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Pathophysiology

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Pathophysiology

Unit 9: Hormonal and Reproductive Disorders

Chapter 24: Endocrine Disorders

 The endocrine system consists of glands that produce and secrete hormones. The

endocrine feedback process is the system's most significant and unique feature.

 The pituitary gland and hypothalamus control hormones. The pituitary is stimulated by

releasing factors secreted by the hypothalamus. It produces tropic hormones, which

induce the release of a hormone by a target endocrine gland. Since it regulates all of the

endocrine glands, it is regarded as the master gland.

 Luteinizing hormone (L.H.), growth hormone (G.H.), thyroid-stimulating hormone

(TSH), prolactin (PRL), follicle-stimulating hormone (FSH), and adrenocorticotropic

hormone (ACTH) are all secreted by the pituitary gland (L.H.).

 The condition is considered a primary disease when an endocrine gland malfunctions and

a secondary condition when the pituitary gland malfunctions.

 Pituitary adenoma, the most prevalent form of pituitary tumor that secretes PRL, is the

leading cause of hyperpituitarism. It causes acromegaly in adults and gigantism in

infants.

 Diabetes insipidus is caused by hypopituitarism of the posterior pituitary, a lack of ADH

that causes polydipsia, polyuria, and dehydration.

 The syndrome of inappropriate ADH (SIADH) is caused by excessive ADH secretion by

the posterior pituitary, which results in hypervolemia, dilutional hyponatremia, and

edema.
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 Cold sensitivity, sluggishness, extreme exhaustion, weakness, weight gain, constipation,

slowed mentation, and depression is hypothyroidism symptoms, most often triggered by

Hashimoto's thyroiditis.

 Thyroid storm is a significant release of thyroid hormone caused by infection or stress,

and it can result in hypertension, heart failure, and pulmonary edema.

 High cortisol levels are induced by adrenal gland hyperactivity, which manifests as

Cushing's syndrome, which involves moon facies, buffalo hump, obesity, hirsutism, and

striae. Addison's disease is caused by adrenal deficiency and is characterized by weight

loss, fatigue, and extreme hypotension.

 Multiple Endocrine Neoplasia 1 is a disease in which tumors in the parathyroid, pancreas,

and pituitary glands develop out of control.

 Pineal gland tumors compress nearby brain tissue, resulting in CSF accumulation, vision

disturbances, seizures, and headaches.

 Hormone replacement therapy can be used with hormone insufficiency Glucocorticoids,

thyroid hormone, sex steroids, G.H., and ADH are the most common substitute

treatments. Overproduction of hormones can be controlled medically or surgically.

Chapter 25: Diabetes Mellitus and The Metabolic Syndrome

 Diabetes mellitus (D.M.) is a metabolic condition in which glucose absorption into cells

in the body is reduced. In the U.S., the disease has taken an enormous toll. Type 1

diabetes and type 2 diabetes are the two most common forms of diabetes.

 Insulin deficiency is found in type 1 diabetes. Body cells resist insulin in type 2 diabetes.

Both forms make glucose build up in the bloodstream.

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 The metabolic syndrome includes apple-shaped obesity, high blood pressure, insulin

resistance, and hyperlipidemia, all of which raise the risk of cardiovascular disease and

diabetes.

 Hyperglycemia starts to develop when glucose is barred from entering body cells. It has a

diverse range of short and long-term effects on the body in unmonitored D.M. Polyuria,

polydipsia, and polyphagia are the main acute signs of D.M.

 In type 1 diabetes, cells "sense" starvation, and the body goes into a starvation state,

releasing glucose and fatty acids from the liver and fat tissue, respectively, resulting in

Diabetic ketoacidosis (DKA). This life-threatening condition needs urgent care.

 Arterial damage sets off chain effects that result in widespread arteriosclerosis. Early

myocardial infarction is caused by coronary arteriosclerosis.

 Blindness is caused by retinal artery damage. Injuries to the delicate glomerular

capillaries cause kidney failure. Ischemic stroke and ischemic necrosis of the lower

extremities are caused by peripheral arteriosclerosis.

 Lack of circulation, reduced feeling, and increased vulnerability to infections affect the

lower extremities, increasing the risk of necrosis and amputation.

 The patient must closely monitor blood sugar levels, diet, and exercise daily to control

diabetes.

 Insulin and oral antidiabetic agents come in a variety of forms to combat the adverse

effects of diabetes.

Chapter 26: Disorders of The Female Reproductive System

 The cervix, uterus, fallopian tubes, ovaries, and boobs are all part of the female

reproductive system. Menstruation gradual changes in these tissues are caused by

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estrogen and progesterone. Estrogen promotes endometrium cellular development, while

progesterone promotes endometrium shedding or menstruation.

 The menstrual disorder can be classified into various categories: when menstruation is

absent, it is referred to as amenorrhea, painful menstruation is dysmenorrhea,

menorrhagia is the loss of excessive blood during menstruation, and oligomenorrhea is

the lack of periods over a long period.

 A follicle develops an ovum and transports it to the surface of the ovary. A benign

follicular ovarian cyst may form if the ovum is not released. It usually resolves by itself.

 The corpus luteum can develop a cyst, causing abdominal pain that usually goes away on

its own.

 Torsion of the ovary may be caused by an ovarian cyst, which induces severe abdominal

pain and necessitates surgery. Polycystic ovarian disorder is a hormonal disease that

results in amenorrhea and infertility.

 A teratoma is an ovarian tumor. Fibroid tumors, also referred to as leiomyomas, are

common benign tumors in the uterus. Endometriosis is a condition in which endometrial

tissue develops outside of the uterus.

 Dysfunctional uterine bleeding happens when the menstrual cycle is interrupted, resulting

in irregular uterine bleeding. The most prevalent cause is anovulatory cycles.

 Squamous cell carcinoma is the most common form of cervical cancer. It is believed to

be caused by HPV. For women of reproductive age, a Pap smear with HPV testing is the

standard screening test.

 Candida albicans, trichomonas, and bacterial vaginosis are the most common causes of

vaginitis. Different medications are needed for each.

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 An ectopic pregnancy most frequently develops in the fallopian tube, resulting in severe

abdominal pain that necessitates immediate surgery.

 Fibrocystic breasts are normal, fluctuate in size with a woman's menstrual cycle, and are

not cancerous. Mastitis is a breast infection that is widespread in the postpartum phase.

Chapter 27: Disorders of The Male Reproductive System

 The male reproductive system is an endocrine feedback system of the hypothalamus that

generates gonadotropin-releasing hormone, which enhances the anterior pituitary to

secrete FSH and L.H. FSH helps the testes to develop spermatozoa. The testes secrete

testosterone in response to L.H.

 The testes, which synthesize testosterone and produce spermatozoa, are the essential

organs in determining male sexuality. Since optimal spermatogenesis needs temperatures

cooler than the average body temperature, the testes must lie away from the body.

 The Tanner stages provide a framework for evaluating puberty. Males experience

precocious puberty as secondary sexual features grow before the age of nine.

 Cryptorchidism is a condition in which the testes do not fall into the scrotum and persist

in the abdomen or high in the inguinal canal. At the end of the first year, the testes should

be lying inside the scrotum. Cryptorchidism, if left untreated, can lead to testicular

cancer.

 Hypospadias and epispadias are penis structural defects. In hypospadias, the urethral

opening is on the posterior side of the penis, and in epispadias, the urethral opening is on

the anterior side.

 Hydrocele, varicocele, and hematocele are scrotal abnormalities that may occur as a

result of trauma.
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 Torsion of the testes is a life-threatening disease caused by the testicle wrapping around

the spermatic cord. It is excruciating and should be treated as a medical emergency.

 BPH (benign prostatic hyperplasia) is a disease that affects men over the age of 50. The

prostate enlarges physiologically as people get older. Medication or transurethral surgery

may be used to treat BPH.

 In men over the age of 50, prostate cancer is the most common cancer. Two screening

techniques that can be used to prevent this cancer are optical rectal examination and

prostate surface antigen.

 STIs cause severe acute and chronic pain, infertility, and infectious disease from puberty

to middle age. Many STIs are asymptomatic in men but symptomatic in women.

 Erectile dysfunction is typical in men with atherosclerosis and diabetes (E.D.). In the use

of E.D. drugs, nitrates are usually prescribed.

Chapter 28: Sexually Transmitted Diseases

 A sexually transmitted disease (STD) is an infection spread between people through

sexual activity such as vaginal intercourse, anal and oral sex. In the U.S., STDs are a

significant public health problem. Chlamydia and gonorrhea are two common STDs that

are easily treated.

 The most common cause of an STD is Chlamydia trachomatis. Cervicitis, urethritis,

Pelvic inflammatory disease (PID), and inclusion conjunctivitis are all symptoms of this

condition. It is an ordinarily asymptomatic and silent illness.

 Gonorrheal infections can induce cervicitis, proctitis, urethritis, PID, conjunctivitis, and

conjunctivitis. Ectopic pregnancy, infertility, and increased HIV sensitivity are all

potential complications.
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 The four stages of syphilis infection are primary, secondary, latent, and tertiary. It can

manifest itself in various ways, and in advanced stages, it can resemble a variety of other

diseases. The painless chancre is a typical syphilis lesion. Infection with syphilis will last

for decades. It increased vulnerability to HIV infection.

 In tropical climates, lymphogranuloma venereum (LGV) and granuloma inguinale are

more common. MSM has a greater chance of contracting LGV. Buboes, or swollen

inguinal lymph nodes, are one of the most common symptoms of the disease.

 HPV infection is a trigger to cervical, anal, rectal, oropharyngeal, and laryngeal cancer.

Genital warts caused by HPV infection are known as Condyloma acuminate. Although

there is no cure, a vaccine is available.

 HSV2, or genital herpes, is a chronic viral disease with periods of exacerbation when

symptoms are present and periods of recovery when symptoms are not present.

 The majority of cases of PID are caused by N. gonorrhoeae or C. trachomatis. Women

with abdominal or pelvic pain should have a pregnancy test to rule out ectopic pregnancy.

Complications associated with PID are ectopic pregnancy and infertility.

Unit 10: Gastrointestinal Disorders

Chapter 29: Disorders of The Esophagus, Stomach, And Small Intestine

 Gastrointestinal (G.I.) disease can manifest itself in several ways, affecting people in both

developed and developing countries.

 Gastroesophageal reflux disease (GERD) is a primary upper G.I. tract condition

diagnosed when an individual has esophagitis on more than a few occasions per week. It

may cause Barrett's esophagus and lower esophageal epithelial metaplasia.

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 The esophagus, liver, and small intestine are all affected by upper G.I. tract diseases.

These organs are in charge of the majority of digestion and nutrient uptake. Malnutrition

and dehydration may result from the malfunction of any of the upper G.I. organs.

 Dysphagia is a risk factor for aspiration pneumonia and can be caused by achalasia,

Zenker's diverticulum, esophageal stricture, stroke, and neuromuscular disease.

 H. pylori and NSAIDs are the most common causes of peptic ulcer disease (PUD). PPIs

are medications used to treat GERD and PUD.

 Chronic gastritis leads to achlorhydria and is linked to a higher risk of stomach cancer.

 High blood pressure, diabetes, coronary artery disease, sleep narcolepsy, and arthritis can

be minimized by bariatric surgery.

 Dumping syndrome is induced by rapid gastric emptying. This is a common side effect of

any surgery that extracts a part or all of the stomach.

 Any surgical operation that extracts a large part of the intestine can result in short-bowel

disorder, which causes malabsorption.

 Pathogens acquired via the oral route, water, or foodborne illness are the most common

gastroenteritis causes. The norovirus most often causes gastroenteritis.

 An abdominal hernia occurs when a loop of the intestine protrudes through the abdominal

muscle wall. It may become strangulated, resulting in intestine ischemia.

 The most common cause of small bowel obstruction is adhesions (SBO).

 Peritonitis causes intense abdominal pain, guarding, and rebound tenderness. A paralytic

ileus, or a lack of peristaltic activity in the intestine, may result.

Chapter 30: Common Disorders of the Large Intestine

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 Alterations in the integrity of the gastrointestinal (G.I.) wall or motility changes are two

types of large intestine conditions.

 Inspection, auscultation, percussion, and palpation can be performed in the order of

physical test procedures used in the abdominal assessment.

 Acute abdomen refers to any condition that causes extreme, intense abdominal pain or

discomfort.

 Crohn's disease and ulcerative colitis are examples of inflammatory bowel disease (IBD).

 Malabsorption, vomiting, arthritis, uveitis, cheilitis, and dermatological disorders are all

signs of Crohn's disease. It can develop anywhere in the gastrointestinal tract.

Inflammation of the liver and bile ducts may also occur. Transmural inflammation with

missed regions of the intestine characterizes this disorder.

 U.C. is an autoimmune condition that affects only the large intestine's surface.

Pseudopolyps and areas of persistent inflammation in the large intestine are popular. It

increases the risk of colon cancer.

 Toxic megacolon, which is a chronic condition, may result from severe Crohn's disease

or U.C.

 Irritable bowel syndrome (IBS) is a disorder characterized by irregular bowel movement

that has no organic origin and is etiologically unexplained.

 The most frequent cause of significant bowel obstruction (LBO) is colon cancer or tumor.

 A colostomy is a surgical operation that involves bringing one end of the large intestine

through the abdominal wall and creating a stoma.

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 Appendicitis starts with a dull ache in the umbilical area that worsens over time and

gradually extends to the right lower quadrant (RLQ). It causes peritoneal inflammation,

as evidenced by rebound tenderness in the RLQ at McBurney's point.

 Diverticulosis is a disease in which the bowel wall is compromised in many ways,

resulting in slight outpouchings called diverticula. Diverticulitis is characterized by

inflammation of these wall weakening, which most often causes tenderness in the left

lower quadrant.

 A volvulus is a twisting of the large intestine that may result in intestinal ischemia and

infarction.

 Hemorrhoids are swollen blood vessels that can bleed, thrombose or prolapse in the lower

rectum. Topical treatments or minimally invasive surgical operations are used to manage

the condition.

Chapter 31: Infection, Inflammation, And Cirrhosis of The Liver

 The liver is the body's main internal organ, weighing about 1.5 kilograms in an average

adult. It is a metabolically vital organ that serves as an accessory digestive, and

endocrine, a hematologic, and an excretory organ all at the same time.

 The liver is a multipurpose organ that produces albumin and coagulation factors,

detoxifies the blood, and facilitates fat digestion. It also can store glucose, vitamins, and

minerals. It renders bilirubin water-soluble by conjugating it.

 Bilirubin in the bloodstream can be caused by RBC degradation, hepatocellular

dysfunction, and obstructed bile release. Pre-hepatic, intrahepatic, and posthepatic

jaundice are the three types of jaundice.

 Jaundice, a yellowing of the skin and sclera, is a symptom of hyperbilirubinemia.

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 The HCV virus, alcohol misuse, and nonalcoholic fatty liver disease (NAFLD), which is

related to metabolic syndrome, hyperlipidemia, obesity, and insulin resistance, are the

most prevalent causes of liver dysfunction.

 NAFLD, the most prevalent type of liver disease in the U.S., will progress to NASH, a

more severe form of the disease that can lead to cirrhosis and hepatocarcinoma.

 Hepatitis A, B, C, D, and E are hepatitis viruses. HAV induces the mildest illness; it is

transmitted exclusively by the feces-oral pathway, is self-limiting, and has no adverse

effects.

 Hepatocellular dysfunction and chronic infection are caused by HBV and HCV,

transmitted by blood and body fluids. They are commonly seen in the presence of HIV,

and both can result in HCC.

 A hepatitis laboratory examination can show hepatitis viral antigen and antibody levels,

which can diagnose hepatitis. Alcohol misuse is the second leading cause of liver

cirrhosis after HCV.

 Cirrhosis is characterized by several signs and symptoms, including jaundice, impaired

fat absorption, reduced coagulation factor production, and inadequate blood

detoxification.

 Portal hypertension is a cirrhosis syndrome that causes Esophageal varices and

hematemesis.

 Liver disease has few therapies, and liver transplantation is often the only option.

Chapter 32: Gallbladder, Pancreatic, And Bile Duct Dysfunction

 The gallbladder, pancreas, and bile duct are all crucial components of the gastrointestinal

system.
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 Bile is produced and secreted by the liver for fat digestion, and some of it is stored in the

gallbladder. The liver releases Bile into the hepatic duct, which progresses to the

common bile duct.

 Bile stasis, which may lead to biliary sludge or cholesterol stones and cholecystitis, is

often caused by reduced gallbladder motility. Cholelithiasis is the term used to describe

the mechanism of gallstone formation.

 Cholecystitis is a common ailment in women over the age of 40. Abdominal pain, regular

indigestion, nausea, vomiting, eructations, and flatulence are all symptoms.

 Biliary colic is cholecystitis-related pain that peaks, then fades, and subsides, causing

immediate relief.

 One of the most general surgical operations is gallbladder removal, also known as

laparoscopic cholecystectomy.

 When a gallstone moves from the cystic duct to the common bile duct, it can lead to the

common bile duct obstruction, inducing Bile back up into the liver and then bilirubin up

into the bloodstream.

 When Bile is unable to reach the stomach, fats are not digested, resulting in steatorrhea.

Bile backs up in the liver, causing hyperbilirubinemia and the accumulation of bile salts

in the bloodstream.

 Jaundice is caused by hyperbilirubinemia, and pruritus is caused by elevated bile salt

levels in the blood.

 Digestive enzymes are produced by the pancreas and secreted into the small intestine via

the pancreatic duct to aid in the digestion of fats, proteins, and carbohydrates.
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 Acute pancreatitis is a life-threatening disease characterized by extreme epigastric pain

radiating through the back. Drug addiction is the most common cause. Some minor

causes include gallstones or cystic fibrosis.

 Chronic pancreatitis induces the pancreas to deteriorate over time due to autodigestion.

Due to a deficiency of digestive enzymes, the patient develops malabsorption,

contributing to weight loss and malnutrition.

 Pancreatic cancer most often develops in the pancreas head and induces an obstruction of

the typical bile duct, necessitating the Whipple procedure. The most prevalent first

symptom of this disease is painless jaundice.

Unit 11: Neurological Disorders

Chapter 33: Cerebrovascular Disorders

 Stroke, also known as cerebrovascular accident (CVA), is the fifth most frequent cause of

mortality and the primary cause of injury in the U.S.

 Ischemic and hemorrhagic strokes are the two most common forms of stroke.

 An embolus or thrombus lodges and obstructs brain blood flow, resulting in an ischemic

stroke. Insufficiency of the vertebral-basilar arterial system can cause cerebellar

ischemia. Atrial fibrillation and carotid stenosis are the risk factors.

 Hemorrhagic stroke develops when a cerebral aneurysm ruptures and a cerebral artery

bleed inside the brain. Hypertension is a significant contributing factor.

 The middle cerebral artery is the most frequently damaged cerebral artery by stroke.

 Cerebral aneurysms are most often located inside the subarachnoid space on the circle of

Willis. A subarachnoid hemorrhage is a form of a cerebral hemorrhage.

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 Stroke is more frequent in African Americans, Hispanic Americans, and Native

Americans than in Caucasians.

 The corticospinal tract contains motor neurons that develop in the brain and move down

into the spinal cord. They join in the medulla at the decussation.

 The effects of ischemic or hemorrhagic damage on one side of the brain are experienced

on the other side of the body.

 Stroke symptoms include one-sided fatigue, lack of feeling in one extremity, facial

drooping, and slurred expression.

 A transient ischemic attack (TIA) is a significant risk factor for stroke and is

characterized by a stroke-like symptom that lasts minutes to hours before disappearing.

 A computed tomography scan is a screening procedure used to distinguish between an

ischemic and hemorrhagic stroke.

 In the case of an ischemic stroke, early therapy can save the nerves inside the ischemic

penumbra.

 The thrombolytic agent recombinant tissue plasminogen activator (rt-PA) can be used to

clear the thrombus in certain patients with ischemic stroke. Surgical thrombectomy may

also be done on ischemic stroke patients who are eligible.

Chapter 34: Chronic and Degenerative Neurological Disorders

 Dendrites, cell body, axon, and axon terminals are the neuron's four main anatomical

components. The dendrites of the neuron transmit signals from other neurons. Its axon

carries the outgoing call to other neurons.

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 The existence of an upper motor neuron dysfunction suggests that the condition is found

in the brain's motor control area. A lower motor neuron disorder indicates that the

condition arises from where the spinal cord's motor nerves exit.

 Ion channel disorders are causing an increasing number of neurological diseases. If a

patient is unconscious, the clinician can use the Glasgow Coma Scale, vitals, and pupil

responses to examine.

 Recurrent seizures are a symptom of epilepsy, which is a persistent neurological disorder.

A seizure is defined by a rapid, irregular, disorderly discharge of neurons inside the brain

that results in a temporary shift in brain activity. Generalized, tonic-clonic, and absence

seizures are among the many forms of seizures.

 Parkinson's disease is characterized by gradual depletion of dopamine-producing cells in

the substantia nigra, located inside the midbrain's basal ganglia. Resting tremors,

bradykinesia, and muscle rigidity are common symptoms.

 Amyotrophic Lateral Sclerosis (ALS) is a chronic neurodegenerative condition in which

upper and lower motor nerves are destroyed.

 Huntington's Disease (H.D.) is a neurodegenerative genetic condition caused by a single

mutant gene on chromosome 4 that directs the development of an irregular protein called

huntingtin, which accumulates in brain neurons. Movement disorders such as athetosis,

chorea, and ballismus are common clinical symptoms.

 Guillain-Barré Syndrome (GBS) is a form of acute peripheral neuropathy that develops

following an infection or vaccine and causes gradual limb weakening for days to weeks.
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 Autoantibodies attacking acetylcholine receptors in the neuromuscular junction triggers

myasthenia gravis (M.G.), an autoimmune disorder. Ptosis is mostly the first symptom of

the condition.

Chapter 35: Brain and Spinal Cord Injury

 Traumatic brain injury (TBI) is the unexpected physical trauma to the brain that may

occur due to a closed head injury, such as when the head collides with an immovable

surface or object.

 With brain injuries, some pathophysiologic changes result, such as changes in intracranial

pressure (ICP) and Level of Consciousness (LOC).

 Blunt injury, acceleration-deceleration, penetration trauma, and blast damage are the four

processes that can cause skull or brain damage.

 The Glasgow Coma Scale (GCS) is used to determine the seriousness of a brain injury. It

is established by ranking three areas: eye-opening, verbal response, and motor response,

and it combines both LOC and inclination.

 The coup-contrecoup system often triggers diffuse axonal injury (DAI), which results in

coma. Diffuse swelling of neural axons, brainstem hemorrhage, and laceration of the

corpus callosum are all symptoms.

 A concussion is a physiologic disturbance in brain activity that may induce a lack of

consciousness or not. It shows up by transient memory loss and a change in mental state.

 A cerebral contusion is a bruising of the brain tissue caused by a blow to the head.

Cerebral edema occurs as a result of elevated ICP, resulting in unconsciousness.

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 A skull fracture and a rupture of the middle meningeal artery induce an epidural

hematoma (EDH), while venous bleeding into the subdural space causes a subdural

hematoma.

 Injury to the spinal cord induces loss of movement or feeling is known as traumatic

spinal cord injury (SCI).

 The signs of SCI differ depending on how the neural tract is damaged. Motor deficits

arise from damage to the descending tracts, while sensory deficits result from damage to

the ascending tracts.

 Flaccid muscles, weakness, loss of feeling above and below the point of injury, and

bowel and bladder impairment are all primary spinal cord injury symptoms, which cause

areflexia.

 The American Spinal Injury Association (ASIA) evaluation tool is used to determine the

type of SCI by describing the injury's neurological extent.

Chapter 36: Psychobiology of Behavioral Disorders

 According to statistics, about 26% of the U.S. population suffers from a psychiatric

condition each year. Just 36 percent of those who are affected undergo medication.

 In clinical practice, the Mini-Mental State Assessment is the most widely used medical

procedure.

 Serotonin, norepinephrine, dopamine, and Gamma-aminobutyric acid are the brain's

primary neurotransmitters implicated in psychiatric disorder.

 The two prevalent forms of psychotherapeutic medication are cognitive-behavioral and

interpersonal therapy. Most mental conditions require the use of both drugs and

psychotherapy.
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 Generalized anxiety disorder, panic attacks, obsessive-compulsive disorder, unusual

phobias, social anxiety disorder, acute stress disorder, and posttraumatic stress disorder

are examples of anxiety disorders.

 In adults and the elderly, major depressive disorder is the most prevalent psychiatric

disorder.

 There are different kinds of antidepressants, including SSRIs, TCAs, MAOIs, and SNRIs.

It takes 3 to 6 weeks for them to achieve therapeutic blood thresholds.

 Schizophrenia is a psychotic disorder caused by a neurobiological disorder. Psychosis is a

mental illness in which the person suffering from it loses contact with reality.

 The most prevalent psychological condition affecting children in the United States is

attention deficit hyperactivity disorder (ADHD). Its cause is unclear. Amphetamines and

other psychostimulants are used in therapy.

 Alzheimer's disease and vascular disease are the two most common forms of dementia.

Amnesia, anomia, aphasia, apraxia, ataxia, and apathy are some of the symptoms. In

dementia patients, pharmacological interventions, including antipsychotic or sedative

drugs, are commonly used as first-line care.

 Delirium is an acute, usually reversible cause of cerebral dysfunction that manifests itself

in various neuropsychiatric symptoms. Drug poisoning, metabolic complications,

infection, electrolyte disruptions, and renal dysfunction are all common causes.

 Alcohol, tobacco, narcotics, opiates, amphetamines, and hallucinogens are the most

widely abused drugs. The CAGE questionnaire is an effective tool for determining

whether or not someone is suffering from alcoholism.

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 Addiction is defined by a compulsive desire for and use of a habit-forming drug and

tolerance and well-defined physiologic withdrawal symptoms.

 Drug tolerance increases as a person's reaction to a drug and its dosage decrease over

time, necessitating an increase in concentration to produce the desired impact.

Unit 12: Musculoskeletal Disorders

Chapter 37: Musculoskeletal Trauma

 Trauma is the primary cause of death for individuals aged 1 to 44 years. Traffic

accidents, physical activities, and osteoporosis are primary causes of musculoskeletal

trauma, varying from acute, life-threatening accidents to mild sprains and strains.

 The musculoskeletal system comprises the skeleton's muscles and bones and tendons,

cartilage, and ligaments. Peak bone mass is reached in early adulthood, between the ages

of 30 and 35.

 Astute evaluation skills are needed if musculoskeletal damage occurs as a result of high-

energy forces. Organ trauma, neurovascular injury, and collateral fractures are all

prevalent complications.

 A sprain is an overstretching of tendons and ligaments that can result from a tear. It is

most often noticed in the ankle. A strain is a muscle contraction or overstretching that

most usually affects the lower back and hamstring.

 Cumulative trauma conditions develop as sections of the musculoskeletal structure are

often moved, causing wear and tear wounds.

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 Rest, ice, compression, and elevation (RICE)are the first remedies for most

musculoskeletal injuries. Often monitor pulses and sensation distal to a musculoskeletal

injury to determine neurovascular status.

 When tissue pressure exceeds perfusion pressure in an enclosed anatomical cavity,

compartment syndrome occurs.

 Compound and open fractures are susceptible to infection.

 Vertebral compression fractures diagnose osteoporosis. In older people with osteoporosis,

the hip, wrist, and vertebrae are the most frequently broken bones.

 The shoulder is the body's most often dislocated joint. When the passive and active

ranges of motion of the shoulder are reduced, it is diagnosed as a frozen shoulder.

 Knee traumatic injury is the second most frequent work-related injury. The most often

damaged ligament in the knee is the middle collateral ligament.

 How the trauma resulted is crucial to the diagnosis. Physical examination outcomes

always indicate malformation, discomfort, and lack of mobility.

Chapter 38: Degenerative Disorders of The Musculoskeletal System

 Osteoporosis is a bone demineralization condition that develops as people age.

Osteoporosis may be caused by a lack of calcium or vitamin D in the diet, lack of

mobility, gender, age, genetics, and specific therapies. Compression fractures of the hip,

wrist, or vertebrae are common.

 A dual-energy x-ray absorptiometry (DEXA) scan is used to visualize bone mineral

density (BMD) to diagnose osteoporosis. Osteoporosis is treated with calcium and

vitamin D supplements, bisphosphonates, and calcitonin.

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 Osteoarthritis (O.A.) is a form of arthritis that progresses as people grow older. Obesity,

repeated joint trauma, age, and genetic predisposition are all factors that put patients at

higher risk for O.A. Osteophytes are classic offshoots of osteoarthritic bone surfaces that

can inflict pain by impinging on nerves.

 Impingement of spinal nerves is a common symptom of degenerative disc disease

(DDD). The intervertebral discs of the cervical and lumbosacral backbone are the most

frequently afflicted. Sciatica is the most prevalent DDD caused by impingement on the

sciatic nerve, which induces discomfort to radiate down the leg.

 Radiculopathy is the result of a herniated disc impinging on a spinal nerve. A typical

symptom of spinal nerve impingement is fatigue or paresthesias in an extremity.

 In infants, osteomalacia, also known as rickets, is bone degeneration induced by

hyperparathyroidism or a lack of calcium or vitamin D in the diet.

 O.A. can show up like rheumatoid arthritis (R.A.); however, R.A. is an autoimmune

disease. Fever, a raised WBC count, and other signs of inflammation are all

manifestations of R.A. In R.A., the joints are also not affected in the same way as they

are in O.A., and there is further joint deformity.

 Plain x-rays are often used to diagnose degenerative disorders of the musculoskeletal

system. However, x-rays are always ineffective, necessitating using C.T. scans, DEXA

scans, or magnetic resonance imaging.

 Nonsurgical procedures for DDD usually include NSAIDs, epidural steroids, and muscle

relaxants.

Chapter 39: Infection and Inflammatory Disorders of The Musculoskeletal System

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 Inflammatory musculoskeletal diseases affect a large percentage of the adult population.

Except in the case of an open injury, musculoskeletal infections are unusual.

 The bacteria S. aureus is the most frequent cause of osteomyelitis (infection of the bone).

Because of reduced distal blood supply and immunosuppression, persons with diabetes

mellitus are at a greater risk for osteomyelitis of the lower extremities.

 Conditions in diabetes mellitus, including lack of feeling and reduced circulation in the

lower extremities, favor bacteria growth; gangrene frequently precludes amputation.

 People that live in deer-infested areas are susceptible to Lyme diseases. The deer tick

carries the bacterium B. burgdorferi. It does not cause illness until it bites a person and

injects bacteria into the bloodstream.

 Septic arthritis is a musculoskeletal infection caused by a staphylococcus infection in a

joint. That may also happen as a result of a sexually transmitted gonorrhea infection.

 Autoimmune diseases, in which the body develops autoantibodies for unexplained

causes, are the most frequent cause of musculoskeletal inflammatory disease.

 Gout is one of the inflammatory diseases that can be caused and worsened by some risk

factors before being treated and managed.

 Ankylosing spondylitis is a condition in which the intervertebral disks, underlying

ligaments, and vertebrae, mainly in the sacroiliac joints, calcify and ossify. The spine will

become rigid and inflexible.

 Polymyalgia rheumatic (PMR) is an inflammatory condition that most frequently

involves the shoulder girdle muscles.

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 During the examination, the clinician should check for erythema, tenderness, swelling,

discharge, onset, location, and length of symptoms infuriating and mitigating factors,

pain severity, and systemic symptoms Fever.

 Complete blood count (CBC) with differential, erythrocyte sedimentation rate (ESR), and

C-reactive protein (CRP) are both vital signs of inflammation or infection in the patient.

 In bacterial or inflammatory musculoskeletal conditions, anti-inflammatory and antibiotic

agents such as cortisone, which can be inserted directly into a bone, are widely used.

Unit 13: Cancer

Chapter 40: Cancer

 A cancerous neoplasm is an irregular mass of tissue that expands uncontrollably and

thrives at a rate that is faster than typical tissue. Cancer is the second major cause of

death following heart disease.

 Tumor suppressor genes, which protect against cancer development, are deficient in

specific cancers. Mutations cause other cancers in proto-oncogenes, which are genes that

govern cell growth and proliferation. Cancer may also be triggered by defective cellular

apoptosis pathways that do not correctly activate programmed cellular degeneration.

 The degree to which neoplastic cells resemble normal cells both structurally and

functionally is referred to as differentiation. Anaplasia refers to a loss of distinction.

 Benign tumors are well-differentiated, remaining localized, cohesive, and well-

demarcated from the underlying tissue. Malignant tumors may be well or poorly

differentiated, but they are often aggressive and disruptive to the surrounding tissue.
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 The TNM system is used to identify cancer tumors based on their size, invasiveness, and

distribution. T stands for tumor size, N for lymph node dissection, and M for distant

organ metastasis.

 The presence of cancer in the body induces paraneoplastic syndrome, which is an

uncommon pathological condition.

 Tumor cell indicators are hormones, enzymes, genes, antigens, or antibodies present in

the blood, spinal fluid, or urine produced by cancer cells. Some are called oncofetal

antigens as they are typically noticed during fetal development.

 Lung cancer is the world's leading cause of cancer-related mortality in both men and

women.

 An inflated left-sided supraclavicular lymph node is known as Virchow's node. It may be

a symptom of cancer in the breast, lung, or abdomen.

 Preinvasive cervical cancer can be detected at the earliest stages using a Pap smear. In

more than 90% of cases, HPV is the cause of cervical cancer.

 Nulliparity is linked to an increased risk of breast, vaginal, and uterine cancer in women.

 Brain and spinal cord metastasis from other primary cancer sites are more prevalent than

primary central nervous system (CNS) tumors.

 Hematuria that is not painful may be a symptom of bladder or kidney cancer.

 The vertebral bones are often damaged by prostate cancer.

 Oral cancer risk is 40 times higher among cigarette and alcohol consumers than non-

smokers and non-drinkers.

Unit 14: Integumentary Disorders

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Chapter 41: Skin Disorders

 The epidermis, dermis, and subcutaneous tissue of the skin form the integumentary

system, connecting the dermis to muscles and accessory structures. Skin conditions,

varying from inflammatory and infectious lesions to skin cancers, affect about 30% of all

Americans.

 A rash is a transient eruption of the skin caused by childhood infections, allergies, heat,

clothing exposure, or a drug reaction.

 A painful or pathological disruption of natural skin continuity, structure, or function is

referred to as a lesion. Psoriasis lesions are erythematous and covered with silvery, white

scales that bleed when extracted.

 Dysplastic nevi are irregularly shaped, variegated-colored lesions with a high risk of

cancerous transformation. To rule out skin cancer, these lesions must be examined

clinically.

 Fair-skinned people are more likely to develop actinic keratosis, a premalignant lesion

that occurs on sun-damaged skin.

 Malignant melanoma appears to have one or more ABCDE characteristics: Asymmetry

of shape, unpredictable Borders, Color difference Diameter above 6 mm, and an evolving

lesion.

 The most prevalent form of skin cancer, basal cell carcinoma, is identified on the face

and seldom spreads to other body areas.

 Human papillomavirus causes warts, which are harmless skin lesions.

 Erythema migrans is a skin rash caused by tick bites bearing the bacteria B. burgdorferi,

which can induce Lyme disease after perforating human skin.

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 Bed bugs are insects that are linked to dirty mattresses or bedding. Lice infestation is

associated with low levels of hygiene. Anaphylaxis is related to wasp and bee stings.

 Eczema, the most prevalent dermatitis, is defined by vesicle forming, oozing, irritation,

and excoriation, which occurs on the cheeks and progresses to the scalp, arms, trunk, and

legs.

 Pityriasis rosea starts as a single patch known as a Herald patch on the neck or trunk.

 Scleroderma and systemic lupus erythematosus (SLE) are autoimmune disorders with

distinct skin symptoms. Scleroderma allows the skin to become excessively rigid and

shiny, while SLE causes an erythematous appearance.

Chapter 42: Burns

 Burns are the third leading cause of premature deaths in the U.S. and can lead to injuries

ranging from minor to fatal. They are classified as electrical, chemical, thermal, or

radiation injuries.

 The degree of heat intensity, length of contact, and thickness of the skin at the point of

contact all influence a burn's extent.

 When people get burnt in a confined area, they get inhalation injuries and C.O. toxicity.

The CO level should be measured for such patients.

 Internal contamination can occur from the inhalation, ingestion, or intrusion of

radioactive contaminants by open wounds, resulting in acute radiation syndrome (ARS).

 The treatment for ARS focuses on decontaminating the patient by removing and bagging

their clothing and shoes, which typically eliminates more than 80% of radioactive

content.

 Electrical shock can result in irregular heart conduction, like cardiac arrest.
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 Thermal injury causes tissue trauma in three phases: coagulation, stasis, and hyperemia.

If it covers more than 30% of the total body surface area, typical physiologic organ

activity is impaired.

 The principle of nines, which splits the body into regions of 9 percent or multiples of

nine, is a standard way of measuring the degree of burn injury.

 According to the American Burn Association Classification of Burn Injury, Burns are

classified as mild, moderate, or severe, which considers both the degree and extent of the

burn.

 The ABCDEF (airway, breathing, circulation, disability, exposure, and fluid

resuscitation) facets of pain management are at the center of burns treatment.

 A severe burn injury can result in respiratory, renal, and gastrointestinal injuries, in

addition to localized tissue damage. Acute tubular necrosis, which results in acute renal

failure, may be caused by myoglobinuria.

 If the burn patient stays immobile, contractures may develop; active and passive physical

activity and exercise are essential.

 Excess swelling or fluid retention inside the musculoskeletal chambers may cause

compartment syndrome.

 Infection is the leading cause of death for major burn survivors.

 Burns are sometimes treated with silver nitrate and other silver formulations as

antibiotics.

 Debridement is the process of removing dead, necrotic, or contaminated tissue to enhance

the remaining healthy tissue's ability to heal. It induces discomfort, necessitating the use

of opioid medications.
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Unit 15: Sensory Disorders

Chapter 43: Eye Disorders

 The eye is a complex sensory organ with a wide range of functions. It helps people to

interpret their surroundings by transmitting pictures to their brains continually.

 Age-related macular degeneration (AMD) is the primary cause of blindness in

Caucasians; cataracts and glaucoma account for more than 60% of blindness in Black

Americans. Trachoma, a Chlamydia-related virus, is a significant cause of blindness in

developing nations.

 The macula, a small region of the eye that supports central vision, deteriorates in AMD.

If the macula degenerates, the patient's central vision deteriorates, and a blind spot forms

in the middle of his or her visual field.

 A cataract is a clouding of the cornea induced by lens overgrowth that most often affects

older people.

 Glaucoma is one of the most common preventable causes of blindness worldwide. It is

induced by a rise of intraocular pressure (IOP), which causes pressure on the optic nerve,

resulting in nerve injury and blindness.

 Increased intracranial pressure causes papilledema, which is the swelling of the optic

disc.

 The World Health Organization uses specific criteria to identify visual deficiency and

blindness. Amblyopia, hyperopia, astigmatism, presbyopia, myopia, and color blindness

are examples of various forms of vision disability. To improve vision, multiple lenses are

used.
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 Myopia, presbyopia, and hyperopia can all be corrected with laser-assisted in situ

keratomileuses (LASIK), also known as laser eye surgery.

 Staphylococcus aureus is the most common cause of eyelid infection.

 Conjunctivitis, or inflammation of the conjunctiva, may be caused by bacteria, viruses, or

allergies.

 Corneal abrasion is the most frequent form of structural eye trauma. It involves injury to

the cornea's epithelial surface, typically caused by a foreign object coming into contact

with the eye.

 Fluorescein dye installation in the vision and examination with a blue cobalt light, which

shows the wound region, are necessary for diagnosis.

Chapter 44: Ear Disorders

 The external, middle, and inner ear compartments make up the ears, which are a pair of

organs. The external and middle ears are responsible for collecting, magnifying,

distributing, and absorbing sound.

 Sound waves activate sensory organs in the inner ear, distributed via a complex

interconnected network of systems and converted into neural impulses, which are sent to

the brain by the auditory nerve, also known as CN VIII.

 Decibels (dB)are used to measure the level of hearing. A gentle whisper is between 0 and

20 decibels. The average frequency of a typical conversation is about 60 decibels. Noise

injury and hearing loss can be caused by sounds more significant than 85 decibels.

 The condition of sound propagation from the external or middle ear to the receptors in the

middle ear is known as conductive hearing loss (CHL). Otitis media (O.M.) and cerumen

impaction are the most frequent causes.

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 Sensorineural hearing loss (SNHL) is a form of hearing loss caused by complications

with the brain's inner ear, auditory nerve, or auditory processes.

 Tinnitus, also known as ringing in the ears, is the sensation of abnormal noises in the ear

or head. The feeling that the room is revolving around you is known as vertigo.

 Connexin-26, a biomarker for hereditary deafness, can be measured using a specific

blood test. The test detects the existence of the DFNB1 gene, which codes for GJB2, a

protein that controls endolymph makeup.

 Infectious agents, external irritants, and allergic reactions are common causes of otitis

externa (O.E.), which is inflammation of the outer ear.

 Otitis media is an inflammation caused by a buildup of fluid in the middle ear. It can

affect people of any age, but it is more prevalent in childhood.

 Ménière's disease is induced by a rise in the volume of endolymph in the membranous

labyrinth, which causes distension in this part of the inner ear. Progressive loss of

hearing, vertigo, and tinnitus are all symptoms of this condition.

 Vestibular schwannomas are harmless tumors that form when the Schwann cells that

envelop CN VIII contract and make it malfunction.

 Hearing impairment affects older adults due to presbycusis or degenerative changes. The

depletion of hair cells triggers the symptoms in the cochlea over time.

Unit 16: Disease Across the Life Span

Chapter 45: Pediatric Disorders

 Pediatrics is the field of medicine that deals with the welfare of infants, kids, and

teenagers. A stable gestational cycle is vital to the newborn's wellbeing.

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 Transesophageal fistula, an unusual connection of the esophagus and trachea, is a

prevalent congenital disability.

 Gastroschisis is an abdominal wall weakness that causes the intestines to protrude

through the umbilical cord cavity, resulting in an omphalocele.

 The talipes equinovarus and congenital hip dysplasia, which develops when the femur's

head is not in anatomical contact with the acetabulum and the joint are unstable, are two

typical musculoskeletal genetic disorders.

 Neuroblastoma is a widespread tumor of the sympathetic nervous system in kids. The

most prevalent abdominal tumor in children is nephroblastoma.

 Congenital abnormalities in the fetus are caused by Toxoplasmosis and Treponema

pallidum pathogens and Rubella, Cytomegalovirus, Herpes simplex, and HIV infections.

 Exanthems are rash-causing diseases in children, such as measles, rubella, roseola,

erythema infectiosum, Scarlet Fever, and varicella-zoster.

 Kawasaki disease is a form of systemic vasculitis that only affects babies and small

children. It may induce aneurysms in the coronary arteries.

 Apnea, the failure of breathing, is related to prematurity, but it may also affect full-term

and healthy babies.

 Croup is caused by a viral infection that induces inflammation in the upper respiratory

tract, resulting in stridor and a "barking" cough.

 Colic is a typical infancy condition marked by regular, abrupt bouts of crying, which tend

to occur in the evenings.

 Fetal alcohol syndrome (FAS) is a condition that affects infants who were subject to

excessive maternal alcohol intake when they were still in the womb.
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 Reye syndrome is a disease that develops following a viral infection such as influenza,

influenza, or coxsackievirus, both of which are prevalent causes of upper respiratory

infection in kids. It is also linked to the application of aspirin to toddlers.

 Lead poisoning is often seen in kids ages 1 to 3 years because of hand-to-mouth conduct.

It may lead to cognitive problems and anemia when inhaled, swallowed, or consumed by

the transdermal application.

Chapter 46: Pathophysiologic Concepts of Aging

 Epidemiological studies indicate that American women's average life span is roughly 81

years; for men, 76 years. Individuals aged 85 and older are the fastest-growing group of

the elderly population in the United States.

 The end fragments of chromosomes—telomeres—shorten each time the cell divides in

mitosis, according to the telomere shortening theory of aging.

 The damage-based theory of aging states that cellular damage accumulates over time due

to harmful metabolic byproducts or ineffective cellular repair mechanisms.

 Atherosclerosis, tightening of the elastic blood vessels, diastolic dysfunction of the heart,

and connective tissue penetration of the heart's conductive tissues are all changes that

occur in the older adult's cardiovascular system.

 A less porous thoracic cage restricts lung expansion with inhalation, and a reduced cough

reflex improves secretion stasis in the lungs, among other respiratory changes in the

elderly.

 Renal changes in the elderly include a reduced kidney's capacity to remove waste

products from the blood and a lower glomerular filtration rate, all of which relate to drug

toxicity.
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 Reduced peristaltic function, which raises constipation vulnerability; atrophy of the

stomach lining and intestinal villi; and reduced pressure of the lower esophageal

sphincter, which makes acid reflux are all gastrointestinal changes observed in the

elderly.

 Integumentary changes in the elderly include the lack of sweat glands, hair follicles, and

sensory end organs, making thermoregulation problematic. Skin also becomes less elastic

and lighter, making it more vulnerable to breakdown.

 The older adult's musculoskeletal changes have an elevated risk of osteoporosis when an

osteoclastic activity starts to surpass osteoblastic function.

 Increased pain threshold, which may interfere with defensive behavior, and increased

difficulty with sight, sound, and taste are also examples of nervous system changes in the

elderly.

 Cognitive changes in the elderly are never natural and must still be adequately evaluated.

Cognitive dysfunction is commonly caused by vascular dementia, Alzheimer's disease,

and frontotemporal dementia.

 Geriatric syndromes are medical problems prevalent among older individuals induced by

urinary incontinence, falls, pressure injuries, delirium, and impaired functioning.

 The Beers criteria for possible unsafe drug usage for older adults may be recognizable to

clinicians who deal with them.

Chapter 47: SIRS, Sepsis, Shock, MODS, And Death

 Patients with serious diseases such as SIRS, septic shock, sepsis, and multiple organ

failure syndromes (MODS) are often treated in intensive care units.

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 SIRS refers to Extreme Inflammatory Response Syndrome. Inflammation may arise from

a variety of sources, both infectious and non-infectious. Sepsis is identified when a

patient satisfies the SIRS criterion and has a known or suspected cause of infection.

Bacteria, fungi, viruses, and parasites may all cause the condition.

 Septic shock is identified when a patient fits the extreme sepsis criterion and has sepsis-

induced vascular dysfunction, such as hypotension, that is resistant to fluid resuscitation.

 MODS is a disorder in which two or more primary organ systems in a chronically ill

patient have become increasingly unstable and cannot sustain homeostasis without drug

therapy.

 Shock is categorized into five diverse classifications: septic, hypovolemic, cardiac,

neurogenic, and anaphylactic shock.

 There are three levels of shock. Tissue perfusion decreases quickly during the early

stages of shock. If this is not addressed immediately, a progressive period of shock

develops. The lungs, kidneys, gut, pancreas, and, ultimately, the heart and brain's

protected regions undergo cellular damage and cease functioning correctly. The

permanent stage of shock occurs when a surprise is not halted during the progressive

phase.

 Acute kidney injury (AKI) is most often affected by kidney hypoperfusion or sepsis-

related drugs such as aminoglycosides, vancomycin, and iodinated IV radiological

contrast media.

 IAH causes reduced ischemia of the gastrointestinal organs, which can result in ischemia

and tissue necrosis.

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 Disseminated intravascular coagulation (DIC) is a condition in which the coagulation

cascade is interrupted, resulting in cycles of bleeding accompanied by periods of clotting.

 The term "death" refers to the loss of consciousness. For a patient to be afflicted with

brain death, some neurological conditions must be followed. The neurological test is the

universal standard for assessing brain death.