-positive
diplococci
◦ Heavily encapsulated (primary
virulence factor)
◦ Human host is resistant to S.
pneumoniae
◦ Organism is very fragile
 Alpha hemolytic – has green
zone around colony because it
only partially destroys RBC
Pneumococcal: caused by S.
pneumoniae
◦ Most common cause of
bacterial pneumonia
◦ Surrounded by capsule
◦ 83 serotypes distinguished
by capsules
 Symptoms:
◦ High fever
◦ Difficulty breathing
◦ Chest pain
◦ Lungs have reddish
appearance due to dilated
blood vessels
Alcoholics – alcohol will suppress
immune system

Immunosuppressed – AIDS
patients who are taking
immunosuppressants for cancer,
transplants etc…

Debilitated individuals
◦ Those who live a very
sedentary lifestyle (morbidly
obese, elderly)
  In response to the infection,
alveoli fill with some RBCs,
neutrophils, and fluid from
surrounding tissues
 Sputum is often rust-colored
from blood coughed up from
lungs

◦ Diagnosis:
 Culture of bacterium from
sputum and optochin
sensitive

◦ Tx: Penicillin

◦ Vaccine available, usually for

children and elderly patients
Smaller players in causing pneumonia
 Klebsiella pneumoniae

◦ Gram-negative enteric
◦ Destroys lungs
◦ Very degenerative
◦ Associated with alcoholics
 Haemophilus influenzae
◦ 5-6 years ago started giving kids a
vaccination
 Mycoplasma pneumoniae
◦ Causes milder type of pneumonia
(Atypical / walking pneumonia)
◦ No cell wall – no treatment with
PCN

◦ Legionnaires' disease, which is
also known as Legionellosis, is a
form of pneumonia.
◦ It is often called Legionnaires'
disease because the first known
outbreak occurred in the Bellevue
Stratford Hotel that was hosting a
convention of the Pennsylvania
Department of the American
Legion.
◦ In that outbreak, approximately
221 people contracted this
previously unknown type of
bacterial pneumonia, and 34
people died.
◦ The source of the bacterium was
found to be contaminated water
used to cool the air in the hotel's
air conditioning system.
◦ An estimated 8,000 to 18,000
people get Legionnaires' disease
in the United States each year.
◦ Transmission:
 Legionnaires' disease is most often
contracted by inhaling mist from water
sources such as whirlpool baths, showers,
and cooling towers that are contaminated
with Legionella bacteria.
 There is no evidence for person-to-person
spread of the disease.
◦ Symptoms:
 Fever
 chills
 cough that may or may not produce
sputum
 abdominal pain
 diarrhea
 Confusion
 This list of symptoms, however, does not
readily distinguish Legionnaires' disease
from other types of pneumonia.
◦ Diagnosis:
 Legionnaires' disease is
confirmed by laboratory tests
that detect the presence of
the bacterium, Legionella
pnuemophila, or the presence
of other bacteria in the family
Legionellaceae.
◦ Tx:
 It is the most often treated
with the antibiotic drug
Erythromycin.
 Although Legionnaires'
disease has a mortality rate of
5 to 15 percent, many people
may be infected with the
bacterium that causes the
disease, yet not develop any
symptoms.
 It is likely that many cases of
Legionnaires' disease go
undiagnosed
◦ Causative agent:
Pneumocystis carinii
 Uncertainty whether
organism is protozoan or
fungus
 Recent analysis of RNA
indicate yeast
 Found in healthy human
lungs but causes disease
among
immunosuppressed
patients
 Before AIDs epidemic,
uncommon disease
 By 1993, indicator of AIDS
in more than 20,000 cases
◦ #1 killer in people with HIV
◦ Most scientists believe PCP is spread
in the air, but they don't know if it
lives in the soil or someplace else.
The PCP bacteria is common all over
the world.
◦ Prevention:
 If HIV +, regular blood test to
check how strong immune system
is.
 TMP-SMZ to prevent PCP if CD4
cell count goes below 200.
 May also start taking TMP-SMZ if
you get certain symptoms, such
as a temperature above 100°F that
lasts for 2 weeks or longer, or a
yeast infection in mouth or throat
(also called "thrush").
 Tx:
◦ People with severe PCP are treated in
a hospital with IV medicine (medicine
put into a vein through a tube).
◦ As they get better--or if the illness
was mild to begin with--they can
take medicine in pill form. TMP-SMZ
is also a good treatment for PCP.
◦ If you can't take TMP-SMZ, or if you
don't get better quickly with TMP-
SMZ, you can take other medicines or
combinations of medicines.
◦ Although these days the treatments
for PCP are good, it's better to try
not to get PCP at all.
 Pertussis, commonly known as
"whooping cough," is an infection
of the respiratory tract caused by
Bordetella pertussis bacteria.
 A pertussis infection is very
contagious and can be quite
serious.
 Once inside the airways,
pertussis bacteria produce
chemical substances (toxins) that
interfere with the respiratory
tract's normal ability to eliminate
germs.
 B. pertussis destroys the ciliated
cells of the trachea and lungs
thus inhibiting the flushing
mechanism out of the lungs.
 Transmission:
◦ People become infected with
Bordetella pertussis bacteria by
inhaling contaminated droplets
from an infected person's cough or
sneeze.
◦ Once an unimmunized child has
been infected after exposure to a
person with pertussis, it usually
takes three days to 21 days for
symptoms to begin.
 Symptoms:
◦ first symptoms of pertussis may be
similar to those of a common cold,
including nasal congestion, runny
nose, sneezing, red and watery
eyes, mild fever, and a dry cough.
◦ After about 1 to 2 weeks, the dry
cough becomes a wet cough that
brings up thick, stringy mucus.
◦ At the same time, coughing begins
to occur in long spells that may last
for over a minute, sometimes
causing a child to turn red from
effort or blue from lack of oxygen.
◦ At the end of a coughing spell,
the child gasps for air with a
characteristic "whooping"
sound.
◦ Infants may not whoop at all
or as loudly as older children.
◦ Severe coughing spells can
lead to vomiting and may
make it hard for a child to eat
or drink.
◦ Severe coughing can also
cause petechiae (tiny, red
spots caused by ruptures in
blood vessels at the skin's
surface) in the skin of the
upper body, as well as small
areas of bleeding in the whites
of the eyes.
◦ Coughing spells can continue
for several weeks.
Tx:
◦ Pertussis is treated with
antibiotics, usually
erythromycin.
◦ Human pertussis serum
immunoglobulin is also used in
treatment.
◦ Antibiotics are also very
important in stopping the
spread of pertussis bacteria
from the infected child to other
people.
◦ To help decrease the chance of
vomiting, give frequent meals
with small portions.
◦ In some cases, a child with
pertussis may need treatment
in a hospital.
 Prevention:
◦ Pertussis can be prevented by the
pertussis vaccine, which is part of the
DTaP (diphtheria, tetanus, acellular
pertussis) or DTP immunizations.
◦ These important immunizations are
routinely given in five doses before a
child's sixth birthday.
◦ The pertussis vaccine has dramatically
decreased the number of cases of
whooping cough that occur each year and
saved countless lives.
◦ Prophylactic (preventive) oral antibiotics
should be given to anyone who lives in
the same household as someone with
pertussis.
◦ Others who have had close contact with
the infected person, including day-care
staff and students, should also receive
prophylactic antibiotic treatment.
Causative agent: Mycobacterium
tuberculosis

Chronic infection of lower respiratory

tract

Symptoms:
 Low grade fever

 Chronic cough

 Tiredness

 Night sweat

 Patients with active TB care

constantly shedding agent in
aerosols when they cough
Second largest infectious disease
killer in the world
◦ 300,000 new cases a year in the
U.S.
◦ U.S. has 10% mortality rate, in
most of the world it is 75%. We
have the meds and the $ so ours
is lower
◦ If you test positive for TB you
must get treatment
◦ Humans mount a significant and
effective immune response but
immune response seriously
damages the lungs.
Two stages of TB

 Inactive
 Active
Inactive
◦ Happens after the organism has
started to grow in the lungs but
hasn’t shown any symptoms.
◦ Body calcifies them – Gohn
tubercules can remain for yrs
◦ When Gohn tubercules begin to
grow infection is activated
◦ Everytime someone with TB
coughs they are releasing it into
the air via droplet nuclei. Even
when moisture dries up, TB is
still there as long as it is inside.
It doesn’t like sunlight.
The Gohn complex is an eponym which describes an inflammatory nodule
in the pulmonary parenchyma (Gohn focus) with an accompanying hilar
adenopathy in line with lymphatic drainage from that pulmonary segment.
The complex is often characteristic of tuberculosis, and is considered a
sequel to primary Tbc.

Primary infection with Mycobacterium Tuberculosis is typically a self-

limited disease in an immune-competent host. The disease has a
prediliction for the lower lobes, although any lobe can be involved.
Radiographically, primary TB typically presents as a consolidative process.
Pleural effusion is often present, but decreases in incidence with increasing
patient age, and can present any time after initial infection. The lesion is
eventually walled off by the body's host immune response, and regresses
to a calcified pulmonary mass known as a Gohn complex. Mediastinal (esp.
paratracheal) adenopathy is common, and involved nodes often calcify with
healing, leading to the Gohn (also called Ranke) complex (Gohn focus +
calcified nodes).
Active TB infection begins when the
mycobacteria reach the pulmonary
alveoli, where they invade and
replicate.

The primary site of infection in the

lungs is called the Gohn focus, and is
generally located in either the upper
part of the lower lobe, or the lower
part of the upper lobe.

Further spread is through the

bloodstream to other tissues and
organs where secondary TB lesions
can develop in other parts of the lung
(particularly the apex of the upper
lobes), peripheral lymph nodes,
kidneys, brain, and bone
 PPD – purified protein derivative
◦ Take pieces of cell and inoculate
under the skin
◦ If PPD is negative you are happy
◦ If PPD is positive you take a
chest x-ray in which they look
for infiltration (cloudy lungs)
 Negative chest x-ray means
you take 6 months of
antibiotics
 Positive means you take 2
years of anti TB drugs. If you
don’t take the meds you can
be arrested.

BCG (Bacillus Calmette-Guérin)

 We don’t give this vaccine in

the U.S b/c mortality rate is so
low.
 PPD test works and if you take
vaccine you will always tests
positive and then everyone will
have to get the chest xrays.
 If you tests PPD positive NEVER
take another test because you
might become anaphylactic
Treatment for TB uses antibiotics to kill the
bacteria. Effective TB treatment is difficult,
due to the unusual structure and chemical
composition of the mycobacterial cell wall,
which makes many antibiotics ineffective a
nd hinders the entry of drugs.

The two antibiotics most commonly used

are rifampicin and isoniazid. However,
instead of the short course of antibiotics
typically used to cure other bacterial
infections, TB requires much longer
periods of treatment (around 6 to 24
months) to entirely eliminate mycobacteria
from the body.
Drug-resistant TB is a public
health issue in many developing
countries, as treatment is longer
and requires more expensive
drugs.

Multi-drug-resistant tuberculosis
(MDR-TB) is defined as resistance
to the two most effective first-
line TB drugs: rifampicin and
isoniazid.

Extensively drug-resistant TB (XDR-

TB) is also resistant to three or more
of the six classes of second-line
drugs
 M. avium intracellular
complex
 M. gordonae
 M. Kanasii

 In the 1960s we had TB

almost gone but then we
stopped putting money into
programs and now it is
coming back.
 Ailments of the
Urinary/Excretory System
 Urinary Tract Infection

• Infection may affect any part of the urinary system: kidneys,

ureters, bladder, and urethra. Most infections are limited to the
urethra (when they are called urethritis), or to the bladder, where
they are called cystitis. Women have urethritis and cystitis more
commonly than men do. Symptoms may include a strong urge to
urinate often; passing small amounts of urine; a burning sensation
when urinating; urine that appears cloudy, pink, or brown, or that
smells odd; or pain in the area of the bladder: If the infection
spreads to the kidneys it can cause serious illness., including pain in
the back or side, fever, chills, and nausea. A urinary tract infection
may be caused by a sexually transmitted infection, or it can be
caused by an invasion of the urinary tract by bacteria from the
digestive tract, due to trauma or a weakened immune system.
• The treatment is usually antibiotics. Doctors will tell you to drink
plenty of water to flush out the bacteria, and avoid coffee, alcohol,
and citrus juice, which can irritate the bladder. Cranberry juice is a
folk remedy and preventative for urinary tract infections, although
the Ma o Cli i sa s its effe ti e ess has ’t ee pro e .
Causative Agent: Escherichia coli was the most common etiological agent
of UTI (74.6%), followed by Klebsiella spp (11.7%), Staphylococcus
saprophyticus (6.4%), and Pseudomonas aeruginosa (2.2%).
 Nephritis

• Nephritis is an inflammation of the kidney, which can be due to

many causes including infection, immune system disorders, or
diabetes. Bright’s disease is an old name for this group of illnesses.
If nephritis is caused by infection of the collecting-basin part of the
kidney, it can be called pyelonephritis; if it is inflammation of the
tiny filters in the kidney, it is called glomerulonephritis. Nephritis is
a serious illness, which can lead to kidney failure, that is, to illness
caused by waste products building up in the blood, or protein or
blood leaking out into the urine. Symptoms may include pink or
brown urine; foamy urine; high blood pressure; puffiness or edema
of the face, hands, ankles or belly; and fatigue.
• Treatment of nephritis depends on the cause. Late-stage kidney
disease can only be helped by kidney transplant or dialysis. Good
health habits may delay the damage from chronic kidney disease:
for example, reducing salt, protein, and potassium in the diet,
controlling blood sugar, and stopping smoking.
 Uremia

• Uremia means urea in the blood. It is caused

by kidney failure, which causes waste products
from protein metabolism (urea and and
creatinine) to accumulate in the blood. The
waste products produce a toxic condition that
can be fatal. Symptoms may include fatigue,
loss of appetite, vomiting, weight loss,
anemia, and high blood pressure. Treatment
for this serious condition is limited to dialysis
or a kidney transplant.
 Kidney Stones

• Kidney stones are small hard masses of mineral deposits that form
within the tubules of the kidneys. They form when the urine is too
concentrated, and has more minerals in it than it can dissolve. Their
formation may be triggered by infection, dehydration, a high-
protein diet, or genetic differences in metabolism. A kidney stone
may not cause symptoms until it moves, often into the ureter, when
it can cause pain in the side and back that spreads into the lower
a do e a d groi , a pai that o es i a es. Kid e sto es
can also cause painful urination, strange-colored or bad-smelling
urine, or frequent urination. Drinking large quantities of water can
help prevent the formation of new stones, or move smaller stones
into the bladder so they can pass out of the body. Larger stones can
be broken up with lithotripsy (shock waves) to get them to pass, or
they can be removed by surgery.
 Bladder Stones

• Small rock-like mineral deposits can form in the

bladder as well as the kidney. They are more common
in men than in women. They can form when an
enlarged prostate gland or other condition crowds the
bladder and causes urine to stagnate, or they can be
triggered by dehydration, infection, or inflammation.
They can occur without symptoms, or they can cause
severe pain in the lower abdomen and back, difficult or
painful urination, fever, or blood in the urine. Small
stones may pass by themselves, especially if the
patient drinks a lot of water. Larger stones can be
broken up by lasers or ultrasound in a surgical
procedure, or they can be surgically removed.
 Kidney Cancer

• Cancer of the kidney is becoming more common.

The most common type is renal cell carcinoma. It
can be detected with a CT scan. Early kidney
cancer rarely has symptoms. Later, it can cause
blood in the urine, back pain just below the ribs,
weight loss, fatigue, or fever. The causes are not
clear, but risk factors include age, smoking,
obesity, high blood pressure, and long-term
dialysis. The various treatments include surgery;
killing cancer cells by freezing them with gas or
destroying them with electrical current; and
drugs.
 Bladder Cancer

• Bladder cancer is more common in men than in women

(the fourth most common type of cancer in men, and the
tenth most common in women). It is more common in
smokers, and in factory workers who work with arsenic and
other industrial chemicals. As with many urinary system
ailments, symptoms include blood in the urine, frequent or
painful urination, and back pain or pelvic pain.
• Bladder cancer often starts in the lining of the bladder and
is highly treatable if caught early, by removing the tumor or
killing its cells with electrical current, a laser, or
i u otherap drugs. Ad a ed a er a e treated
by removing the entire bladder, or by chemotherapy.
 Interstitial cystitis (IC)
• also called painful bladder syndrome, is a
chronic bladder condition, primarily in
women, that causes bladder pressure and
pain and, sometimes, pelvic pain to varying
degrees, according to the Mayo Clinic. It can
cause bladder scarring, and can make the
ladder less elasti . While the ause is ’t
known, many people with the condition also
have a defect in their epithelium, the
protective lining of the bladder.
 Prostatitis
• Prostatitis is a swelling of the prostate gland
and, therefore, can only occur in men. Often
caused by advanced age, symptoms include
urinary urgency and frequency, pelvic pain
and pain during urination, the Mayo Clinic
noted.
 Urethritis

• Caused by sexually or non-sexually transmitted bacterial

infections, this excretory system disease may exhibit a
different set of symptoms among human males and
females. The most obvious diagnostic signs include
frequent urination with a sensation of burning, yellowish
and bloody discharge from the urethra, pain in lower part
of abdomen and painful sexual intercourse, particularly, in
women. Diagnosis can be assisted by the patient history,
and physical as well as microscopic examination. Commonly
applied and effective treatment measures include the
prescription of antibiotics, administration of analgesics and
the use of cranberry juice which may enhance the
effectiveness of some medications.
 Vaginal Cancer

• Occurring in women, usually, over the age of 50, it is one of

the rare excretory system disorders, and represents less
than two percent of all gynecologic cancers. Vaginal cancer
involves the symptomatic conditions of vaginal bleeding
between menstrual periods or after menopause, vaginal
pain or itching, and firm, raised growth in the vagina. For
accurate diagnosis, the health care providers may get help
fro patie t’s histor , g e ologi e a i atio , Pap s ear
technique and colposcopy. In case the malignancy is
diagnosed in the very earliest stage, a cream is
recommended to be applied intravaginally that contains the
chemotherapeutic medication fluorouracil, while some
other commonly applied treatments include laser surgery,
radiation therapy, conventional therapy, and so on.
 Renal Vein Thrombosis

• Abbreviated as RVT, it is one of the uncommon excretory

system diseases that results in the formation of blood clot
in one or both of the veins carrying the blood from the
kidneys to the heart. The obvious symptoms witnessed in
infants include blood in the urine, fever and chills, while
those observed in adults are shortness of breath, cough
with bloody sputum, chest pain, anxiety, palpitations,
profuse perspiration, and so on. Some of the most effective
treatment methods are the prescription of anticoagulant
medications, administration of enzymes (such as urokinase
and streptokinase), and for the life-threatening cases of the
disorder in infants, surgical removal of the affected kidney
may be required.
 Acute Renal Failure

• In case both of your kidneys suddenly stop functioning, the

life-threatening condition is termed as acute renal failure
(or acute kidney failure) which results in many mild or
unbearable symptoms, namely, passing only small amounts
of urine, weight gain, swelling of the ankles or some other
body parts, loss of appetite, fatigue, widespread itching,
bloody urine, shortness of breath, mental confusion, loss of
consciousness, abdominal pain and unexplained bleeding,
et . World’s re o ed kid e spe ialists, usuall , appl the
treatment measures, such as, prescription of diuretics, anti-
hypersensitive drugs, intravenous injection of glucose,
sodium bicarbonate or other substances, dialysis, surgical
therapy and kidney transplant, etc.
 Chronic Renal Failure

• Also known as end-stage renal failure, this chronic disease occurs

when both of your kidneys gradually cease to function. The
symptoms of this life-threatening condition do not appear before
80 to 90 percent of your kidney tissues have been destroyed. After
the entire failure, excessive amounts of fluid, minerals (like
potassium), acid and waste materials get accumulated in the body.
Such a condition leads to the symptoms of frequent urination,
general feeling of poor health, swelling of ankles or tissues around
the eyes, shortness of breath, loss of appetite, weight loss, fatigue,
drowsiness, mental confusion, loss of consciousness, pale skin, and
so on. Depending upon the severity, different curative measures are
in vogue these days, which include controlled diet, anti-
hypersensitive drugs, sodium bicarbonate, phosphate-binding
calcium agents, surgical operation, dialysis and kidney transplant,
etc.
 Renal Artery Stenosis

• Characterized by the blockage of one of the arteries that supply

blood to the kidneys, the condition of renal artery stenosis leads to
the irreversible damage of the tissues of the affected kidney. The
major and prevailing causes of this disease include the buildup of
plaque in arteries (atherosclerosis) and an inherited condition of
fibromuscular dysplasia. Though it has no particular symptoms,
extreme severity of the disease may show the sings of blood in
urine, dull flank pain, nausea, vomiting, and so on. You can easily
prevent the abnormality by maintaining a healthy weight, diet and
lifestyle, and the avoidance of smoking, so that there is no buildup
of plaque in the arteries. However, an unfortunate victim can be
treated by the administration of cholesterol lowering drugs, surgery
and percutaneous transluminal angiography, etc.
 Proctitis

• It is an inflammatory disease of the lower portion of

the digestive tract, called rectum, which connects the
colon or large intestine to anus. As the condition may
occur owing to a variety of causes, symptoms do vary
depending upon the cause and severity of
inflammation, and include frequent or painful bowel
movements, straining at stool, rectal pain, bloody
discharge, fever, constipation, diarrhea, blisters in or
around the anus and rectum, difficulty in urination and
impotence. Depending upon the causative agent and
severity of the disease, your health care provider may
prescribe you corticosteroids suppositories, antibiotics,
antiviral drugs and over-the-counter pain relievers.
 Pinworms

• As the very name suggests, the causative agents of the

disease are pinworms that are white, slender, thread-like
worms, about the third of an inch and infest the intestinal
tract. After someone has swallowed their eggs, the worms
develop and mature in the intestine, and exit through anus
to lay new eggs when the victim is sleeping. That is why
pinworms are considered more of a nuisance than a serious
health issue that may threaten your life. Anyhow, an
unfortunate victim may show the symptoms of anal pain or
itching, fidgetiness or irritability, vaginal pain, discharge or
itching and restless sleep. The infected individuals can
easily be treated with medications, like pyrantel pamoate
and mebendazole as these are very effective in killing the
germs.
 Nephrosis
• Definition: Also identified as nephrotic
syndrome, nephrosis includes symptoms of
swelling, protein in urine, low blood protein
levels, high cholesterol levels and elevated
triglyceride levels.
• Causes: The causes of nephrosis include
membranous nephropathy, immune system
disorders, genetic problems, kidney malfunction,
infections such as hepatitis, mononucleosis or
strep throat, use of certain medications, etc.
 Vesicoureteral Reflux
• Definition: it is said to occur when the urine
flows back from bladder into ureters. Seen
commonly in children, the advance in age sees
the reduction on the disease.
• Causes: The main reason of the disease is the
defective valve between the ureters and the
bladder. The defect may also be present before
the birth. A secondary cause is blockage in the
urinary system or malfunctioning of the urinary
system.
 Urethral Stricture
• Definition: The scarring in and around the
urethra is called urethral stricture. It blocks
the passageway of urine to outside. The
disease is more prevalent in women compared
to men.
• Causes: This can be caused by infection of the
urinary tract and injuries due to pelvic
fracture.
CIRCULATORY
SYSTEM
DISEASES AND
DISORDERS
Coronary Artery Disease
O Clogging of the arteries supplying the heart
O Cause of about 30% of all deaths globally.
O occurs when the blood vessels that supply
oxygen to the heart narrow and stiffen.
Smoking, an unhealthy diet, stress, and a
sedentary lifestyle all increase the risk of
heart disease. A heart attack or stroke can
occur if the condition is untreated.
 Myocardial Infraction
O death of a section of the myocardium, the
muscle of the heart , caused by an interruption
of blood flow to the area. A heart attack results
from obstruction of the coronary arteries. The
most common cause is a blood clot (thrombus)
that lodges in an area of a coronary
artery thickened with cholesterol-containing
plaque due to atherosclerosis.
 Artherosclerosis
O a common disease of the circulatory system
caused by the buildup of fat cholesterol, or
other substance in the artery wall.
O Deposits in the artery cause the vessel to
stiffen and narrow
O Diabetes, high cholesterol, smoking, and
high blood pressure can result in stiff
arteries that restrict blood flow through the
heart.
 Aortic Aneurysm
O Occurs when a section of the aorta bulges,
stretches, and swells.
O This bulge can weaken the aorta to the point
that it bursts, releasing blood into the body.
Bleeding from an aortic aneurysm is a
medical emergency that can be caused by
high blood pressure, smoking, aging, high
cholesterol, and a positive family history.
 Angina
O Symptom of an underlying heart condition
that occurs when the flow of blood and
oxygen are restricted to the heart muscles.
Symptoms of angina include:
• Chest pain
• Pressure or squeezing in the chest
• Frequent or infrequent chest pain.
• Tightness in chest
 Hypertension
O Also known as high blood pressure, occurs
when a high force of blood presses against
the artery walls over time.
O This condition can develop from a diet high
in salt, smoking, kidney disease, or some
other underlying medical condition.
O Untreated high blood pressure may lead to
stroke, heart failure, or visual problems
 Varicose veins
O another common disease of the circulatory
system that happens when veins in the legs
twist, swell, and become painful
O Aging, pregnancy, prolonged standing, and
defective valves can all contribute to the
development of varicose veins.
 Arrhythmia
O occurs when the heart beats too fast, too
slow, or skips a beat. Common symptoms of
arrhythmias include:
• Fatigue
• Shortness of breath
• Chest pain
 Types of Arrhythmia
O Bradycardia = slow heart rate
O Tachycardia = rapid heart rate
 Endocarditis
O Inflammation of the inner layer of the heart
this can be infective or non-infective.
O Endocarditis is caused by any of a number
of microorganisms, including
bacteria(bacterial endocarditis), fungi,
rickettsias, and possibly viruses, that enter
the bloodstream and become trapped in the
heart.
Symptoms include:
O Fever
O Heart murmur
O Irregular or rapid heartbeat
O Fatigue
O Loss of appetite
O Night sweats and chills
Congenital Heart Defects
O Structural abnormalities of the heart that is
present at birth. Abnormalities are generally
caused by abnormal development of the
heart and circulatory system before birth.
Abnormal development can be caused by a
variety of factors, including infection and use
of certain drugs by the mother during
pregnancy.
 Types of CHD
O Coarctation of the Aorta
O Patent Ductus Arteriosus
O Septal Defect
O Tetralogy of Fallot
 Cardiomyopathy
O Disease of the heart muscle where the
chambers enlarge and weaken.
O It affect the size and shape of your heart
and can also affect the way the electrical
system makes your heart beat.
O Results in heart failure due to a decrease in
the pumping power of the heart or due to an
impairment in the filling of the cardiac
chambers.
 Anemia
O It is a condition in which the oxygen-carrying
capacity of blood is reduced
O It is characterized by reduced number of
RBC or a decreased amount of hemoglobin
in the blood.
 Sickle Cell Disease
O The RBCs of the person with SCD contain
Hb-S, an abnormal kind of hemoglobin.
O When Hb-S gives up oxygen to the interstitial
fluid, it forms long, stiff, rod-like structures
that bend the erythrocytes into a sickle
shape.
 Hemophilia
O It is an inherited deficiency of the clotting in
which bleeding may occur spontaneously or
after a minor trauma.
O Characterized by spontaneous, or traumatic
subcutaneous and intramuscular
hemorrhage, nose bleeds, blood in urine,
and hemorrhages in the joints that produce
pain or tissue damage.
 Leukemia
O It refers to the group of red bone marrow
cancers in which abnormal white blood cells
multiply uncontrollably.
 Kawasaki Disease
O Is acondition that causes inflammation in the walls
of medium-sized arteries throughout the body,
including the coronary arteries, which supply blood
to the heart muscle.
O It can lead to severe heart problems including
myocarditis (inflammation of the heart muscle),
dysrhythmia (abnormal heart rhythm), and
aneurysm (weakening and bulging of the artery
wall).
 Buerger’s Disease
O Buerger's disease (thromboangiitis obliterans)
is a rare disease of the arteries and veins in
the arms and legs. In Buerger's disease, your
blood vessels become inflamed, swell and can
become blocked with blood clots (thrombi).
O This eventually damages or destroys skin
tissues and may lead to infection and
gangrene. Buerger's disease usually first shows
in your hands and feet and may eventually
affect larger areas of your arms and legs.
 The
Digestive
System
and its
DISEASES
• The digestive system is a tubular system.
It extends from the mouth to the anus, forms an
extensivesurface area in contact with the external
environment, and is closely associated with the
cardiovascular system.
• The combination of extensive environmental exposure and
close association with blood vessels is essential for
processing the food that we eat.
• Gastroenterology
The medical specialty that deals with the structure, function,
diagnosis, and treatment of diseases of the stomach and intestines.
• Proctology
The medical specialty that deals with the diagnosis and treatment of
disorders of the rectum and anus.
 COMPOSITION OF THE DIGESTIVE SYSTEM
• GASTROINTESTINAL TRACT
-Organsof the gastrointestinal tract include the mouth, most of the
pharynx, esophagus, stomach, small intestine, and large intestine.
-In a living person when the muscles along the wall of the GI tract organs
are in a state of tonus (sustained contraction).
• ACCESSORY DIGESTIVE ORGANS
-Include the teeth, tongue, salivary glands, liver, gallbladder, and
pancreas.
-They produce or store secretions that flow into the GI tract through ducts;
the secretions aid in the chemical breakdown of food.
 FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion: taking food into mouth.
2. Secretion: release of water, acid, buffers, and enzymes into lumen of GI tract.
3. Mixing and propulsion: churning and propulsion of food through GI tract.
4. Digestion: mechanical and chemical breakdown of food.
5. Absorption: passage of digested products from GI tract into blood and lymph.
6. Defecation: elimination of feces from GI tract.
 PHASES OF DIGESTION
• CEPHALIC PHASE
- During the cephalic phase of digestion, the smell, sight, thought, or initial taste of food activates
neural centers in the cerebral cortex, hypothalamus, and brain stem.
- The facial and glossopharyngeal nerves stimulate the salivary glands to secrete saliva, while the
vagus nerves stimulate the gastric glands to secrete gastric juice.
PURPOSE: to prepare the mouth and stomach for food that is about to be eaten.

• GASTRIC PHASE
-Once food reaches the stomach, the gastric phase of digestion begins. Neural and hormonal
mechanisms regulate the gastric phase of digestion to promote gastric secretion and gastric
motility.
• INTESTINAL PHASE
-The intestinal phase of digestion begins once food enters the small intestine. In contrast to
reflexes initiated during the cephalic and gastric phases, which stimulate stomach secretory
activity and motility, those occurring during the intestinal phase have inhibitory effects that
slow the exit of chyme from the stomach.

PLAY SONG
 DISORDERS
OF THE
DIGESTIVE SYSTEM
 COLORECTAL CANCER

• It is characterized by uncontrolled growth of cells

within the large intestine (colon) or rectum (terminal
portion of the large intestine).
• Colon cancer or Bowel cancer and rectal cancer are
sometimes referred to separately.
• Colorectal cancer develops slowly but can spread to
surrounding and distant tissues of the body.
 CAUSES AND SYMPTOMS
• Colorectal cancers have multiple causes, many of which
remain unknown.
• Some cases appear to be inherited, while others seem to
occur randomly or to have non-genetic causes.
• 95% of Colorectal cancers involve the glandular cells in the
wall of the colon called adenocarcinomas.
• Others may begin among hormone-producing cells, immune
cells, or underlying connective tissue.
 CAUSES AND SYMPTOMS (CONTINUED..)

• SYMPTOMS: abdominal pain

episodes of diarrhea or loss of appetite
constipation that extend
fatigue.
for days
blood in the stool
rectal bleeding
Jaundice
 DIAGNOSIS
• Diagnoses of colon and rectal cancers are made by means of
several techniques.
Digital Rectal Exam
Fecal Test
Sigmoidoscope
Colonoscopy
Biopsy
Double-contrast Barium Enema ( X-Ray Procedure)
 TREATMENT
• Colorectal cancer is treated by surgery, chemotherapy, or radiation.
 Colonoscope - or early-stage colon cancer to remove the cancerous
tissue. Other early cancers require a
 Surgical resection - the portion of the colon containing the cancerous
tissue is removed along with surrounding tissue and nearby lymph
nodes and the remainder of the colon is repaired.
 Removing only the cancerous polyp or polyps, the cancer plus
surrounding tissues, or larger sections of the rectum.
 Electrofulguration - removing cancer by burning.
 TREATMENT (CONTINUED..)
 Colostomy - the surgeon creates an artificial opening for the removal of
waste in cases where the lower portion of the rectum is involved.
 If colorectal cancer has spread to surrounding tissues such as those of the
uterus, prostate, liver, kidneys, or bladder, more extensive surgery may be
required to remove all or part of these organs.
• Radiation - using either external beams or surgically implanted radioactive
pellets. It is usually used in conjunction with surgery—either before the
surgery to shrink tumours or following surgery to destroy small amounts of
remaining cancerous tissue.
• Chemotherapy may also be indicated for treatment of colorectal cancers.
 GASTROESOPHAGEAL
REFLUX DISEASE (GERD)
• It is a relatively common digestive disorder characterized by
frequent passage of gastric contents from the stomach back
into the esophagus.
 SYMPTOMS
 Heartburn
A Burning Sensation In The Chest And Upper Abdomen
Coughing
Frequent Clearing of The Throat
Difficulty in Swallowing (Dysphagia)
Hoarseness
Exacerbation of Asthma.
Endoscopic image of peptic
stricture showing narrowing of
the esophagus near the junction
with the stomach due to chronic
gastroesophageal reflux in the
setting of scleroderma.
 CAUSES
relaxation of the muscle that connects the esophagus and
the stomach (lower esophageal sphincter)
delayed emptying of the esophagus or stomach
hiatal hernia or obesity.
 Pregnancy – common cause for women
 TREATMENT
• GERD can be treated with antacids or raising the head of the bed to
with medications that inhibit acid discourage nocturnal reflex
production, such as histamine receptor
antagonists (Zantac™, Pepcid™) or cessation of smoking
proton pump inhibitors (Prilosec™, weight loss
Prevacid™).
Surgery may be necessary in
• dietary and lifestyle changes such as:
cases of severe reflux.
not eating for three hours before
bedtime
avoiding acidic or fatty foods or
beverages
 JAUNDICE
• It is the excess accumulation of bile pigments in the
bloodstream and bodily tissues that causes a yellow to
orange and sometimes even greenish discoloration of the
skin, the whites of the eyes, and the mucous membranes.
• The degree of coloration depends on the concentration of
bile pigment (bilirubin) in the blood, its rate of tissue
diffusion, and the absorption and binding of bilirubin by the
tissue.
 TYPES
• Jaundice is classified as hepatocellular, hemolytic or obstructive.
• Hepatocellular jaundice - a type of jaundice that occurs as a result of
liver disease or injury.
• Hemolytic jaundice - a type of jaundice that occurs as a result of
hemolysis (an accelerated breakdown of erythrocytes - red blood
cells) leading to an increase in production of bilirubin.
• Obstructive jaundice - a type of jaundice that occurs as a result of an
obstruction in the bile duct (a system of tubes that carries bile from the
liver to the gallbladder and small intestine), which prevents bilirubin
from leaving the liver.
 CAUSES
• Some underlying conditions that may cause jaundice are:
• Acute inflammation of the liver - may impair the ability of
the liver to conjugate and secrete bilirubin, resulting in a
buildup of bilirubin.
• Inflammation of the bile duct - may prevent the secretion
of bile and removal of bilirubin, causing jaundice.
• Obstruction of the bile duct - prevents the liver from
disposing of bilirubin, which results in hyperbilirubinemia.
 CAUSES (CONTINUED..)
• Hemolytic anemia - Production of bilirubin increases when
large quantities of erythrocytes are broken down.
• Gilbert's syndrome - an inherited condition that impairs the
ability of enzymes (biomolecules that provoke chemical
reactions between substances) to process the excretion of
bile.
• Cholestasis-a condition in which the flow of bile from the
liver is interrupted. The bile containing conjugated bilirubin
remains in the liver instead of being excreted.
 SYMPTOMS
Yellow tinge to the skin and Vomiting
the whites of the eyes Fever
Pruritis (itchiness) Paler than usual stools
Fatigue Dark urine.
Abdominal pain - typically
indicates a blockage of the
bile duct.
Weight loss
 LIVER CANCER

• Liver cancer is any of several forms of disease characterized

by tumours in the liver; benign liver tumours remain in the
liver, whereas malignant tumours are, by definition,
cancerous.
• Most malignant liver tumours are hepatomas.
 SYMPTOMS
Losing weight without Abdominal swelling
trying Yellow discoloration of
Loss of appetite your skin and the whites of
Upper abdominal pain your eyes (jaundice)
Nausea and vomiting White, chalky stools
General weakness and
fatigue
 CAUSES
• The causes of liver cancer vary and in many cases remain unknown,
but several factors have been identified that increase the risk of
developing the disease.
Previous infection with hepatitis B or hepatitis C viruses
Exposure to several chemicals (such as vinyl chloride, thorium
dioxide, aflatoxin and arsenic)
Use of anabolic steroids and oral contraceptives
Other illnesses such as gallstones, chronic inflammation of the colon
or gallbladder, and certain parasitic infections are also risk factors.
 DIAGNOSIS
• Blood tests - may reveal liver function abnormalities.
• Imaging tests - such as an ultrasound, computerized
tomography (CT) scan and magnetic resonance imaging
(MRI).
• Removing a sample of liver tissue for testing - for
laboratory testing in order to make a definitive diagnosis of
liver cancer.
 TREATMENT
• Surgery
1. Surgery to remove the tumor.
2. Liver transplant surgery.
• Localized treatments
1. Heating cancer cells
2. Freezing cancer cells.
3. Injecting alcohol into the tumor
4. Injecting chemotherapy drugs into the liver
5. Placing beads filled with radiation in the liver
 TREATMENT (CONT..)
• Radiation therapy
• Targeted drug therapy
• Supportive (palliative) care
• Alternative medicine
1. Acupressure
2. Acupuncture
3. Deep breathing
4. Listening to music (music therapy)
5. Massage
 DIARRHEA

• Diarrhea also spelled diarrhoea , abnormally swift passage of

waste material through the large intestine, with consequent
discharge of loose feces from the anus. Diarrhea may be
accompanied by cramping.
 SYMPTOMS
Frequent, loose, watery stools
Abdominal cramps
Abdominal pain
Fever
Blood in the stool
Bloating
 CAUSES
viral gastroenteritis (stomach giardiasis, hookworm, or
flu) amebiasis)
bacterial gastroenteritis bacterial infection (for
(food poisoning) example, shigellosis or e.
food allergies coli)

PMS irritable bowel syndrome

lactose intolerance
parasites (for example,
 OTHER CAUSES
drug allergies celiac disease
appendicitis Crohn’s disease
diverticulitis West Nile virus
fecal impaction some forms of cancer
intestinal obstruction
cystic fibrosis
colitis
 TREATMENT
replenish lost fluids, salts, and electrolytes to prevent
dehydration
clear liquids as well as electrolyte-rich formulas like Pedialyte
and Gatorade can be helpful
Anti-diarrheal medications – such as loperamide (Imodium) and
bismuth subsalicylate (Pepto-Bismol) and kaolin pectin
suspension (Kaopectate) – can reduce the severity of symptoms
but won’t speed recovery
If a parasite or bacterial infection has caused diarrhea, a course
of antibiotics may be prescribed.
 CONSTIPATION

• Constipation is the delayed passage of waste through

the lower portion of the large intestine, with the
possible discharge of relatively dry, hardened feces
from the anus.
 CAUSES
Antacid medicines containing Neurological conditions such
calcium or aluminum as Parkinson's disease or
Changes in your usual diet or multiple sclerosis
activities Not being active
Colon cancer Not enough water or fiber in
Eating a lot of dairy products. your diet

Eating disorders
Irritable bowel syndrome
 CAUSES (CONT..)
Overuse of laxatives (Over hemorrhoids
time, this weakens the bowel Some medications (especially
muscles) strong pain drugs such as
Pregnancy narcotics, antidepressants, or
Problems with the nerves and iron pills)
muscles in the digestive system  Stress
Resisting the urge to have a Under active thyroid
bowel movement, which some (hypothyroidism)
people do because of
 SYMPTOMS
Few bowel movements
Trouble having a bowel movement (straining)
Hard or small stools
A sense that everything didn’t come out
Swollen abdomen or abdominal pain
Vomiting
 DIAGNOSIS
Blood tests to check on hormone levels
Barium studies to look for any blockages in your colon. For
this test, you'll down a special drink and then get an X-ray.
Colonoscopy or other tests to look for blockages in your
colon
 TREATMENT
• Diet and Lifestyle changes 2. Stimulants
1. Increase your fiber intake 3. Osmotics
2. Exercise most days of the 4. Lubricants
week 5. Stool softeners
3. Don't ignore the urge to have a • Other medications
bowel movement.
1. Medications that draw water
• Laxatives into your intestines.
1. Fiber supplements 2. Medications in clinical trials.
 GALLSTONE
• Also called cholelith, is a concretion composed of crystalline
substances (usually cholesterol, bile pigments, and calcium
salts) embedded in a small amount of protein material formed
• The most common type of gallstone consists principally of
cholesterol; its occurrence has been linked to secretion by the
liver of bile that is saturated with cholesterol and contains
abnormally low levels of bile salts and the phospholipid lecithin,
which in normal bile are present in sufficient quantities to keep
cholesterol in solution.
A photomicrograph (100x magnification) of
a hematoxylin- and eosin-stained gallstone
within the gallbladder of a golden lion
tamarin (Leontopithecus rosalia).

Gallstones
 CAUSES
Your bile contains too much cholesterol

Your bile contains too much bilirubin.

Your gallbladder doesn't empty correctly.

 SYMPTOMS
Severe abdominal pain
Pain that may extend beneath the right shoulder blade or to
the back
Pain that worsens after eating a meal, particularly fatty or
greasy foods
Pain that feels dull, sharp, or crampy
Pain that increases when you breathe in deeply
Chest pain (angina)
 SYMPTOMS (CONT…)
Heartburn, indigestion, and excessive gas
A feeling of fullness in the abdomen
Vomiting, nausea, fever
Shaking with chills
Tenderness in the abdomen, particularly the right upper
quadrant
Jaundice (yellowing of the skin and eyes)
Stools of an unusual color (often lighter, like clay)
 DIAGNOSIS
Ultrasound.
Abdominal X-ray
Computed Tomography (CT) Scan.
Magnetic Resonance Imaging (MRI)
Endoscopic Retrograde Cholangiopancreatography (Ercp)
Cholescintigraphy (also called DISIDA, HIDA Scan, Or
Gallbladder Radionuclide Scan).
 TREATMENT
• Keyhole surgery to remove the gallbladder
• Single-incision keyhole surgery
• Open surgery
• Endoscopic retrograde cholangio-pancreatography (ERCP)
• Medication to dissolve gallstones
 HEPATITIS
• Inflammation of the liver that results from a variety of causes,
both infectious and noninfectious.
• Infectious agents that cause hepatitis include viruses and
parasites; noninfectious substances include certain drugs
and toxic agents.
• In some instances hepatitis results from an autoimmune
reaction directed against the liver cells of the body.
 HEPATITIS (CONT..)
• There are seven known hepatitis viruses, which are labeled A, B,
C, D, E, F, and G.
• Hepatitis A, E, and F viruses are transmitted through the
ingestion of contaminated food or water (called the fecal-oral
route); the spread of these agents is aggravated by crowded
conditions and poor sanitation.
• The B, C, D, and G viruses are transmitted mainly by blood or
bodily fluids; sexual contact or exposure to contaminated blood
are common modes of transmission.
SIGNS AND SYMPTOMS
 HEPATITIS A

• Hepatitis A, caused by the hepatitis A virus (HAV), is the

most common worldwide.

• The onset of hepatitis A usually occurs 15 to 45 days after

exposure to the virus, and some infected individuals,
especially children, exhibit no clinical manifestations.
 HEPATITIS A (CONT..)
• In the majority of cases, no special treatment other than bed
rest is required; most recover fully from the disease.
• Hepatitis A does not give rise to chronic hepatitis. The
severity of the disease can be reduced if the affected
individual is injected within two weeks of exposure with
immune serum globulin obtained from persons exposed to
HAV.
 HEPATITIS B

• Hepatitis B is a much more severe and longer-lasting

disease than hepatitis A.

• It may occur as an acute disease, or, in about 5 to 10 percent

of cases, the illness may become chronic and lead to
permanent liver damage.
 HEPATITIS B (CONT..)
• Symptoms usually appear from 40 days to 6 months after
exposure to the hepatitis B virus (HBV).
• Those persons at greatest risk for contracting hepatitis B
include intravenous drug users, sexual partners of
individuals with the disease, health care workers who are not
adequately immunized, and recipients of organ transplants
or blood transfusions.
 HEPATITIS C
• Hepatitis C virus (HCV) was isolated in 1988.
• It typically is transmitted through contact with infected
blood.
• Infection may cause mild or severe illness that lasts
several weeks or a lifetime; in the early 21st century, an
estimated 130 to 170 million people worldwide had
chronic HCV infection.
 HEPATITIS C (CONT..)

• About 80 percent of those who become infected are

asymptomatic; those who do show symptoms may
experience a flu-like illness, with fatigue, nausea, vomiting,
and sometimes jaundice.
• Approximately 60 to 70 percent of chronic infections
progress to chronic liver disease, such as cirrhosis or liver
cancer. Alcoholics who are infected with hepatitis C are
more prone to develop cirrhosis.
 HEPATITIS D
• Infection with hepatitis D virus (HDV), also called the delta
agent, can occur only in association with HBV infection,
because HDV requires HBV to replicate.
• Infection with HDV may occur at the same time infection
with HBV occurs, or HDV may infect a person already
infected with HBV.
• The HDV situation appears to give rise to a more serious
condition, leading to cirrhosis or chronic liver disease.
 HEPATITIS E
• Discovered in the 1980s, the hepatitis E virus (HEV) is similar
to HAV.
• HEV is transmitted in the same manner as HAV, and it, too,
only causes acute infection.
• The effects of infection with HEV are more severe than those
caused by HAV, and death is more common.
• The risk of acute liver failure from infection with HEV is
especially great for pregnant women.
 HEPATITIS F AND G
• Some cases of hepatitis transmitted through contaminated
food or water are attributed to the hepatitis F virus (HFV),
which was first reported in 1994.
• Another virus isolated in 1996, the hepatitis G virus (HGV),
is believed to be responsible for a large number of sexually
transmitted and bloodborne cases of hepatitis.
• HGV causes acute and chronic forms of the disease and
often infects persons already infected with HCV.
 OTHER CAUSES
• Most cases of chronic hepatitis are caused by the hepatitis viruses B,
C, and D, but other factors such as alcoholism, reaction to certain
medications, and autoimmune reactions lead to development of the
disease.
• Chronic hepatitis may also be associated with some illnesses, such as
Wilson disease and alpha-1-antitrypsin deficiency.
• Chronic hepatitis B primarily affects males, whereas chronic hepatitis
C arises in equal numbers in both sexes.
• Autoimmune hepatitis, a disorder associated with a malfunction of
the immune system, generally occurs in young women.
 SYMPTOMS
The initial phase of hepatitis is called the acute phase. The
symptoms are like a mild flu, and may include:
 Diarrhea  Nausea
 Fatigue  Slight abdominal pain
 Loss of appetite  Vomiting
 Mild fever  Weight loss
 Muscle or joint aches
The acute phase is not usually dangerous, unless it develops into the
fulminant or rapidly progressing form, which can lead to death.
 SYMPTOMS (CONT…)
As the patient gets worse, these symptoms may follow:
Circulation problems (only Headache (only toxic/drug-induced
toxic/drug-induced hepatitis) hepatitis)
Dark urine Hives
Dizziness (only toxic/drug-induced Itchy skin
hepatitis) Light colored feces, the feces may
Drowsiness (only toxic/drug-induced contain pus
hepatitis) Yellow skin, whites of eyes, tongue
Enlarged spleen (only alcoholic (jaundice). NOTE: Patient outcomes after the
acute phase depend on various
hepatitis) factors, especially the type of
hepatitis.
 DIAGNOSIS
Physical Exam
Liver Biopsy
Liver Function Tests
Ultrasound
Blood Tests
Viral Antibody Testing
 TREATMENT
• Bed rest, abstaining from alcohol, and taking medication to
help relieve symptoms. Most people who have hepatitis A
and E get well on their own after a few weeks.
• Hepatitis B is treated with drugs, such as lamivudine and
adefovir dipivoxil.
• Hepatitis C is treated with a combination of peginterferon
and ribovarin.
• Liver transplant of hepatitis B or C, or D-caused liver failure.
 INDIGESTION

• Indigestion can be pain or discomfort in your upper

abdomen (dyspepsia) or burning pain behind the
breastbone (heartburn).

• Dyspepsia and heartburn may occur together or on their

own.
 CAUSES
Indigestion has many causes, including:
Diseases: Medications:
• Ulcers • Aspirin and other
painkillers, such
• GERD as NSAIDs like ibuprofen (
• Stomach cancer (rare) Motrin, Advil),
and naproxen (Naprosyn)
• Gastro paresis
• Estrogen and
• Irritable bowel syndrome oral contraceptives
• Chronic pancreatitis • Steroid medications
• Thyroid disease • Certain antibiotics
• Pregnancy • Thyroid medicines
Lifestyle:
• Eating too much, eating
too fast, eating high-fat
foods, or eating during
stressful situations
• Drinking too much
alcohol
• Cigarette smoking
• Stress and fatigue
 SYMPTOMS
Bloating
Belching and gas
Nausea and vomiting
An acidic taste in your mouth
Fullness during or after a meal
Growling stomach
Burning in your stomach or upper belly
Belly pain
 TREATMENT
• Try not to chew with your mouth open, talk while you chew, or eat too
fast. This makes you swallow too much air, which can add to
indigestion.
• Drink beverages after rather than during meals.
• Avoid late-night eating.
• Try to relax after meals.
• Avoid spicy foods.
• If you smoke, quit.
• Avoid alcohol.
 LARYNGITIS
• Inflammation of the larynx or voice box, caused by
chemical or mechanical irritation or bacterial infection.
• Laryngitis is classified as simple, diphtheritic,
tuberculous, or syphilitic laryngitis.
• Simple laryngitis is usually associated with the common
cold or similar infections.
 LARYNGITIS (CONT..)
• Diphtheritic laryngitis is caused by the spread of diphtheria
from the region of the upper throat down to the larynx.
• Tuberculous laryngitis is a secondary infection spread from
the initial site in the lungs. Tubercular nodule-like growths
are formed in the larynx tissue.
• Syphilitic laryngitis is one of the many complications of
syphilis.
 CAUSES
• Upper respiratory infection or the common cold
• Overuse of the vocal cords by talking, singing, or shouting
• Gastroesophageal reflux disease (GERD) causing reflux
laryngitis
• Smoking
• Exposure to secondhand smoke
• Exposure to polluted air.
 SYMPTOMS
Hoarseness
Weak voice or voice loss
Tickling sensation and rawness of your throat
Sore throat
Dry throat
Dry cough
 TREATMENT
• Acute laryngitis often gets better on its own within a week or so. Self-
care measures also can help improve symptoms.
• Antibiotics- In almost all cases of laryngitis, an antibiotic won't do any
good because the cause is usually viral. But if you have a bacterial
infection, your doctor may recommend an antibiotic.
• Corticosteroids can help reduce vocal cord inflammation. However,
this treatment is used only when there's an urgent need to treat
laryngitis — for example, when you need to use your voice to sing or
give a speech or oral presentation, or in some cases when a toddler
has laryngitis associated with croup.
 PHARYNGITIS
• Inflammatory illness of the mucous membranes and
underlying structures of the throat (pharynx).
• Inflammation usually involves the nasopharynx, uvula, soft
palate, and tonsils.
• The illness can be caused by bacteria, viruses, mycoplasmas,
fungi, and parasites and by recognized diseases of uncertain
causes.
Viral pharyngitis.
 CAUSES
• Measles
• Adenovirus, which is the cause of the common cold
• Chickenpox
• Croup, which is a childhood illness distinguished by a barking
cough
• Whooping cough
• Viral infections
• Bacterial infection
 SYMPTOMS

Sneezing Chills
Runny nose Fever (a low-grade fever
Headache with a cold and higher-
grade fever with the flu)
Cough
Fatigue
Body aches
 TREATMENT
• Getting plenty of rest (either in or out of bed)
• Taking ibuprofen (Advil, Motrin), acetaminophen (Tylenol)
or aspirin (in adults only) to relieve throat pain
• Drinking plenty of water to prevent dehydration
• Gargling with warm salty water to ease throat pain
• Drinking warm liquids (tea or broth) or cool liquids or eating gelatin
desserts or flavored ices to soothe the throat
• Using a cool mist vaporizer to relieve throat dryness
• Using nonprescription throat lozenges or anesthetic throat sprays
 STOMACH CANCER
• Also called gastric cancer, a disease characterized by abnormal
growth of cells in the stomach.
• The incidence of stomach cancer has decreased dramatically
since the early 20th century in countries where refrigeration has
replaced other methods of food preservation such as salting,
smoking, and pickling.
• Stomach cancer rates remain high in countries where these
processes are still used extensively.
 RISK FACTORS
A diet high in salty and Infection with Helicobacter
smoked foods pylori
A diet low in fruits and Long-term stomach
vegetables inflammation
Eating foods contaminated Pernicious anemia
with aflatoxin fungus Smoking
Family history of stomach Stomach polyps
cancer
 SIGNS AND SYMPTOMS
Fatigue Nausea that is persistent and
Feeling bloated after eating unexplained

Feeling full after eating small Stomach pain

amounts of food Vomiting that is persistent
Heartburn that is severe and Weight loss that is
persistent unintentional
Indigestion that is severe and
unrelenting
 DIAGNOSIS
• A tiny camera to see inside your stomach (upper endoscopy).
A thin tube containing a tiny camera is passed down your throat
and into your stomach. Your doctor can look for signs of cancer. If
any suspicious areas are found, a piece of tissue can be collected
for analysis (biopsy).
• Imaging tests. Imaging tests used to look for stomach cancer
include computerized tomography (CT) scans and a special type
of X-ray exam sometimes called a barium swallow.
 DETERMINING THE STAGE OF
STOMACH CANCER
• Imaging tests. Tests may include a CT and positron emission
tomography (PET).
• Exploratory surgery. Your doctor may recommend surgery to
look for signs that your cancer has spread beyond your stomach
within your abdomen. Exploratory surgery is usually done
laparoscopically. This means the surgeon makes several small
incisions in your abdomen and inserts a special camera that
transmits images to a monitor in the operating room.
 STAGES OF STOMACH CANCER
• Stage I. At this stage, the tumor is limited to the layer of tissue that lines the
inside of the stomach. Cancer cells may also have spread to a limited number
of nearby lymph nodes.
• Stage II. The cancer at this stage has spread deeper, growing into the muscle
layer of the stomach wall. Cancer may also have spread to more of the lymph
nodes.
• Stage III. At this stage, the cancer may have grown through all the layers of
the stomach and spread to nearby structures. Or it may be a smaller cancer
that has spread more extensively to the lymph nodes.
• Stage IV. This stage indicates that the cancer has spread to distant areas of
the body.
 TREATMENT
• Surgery
The goal of surgery is to remove all of the stomach cancer and a
margin of healthy tissue, when possible. Options include:
1. Removing early-stage tumors from the stomach lining
2. Removing a portion of the stomach (subtotal gastrectomy).
3. Removing the entire stomach (total gastrectomy).
4. Removing lymph nodes to look for cancer.
5. Surgery to relieve signs and symptoms.
 TREATMENT (CONT..)
•Targeted drugs
1. Trastuzumab (Herceptin) for stomach cancer cells that
produce too much HER2.
2. Ramucirumab (Cyramza) for advanced stomach cancer that
hasn't responded to other treatments.
3. Imatinib (Gleevec) for a rare form of stomach cancer called
gastrointestinal stromal tumor.
4. Sunitinib (Sutent) for gastrointestinal stromal tumors.
5. Regorafenib (Stivarga) for gastrointestinal stromal tumors.
 TREATMENT (CONT..)

• Radiation therapy
• Chemotherapy
• Clinical trials
• Supportive (palliative) care
 VOLVULUS
• Volvulus is the twisting of a portion of the digestive tract on its
mesentery (the fold of membrane that attaches the intestine to
the posterior abdominal wall), resulting in intestinal obstruction,
severe pain, distension of the involved segment, and
interference with circulation to the affected area.
• Volvulus may be congenital or acquired; the areas most
frequently affected are the sigmoid colon, the ileocecal region,
and the stomach.
Mesenteric
volvulus from a
German Shepherd
Dog.
 CAUSES
• Volvulus is most commonly due to a birth defect called
malrotation, which is when the bowel becomes misaligned
during fetal development.
• Volvulus can also occur in the absence of underlying
malrotation. If the volvulus is associated with malrotation, it
often occurs early in life, frequently in the first year.
 SYMPTOMS
• Symptoms which may indicate bowel obstruction due to volvulus
include:
• Abdominal tenderness
• Nausea or vomiting
• Vomiting green bile-looking material
• Bloody or dark red stool
• Constipation or difficulty expelling stools
• Distended abdomen
• Shock
 TESTING
• In testing for volvulus, the following tests may be performed:
1. A stool sample test finds blood in the stool.
2. An upper GI X-ray with small bowel follow-through shows a
malrotated bowel or midgut volvulus.
3. A CT scan may show evidence of intestinal obstruction.
4. A barium enema often shows an abnormal position of the
bowel, suggesting malrotation.
5. Blood tests to check the electrolytes may show abnormalities.
 TREATMENT
• Emergency surgery is necessary to repair a volvulus.
• An incision is made in the abdominal wall, and the bowels are
untwisted and the blood supply restored.
• If a small segment of bowel is necrotic (dead from lack of blood flow),
it is removed and the ends of the healthy bowel are sewn back
together, or used to form a colostomy or ileostomy (a tube to the
outside through which bowel contents can be removed -- the term
depends on where the tube is placed).
• If the entire bowel is necrotic, the outlook is poor and life threatening.
 HEMATURIA
• also spelled Haematuria, presence of blood in the urine, an
indication of injury or disease of the kidney or some other
structure of the urinary tract; in males blood in the urine can also
come from the reproductive tract.
• The blood may become apparent during urination or only upon
microscopic examination.
Hematuria in urine
sediment after
centrifugation.
 CAUSES
• In hematuria, your kidneys — or other parts of your urinary tract —
allow blood cells to leak into urine. A number of problems can cause
this leakage, including:

Urinary tract infections. Cancer

Kidney infections. Inherited disorders.
A bladder or kidney stone Kidney injury.
Enlarged prostate. Medications.
Kidney disease Strenuous exercise
 SYMPTOMS
• The visible sign of hematuria is pink, red or cola-colored urine
— the result of the presence of red blood cells. It takes very little
blood to produce red urine, and the bleeding usually isn't
painful.
• If you're also passing blood clots in your urine, that can be
painful. Bloody urine often occurs without other signs or
symptoms.
• It's possible to have blood in your urine that's visible only under
a microscope (microscopic hematuria).
 DIAGNOSIS
• To find a cause for urinary bleeding, the following tests and exams play a key
role:
• Physical exam, which includes a discussion of your medical history.
• Urine tests. Even if your bleeding was first discovered through urine testing
(urinalysis), you're likely to have another test to see if your urine still contains red
blood cells. Urinalysis can also check for urinary tract infection or the presence
of minerals that cause kidney stones.
• Imaging tests
• Cystoscopy. In this procedure, your doctor threads a narrow tube fitted with a
tiny camera into your bladder to closely examine both the bladder and urethra
for signs of disease.
 TREATMENT
• Hematuria has no specific treatment. Instead, your doctor will focus
on treating the underlying condition.
• This includes:
1. taking antibiotics to clear a urinary tract infection
2. trying a prescription medication to shrink an enlarged
prostate
3. or shock wave therapy to break up bladder or kidney
stones
THANK YOU!
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Disease and
Disorders
Sa Sense Organs
By: Juan Tamad
Content:

AGEUSIA: Complete Loss of Taste

HYPOGEUSIA: Partial Loss of Taste

DYSGEUSIA: Distorted Taste

Ageusia
Loss of the taste in the tongue, and
particularly the inability to detect
sweetness, sourness, bitterness,
saltiness and umami.
It is rare to have true ageusia,
which is when a person cannot
taste anything that is applied to
their tongue.
Symptom
• The main symptom of ageusia is
having the inability to distinguish
between the various tastes, which are
sourness, saltiness, bitterness, and
sweetness.
Causes
• Having tissue damage to the nerves that support your tongue
• Having a deficiency of zinc and vitamin B3 can cause a person
to have problems with the endocrine system which can cause
an alteration or loss of taste.
• Medicinal side effects from medications
• Inflammation or local damage that interferes with your local
nervous system or your taste buds such as from radiation
therapy, dentures that are ill fitting, tobacco use, etc.
• Anxiety disorders
• Cancer
• Renal and liver failure
• Drinking alcohol
• Damage to your tongue
Hypogeusia
•A reduced ability to taste
things (to taste sweet, sour,
bitter, or salty substances).
•Hypogeusia may be
temporary or chronic.
Symptom
• Diminished ability to taste, flavors will
seem less distinct
Causes
• Heavy smoking
• Dehydration
• radiation therapy administered to the neck or head
• burns to the tongue
• prescription drugs, such as antidepressants, can cause
hypogeusia as well.
Dysgeusia
Is a “a a or al taste or ha ge i taste
that wo ’t go away. It a e des ri ed as
bad, metallic, salty, foul or rancid.
Some people with dysgeusia also have an
altered sense of smell. About 75% of flavor
and taste sensations come from nerve cells
involved with smell. Both taste and smell
cells work together to produce the sense of
taste.
Symptom
• Changes in the sense of taste (and
sometimes smell) are the only
symptoms.
Causes
• Smoking (especially pipe smoking)
• Gingivitis (inflammation of the gums)
• Periodontal disease (advanced gum disease)
• A dental abscess
• Oral yeast infection
• Certain medicines, including lithium, antibiotics, ACE inhibitors and many cancer drugs
• Dry mouth (xerostomia), which can be caused by Sjögre ’s syndrome and many medicines
• Vitamin or mineral deficiency
• A brain tumor or trauma to the head
• Damage to the taste nerves
• Metabolic or endocrine problems, such as diabetes or thyroid disease
• Depression
• Surgery of the larynx (voice box)
• Head and neck radiation
• Migraine headache
• Chlorhexidine oral rinse for Periodontal (gum) disease
• Bell’s palsy
• Dysgeusia may also occur along with burning mouth syndrome or glossitis, and other oral
conditions.
Content
Dysosmia – Change of sense of smell
Anosmia – loss of smell
Hyposmia – reduced ability to smell
Phantosmia – s elli g odors that are ’t there
Dysosmia
Dysosmia is an olfactory disorder that
occurs when your sense of smell is changed.
As the olfactory system and oral cavity are
connected, dysosmia could affect both
sense of smell and taste in some patients. A
dysfunction of the olfactory system tends to
affect the sense of smell and the ability to
detect odors. The condition could affect you
through different sub-conditions that
include anosmia, parosmia and phantosmia.
Symptom
• distorted olfactory function - things
that smell pleasant to you normally
could smell strange and distorted
• loss of olfactory function - you will
not be able to smell anything around
you
Causes
• Blocked nose or infected nasal polyps or nasal sinuses.
• Constant use of medication like decongestants and
antihistamines can lead to a blocked nose
• Nasal sprays could damage the olfactory receptor neurons.
• Structural defects in the nose
• Damaged olfactory receptor neurons
• Contact with toxics substances
• Head trauma that affects the olfactory bulb responsible for
smell.
• Neurologi al disorders i ludi g Alzhei er’s a d
schizophrenia.
Anosmia
Anosmia is the medical term for
loss of the sense of smell. It's
usually caused by a nasal condition
or brain injury, but some people
are born without a sense of smell
(congenital anosmia).
Symptoms
• The obvious sign of anosmia is a
loss of smell. Some people with
anosmia notice a change in the
way things smell. For example,
familiar things begin to lack odor.
Causes
• Nasal polyps -- small noncancerous growths in the nose and sinuses
that block the nasal passage.
• Injury to the nose and smell nerves from surgery or head trauma.
• Exposure to toxic chemicals, such as pesticides or solvents.
• Certain medications, including antibiotics, antidepressants, anti-
inflammatory medication, heart medications, and others.
• Cocaine abuse.
• Old age. Like vision and hearing, your sense of smell can become
weaker as you age. In fact, one's sense of smell is most keen
between the ages of 30 and 60 and begins to decline after age 60.
• Certain medical conditions, such as Alzheimer's disease, Parkinson's
disease, multiple sclerosis, nutritional deficiencies, congenital
conditions, and hormonal disturbances.
• Radiation treatment of head and neck cancers.
Hyposmia
Hyposmia is a reduced ability to
smell and to detect odors. A
related condition is anosmia, in
which no odors can be detected.
Symptom
• The primary symptom of hyposmia is a reduced sense of
smell. In its milder forms, hyposmia may not even be
noticeable. Hyposmia may be temporary, as is the case
with nasal congestion. Severe hyposmia may inhibit your
ability to smell sharp odors like smoke or spoiled food.
Causes
• Can occur as result of injury
• exposure to toxins,
• Disease
• use of some prescription medications
• Nasal polyps can obstruct your nasal passageways and lead to
hyposmia.
• Cancer therapies have been known to cause hyposmia.
• Hyposmia may occur as a result of serious medical conditions,
such as Alzheimer's disease, Parkinson's disease, or multiple
sclerosis.
• can also happen naturally with age
Phantosmia
'Phantosmia' is the medical term for an imaginary odour
(phantom smell).
It is also known as an "olfactory hallucination".
The smell is unique to the person and is usually unpleasant,
spoiling the taste of any food or drink consumed. It can be in
one or both nostrils.
Symptom
• Smelling odors that don't exist
• Altered sensation of smell
Causes
• nasal infection – some people start to perceive a smell after
they develop an infection that affects their nose or sinuses.
The smell may become noticeable after a sudden change in
airflow through their nose – for example, just after they've
sneezed. It usually goes away when the infection clears
• nasal polyps, which are abnormal tissue growths that form
inside the nasal passages and sinuses (read more about nasal
polyps)
• migraine with aura – some people smell phantom odours just
before or during a migraine (read more about migraines)
• dental problems
• smoking
• exposure to certain chemicals such as insecticides or solvents
• radiation for treatment of head and neck cancer
Diseases of the Endocrine System
• Hyposecretion − inadequate release
of hormones

• Hypersecretion − excessive release

of hormones
• Anterior Pituitary- involves human growth hormones (HGH)
• Dwarfism
• Gigantism
• Acromegaly

• Posterior Pituitary-
• Diabetes Insipidus
• Neurogenic Diabetes Insipidus
• Nephrogenic Diabetes Insipidus
• Hyposecretion of HGH during the growth
years slows bone growth, and the
epiphyseal plates close before normal
height is reached
• Some organs fail to grow
• Body proportions are childlike
• Hypersecretion of HGH during
childhood
• Abnormal increase in the length of
long bones
• Grows very tall, but body proportions
are about normal
• Hypersecretion of HGH during childhood
• Increase in size of the bones in the hands,
feet, cheeks, jaws (thickens), tissues
(enlarge), eyelids, lips, tongue, nose
(enlarge), and skin (thickens)
• Develop furrows, especially on the
forehead and soles
Diabetes Insipidus
• Defects in Antidiuretic hormone
(ADH)
• Inability to secrete ADH
• Symptom − excretion of large
volumes of urine resulting to
dehydration and thirst
• Hyposecretion of ADH due to brain tumor,
head trauma, brain surgery
• Kidneys do not respond to ADH.
Affects major body systems
Most common endocrine disorders

•Congenital Hypothyroidism
• Myxedema
•Grave’s Disease
•Goiter
• Hyposecretion of thyroid
hormones that is present at birth
• “Cretinism”
• Causes severe mental retardation
and stunted bone growth
• Produced by hypothyroidism during the adult years
• Occurs five times more often in females than in males
• A hallmark of this disorder is edema (accumulation of
interstitial fluid) that causes the facial tissues to swell
and look puffy.
• Person with myxedema:
• Slow heart rate, low body temperature. sensitivity to
cold, dry skin, dry hair, muscular weakness, general
lethargy, gains weight easily, less alert
• Most common form of hyperthyroidism
• Occurs seven to ten times more often in females than
males
• Usually before 40
• An autoimmune disorder in which the person
produces antibodies that mimic the action of thyroid-
stimulating hormone (TSH)
• Signs: Enlarged thyroid and Exophthalmos (causes the
eye to protrude)
• Enlarged thyroid gland
• Caused by inadequate dietary
iodine intake
• Associated with hyperthyroidism,
hypothyroidism, euthyroidism
• overactivity of one or more of
the parathyroid lobes, which make
too much parathyroid hormone

•Hypoparathyroidism
•Hyperparathyroidism
• Too little parathyroid hormone
(PTH)
• Leads to blood calcium deficiency
• Caused by accidental damage to
the parathyroid glands or to their
blood supply
• An elevated level of parathyroid hormone
• Often due to a tumor of one of the
parathyroid glands
• Person with hyperparathyroidism:
•Fatigue
•Personality changes
•Lethargy
• your glands make too much or not
enough hormones.

•Cushing’s Syndrome
•Addison’s Disease
•Pheochromocytomas
• Produced by hypersecretion of cortisol by the adrenal
cortex
• Causes are the secretion of cortisol by a tumor of the
adrenal gland, or a tumor elsewhere that secretes
adrenocorticotropic hormone (ACTH)
• Characterized by the breakdown of muscle proteins
and redistribution of body fat
• Person with Cushing’s Syndrome: Flushed facial skin,
Stretch marks on the skin covering of the abdomen,
Bruises easily, Wound healing is poor
• Caused by hyposecretion of glucocorticoids and
aldosterone
• Symptoms:
• Mental lethargy
• Anorexia
• Nausea and vomiting
• Weight loss
• Hypoglycemia
• Muscular weakness
• Benign tumors of the chromaffin cells of the adrenal medulla
• Cause hypersecretion of epinephrine and norepinephrine
• Resulting to:
• Rapid heart rate
• High blood pressure
• High levels of glucose in blood and urine
• Elevated basal metabolic rate (BMR)
• Flushed face
• Nervousness
• Sweating
• Decreased gastrointestinal motility
• Diabetes Mellitus
•Type 1 Diabetes
•Type 2 Diabetes
• Ketoacidosis
• Hyperinsulinism
• Insulin Shock
• Most common endocrine disorder
• Caused by an inability to produce or use insulin
• Fourth leading cause of death due to its damage
to the cardiovascular system
• Hallmarks are the 3 “polys”
• Polyuria – excessive urine production
• Polydipsia – excessive thirst
• Polyphagia – excessive eating
• Previously known as insulin-dependent
diabetes mellitus (IDDM)
• Occurs due to the destruction of
pancreatic beta cells
• Pancreas produces little or no insulin
• Usually develops in people younger than
20
• Previously known as non-insulin-
dependent diabetes mellitus
(NIDDM)
• More common than type 1
• Often occurs in obese people who
are over age 35
• Fall of blood pH caused by the buildup of
ketones
• Result of too much insulin
• Main symptoms is hypoglycemia (decreased blood
glucose level)
• Resulting to:
• Anxiety
• Sweating
• Tremor
• Increased heart rate
• Hunger
• Weakness
• Shock due to an insulin overdose
 CATARACT
• Is the opacity of the crystalline lens of
the eye.
• This occurs in 50% of people
between the ages of 65 and 74, and
in 70% of people over the age of 75.
 CATARACT
• Age-related cataracts can cause
cloudy vision, glare, colour vision
problems, changes in eyeglass
prescription, double vision.
• Age-related cataracts are usually
bilateral
 CATARACT
• Cataracts can affect one or both eyes
and can produce severe visual
impairment and amblyopia.
• They can occur by themselves; in
association with genetic and
metabolic diseases, in utero maternal
infections, or toxin exposure; or in
combination with other congenital eye
problems.
 CATARACT
• In addition to age-related lens
changes, some systemic diseases
can promote cataract formation.
Management of symptomatic
Cataracts is surgical, requiring
removal of the offending lens and
placement of an artificial lens within
the eye.
 CATARACT
• Such implants are known as
intraocular lenses—may be
monofocal (set for near, far or
intermediate vision)or
multifocal(which can be moved by the
eye muscles to accommodate
focused vision at different distances).
 CATARACT
• Placement of an artificial lens within
the eye requires special
considerations and may not be
appropriate depending on the
child/person’s age. Eyeglasses or
contact lenses are commonly used
postoperatively to improve vision, and
occlusion patching of the unaffected
eye is often necessary to treat
associated amblyopia.
 3 common Cataract Types

• Nuclear Sclerotic Cataracts

• Cortical Cataracts
• Posterior Subcapsular Cataracts
Nuclear Sclerotic Cataracts

• Refers to the hardening of the nucleus, or

thAe centre of the lens of the eye.
• During the early stages of this condition,
the lens becomes cloudy and yellow
before eventually hardening (sclerosis)
Nuclear Sclerotic Cataracts

• The hardening of the lens causes the eye

to lose the ability to focus and the
yellowing and clouding of the lens causes
reduction or cessation of light entering the
eye and so eventually lead to blindness.
Nuclear Sclerotic Cataracts

• Nuclear Sclerotic Cataracts are

usually age-related and symptoms
may take years before actually
affecting sight.
 Cortical Cataracts

• A Cortical Cataract is a condition in

which areas of white cloudiness will
develop in the outer edges of the lens
called the cortex spreading inward
and having the appearance of a
spoke-like wheel or a star.
 Cortical Cataracts
• This condition scatters the light that
enters the eye causing blurred vision
and glare as well as difficulties in
judging contrast and depth
perception.
 Cortical Cataracts

• Advanced Cortical Cataracts can

cause the lens to appear white, a so-
called mature cataract.
 Posterior Subcapsular
Cataract

• Posterior Subcapsular Cataracts are

located near the very back of the
lens, and can cause vision difficulties
even at a relatively small size.
 Posterior Subcapsular Cataract
• In contrast to Nuclear and Cortical
Cataracts, Posterior Subcapsular
Cataracts tend to occur in younger people.
• This results from the use of steroids,
exposure to radiation or trauma, people
that have diabetes, persons who suffer
from extreme near-sightedness and/or
retinitis pigmentosa.
 Other Types of Cataracts

• Congenital Cataracts—Cataracts
present at birth.
• Infantile Cataracts—Cataracts that
are evident in the first year of life.
ASTIGMATISM
• Astigmatism is the non-
uniform curvature of the
cornea that causes the eye
to focus images at different
distances, depending on the
orientation of light as it
strikes the cornea.
ASTIGMATISM
• Effect of Astigmatism can also be
produced by abnormalities or
misalignment of the crystalline lens.
• Portions of the image that are not
focused on the retina appear blurred.
ASTIGMATISM
• Astigmatism occurs independent of
he existence of near-sightedness or
far-sightedness.
• Astigmatism can be corrected through
a precisely designed lens that
counteracts the underlying corneal
asymmetry.
ASTIGMATISM
• Refractive surgery is also capable of
correcting limited amounts of
astigmatism.
• A troublesome form of Astigmatism is
“Irregular Astigmatism” which is caused
by corneal scars and certain corneal
diseases and can sometimes be seen
after corneal transplant.
 MYOPIA
• Myopia is also called near-
sightedness.
• It is the visual abnormality in which
the resting eye focuses the image of
a distant object at a point in front of
the retina, resulting in a blurred
image.
 MYOPIA
• Myopic eyes are usually longer than
normal from front to rear, are
somewhat more susceptible to retinal
detachment than are normal or far-
sighted eyes.
 MYOPIA
• Myopia can be corrected by concave outer
lenses.
• The use of LASIK (Laser-assisted in situ
keratomileusis) surgery has become
common. This method is often preferred to
photorefractive keratectomy (PRK), another
type of laser-based surgery used to
reshape the cornea.
HYPERMETROP
IA
• Is also called “Hyperopia” and Far-
sightedness is the refractive error or
abnormality in which the cornea and
lens of the eye focus the image of the
visual field at an imaginary point
behind the retina.
 HYPERMETROP
IA
• The retina receives an unfocused
image of near objects, though distant
objects may be in focus.
• Frequently occurs when an eye is
shorter than normal from front to rear;
the lens is unable to increase its
convexity sufficiently to focus images
of close objects.
HYPERMETROP
IA
• Corrective lenses for hyperopia are
designed to supply the additional
convexity needed for focusing.
• H-LASIK and H-PRK are common
surgical methods that reshape the
cornea to improve vision in hyperopic
patients.
 OTITIS

• Otitis is the inflammation of the ear.

TYPES OF OTITIS

• Otitis Externa
• Otitis Media
• Labyrinthitis (inner ear otitis)
 OTITIS
EXTERNA
• Dermatitis of the external auditory
canal and the exposed ear.
• The skin on these ear parts become
dry, scaly and itchy and there may be
foul-smelling watery or purulent
discharge, pain, fever and intermittent
deafness.
 OTITIS
EXTERNA
• Predisposing factors include
excessive perspiration, trauma,
allergy, underwater swimming and
diving, and a warm, damp
environment.
• The infection is bacterial in origin.
 OTITIS MEDIA
• Is the inflammation of the lining of the
middle ear.
• It commonly develops in association
with an infection of the upper
respiratory tract that extends from the
nasopharynx to the middle ear
through the eustachian tube.
 OTITIS MEDIA
• Symptoms include fever, earache and
sometimes suppuration (discharge of pus)
• Diagnosis is established by careful visual
examination of the tympanic membrane
(eardrum) and by techniques that can
provide evidence of fluid behind the
eardrum.
 OTITIS MEDIA
• Antibiotics or Antivirals generally are given
for acute otitis because the infection can
spread to the nearby bones and the
central nervous system.
• This disease can be complicated by
perforation of the eardrum and by
permanent hearing losses that lead to
delay in development.
 LABYRINTHITI
S
• Is an inner ear disorder.
• Occurs when one of the two
vestibular nerves in your inner ear
becomes inflamed.
• Symptoms include dizziness, marked
sensation of moving even when not.
LABYRINTHITI
S
• The treatment for Labyrinthitis usually
involves using medications to control
your symptoms.
Disorders and Diseases
of the Nervous System
Group 6
BS Psychology 3-1
Meningitis
• inflammation of the meninges - membranes surrounding
the brain and spinal cord.
• most often caused by a bacteria and less often by a virus
• A large number of bacteria can infect the meninges,
however the five leading causes are: Haemophilus
influenza, Streptococcus agalactiae, Neisseria
meningitidis, Listeria monocytgenes and Streptococcus
pneumonia.
• Pus may accumulate in the subarachnoid space, block
CSF flow and result in hydrocephalus. In severe cases,
meningitis may also cause paralysis, coma or death.
• Symptoms:
– fever
– lethargy
– irritability
– photophobia
– stiffness of the neck
– headache
Coma
a prolonged state of unconsciousness in which the
client is unaware of self or the environment for
sustained periods of time from hours to months.
(Hickey, 2003)
Assessment
• Glasgow Coma Scale
• Mini-mental Status Exam
• Diagnostic Tests
– CT and MRI
– Lumbar Puncture
– EEG
– Laboratory Tests
• Tests for Abnormal
Reflexes
– Oculocephalic Reflex
Response
– Oculovestibular Reflex
Response
The Glasgow Coma Scale (GCS) is a universally
used neurological assessment tool to assess
degree of consciousness impairment. CGS
measures eye, verbal, and motor response.

It is an excellent scale to measure arousal. It is

less helpful related to content measurement.
 GLASGOW COMA SCALE SCORE (GCS)

Eyes 1 Closed at all times

2 Opens to pain
3 Opens to voice command 15 (top score)
4 Open spontaneously A score of 10 or less
Motor 1 No response
indicates a need for
2 Extension (decerebrate)
3 Flexion posturing (decorticate) emergency attention
4 Flexion withdrawal
A score less than 7
5 Localizes painful stimulus
6 Obeys commands is interpreted as
Verbal 1 No response coma
2 Incomprehensible sounds
3 Inappropriate words
4 Disoriented and converses
5 Oriented and converses
Tumor
• group of cells growing independently of the rest of the
body.
• can be encapsulated or infiltrating
• can be benign or malignant
• metastatic tumors - originate in one organ and spread to
another
• multiple brain tumors are often the first signs of lung
cancer
Cerebrovascular Accidents
• CVAs, commonly called strokes, occur when blockage or
interruption of the flow of blood to a brain area causes
brain tissue to die from lack of oxygen. Such a deprivation
of blood to a tissue is called ischemia

• People who survive a CVA may be paralyzed on one side

of the body or have sensory or language deficits.
Epilepsy
• any disorder in which epileptic seizures recur
spontaneously
• When convulsions (motor seizures) are present, it is easy
to diagnose; include tremor, rigidity, loss of balance, or
loss of consciousness. However, many seizures involve
subtle changes in thought, mood, and or behavior with no
convulsions whatsoever.
• The observation of epileptic spikes in the EEG is evidence
of epilepsy.
There are two main classes of seizures:
• Partial Seizures: do not involve the entire brain.
epileptics typically have no memory of the event.
– simple partial seizures produce symptoms in the sensory or
motor areas
– complex partial seizures are often restricted to the temporal
lobes
• Generalized seizures: involve the entire brain.
– grand mal seizures (“big trouble”)
– petit mal seizures (“small trouble”)
Narcolepsy
• sudden sleep attacks that occur during any activity at any
time of the day.
• usually begins between the ages of 15 and 25. But it can
become apparent at any age.
• cause is not known, however scientists have made
progress toward identifying genes associated with this
disorder.
• Symptoms:
– excessive daytime sleepiness
– cataplexy
– hallucinations
– sleep paralysis.
Congenital Malformations
• Anencephaly (“without a brain”) - failure of the rostral
part of the groove to close and form a complete brain, so
the cerebrum and cerebellum never develop
• Microcephaly - formation of a small brain and skull
• Hydrocephalus (“water on the brain”) - Excessive
accumulation of cerebrospinal fluid (CSF) in the ventricles
or subarachnoid space that exerts a crushing pressure on
the brain. Causes:
– tumor
– meningitis
– overdeveloped choroid process
types of hydrocephalus:

1. Internal or non-communicating Hydrocephalus

Accumulation of cerebrospinal fluid (CSF) within the
ventricles, when the apertures of the fourth ventricle or the
cerebral aqueduct are blocked, which results in increased
CSF pressure.
2. External or communicating Hydrocephalus
Accumulation of cerebrospinal fluid (CSF) in the
subarachnoid space. In this condition, pressure is applied to
the brain externally, compressing neural tissues and
causing brain damage.
Cerebral Palsy
• a lifelong neural disorder in which the voluntary muscles
are poorly controlled or paralyzed
• this condition reflects damage to the cerebral motor cortex
or, less often, to the cerebellum or basal nuclei
• usually caused by infections of the placenta during the
mother's pregnancy
• affects 2 of every 1000 full-term births, but occurs 70
times more frequently among premature infants
• symptoms can include
– spasticity
– speech difficulties
– motor impairments
– seizures
– mental retardation
– deafness
– visual impairments
Facial Palsy / Bell's Palsy
• A unilateral paralysis of the facial muscles
• caused by herpes simplex (viral) infection, which
produces inflammation and swelling of the facial nerve
• can result from a stroke or tumor in the cerebral cortex
or brain stem
manifestations:
• lower eyelid droops
• corner of mouth sags
• eye constantly drips tears and
cannot be completely closed
Tic Douloureux
• aka Trigeminal Neuralgia, is considered to produce the
most excruciating pain known
• a chronic pain condition that affects the trigeminal or fifth
cranial nerve. 2 Forms:
– Type I or TN1 or classic form – causes extreme, sporadic,
sudden burning or shock-like facial pain that lasts anywhere
from a few seconds to as long as 2 minutes per episodes.
These attacks can occur in quick succession, in volleys lasting
as long as two hours
– Type II or TN2 or atypical form – characterized by constant
aching, burning, stabbing pain of somewhat lower intensity than
type 1
Hansen's Disease
• also known as leprosy.
• Caused by Mycobacterium leprae - the only known
human pathogen to preferentially attack the peripheral
nerves, particularly of the skin.
• this disease occurs in multiple forms:
– tuberculoid leprosy
– lepromatus leprosy
1) Tuberculoid leprosy
a) Most superficial, least severe form
b) Results in skin nerve damage causing an area
of sensation loss surrounded by nodules
c) Generally has few
complications and is the
easiest form to treat
d) Sometimes heals
spontaneously
2) Lepromatous leprosy
a) Widespread dissemination of the
bacteria
b) Responsible for the disfiguring
nodules associated with the disease
c) Generally affects cooler regions of
the body (nose, ears, eyebrows,
chin, and testes)
d) Loss of sensation & necrosis
also occurs
Amyotrophic Lateral Sclerosis
• aka ALS or Lou Gehrig's disease
• affects people between the ages between 40 and 70
• the disease selectively destroys both upper and lower
motor neurons
• begins with weakness and clumsiness and progresses
within 2 to 5 years to loss of muscle control
• initial symptoms include weakness in using hands or
difficulty in swallowing or speaking
Multiple sclerosis
It is a progressive
autoimmune disease
that destroys patches
of myelin in the brain
and spinal cord,
leading to sensory
disorders and
weakened
musculature.
• Common signs & symptoms include:
– Numbness or pain
– Disturbances of vision
– Ataxia
– Tremor
– Muscle weakness or paralysis
– Difficulty in maintaining balance
– Slurred speech
– Bladder incontinence
– Fatigue
– Depression
Alzheimer's Disease
• A progressive degenerative disease of the brain that
ultimately results in dementia (mental deterioration).
• may begin in middle age.
• Victims exhibit a wide variety of mental defects including:
– Loss of memory (particularly for recent events) or
Forgetfulness
– Shortened attention span
– Inability to perform the most simple responses (e.g.,
swallowing)
– Depression
– Disorientation
Tay-Sachs Disease
• Autosomal recessive lysosomal enzyme disorder caused
by mutations to the Hexoseaminidase A gene - breaks
down gangliosides in in the light sensitive cells in the eye
• GM2 ganglioside accumulates in cells and damages them
• leads to blindness
• has 2 forms: classic form and late-onset Tay Sachs
Classic form - a hereditary disorder of infants, usually
before age 5. Symptoms include paralysis, blindness, and
can lead to death
Late-onset Tay-Sachs or LOTS - also caused by
mutations in the Hex A genes. Affected indiv often have a
combination of one severely affected allele that fails to code
for Hex A and another allele that results in reduced
production of Hex A. It is characterized in problems of
– Gait
– Cognition
– Speech
– Psychiatric problems
 Parkinson's Disease
• a motor system disorder, which
is a result of the loss of
dopamine-producing brain cells
• usually affects people over the
age of 50.
• 150 in 100,000 develop this
disease
• Life expectancy is 25 yrs post
onset
Primary symptoms are:
– Tremor
– Rigidity
– Bradykinesia
– Postural instability

Other key symptoms include:

• Flexed posture
• Loss of postural reflexes
• Freezing movements
Huntington's Disease
• results from genetically programmed degeneration of
neurons in certain areas of the brain. this causes
uncontrolled movements, loss of intellectual faculties, and
emotional disturbance.
• specifically affects the cells of the basal ganglia, and
especially targets neurons of the striatum
• it also affetcs the brain's outer surface, or cortex
• Usual symptoms:
– mood swings
– uncharacteristically irritable, apathetic, passive,
depressed, or angry behavior
– hostile outbursts or deep bouts of depression
– slurred speech
– declining of vital functions
– inability to recognize people
Thank you for listening!

Sabior, Juliet Ann

Villorente, Jenesis
Vasquez, Rosalee Grace
Dimapilis, KC Mae
De Vera, Joana Jirah