P.A.T.H.

Arthritis is a group of inflammatory diseases of joints with severe causes: Degenerative joint disease from wear and tear over time, i.e. osteoarthritis Autoimmune joint disease where the body makes antibodies against synovial cells in the joint, i.e. rheumatoid arthritis Metabolic, where protein synthesis is inadequate and crystals form, i.e. gouty arthritis Infection within the joint cavity, i.e. septic arthritis Osteoarthritis Degenerative joint disease where cartilage is degenerated. Site: localised or generalised (more than 3 joints), affects weight bearing joints, knee, hip, spine and joints of hands and feet Age: over 50 Cause: primary or secondary, due to trauma, defects of joint structures or inflammatory diseases Characteristics: progressive loss of articular cartilage Risks: age, obesity, occupation (e.g. heavy lifting), crystal deposition and inflammation Symptoms: joint pain increased by night, cold and damp weather and relieved by heat a...

Abnormalities of spinal curvature Kyphosis : excessive outward curvature of the spine, causing hunching of the back Lordosis:  excessive inward curvature of the spine Scoliosis:  abnormal lateral curvature of the spine, congenital or developed from poor posture Fractures Fractures of bones are classified according to the pattern of the break and heal in a predictable manner. Treatment: alignment of the bones back together, immobilisation with plaster/pins, stress relief Closed (simple) fracture: skin is not punctured by bone Open (compound) fracture: ends of broken bone tear through skin Compression fractures: collapse of a vertebrae (most commonly due to osteoporosis, primary tumours or infection) Result: thrombotic or fat embolisms released into ruptured blood vessel → infarction and necrosis, infection (osteomyelitis), impaired fracture healing due to malunion Diagnosis: X-ray, CT and MRI (for spinal fractures when testing spinal cord injury)...

Pancreatitis Pancreatitis can either be acute or chronic. We will mainly talk about acute pancreatitis here. Acute pancreatitis Characteristics: enzymatic necrosis and inflammation of pancreas, increase in pancreatic enzymes in blood and urine Result: acute onset of epigastric pain (worse in supine position, radiates to back), cause and vomiting, abdominal distention due to fluid accumulation, pseudocyst (cyst with fibrous or granulation tissue), systemic organ shock, renal failure, intravascular coagulation, duodenal obstruction Cause: alcohol, gallstones, trauma Pathogenies: amylase, lipase and protease leak out of pancreatic acinus and pancreatic duct, causing a steep rise in amylase and smaller rise in lipase blood levels. Lipase causes fat necrosis and protease causes blood vessel destruction and haemorrhage. Diagnosis: sharp increase amylase, followed by smaller, slower increase in lipase levels Consequences of chronic pancreatitis Pancreatic pseudocys...

What are the tests to identify hepatobiliary function?    1.   Bilirubin Levels Normal serum bilirubin levels: 1.2mg/dL Jaundice serum bilirubin levels: 2.0mg/dL (severe jaundice 30mg/dL)    2.   Liver Enzymes   i. Aminotransferases and aspartate aminotransferase are liberated into the blood whenever liver cells are damaged.  ii. Alkaline phosphatase is the main indicator for biliary obstruction iii. Gamma glutamyl transferase increases as a sensitive indicator of liver abnormality    3.   Plasma Protein   i. Albumin  ii. Coagulative factors iii. Prothrombin Liver Cirrhosis Liver cirrhosis is the necrosis, fibrosis and conversion of the normal liver architecture into abnormal nodules. There are three types of cirrhosis: Post-Necrotic Cirrhosis (follows hepatitis) Biliary Cirrhosis (follows obstruction) Alcoholic Cirrhosis Below is a summary of the stages of alcohol...

Gastritis Inflammation of the gastric mucosa that can be either acute or chronic. Age group: Acute: 40-50 year olds Chronic: over 60 year olds Risks: helicobacter pylori infection, smoking/alcohol abuse/high caffeine, spicy food, aspirin and NSAID use (most common risk) Acute Gastritis Erosion of the surface epithelium where mucous barrier is broken down, exposing cells to the strong acidity of the gut. Healing time: few days (due to high regeneration rate of cells) Symptoms: epigastric pain and hematemesis Chronic Gastritis Produces scarring and involves atrophy of the gastrointestinal mucosa. Characteristics: low no. of secretory cells, progressive and permanent thinning and degeneration of the gastric mucosa, decreased digestion of protein and decreased HCl, lack of intrinsic factor → pernicious anaemia Result: can lead to gastric cancer (2 in 3 chance) Hiatal Hernia A hernia occurs when a portion of an organ pushes up, through or into an o...

An introduction to nuclei... Nuclei of the basal ganglia: Substantia nigra Caudate Putamen Globus pallidus These nuclei are associated with allowed us to develop highly skilled behaviour. Basal ganglia disease: increase or decrease in the motor output of the cortex Parkinson's Disease Cause: unknown, damage to nigral neurons Characteristics: extrapyramidal, progressive movement disorder, chronic degenerative disorder Symptoms: tremor, jerky movements, rigidity, mask-like face, stiff heavy and tired limbs, lead-pipe resistance Akinesia Definition: loss of associated and voluntary movements of all skeletal muscles Symptoms: inability to maintain upright position, saliva dripping, gait step, dementia, depression Huntington's Disease Age group: 30-50 years Cause: degeneration of caudate, putamen and front cerebral cortex due to autosomal dominant trait Characteristics: enlarged lateral ventricle, decrease in Ach and GABA, increase in d...