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what is chronic kideny deases
slow, chronic decline of renal functions. This when >75% kidney function is lost.
caused by damage accumulated from other chronic diseases or AKI
irreversible
what does kidney failure cause
accumaltion of waste Water imbalance Salt imbalance Long-term blood pressure out of control Acid/base imbalance of blood
what is acute kidney injury
sudden damage to the kidneys that causes them tonot workproperly. It can range from minor loss of kidney function to complete kidney failure.
normally a complication of another serious illness.
usually reversible if treated quickly
what does renal failure lead to
Impaired renal excretion results in accumulation of waste and toxins in body fluids
Leads to disruption in endocrine and metabolic function, fluid, electrolyte and acid-base disturbances
what is renal failure
When kidneys unable to remove body’s metabolic waste
Unable to perform regulatory functions
what is the biliary trees
biliary tree is a system of vessels that directs these secretions from the liver, gallbladder and pancreas through a series of ducts into the duodenum.
where is bile stored
The liver makes bile which is stored in the gallbladder.
what is bile
The bile ducts carry bile. This is a fluid that helps to digest food by breaking down fat.
what is the bile duct
The bile ducts are part of the digestive system. They are the tubes that connect the liver and gallbladder to the small bowel.
what is the role of motor neurons
controlling the various activities of the body that involve muscle movement including walking, running, speaking, swallowing, breathing and gripping
what is the treatment of a mallory - weiss tear
Self limiting in 80-90% of cases (stop bleeding and heal on its own) injection or a heat treatment to stop bleeding Surgical repair (rare)
what are the signs and symptoms of a mallort weiss tear
haematoemesis vomiting of bright red or coffee grounds blood Melaena (stool with blood) - dysphagia/odynophagia anaemia fatigue, dizziness, faintness shortness of breath abdominal or chest pain
what are the causes of a Mallory-Weiss Tear
Causes:
violent coughing, retching, vomiting and/or straining (common cause)
hiatal hernia (rare)
childbirth (rare)
what is a traumatic brain injury
an external force results in temporary or permeant brain dysfunction
give some signs and symptoms of a traumatic brain injury
Traumatic brain injury can have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later
who’s most at risk of a traumatic brain injury
The people most at risk of traumatic brain injury include:
Children, especially newborns to 4-year-olds
Young adults, especially those between ages 15 and 24
Adults age 60 and older
Males in any age group
what causes a dramatic brain injury
Traumatic brain injury is usually caused by a blow or other traumatic injury to the head or body. The degree of damage can depend on several factors, including the nature of the injury and the force of impact.
Common events causing traumatic brain injury include the following:
Falls.
Vehicle-related collisions.
Violence.
Sports injuries.
Explosive blasts and other combat injuries.
Penetrating wounds
Severe blows to the head with shrapnel or debris, and falls or bodily collisions with objects following a blast.
what are the symptoms of Caudia equina
Urinary retention
Urinary and/or fecal incontinence.
“Saddle anethesia” sensory disturbance, which can involve the anus, genitals and buttock region.
Weakness or paralysis of usually more than one nerve root.
Pain in the back and/or legs
Sexual dysfunction.
what are the causes of goitre
Iodine Deficiency:
Graves’ Disease:
In this condition the immunes system mistakes the thyroid gland for foreign and beings to attack which causes it to produce excess thyroxine.s.
autoimmune disease that can cause damage to the thyroid
Thyroid Cancer
Pregnancy
Inflammation
what is the role of the thyroid
The role of the thyroid is to produce two main hormones: thyroxine triiodothyronine (T-3). The role of these is to regulate the metabolism
what is goitre
Goitre is an abnormal enlargement of the thyroid gland.
what are the signs and symptoms of goitre
A swelling at the bottom of the neck that might be obvious to see as well as palpate
- Tight feeling in throat
- Coughing
- Hoarseness in voice
- Dysphagia
- Difficult in breathing
what is the risk factors to goitre
-Iodine deficiency
-Female
-Over 40
-Medical history of autoimmune diseases
-Pregnancy and menopause
-Medications such as amiodarone and psychiatric drugs containing lithium
–Radiation exposure
what is gastric motility
Paralysis of the stomach (fails to empty content into intestine)
what is the cause of gastric motility
- diabetes (most common cause -1/3 of the cases)
- neurological disorders such as MS, Parkinson’s disease
- connective tissue disorders
- post surgical complications
what are the signs and symptoms of gastric motility
Stomach/abdominal pain, bloating, heartburn, nausea, vomiting, early satiety, malnourishment, dehydration, weight loss, fatigue
how to diagnose gastric motility
Gastric Emptying Study (GES) using radioactive material traced by a scanner
Upper endoscopy
Barium x-rays
Wireless motility capsules (SmartPill)
what is the treatment for gastric motility
Dietary changes (small, frequent meals low in fat and fibre)
Medication to increase motility
Symptom management medications
Surgeries and/or feeding tubes, total parenteral nutrition
what is alcoholic induced liver disease
alcohol is sent to the stomach which is sent to the liver for processing
the liver breaks down alcohol leading to the liver making more fatty acids
this causes the liver to get large, heaver, greasy and tender
what is the treatment to jaundice
phototherapy
what are the causes jaundice
viral hepatitis
drugs / alcohol
cirrhosis (permeant damage to the liver )
explain the pathophysiology of jaundice
billrubin
red blood cells breakdown when they are old
this leaves high levels of uncondrigated bilirubin in the blood
this is then sent to the liver to congregate the bilirubin
if the liver is damages and cannot conjugate bilirubin
leads to an increase of bilirubin in the blood
what is jaundice
yellowing of the skin and eyes
what are the symptoms of hepatitis
fever
nausea
enlarged liver causing pain
what is the pathophysiology of hepatitis
virus targets the cells in the liver
infect the cells so immune cells attack the liver
they recognise these proteins shouldn’t be their
cytotoxic killing happens
cuasing inflammation and liver death
what is hepatitis
inflammation of the liver due to a virus
what is the pathophysiology of portal hypertension
obstruction prevents blood flow
blood accumulates in the portal system
causing pressure to rise above 12mmhg (this causes portal hypertension)
this stops the liver being able to perform its function approitay
what is portal hypertension
high blood pressure in the hepatic portal system
what are the symptoms of hemochrombtosis
joint pain
adominal pain
fatigue
bonze or grey skin
what are the complication of hemochrombtosis
liver gets mostly left over iron leading to liver choruses
comlication depends on where iron is absorbed
explain the pathophysiology of hemochrombtosis
extra iron is disposeted in organs mostly the liver
slowly damages the cells and causes cell death
this is due to a genetic mutation in chromosome 6 leading to unable to regulate the iron being let into the blood stream therefore to much is let in
at what age is hemochrombtosis diagnose
age 50 plus in men
10-20 years after the menopause
what is hemochrombtosis
metabolic disorder where the body absorbs to much iron- it leads to elevated iron in the blood
what is the function of the kidney’s
Removal of waste (anything not necessary or toxic)
Water balance (water in = water out)
Salt balance (homeostasis of blood osmolarity)
Long-term blood pressure homeostasis
Acid/base balance of blood
what are the signs and symptoms of kidney stones
Pain
Haematuria (blood in urine)
Raised temperature
Nausea and Vomiting
explain the pathophysiology of anaphylaxis
these cells are preformed to the thing and individual is allergic to
an antigen enters the body- what they are allergic to
helper t-cells that suited for the specific antigen recognise the antigen
immune cells comes as back up from a B-cell (these produce antibodies)
makes IgE cells- these bind to cells that produce inflammatory agents (Mast cells)
this causes hives, swelling and closing of the airways
what is secondary hyperthyroidism
causes by overstimulation by the thyroid- pituarty producing to much TSH
what is primary hyperthryoism
causes by thyroid pathology- abnormally producing to much thyroid hormone
what is hyperthyroidism
anxiety sweating tachycardia weight loss fatigue frequent loss stools
what is a thyroid storm
more acute severe presentation- more serve symptoms
what is the pathophysiolgy of hyperthyroidism
increase synthesis and secretion of bodys t3 and t4
what is hyperthyroidism
elevated thyroid hormone levels- thyroid producing to much thyroxine
what is the causes of Addison’s disease
autoimmune destruction - immune system attack healthy tissues in adrenal Cortex
what is primary adrenal insufficiency
adrenal cortex gets progressively damaged over time
what is Addison’s disease
adrenal gland can’t produce enough horses the body needs
what is anaphylaxis ?
immune response that the body uses against allergies antigens
What is a Mallory- Weiss tear
Test of the tissues in the lower esophagus
What is Pyclonephritis
Inflammation of the kidney that develops quickly—>usually a result of bacteria infection
The infection starts at the lower urinary system and makes it’s way towards the kidney
Common cause:upper urinary infections, faliure of the valve that stops Urine flowing backwards
Risk factors for Pyclonephritis
Female sex
Sexual intercourse
Catheters
How does Pyclonephritis happen
Starts by bacteria attaching to the epithelium in the kidney—>triggers and inflammatory response—>white blood cells are weed out
Symptoms of Pyclonephritis
Fever Chills Pain when peeing Nausea Vomiting
Treatments for Pyclonephritis
Antibiotics
Staying hydrated
Kidney stones
Substances stick together forming crystals or stones—>kidney removes excessive calcium into our urine—>builds up and sticks together—>overtime forms a stone
3 step process
Crystallisation
Aggravation
Crystal growth
Eventually get too large to pass
Diagnosis of kidney stones
Urine analysis
Ultra sound
CT
X-ray
Risk factors of Kidney stones
Male
Age
Family history
Dehydration
Overall meaning of cardiomyopathy
Cardiomyopathy is a general term used for a disease of the heart muscle, where the walls of the heart chambers have became stretched,thickens or stiffens
Dilated cardiomyopathy
The muscle walls become stretched and thinner, so they cannot contract properly to pump blood
Hypertrophic cardiomyopathy
The heart muscle enlarge and the walls of the heart chambers thicken, the heart chambers reduce in size and cannot hold as much blood therefore meaning the walls cannot relax and may stiffen
Restrictive cardiomyopathy
The walls of the main heart chambers become stiff and rigid and cannot relax properly after contracting
Polycystic kidney disease
Genetic disease which the kidneys become filled with hundreds of cysts causing them all to be larger
They develop in both the outer layer(cortex) and the inner layer(medulla)
What is the pathophysiology of polycystic kidney disease
Cysts fill with liquid and get bigger overtime—>this can cause blood vessels to be compromised—>this can starve the blood vessels of oxygen—>can lead to hypotension
Meningitis
Affects the menigines
3 protective layers around the brain and spinal cord “inflammation of the meniges” two inner layers
Cerebrospinal fluid: clear watery fluid which is pumped around the spinal cord and brain, cushions them for impact.
Inflammation trigger
autoimmune-where the body attacks itself
Direct spread of meningitis
Pathogen gets inside the skull or the spine and penetrates the meniges, ends up in the cerebral spinal fluid
Causes: pathogens comes up the nose or through the skin
Skull fracture: bacteria, virus, fungal
Hematogenus spread-Pathogens enters the blood stream—>moves through the endothelial cells into the blood vessels—>gets into the celebrum spine fluid—>it’s then starts to multiply—>white blood cells then respond
Symptoms of meningitis
Headache Fevers Neck stiffness Photophobea Altered mental state
Diagnosis
Kernigs spine
Lumbar puncture
Treatment
Antibiotics,steroids,drug treatment
What is Multiple sclerosis
It effects the brain and spinal cord
Myelin is the sheath that surrounds the axons of the neurons, allows them to send electrical impulses
What happens during MS
The immune system attacks and destroys then myelin—>leads to a breakdown in communication—>leads to sensory,motor and cognitive problems—>blood brain barrier only lets certain molecules and cells through—>immune cells are only allowed through if they have the right surface molecule—>once t-cells get through and activates on the mylin, it sends more t-cells to the sight—>t-cells release cytokines that help dictate the blood vessels allow loads of immune cells in response—>they then cause inflammation and release antibodies that start to damage the mylien—>this leaves behind areas of scare tissue
Causes and symptoms of Multiple sclerosis
Genetics Female Gene coding Environmental factors infection Vitamin D deficiency
Symptoms Difficulty in speaking Tremors Involuntary eye moment Fatigue Loss of balance/dizziness
Diagnosis
MRI scans
Treatment
Medications
Immunosuppressants
B-cells and T-cells
B-cells recognise antigens
Engulfs, antigens once they are binded to receptors—>realises lymphoids that multiply by mitosis allowing duplication of b-cells—>also releases plasma that releases antibodies
Cytokines-signalling proteins—> leads to inflammation—>recit and activate more cells of immune system
T-cells have t-cell receptors that are specific to a single antigen
What two hormones control the glucose in the body
Insulin and glucagon
What is glucose
A source of energy
What is insulin
Hormone produced by beta cells in the pancreas
Can bind to insulin receptors in cell membranes allows glucose to be transported into the cell
What is glucagon
Realised by alpha cells
Gets liver to generate new molecules of glucose
Breaks down into glucose
All gets into blood
Diabetes type 1 and 2
Type 1- Dosent produce enough insulin, type 4 hypersensitivity response, where T-cells attack the pancreas in particular, the beta cells, means less insulin is produced and glucose remains in the blood as it can’t enter the beta cells
TYPE 2- bosh tissues don’t respond well to insulin, body providing enough insulin but cells don’t react to transport->cells are insulin resistant->leads to body realising more insulin to get the same effect->does this by increasing beta cells attempt to make more insulin
Diabetic ketoacidosis
Ketone bodies-increase acidity In blood->this can have major effects on your body->lead to laboured breathing->reduce co2 to overall reduce acidity
Symptoms-nausea,vomiting,mental changes,fruity breath
Treatment-fluids for dehydration,insulin to lower blood glucose levels,replacement of electrolytes
Hypoglycaemia-glucose Levels low
Hyperglycaemia-glucose level high
Hypoglycaemia-imbalance in glucose production and use of glucose( can lead to death)
Causes
Tumors
Metabolic errors
Excessive insulin
Symptoms Tremors Shaking Tachycardia Same symptoms as a stroke
Symptoms and risk factors for diabetes
Symptoms Hungry(polyphagia) Increased wee(Glucose wee) Glucose wee(polypharia) Increase thirst(polyclipsa)
Risk factors
Obesity
Lack of exercise
Hypertension
What is hyperglycaemia
Medical term for high blood sugar
It can effect people with type 1 and 2 diabetes as well as pregnant women with gestational diabetes
Not injecting insulin properly or expired insulin
Not using enough insulin or oral diabetes medication
Being inactive
Having illness or infection
Using meds such as steroids
Being injured or having surgery
Emotional stress
Treatment for diabetes
Insulin therapy
What is Parkinson’s
Progressive neurological condition where your brain gets damage overtime
Symptoms- Tremors Postural instability Vision problems Rigidity Freezing Slow movement Stiff movement
Causes
Not enough chemical dopamine(this is caused by a loss of nerve ending cells)->chemicals that inflict movement->causes symptoms
Caudi equina
Collection of nerves at the end of the spinal cord is called caudiequina
Carnes nerves that control the bladder as nerves for the movement of legs
Extreme pressure or swelling at the nerve endings of the spine
Types of encephalitis
Primary-occurs when a virus directly effects the brain, can be concentrated in one area or widespread
Secondary-results from a faulty immune system reaction to an infection elsewhere in the body, instead of attacking only cells In the body causing infection the faulty immune system also attacks the healthy cells in the brain, normally occurs 2-3 weeks after initial infection
Causes-
Viruses
Autoimmune and metabolic
Risk factors
Young and old
People who have immune compromise
Signs and symptoms Headaches Aches and pains Feeling generally unwell Fever Altered mental state
Gastric erosion
Mucous membrane lining the stomach becomes inflamed
Stomach ulceration
Open sores that develop in the stomach lining
Signs and symptoms
Pain in center of stomach
Indigestion
Heartburn
Causes Layer protecting the stomach lining from acid breaks down Leads to a damaged stomach lining Infection Long term anti inflammatory drugs
Common in men over 60
Gastric-intestinal varices
Swollen burns found in the stomach and oesophagus->often occurs due to pressure on the liver->or abnormalities with portal veins
Haemotenits
“Vomiting blood”
Coffee ground colour-due to bring partially digested In the stomach
Upper GI tract->as blood is lost the total volume blood is decreased->cause construction in blood vessels->impaired blood flow to the vital organs
Causes
Swallowed blood
Gastro-osephagous reflux disease
Motor neuroN disease
Affects the brain and spinal cord And causes weakness and gets worse overtime
Progressive degeneration of the motor neuron
Symptoms Weakness Slurred speech Weak grip Muscle cramps Weight loss
Causes
Mutation of DNA
Virus
Toxins and chemicals
Motor neurons control skeletal movement, overtime leads to weakened muscles
ALS effects upper and lower motor neurons
Renal failure
Pre-renal sudden drop in blood pressure(shock)
Inter-renal-direct damage to kidneys due to inflammation
Postrenal-sudden obstruction of urine flow
Signs and symptoms Acidosis Electrolyte imbalance Accumulation of urea No urine produced
Diagnosis Urine test Blood test Kidney biopsy Imaging tests
Management
Treating underlying cause
Dialysis
Correction of fluid
What is dementia
Loss of memory and other thinking abilities to interfere with daily life
Types of dementia
Vascular dementia-damage to the blood to the brain, problem solving and memory loss
Treatment Medications Counselling CBT Cognitive rehab Activities such as music art Lewy body dementia-abnormal clumps of protein, slow movements and tremors
Mixed dementia-people of 80 years show a mix of all dementia
Frontotemporal-breakdown of nerve cells and their connections in the frontal lobes, behaviour change
Alzheimer’s disease- plaques and tangles in the brain with lumps of proteins called amyloid, damage healthy sounds around them
What is a stroke
A stroke is where a part of your brain Dosent receive blood supply and gets cut off, urgent hospital attention is needed
Causes
A stroke can happen due to either a blood clot in the brain or a bleed on the brain, a blocked artery(ischemic stroke) leaking or bursting of a blood vessel(haemorrhagic stroke)
Treatments
Medicines To treat blood clots
Brain surgery
