Lecturio Medical Videos

Pulmonary Hypertension Medication: Outline of Pharmacological Therapy

In this article, we will be reviewing mainly about the advanced therapies which are available for pulmonary hypertension with the brief coverage of primary therapy. The advanced therapies are especially studied for IPAH.

Alpha 1 Antitrypsin Deficiency: Etiology, Clinical Manifestations and More

Without the liver, we would not be able to metabolize some components of the food, drinks, and medications that we eat; there would be problems in hemostasis and we would not be able to properly digest the food that we eat, particularly fatty ones. These are only a few among the many contributions of the liver to homeostasis. However, there are also a lot of factors that can bring damage to the liver. Although the pathogenesis of liver diseases are most likely caused by a combination of a lot of factors, there have been well-studied disorders where genetics play the most crucial role in initiating disease. An example of which is alpha 1 antitrypsin deficiency.

Acetaminophen Overdose and Drug-Induced Liver Injury

The advances in modern medicine have brought about a lot of changes in how we deal with illnesses. One of these relatively new found technologies is the use of medications. However, this has led many to assume that all of the diseases suffered can be treated with medications alone. The danger is more prominent among those who take these without the consultation of health care providers. A poor understanding of the mechanism of actions of the readily available medications can also bring more harm than good for individuals who prefer to deal with their sickness by themselves. An example of a heavily affected organ during drug toxicities is the liver. In this article, we will understand how excessive and inappropriate intake of medications affect the function of the organ.

Peutz-Jegher's Syndrome, Juvenile Polyposis and HNPCC

The small and large bowels are parts of the digestive tract, they are responsible for digestion and absorption. The large intestine plays a large role in fecal formation and storage, as well as absorption of water, minerals, and vitamins. Any alterations in the integrity of this region of the digestive tract can result in subsequent issues. One of the most prevalent conditions that could lead to this is the development of new growths or neoplasms in any of the layers of the intestines. Among the two, neoplasms occur more commonly in the large intestine. In this article, we shall look into different types of polyps and cancerous growths, particularly hamartomatous polyps and the Lynch syndrome.

Small Intestinal Bacterial Overgrowth (SIBO) — Symptoms and Treatment

Our body is able to make use of the metabolic sources in the environment by way of the alimentary tract. In order for it to serve as a conduit for the food and other essential substances, it has to undergo specific functions such as food propulsion, secretion of digestive juices, and absorption of simplified nutrients and vitamins, among others. Needless to say, any interruptions in the continuity of any portion of the digestive tract would result in a lot of problems, including absorption. Small intestine bacterial overgrowth is an example of a condition that could result in malabsorptive conditions.

Multifocal Atrial Tachycardia — Symptoms and Treatment

Multifocal atrial tachycardia is a type of atrial arrhythmia characterized by rapid heart rate with at least 3 or more P wave morphologies. It is termed multifocal since the signals arise exclusively from atrial tissues instead of the sinus node. For an adult, normal heart rate ranges between 60 and 100 beats per minutes. In multifocal atrial tachycardia, the heart rate range between 100 and 250 beats per minute. It is more common in people with serious cardiopulmonary diseases (heart-lungs).

Hereditary Hemochromatosis: Risk Factors, Classifications, Diagnosis

Hereditary hemochromatosis (HH), also termed “genetic hemochromatosis”, is a genetic autosomal recessive disorder which occurs as a result of genetic mutations of certain genes (HFE gene) involved in the metabolism of iron, resulting in increased intestinal iron absorption. Common initial symptoms comprise abdominal pain, paleness, lethargy, and weight loss. The start of symptoms is between 30 to 50 years in males and afterward menopause in females. If left untreated, hemochromatosis could cause serious disease and early death. The keystone of screening is the level of serum transferrin saturation as well as the serum ferritin level. Definition, risk factors, pathophysiology, clinical features, investigations and treatment of hemochromatosis will be discussed in this article.

Crohn’s Disease (Ileitis) and Ulcerative Colitis (UC) — Causes and Treatment

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tracts and is comprised of two major disorders: ulcerative colitis (UC) and Crohn's disease (CD). Both diseases have characteristic and overlapping findings, which will be discussed in detail throughout this article.  

Thyroid During Pregnancy: Maternal Fetal Thyroid Pathology

Thyroid hormones are amine hormones produced by the thyroid gland. There are two types of thyroid hormones: triiodothyronine (T3) and thyroxine (T4). They are stored in thyroid follicles as a component of thyroglobulin. Once released in the blood, 2/3 of the hormones are transported while bound to Thyroxine-Binding Globulin.

Pulmonary Embolism (PE) — Symptoms and Treatment

Pulmonary embolism (PE) is a fatal clinical condition that occurs as a result of mechanical obstruction of the pulmonary artery or its branches by any material (such as thrombus, air or fat) from anywhere in the body. Pulmonary embolism can be an acute condition, in which the signs and symptoms develop immediately after the event (i.e., the obstruction of the pulmonary vessels), or it can be chronic, in which the signs and symptoms develop progressively for years. In this article, you will be able to understand the definition, incidence, pathophysiology, risk factors, symptoms and signs and the prognosis of pulmonary embolism.

Abnormal Looking Cervix: Cervical Fibroids and Cancer and Ectropion

Abnormal looking cervix, or suspicious cervix, is a common clinical condition seen in gynecological practice. Colposcopic examination of the cervix allows differentiation between physiologic changes that occur in response to normal cyclic variations in hormone secretion and a variety of structural and pathological conditions. This article addresses some of these common clinical problems and provides a step-by-step approach to differentiating them.

Asbestosis and Silicosis — Causes and Treatments

Occupational lung disease covers a specific area of knowledge in respiratory medicine. In these cases, information on the patients's history play an important role in the detection of these disorders, guiding investigations and management. Awareness of this topic is essential.

Renal Glucose Reabsorption: Glucose in the Urine & Disease Correlation

The kidney is a key player in glucose hemostasis by two mechanisms. It filters and reabsorbs glucose from the urine and it releases the sugar during times of fasting through gluconeogenesis. Here you will read everything about it.

Hypocalcemia: Etiology, Symptoms, Treatment

The calcium levels are regulated by a hormone known as the parathyroid hormone (PTH) which is secreted by the parathyroid gland. If the body fails to maintain the calcium levels within the normal ranges, hypercalcemia or hypocalcemia results. This article will focus on hypocalcemia. Hypocalcemia is the condition in which the serum calcium levels in the blood are low. The presentation of the patients with hypocalcemia can vary from asymptomatic to life threatening situations. Read on to learn about the etiology, symptoms, differential diagnosis, investigations and treatment of hypocalcemia.

Tumor Pathology: Definition, Development & Metastases

Tumor malignancy is the second leading cause of death in the United States today with increasing incidence. Furthermore, the general public usually associates the term with disease leading to death. Not every diagnosis of a tumor, however, translates to a shortened lifespan in actuality. The following article will define the word “tumor”, will shed light on the mechanism of tumor development and detail means of classification with respect to treatment plans.

Staging and Grading – Understanding the Basics of Tumor Classification

Malignant neoplasms are among the leading causes of death in recent US statistic: death from malignancy is currently only second to cardiovascular diseases. As an aspiring medical professional, you will find cancer in nearly every clinical field. As widely varied as tumors can be, characterization through staging and grading is virtually universally applicable. Both indicators help to make statements regarding prognosis and treatment. Here you will learn the appropriate terminology, and how to classify and differentiate between them.

Wolff-Parkinson-White (WPW) Syndrome — Causes, ECG and Treatment

Wolff-Parkinson-White Syndrome (WPW) is a term referring to Louis Wolff who published an article in 1930 that describes 11 patients suffering from episodes of tachycardia with characteristic ECG findings (ECG pattern shows bundle branch block and shortened P-R interval). In 1943, anatomical accessory pathway of conducting tissue has been described that bypasses the atrioventricular (AV) conduction system. This article will describe definition, pathophysiology, clinical manifestations, diagnosis and treatment of Wolff-Parkinson-White Syndrome.

Cell Surface Receptors: Types & Downstream Mechanisms

Receptors are proteins. They receive signals from outside the cell; when located on the surface of the cell, they are called cell surface receptors. Learn about the different types and their downstream mechanisms in the following article.

Hypercalcemia — Causes and Treatment

The normal calcium level in the body is between 2.2–2.6 mmol/L. The calcium levels are regulated by a hormone known as the parathyroid hormone (PTH) which is secreted by the parathyroid gland. If the body fails to maintain the calcium levels within the normal ranges, hypercalcemia or hypocalcemia results. This article focuses on hypercalcemia. Read on to learn about the causes, symptoms, diagnosis and management of hypercalcemia.

Helicobacter Pylori Infections — Differential Diagnosis and Medical Treatment

Helicobacter pylori is a type of bacteria, which results in gastric infection. It is estimated to be found in more than 50% of the international population. It is not sure how exactly the bacteria can be spread; however, unclean food or water may aid in the spreading of the infection and result in different gastric diseases or conditions, including peptic ulcer disease or gastric cancer in severe complications.

Paget's Disease of Bone (PDB) — Causes and Treatment

For the purposes of the USMLE, it is important to be able to identify and understand the pathophysiology of the Paget's disease and how to differentiate it from other musculoskeletal disorders. Throughout this article you will find the details of Paget’s disease and the key points bolded.

Regulation of ADH & Syndrome of Inappropriate ADH Secretion

Antidiuretic hormone or arginine vasopressin, is a peptide hormone released by the posterior pituitary in response to low plasma volume or increased plasma osmotic pressure. The hormone increases reabsorption of water at the kidney and increases systemic vascular resistance. When ADH is released in an unregulated fashion the circulating plasma becomes diluted, resulting in hyponatremia. This is called syndrome of inappropriate antidiuretic hormone secretion.

Water Balance: Regulation of Fluid Balance

Fluid balance is a carefully regulated system with many mechanisms to monitor and modify the absorption and secretion of water. Water is in constant motion between compartments that make up the body. When the body senses a drop in the effective circulating volume it stimulates a response to restore blood pressure and retain fluids. When there is too much fluid the body increases secretion and excretion of the excess.

Gastrointestinal Bleeding (GI Bleed) — Symptoms, Diagnosis and Treatment

Disorders of the digestive tract may result in gastrointestinal bleeding. The blood is not always visible in the stool or vomit; however, it may result in tarry black stools. Bleeding can be life-threatening in some cases. Identifying the source of bleeding is not always easy, especially if its origin is in the small intestines.

Respiratory Failure: Hypoxemia, Hypercapnia and Hypoxia

The inspiration of oxygen and expiration of carbon dioxide are vital functions of the human body. A decrease in PO2 and increase in PCO2 can alter many normal physiologic processes, and may eventually be fatal. The human body has various reflex mechanisms to manage such changes. Understanding of these reflexes and identification and management of any impairment in them is essential in the management of many respiratory and renal diseases.

Pituitary Hormones: Posterior Pituitary & Anterior Pituitary

The pituitary gland, also known as hypophysis, is a small pea-sized gland about 1 cm in diameter and 0.5 to 1 gram in weight. The pituitary gland resides in a small bony cavity situated at the base of the brain, known as sella turcica, and a pituitary stalk (infundibulum) maintains a connection between the pituitary gland and hypothalamus. The secretion of hormones by the pituitary gland is under the influence of the hypothalamus through its various hormonal and neuronal signals. There are two distinct divisions of the pituitary gland: the posterior pituitary and the anterior pituitary. Between these two, there is a small zone, which is relatively avascular and less well-developed in humans, known as pars intermedia.

Laxative Abuse — Causes, Symptoms and Treatment

Laxatives are an effective treatment for occasional constipation, but laxative abuse and misuse is very common and can damage the intestines and lead to malabsorption and dehydration. Individuals abuse laxatives for a variety of reasons including weight loss (the most common form of laxative abuse), as a method to improve health, and as a part of a factitious disorder. There are gross and histological changes to the intestines that are usually reversible. Treatment consists of laxative sensation and treating the underlying condition.

Inflammatory Bowel Disease (IBD) — Types, Causes and Treatment

Inflammatory bowel disease (IBD) is a group of conditions that affect the gastrointestinal system. IBD consists of autoimmune diseases that attack the GI mucosa, resulting in inflammation of the gut wall. For this discussion, we will be focusing on ulcerative colitis (UC) and Crohn’s disease (CD). The main differences between the two are that ulcerative colitis mainly involves the large intestine and rectum while Crohn’s disease can affect the GI system anywhere from the mouth to the anus and usually skips the rectum. Other conditions such as microscopic colitis and Behçet's disease are also types of IBD. IBD is different from irritable bowel syndrome (IBS) which is a functional disorder that is defined as abdominal pain and bowel movement changes.

Angiodysplasia — Symptoms and Treatment

Angiodysplasia describes abnormal vascular malformations found in the gastrointestinal (GI) tract, especially in the cecum and right colon. These malformations are prone to bleed and may be responsible for painless hematochezia, melena and concomitant anemia. Diagnosis can be made by direct visualization during endoscopy or angiography. Treatment consists of endoscopic interventions, including embolization and coagulation, antifibrinolytic medications and surgery as a last resort.

Carcinoid Syndrome — Symptoms, Diagnosis and Treatment

The carcinoid syndrome describes the signs and symptoms associated with unregulated vasoactive hormone production by neuroendocrine tumors. Carcinoid tumors can be found anywhere throughout the body, but these will not result in carcinoid syndrome unless they form in the liver as a primary tumor or as a metastasis. Symptoms of carcinoid syndrome include flushing, diarrhea, and wheezing. VIPomas usually form in the pancreas and release vasoactive intestinal peptide (VIP) which results in profound chronic diarrhea with concomitant hypokalemia and dehydration, wheezing, and flushing (similar to carcinoid syndrome). VIPomas are often associated with multiple endocrine neoplasia type 1 (MENI). Diagnosis is based off blood or urine measurements of serotonin and VIP. Treatment consists of minimizing symptoms with medication and complete surgical removal of the tumor.

Radiation Colitis — Symptoms and Differential Diagnosis

Radiative colitis is an enteropathy syndrome that may develop after radiation therapy to the abdomen or pelvis. Radiation therapy is a treatment option for cancers in that area. Symptoms start weeks to years after initial radiation dose and include diarrhea, malabsorption, abdominal pain, and nausea. Therapy involves treating symptoms and allowing the bowels to heal. In severe cases partial colectomy may provide the best chance at recovery.

Whipple’s Disease — Symptoms and Diagnosis

Whipple's disease is a rare infection affecting several tissues throughout the body including the GI tract, central nervous system, and heart by the bacteriaTropheryma whipplei. Symptoms include malabsorption, weight loss, and diarrhea with extra GI symptoms including arthritis and joint pain. The following article contains all important facts about the Whipple's disease.

Arterial Blood Gas (ABG) Analysis

ABG analysis is an indispensable test for critically ill patients or patients treated in an ICU. Interpretation of ABG analysis seems complicated; however, an understanding of the basic physiology can ease the interpretation. In this article, the basic physiology behind ABG analysis and a stepwise approach to interpreting ABG analysis will be discussed in detail.

Pulmonary Hypertension (PH) — Categories, Causes and Treatment

Pulmonary hypertension (PH) is a clinical condition that is characterized by elevated pulmonary arterial pressure. It can lead to serious clinical consequences, thus early detection and treatment is important before it becomes advanced and less responsive to therapy. PH is a feature of advanced underlying disease that are usually caused by cardiac, pulmonary, or intrinsic vascular diseases. Therefore, suspected cases will undergo diagnostic testing to confirm the condition and identify the underlying cause. The definition, epidemiology, classification and etiologies, pathophysiology, clinical features, diagnostic evaluation and treatment all will be discussed in this article.

Arrhythmia (Irregular Heartbeat) — Classification and Types

Cardiac arrhythmia is an abnormal heartbeat, either the heart is beating too fast, too slow, or in an irregular manner. A healthy heart beats in a coordinated and regular way. Electrical and chemical impulses develop into specialized cells. These impulses stimulate the heart muscle cells (myocytes) to contract. When the heart is irritated or damaged, these impulses can develop spontaneously in the atria or the ventricle. Some spontaneous contractions are normal, but certain contraction patterns are very dangerous and can result in permanent heart damage, stroke, or death.

Stomach Ulcer (Peptic Ulcer) — Symptoms and Treatment

Approximately 10% of the US population experience peptic ulcer disease, which has significantly impacted the health care system; both men and women appear to be affected equally with the condition. Peptic ulcer disease may lead to several complications, including an upper gastrointestinal hemorrhage.

Hypopituitarism — Symptoms, Diagnosis and Treatment

The pituitary gland also referred to as Hypophysis, or “Master gland” is a pea-sized organ, that lies in a protective bony enclosure called the sella turcica (saddle/chair) at the base of our brain. Read on to learn all about the pituitary gland and its hormones, as well as Hypopituitarism.

Respiratory Failure

Normal respiration is controlled by complex physiological pathways in the body. A respiratory failure can prove fatal and can cause death if untreated. In this article, normal physiology of respiration, types, pathophysiology, and treatment of respiratory failure will be discussed in detail.

Chronic Bronchitis — Symptoms and Treatment

Chronic bronchitis is characterized by expectoration for a period of more than three months, in more than two consecutive years. Chronic irritation caused by smoking promotes hyperplasia of mucus glands and increases the production of mucus. Central and peripheral airways are involved in the pathophysiology of the disease and it includes inflammation, oxidative stress, inhibited repair processes, and an imbalance of proteinases/anti- proteinases. This article will prepare you perfectly well for your next exam!

Infant Respiratory Distress Syndrome (IRDS) — Symptoms and Treatment

Respiratory Distress Syndrome (RDS), also known as "Hyaline membrane disease", is caused by the deficiency of lung surfactant in a pre-term infant due to the immaturity of the lungs. The risk of RDS is inversely related to the gestational age, and, most commonly occurs in infants less than 28 weeks of gestational age. Neonatal respiratory distress syndrome is associated with high morbidity and mortality in pre-term infants and considered one of the most common causes of neonatal death. Respiratory distress syndrome should be differentiated from the other causes of respiratory distress after birth, which will be discussed in details in this article.

Hypersensitivity Pneumonitis & Eosinophilic Pneumonia

Hypersensitivity pneumonitis (HP), also called "extrinsic allergic alveolitis," is an immunologically-induced inflammatory disease affecting the alveoli and terminal airways (bronchioles), caused by repeated inhalation of a variety of inciting agents in a susceptible host. A wide range of organic antigens have been identified from different occupations. The clinical presentations of hypersensitivity pneumonitis vary depending upon the frequency, length, and intensity of exposure to the inciting agent. Surprisingly, cigarette smoking reduces the risk of developing the disease due to decreased antibody reaction to the antigen.

Pulmonary Function Tests (PFT)

Pulmonary function tests (PFT) are a battery of tests that measure lung function and aid in the management of patients with respiratory disease. They are performed using standardized equipment and can be used for diagnosis, prognostication, management and follow-up of patients with pulmonary pathology. Although PFT may not identify the exact pathology, it broadly classifies respiratory disorders as either obstructive or restrictive. In this article, the role of PFT in the measurement of lung mechanics and diagnosis of various diseases will be discussed in detail.

Vasospastic Angina (Prinzmetal Angina) — Definition and Treatment

Vasospastic angina is a variety of angina pectoris (chest pain) occurring at rest in which myocardial ischemia is due to transient vasospasm, with or without any underlying pathology. It is one of the syndromes that cause ischemic myocardial pain (angina pectoris), the other two being stable and unstable angina. Although rare in comparison, students are expected to know about it for the purposes of USMLE, as well as for their clinical knowledge.

Dyspnea (Shortness of Breath) — Causes and Symptoms

Dyspnea or shortness of breath is a normal manifestation of heavy exertion, but it can also be caused by different underlying diseases, therefore understanding the etiology, pathophysiology and differential diagnosis of dyspnea is important in the diagnosis of serious underlying clinical conditions. In this article, the etiology, pathophysiology and differential diagnosis of dyspnea will be discussed in detail.

Emphysema — Causes and Treatment

Emphysema is a condition characterized by the dilation of air spaces, with decreased elasticity and increased compliance, due to alveolar wall destruction; capillaries are also destroyed along with the alveoli. The most common cause for developing emphysema is smoking. Alpha-1-antitrypsin deficiency may also result in the development of emphysema.

Acute Respiratory Distress Syndrome (ARDS) — Phases and Treatment

Acute respiratory distress syndrome (ARDS) is a clinical condition characterized by acute inflammatory lung injury that leads to rapid onset of dyspnea and hypoxemia, with diffuse bilateral radiographic opacities due to the underlying alveolar damage. ARDS ultimately leads to respiratory failure. Acute lung injury (ALI) is a less severe form of the condition, but it can progress rapidly into ARDS.

Heart Sounds

The detection and recognition of heart sounds play an important role in the diagnosis of various cardiac and valvular conditions. Because familiarity with heart sounds has such practical importance, students undertaking the USMLE are expected to have a good understanding of its theory and clinical applications.

Got Milk? Medical Facts on Calcium and Osteoporosis

Whether milk is good or bad for calcium intake is a question that you will often have to answer in clinical practice. Many people think that the consumption of milk and dairy products will prevent osteoporosis—a belief that is being promoted in the media and through advertising campaigns but is also deeply rooted in our cultural heritage. Is there any medical consensus regarding this controversial issue? What have recent studies found out? How can physicians develop a well-founded stance on the subject without falling back on fatalistic platitudes? And most importantly: How can you as a medical practitioner adequately advise your patients on osteoporosis prevention while simultaneously dispelling any unfounded myths?

Ventricular Tachycardia (VT) — Types and ECG

Ventricular tachyarrhythmias are a group of arrhythmias that result in a heartbeat greater than 100 beats per minute and originate anywhere in the ventricle. There are three main types of ventricular tachyarrhythmias: ventricular fibrillation, monomorphic ventricular tachycardia, and polymorphic ventricular tachycardia. Each one is associated with a high mortality rate. Symptoms include chest pain, palpations, hemodynamic collapse, and end-organ damage. If the ventricular tachyarrhythmia is suspected, start advanced cardiac life support measures immediately.

Cardiovascular Examination

The cardiovascular exam is one of the most important parts of the physical. You will repeat this exam throughout your training and perform it on almost every patient in a hospital or a clinic. This part of the physical evaluates the heart and peripheral blood vessels (both arteries and veins). We use the stethoscope to auscultate, the fingers and palm to palpate and the eyes to observe.

Celiac Disease (Celiac Sprue, Gluten Enteropathy) — Symptoms and Treatment

Celiac disease, also called gluten-sensitive enteropathy or nontropical sprue, is a type of malabsorption syndrome. Relevant exam topics include the symptoms of gluten sensitivity and the clinical presentation of chronic malabsorption. Diagnosis is led by the characteristic histological findings and specific autoantibodies.

Diarrhea — Differential Diagnoses and Treatment

Diarrheal diseases are a very common reason why patients consult their doctor. Acute diarrhea lasts no longer than 2 weeks and has usually a rather mild course; however, if the diarrhea becomes more severe or is persistent, it can pose a serious health problem. Diarrheal diseases are most commonly due to infections. Chronic diarrhea represents a challenge to any doctor’s diagnostic skills as there are a multitude of differential diagnoses. In the following article, we will present you with all the important information you might need for clinical exams and clinical practice.

Cough and Wheezing — Definition and Treatments

A cough is one of the common presenting symptoms in the clinic and is associated with a number of respiratory and non-respiratory diseases. It can have a number of distinguishing characteristics such as quality, sputum production, timing, onset, duration and associated symptoms. The physiological mechanisms underlying cough involve a reflex arc with a command center in the medulla. Common non-respiratory causes include gastroesophageal reflux disease and postnasal drip, whereas, the most common respiratory etiologies are infectious diseases, chronic obstructive pulmonary disease, asthma and interstitial lung disease. Wheezes are high-pitched, loud sounds that usually accompany asthma, while stridor is most prominent with upper respiratory obstruction. In this article, physiology, different causes of cough and wheezing will be discussed in detail.

Colon Cancer (Colorectal Cancer) — Causes, Symptoms and Prognosis

Colorectal cancer originates from the colon and rectum in the body. It is a very common type of cancer in the United States. The molecular pathogenesis of colorectal cancer involves complex pathways. There are different types of colonic polyps associated with colorectal cancer; mostly are precancerous in nature. In this article, different pathological mechanisms, colonic polyps, symptoms, diagnostic tests, treatment and prognosis of colorectal cancer will be discussed in detail.

Thiazide Diuretics

Thiazide diuretics are some of the most common diuretics currently in use. Their mechanism of action involves inhibition of the Na/Cl co-transporter channel in the proximal part of the distal convoluted tubule, leading to increased sodium and chloride secretion. Their effects on reducing peripheral vascular resistance further contribute to their antihypertensive properties, in addition to their ability in decreasing effective blood volume. Besides hypertension, they are indicated for the treatment of heart failure exacerbation, hypercalciuria and diabetes insipidus. Important side effects include hypokalemia, hypercalcemia, hyponatremia, hyperglycemia, hyperuricemia and hypomagnesemia.

Ischemic Heart Disease

Patients with IHD can present with chronic artery disease or acute coronary syndromes. Read about the different kinds, their diagnosis and treatment!

Chronic Venous Insufficiency — Symptoms and Treatment

In a healthy individual blood passes through the deep and superficial veins of the legs into the thighs and then the iliac veins to the inferior vena cava. The blood is pushed by the heart and also by skeletal muscle pumps as the leg muscles contract and relax. Retrograde motion is prevented by organic valves in the veins. As the valves weaken blood begins to pool in the legs and feet resulting in discoloration, vein engorgement, varicose veins, and edema.

Atrial Flutter — Symptoms and Diagnosis

Atrial flutter is an irregular heart rhythm of the atria. It is classified as a supraventricular tachycardia. This rhythm is associated with heart disease and hypertension. Symptoms include palpitations. Complications include increased risk of stroke and congestive heart failure. Diagnosis is made by observing sawtooth “flutter” P waves on EKG at a rate of 240–400 contractions per minute. Treatment through ablation is usually curative, though medication can also play a role.

Loop Diuretics

Loop diuretics are one of the important classes of diuretics. Furosemide is the most commonly used loop diuretics. Other loop diuretics used are bumetanide, torasemide and ethacrynic acid. Loop diuretics are the most efficacious in causing diuresis in all the classes of diuretics. All the loop diuretics have the same mechanism of action, but different pharmacokinetic properties. They are used to treat/manage numerous diseases such as edema associated with CHF and liver cirrhosis. Diuretics most commonly cause electrolyte imbalance in the body on prolonged use.

Aldosterone Antagonist

Aldosterone antagonists are the class of drugs used to treat several conditions such as edema, hypertension or congestive cardiac failure (CCF). Aldosterone antagonists act by competitive antagonism of aldosterone binding receptors on the distal convoluting tube and the upper collecting duct. Spironolactone is an important and widely used aldosterone antagonist. Other drugs in this category are eplerenone and finerenone.

Usual Interstitial Pneumonia (UIP) and Idiopathic Pulmonary Fibrosis (IPF) — Symptoms and Treatments

Idiopathic pulmonary fibrosis (IPF) belongs to a group of diseases whose specific cause is not well known, which keeps clinicians and researchers worried: the often rapid progression of IPF is very distressing. Also the underlying causes are mostly unknown, pathophysiologic explanations and findings are still unsatisfying. With only a 5-year survival rate of 20–40 %, only quick decisions such as initiating a lung transplantation, might help prolong a patient’s life.

Types of Intravenous Fluids

Intravenous fluids are most commonly administered in acute and severe hypovolemic conditions. In the therapeutics, two classes of i.v. fluids are most commonly utilized: crystalloids and colloids; both have their own advantages and disadvantages. The effect of various clinical conditions on the volume of ICF and ECG can be best studied by Darrow-Yannet diagrams.

Renal Cysts

A kidney cyst can arise in any part of the nephron and collecting ducts, and can be found incidentally on imaging tests, or can be part of a renal or systemic disease. Renal cystic diseases consist of a large spectrum of diseases that differ in regards to pathophysiology, prognosis and treatment and that can be usefully divided into hereditary, acquired and developmental conditions. Hereditary renal cystic diseases often lead to kidney failure and are commonly associated with extrarenal manifestations, whereas non-genetic cystic disorders are usually limited to the kidney and rarely result in kidney functional deterioration.

Dysarrhytmias & Conduction System Disease: Bradyarrhythmias

Bradyarrhythmias, an arrhythmia with bradycardia (less than 60 ventricular depolarizations per minute) can result in a drop in cardiac output, low perfusion and hemodynamic instability. Bradycardia is occasionally seen in professional athletes due to their increased vagal tone. It is not a concern in this group, but may pose a risk when found in the general population. There are many causes for a slow heart rate including medication, electrolyte imbalance and physical changes to the heart associated with deterioration or fibrosis.

Glomerulonephritis: An Overview

The kidney is the central filter organ of our body. More specifically, it is the small glomeruli that filter those substances from the blood that have to be excreted and thus produce the primary urine. Various factors may cause damages to the glomeruli, resulting in a malfunctioning filtration process. The type of malfunction can vary, and accordingly, so do its clinical manifestations. Differentiating these variable clinical presentations of glomerulonephritis is for many medical students a rather challenging task. The following article will help you to understand the difficult topic of glomerulonephritides

Urinalysis

Urinalysis is the test performed to analyze the physical, chemical and microscopic characteristics of urine. The information from this test might be used to diagnose or rule out diseases based on the findings. Urinalysis is most commonly used in identifying diseases of the urinary tract and diabetes. It includes macroscopic, microscopic/cytological and chemical analysis of the individual elements in urine.

Constrictive Pericarditis — Symptoms and ECG

Constrictive pericarditis is characterized by a thickened and scarred pericardial sac that lays around the heart and prevents proper diastolic filling. Diagnosis is very difficult because this condition mimics many other diseases.

Acute Pericarditis — Causes and Treatment

Patients with acute pericarditis may present with this significant sign: their chest pain improves while leaning forward. But this may not be seen in every case. To understand and know under which circumstances a patient might develop a pericarditis, helps you to think of the right diagnosis in the right moment. This article covers all the important information you need to know about acute pericarditis.

Kidney Stone (Nephrolithiasis) — Classification, Symptoms and Treatment

Nephrolithiasis is a clinical condition characterized by the presence of calculus in the urogenital tract. Calcium oxalate stones are the most common stones. Clinical presentation involves acute presentation with flank pain, which occasionally radiates to the groin. Non-contrast CT is the investigation of choice in nephrolithiasis and can diagnose all types of stones. Management depends on the location and size of the stone. Smaller stones have a greater chance to pass spontaneously, while stones larger than 5 mm need surgical management with percutaneous nephrolithotomy, ureteroscopy and extracorporeal lithotripsy.

Bronchiectasis — Diagnosis and Treatment

Bronchiectasis can develop from chronic lung diseases or pulmonary infectious diseases. Since it is irreversible, it is most important to diagnose it timely. Only then, it is possible to prevent it from progressing by implementing appropriate measures. This article will introduce you to the pathophysiological and etiological basics of bronchiectasis, and will prepare you for the treatment of affected patients.

Water and Sodium Balance and Their Associated Disorders

Sodium is one of the most important active osmotic solutes in the human body, which is maintained in constant amounts in extracellular and intracellular fluid compartments. Understanding the normal physiological basis of water and sodium balance, and the associated clinical implications of any change in this balance, are of clinical significance, as even small changes can result in emergency conditions. This will be discussed in detail in this article.

Atrial Fibrillation (AF) — Symptoms and ECG

Atrial fibrillation is the most common form of supraventricular arrhythmia. In its chronic form, it poses an increased risk of thromboembolic events, especially for people in advanced age. As this disease entails a reduced quality of life and increased mortality for the affected individuals, it is of the utmost importance that a physician knows the different forms of this widespread disease very well as to be able to make the opportune treatment decisions. The following article will provide you with an overview of the underlying mechanisms of disease and different treatment approaches.

Pericardial Effusion And Cardiac Tamponade — Symptoms and ECG

Pericardial effusion is the condition of having an abnormal amount of fluid in the pericardial cavity of the heart. The pericardium does not expand. If enough fluid accumulates it will restrict cardiac filling and lead to acute heart failure, this is called cardiac tamponade. Small effusions are usually asymptomatic. Symptoms of a large effusion include Beck’s triad of distended neck veins, low blood pressure and muffled, distant heart sounds. Larger effusions are treated by pericardiocentesis, carefully removing the fluid with a needle.

Tumor Markers in the Blood

Cancer is one of the most widespread and most feared diseases in the world. Its onset is often insidious and initially proceeds without any noticeable symptoms. For treatment to be successful, an early detection is necessary. However, every year about 225,000 people worldwide lose this race against the clock. Tumor markers in the blood—are they an alarm signal of the organism? Are regular blood tests the best prophylaxis against cancer? Read more about this topic in the following article.

Myocardial Infarction (Heart Attack) — STEMI vs. NSTEMI

Myocardial infarction is one of the most common causes of death in industrialized countries and requires immediate intervention, according to the principle “Time is Muscle”. 40 % of all patients die before their first post-infarction day, and 50 % die in the first four weeks. Early detection and swift action are of crucial significance, especially in the case of ST-segment elevation myocardial infarction.

Cystic Fibrosis (CF, Mucoviscidosis) — Symptoms and Diagnosis

Mucoviscidosis or Cystic Fibrosis is the most common congenital and early lethal metabolic disease in Europe. Only if diagnosed early do those affected stand a chance of living beyond young age. The following article summarizes all the facts on formation, diagnosis, therapy and prognosis of mucoviscidosis. This will prepare you comprehensively for clinical exams, practical trainings and your final exam.

Hodgkin's Lymphoma (Hodgkin's Disease) — Stages, Classification and Prognosis

Hodgkin's disease is one of the first cancerous diseases for which effective treatment options have been developed. While this disease still ended lethally earlier, the prognosis is very good today. This is particularly due to the radiation sensitivity of lymphoma. 80 % of the patients can be cured permanently. This article provides a comprehensive overview of the hematologic disease, the symptoms, diagnosis and therapeutic principles.

Chronic Obstructive Pulmonary Disease (COPD) — Classification, Symptoms and Diagnosis

Chronic obstructive pulmonary disease (COPD) is the most common chronic disease of the airways that is caused in 90 % of cases by smoking. COPD is a preventable and treatable disease. However, many patients do not know that they suffer from the disease, so the number of unreported cases of patients is very high. In this article, you will find important information on the epidemiology, etiology, pathophysiology and diagnosis, as well as the differential diagnosis and treatment of COPD.

Mesenteric Ischemia (Bowel Infarction) — Diagnosis, Therapy and Ortner's Syndrome

This article treats the mesenteric infarction as a potentially life-threatening disease, which constitutes an emergency in vascular surgery. It includes both, the epidemiology as well as the aetiology, symptoms, diagnosis and treatment of this ischemic intestinal disorder. Every doctor should know the mesenteric infarction as a differential diagnosis of the acute abdomen, because the lethality is 90% due to the often late diagnosis.

Goiter – Differential Diagnosis of Frequent Symptoms

It is known that iodine deficiency is a major cause of a goiter. However, there are many other causes that can lead to an increase and change in the consistency of the thyroid. In order to be able to come to an unambiguous assessment, differential diagnostic skills are essential. Therefore, the following article may help you learn more about etiology and differential diagnosis of a goiter.

Diverticulosis (Diverticular Disease) and Diverticulitis (Colonic Diverticulitis) — Symptoms and Treatment

Diverticulosis (diverticular disease) is an extremely common disease of the colon. The colonic wall is exposed to high luminal pressure which forces the wall outwards to form outpouchings called diverticula. This is a painless condition, but patients can become very worried as it can cause rectal bleeding. This condition is very prevalent in Western society because of the low fiber diet. Diverticulitis is a much more serious condition and occurs when a diverticula becomes inflamed. It is related to diverticulosis as the diverticula in this disease can become obstructed and/or inflamed due to an infection. The outpouching becomes very painful due to the inflammatory response and can continue to grow in size. If the outpouching is not treated rapidly, it can progress to rupture and lead to peritonitis, sepsis and death.

Esophageal Cancer (Esophageal Carcinoma) — Classification, Staging and Prognosis

If diagnosed and treated in time, a patient with esophageal carcinoma can be cured. However, the symptoms are often non-specific and only appear once the tumor is already advanced. Therefore, it is all the more important not to overlook any relevant indications in clinical practice. Questions about esophageal carcinoma occasionally come up in exams, especially on etiology and clinical symptoms. Therefore, it pays to read on to learn more!

AIDS (Human Immunodeficiency Virus, HIV) — Etiology, Stages and Prognosis

Retroviruses. HAART. Sexual transmissibility. All buzz words that most people immediately link with HIV infection. Although HIV is only briefly mentioned as part of immunology studies, it’s essential for physicians to create themselves a picture of the sources, expression of the infection, therapy as well as understanding the development of the disease from a death sentence to a chronic disease as a result of improved treatment options. This article will help you to be properly prepared for clinical work, tests and medical examinations.

Phlebothrombosis and Deep Vein Thrombosis (DVT) — Diagnosis and Classification

Phlebothrombosis is a very common and very serious condition. Blood clots in veins can mobilize and cause significant harm and even death in some cases by blocking downstream vessels. This condition needs to be thought of in all new hospital admissions, especially those who will be particularly immobile or those undergoing operations, so they can be given medical prophylaxis to reduce the chance of a blood clot forming in the venous system.

Thyroid Cancer — Classification and Treatment

Thyroid cancer is an uncommon cancer that can be managed well if detected early enough. It arises from follicular or parafollicular cells within the thyroid. There are subtypes of cancer depending on the cell involved and the mutations that occur. The most common cure for this cancer is surgical removal of the thyroid, along with chemotherapy or radiotherapy.

The Pancreas – An Important Gland in the Digestive System

The pancreas is an organ that actually consists of two glands: one exocrine and one endocrine gland. The glandular epithelium is a specialized epithelial tissue which produces and excretes substances to control our bodily functions. The exocrine gland secretes its fluids via ducts (into the intestinal lumen), while the endocrine gland secretes its substances via the extracellular space into the vascular- and the lymphatic-system. The two parts of the pancreas differ both in structure and function. The following article should give you an overview about the histological features of the two glandular parts.

Aortic Dissection — Classification and Diagnosis

Aortic dissection is a rare but serious medical condition. It can be suddenly fatal and needs to be detected early. 40% of people do not survive once the aorta dissects and therefore despite its rare nature, patients with related symptoms should be thoroughly investigated.

Molar Pregnancy (Hydatidiform Moles) and Choriocarcinoma — Symptoms and Treatments

During pregnancy, it is possible for the tissue surrounding the embryo to degenerate. Such degeneration typically manifests itself in hydatidiform moles and choriocarcinoma. These tumors are difficult to diagnose and are associated with an increased level of beta hCG. Treatment involves the complete removal of the tumorous growth. The characteristics of the tumors are described in more detail below.

Chronic Myeloid Leukemia (CML) — Classification and Staging

Chronic myelogenous leukemia, also called chronic myeloid leukemia (CML), is an acquired monoclonal expansion of white blood cells of myeloid lineage. It is common in middle and old age accounting for 20% of adult leukemia. It is sometimes diagnosed incidentally on routine blood investigations or the presence of splenomegaly on examination. CML is classically associated with the Philadelphia chromosome (BCR-ABL fusion gene) and has excellent prognosis with modern therapy.

Types of Shock — Definitions

One mainly realizes the importance of functioning blood circulation if it suddenly stops working. If the circulation system decompensates and tissue cannot sufficiently be supplied, the state of the patient can severely worsen within very little time – and you have to act quickly. Shock is life threatening. Thus, it is absolutely necessary that you know all about it as a prospective physician. Here you learn the 3 main causes of shock, and how to treat each of them.

Stomach Cancer (Gastric Cancer) — Classification and Prognosis

Over the past several years, more and more individuals attract malignant gastric cancer. In many cases, however, the initial symptoms of the disease are so non-specific that the tumor is not diagnosed until it is in an advanced stage, resulting in the prognosis being worse. Which risk factors promote the development of gastric cancer, and what are the treatment options once the diagnosis of gastric carcinoma has been made? In the following article, you will find out everything you need to know about gastric cancer.

Placenta – Functions and Insufficiency

During pregnancy, the placenta develops and adapts to the needs of the child. The placenta fulfils numerous tasks, but mainly serves the child’s oxygen and nutrients supply. Due to various causes, a malfunction is possible, whereby the child is under-supplied and can no longer grow properly. Early diagnosis with therapeutic measures is therefore important.

Cardiomyopathy – An Overview

A cardiology exam is coming up and you have not studied yet? Indeed, cardiomyopathies are not necessarily among the most studied topics; however, they appear quite often and are actually one of the most common causes of heart insufficiency. Here, you get an overview of important types of cardiomyopathy for exams – easy to understand and a huge time-saver!

Premature Placenta Detachment and Placenta Praevia

In the context of precocious pregnancy, flawed implantation of the placenta is possible. This can remain asymptomatic in the beginning. However, bleeding mostly occurs during the end stages of pregnancy. Also, vaginal bleeding can be the cause of premature placenta detachment. This bleeding is life threatening to both the mother and child, and is very painful. In the following article, the clinical picture of premature placenta detachment and placenta praevia are further explained together with their differential diagnosis.

Gastritis (Stomach Inflammation) — Complication and Special Forms

Increased production of stomach acid or damage of the gastric mucosal barrier may irritate the sensitive gastric mucosa or stomach lining to the degree that gastritis occurs. Gastritis may develop over a longer period of time, but may also occur suddenly and have many causes. As gastritis is one of the most common stomach diseases, this article will provide you with on overview of the various types of gastritis and also address very rare forms of this disease.

Acute Lymphoblastic Leukemia (ALL) — Classification, Laboratory Evaluation and Survival Rate

Acute lymphoblastic leukemia is a monoclonal malignancy of hematopoietic stem cells affecting the lymphoid lineage. It is the most common childhood cancer. The clinical manifestations are due to the replacement of normal marrow cells by the leukemic cells leading to bleeding, infections, and pallor. It has one of the best prognoses among cancers if treated timely.

Atherosclerosis (Atherosclerotic Cardiovascular Disease) — Definition and Pathology

Atherosclerosis is an incurable disease, but for which there are clearly defined risk factors that often can be reduced through a change in lifestyle and behavior of the patient. It is the most abundant primary disease of the arterial vascular system and is responsible for coronary heart disease, the leading cause of death worldwide.

Hypertension (High Blood Pressure, HBP) — Classification and Clinical Signs

With a prevalence of approximately 50 %, arterial hypertension is a very common disease. Blood pressure is a risk factor of secondary diseases such as stroke, CHD and cardiac insufficiency. Social connections as well as a relationship between hypertension, body weight and age are apparent. Many individuals with hypertension are not treated at all or receive insufficient therapy and, in many cases, are not aware they have the disease.

Ectopic Pregnancy (Extrauterine Pregnancy) — Symptoms and Treatment

Eccyesis or tubal pregnancy refers to the implantation of the blastocyst outside the uterine cavity. Thereby, affected patients suffer from acute abdominal pain. Eccyesis or tubal pregnancy can be quickly diagnosed by means of an ultrasound and laboratory analysis. In severe cases, in the case of rupture and hemorrhage, the fastest possible action is required. Surgery should be considered as a therapeutical approach.

Acute Myeloid Leukemia (AML) — Classification and Survival Rate

Acute myeloid leukemia is due to a malignant transformation of the hematopoietic stem cells. It is predominantly seen in the age group of 50 – 60 years and is characterized by the arrest of leukocyte development in the early stage of development. Diagnosis is based on the presence of blast cells in the peripheral circulation. It is treated by chemotherapy, which includes treatment of remission and post-induction remission. Refractory cases of acute myeloid leukemia are treated by bone marrow transplants. Complications of AML include anemia, infections and bleeding, along with acute medical emergencies such as necrotizing enterocolitis, hyperleukocytosis and tumor lysis syndrome.

Boerhaave Syndrome and Mallory-Weiss Syndrome (MWS) — Diagnosis and Complications

In clinical practice, Boerhaave and Mallory-Weiss syndromes rarely appear. However, you should have these two syndromes in mind when dealing with patients in acute pain or bleeding after an episode of violent vomiting in order to make a correct diagnosis at the crucial moment. Questions about this subject are also likely to be asked in tests. Therefore, medical students should be able to keep these two syndromes apart, particularly their epidemiology and clinical symptoms.

Zenker's Diverticulum and Other Esophageal Diverticula — Definition and Symptoms

Diverticula can be found in various organs, in particular in the colon, but also in the duodenum or ileum, and in the esophagus. Every medical student should internalize the differences between true and pseudo-diverticula. Zenker's diverticulum, in particular, is often quizzed in exams.

Chronic Lymphocytic Leukemia (CLL) — Staging and Prognosis

Chronic lymphocytic leukemia (CLL) affects the B-cells of the immune system and is, as the most common leukemia in adults, an important hematological differential diagnosis. It often hardly progresses for years and therefore a CLL does not always need immediate therapy. In the past years especially, a lot has happened with regard to diagnostic options and treatment, so that being informed about cytogenetic diagnostics and new treatment methods is extremely important.

Abnormalities of the Female Reproductive Organs

Abnormalities and disorders which can affect the female body are by no means rare and are not just of cosmetic relevance. A malformed uterus can cause a woman to be infertile, ectopic breast tissue can degenerate malignantly, and atresia of the hymen leads to amenorrhea. The following article gives prospective doctors an overview of the abnormalities of the reproductive organs – in order to allow for these to be diagnosed securely in clinical or general practice examinations – and to allow a treatment strategy to be developed with the patient.

Peripheral Artery Disease (PAD) — Definition, Stages and Treatment

Peripheral artery disease, shortly referred to as PAD, is a condition caused due to atherosclerosis. Estimated to be affecting around 200 million people in 2010, the intermittent claudication is a medical entity of rising impact, which every prospective physician should master. The underlying atherosclerosis is not only the most common arterial vascular disease but also the pathologic substrate for many other common and often life-threatening diseases. These include strokes, heart attacks or aneurysms—comorbidities and risks, which can first manifest as PAD. This article´s purpose is to illustrate how PAD is diagnosed and treated as well as to provide exam-oriented information.

Histology of the Kidney – Cortex to Medulla

Only a few organs are essential enough that the body owns two of their kind. The kidney, which filters metabolic products, toxins and drugs, is one of them. Modern medicine can replace it but the price dialysis patients have to pay is high. By contrast, the body is able to accomplish this complicated task within the smallest space. Every tissue of the kidney is specially structured depending on its task and the demanding function already manifests in its histology.  

Achalasia (Cardiospasm) — Diagnosis and Surgery

Mostly, achalasia has an insidious onset and the patients often had an odyssey of consultations of physicians and medical specialists before the correct diagnosis is made. It is all the more important to discuss achalasia in university and to remember it in the right situation – be it when examining patients or during exams. Below is a discussion of all the important information concerning achalasia.

Renal Physiology — Renal Clearance, Tubular Transport and the RAAS

The kidney’s physiology is an extremely complex issue in medicine, which is therefore a popular topic in exams. Since the kidney fulfills many important functions in the body in addition to its function as an excretory organ, it can be referred to as a multifunctional organ. The physiology of the kidney derives from the circumstances of its anatomical structures, especially those of the nephrons.

Breast Cancer (Mammary Carcinoma) — Diagnosis, Treatment and Survival Rate

As mammary carcinoma is the most frequent malignant disease in women, early detection is important. There are numerous diagnostic tools available, the mammogram being the gold standard. The next step would be developing a treatment plan that is individualized for the patient and the type of carcinoma. The following article will teach you to accurately diagnose mammary carcinoma and to initiate the appropriate therapy.

Miscarriages (Spontaneous Abortion) — Definition and Therapy

Abortions, or so-called miscarriages, frequently occur in the context of precocious pregnancies. Generally, the affected people consult a gynecologist since vaginal bleeding occurs during pregnancy. There are different forms of abortions, which can be very painful but also asymptomatic. Mostly, removal of the fetus is necessary to avoid infections or further bleeding.

Uterine Rupture — Symptoms and Treatment

A uterine rupture represents an important complication during pregnancy, as well as during delivery. A uterine rupture can become a life-threatening emergency which requires an immediate Caesarean section. The patient complains about severe, devastating pain. The uterus feels rigid when palpated, and signs of hypovolemic shock are visible. This article presents you with a compact overview of this complication.

Rheumatoid Arthritis (RA, Atrophic Arthritis) and Still's Disease — Symptoms and Treatments

The form circle of rheumatic inflammatory systemic diseases includes a number of diseases, whose etiology is mostly unknown. Due to the fact that specific antibodies are often found, diseases such as rheumatoid arthritis are considered autoimmune diseases. Therefore, the diagnosis of antibodies plays a significant role in the diagnosis of rheumatic diseases. The following article features two diseases, rheumatoid arthritis and Still's disease, both from the rheumatic disease form circle.

The Male Reproductive System

The male reproductive system with testicles and spermatic duct can be divided into different sections, but are treated as one unit in anatomy. This article is concerned with the anatomy and physiology of the male sexual organs. At the end, final pathology concludes with a general view on the most important dysfunctions.

Gonorrhea (The Clap) — Symtoms and Case Studies

Gonorrhea is one of the most common sexually transmitted diseases (STDs). Approximately 1 % of the world population is infected annually, which is equivalent to about 60 million people. The severity ranges from asymptomatic infection to disseminated gonococcal infection with sepsis and hematogenic spread. In the following article, you will read everything that is important to you as a physician - from Bonjour-drops to treatment.

Hyperthyroidism (Overactive Thyroid) and Graves' Disease (Basedow Disease)

Hyperthyroidism is caused by the excess of thyroid hormones T3 and T4. Graves’ disease is the most common cause of hyperthyroidism. Clinical features of hyperthyroidism are mostly due to the increased body’s metabolic rate. Hyperthyroidism is diagnosed by estimation of TSH and free T4 and T3. It is treated by pharmacological and surgical means.

Breast Cancer (Mammary Carcinoma) — Causes, Classification and Symptoms

Breast cancer (mastocarcinoma) is the most common form of cancer among women. Consequently, it will be encountered by doctors as part of their work in hospitals and medical practice. This disease exhibits a heterogeneous pattern including different histological subtypes, which may differ considerably in their degree of malignity and, consequently, in their clinical symptoms and therapy. The following article helps you to understand the clinical picture of mastocarcinoma, identify its symptoms and to classify its histology correctly.

Hypothyroidism (Underactive Thyroid) — Medication and TSH Levels

Hypothyroidism is caused by the deficiency of T3 and T4. Hashimoto's disease (autoimmune thyroiditis) is the leading cause of hypothyroidism in non-iodine deficient regions. Clinical features of hypothyroidism are primarily due to the accumulation of matrix substances and a decreased metabolic rate. Hypothyroidism is diagnosed by the estimation of TSH and free T4. It is treated by administration of synthetic T4.

Bacterial Infections: Gram-Positive Cocci

Although there are countless types of bacteria, it is of particular importance for a physician to know the most common ones. Knowing them includes the typical clinical picture they cause, as well as the basics about their structure, virulence, morphology and bacterial culture in order to be able to recognize and distinguish them from other bacteria and to treat and target them properly.

Shock as Cardinal Symptom and an Overview of Differential Diagnosis

Clinical parameters have to be met for making the diagnosis of shock. However, differential diagnosis are also of great importance since without knowing the cause, this life-threatening condition can recur at any time.

Huntington’s Disease (HD, Huntington's Chorea) — Genetics and Progression

The clinical picture of Huntington’s disease belongs to the category of movement disorders or extrapyramidal disorders and has autosomal dominant inheritance. The disease is characterized by a progressing hyperkinetic syndrome, where an increase in motions or an akathisia occurs. The complete medical picture is characterized by a combined indication of choreatic hyperkinesia, dementia as well as weight loss (anorexia), which is caused by an increased basal metabolic rate.

Mycology: Characteristics of Fungi, Fungal Diseases and More

Almost every clinically active doctor is confronted with fungal infections during their working life. It can be foot or nail fungi if they are a family doctor, fungal pneumonia if they are a haemato-oncologist, or irritant diaper dermatitis if they are a pediatrician. What matters is knowing these mycoses’ typical manifestations, diagnostic methods and therapies in order to treat patients in the best way possible. This article provides a complete insight into the wide field of mycology.

Coronary Artery Disease (CAD, Atherosclerotic Heart Disease) — Risk Factors and Prevention

Coronary heart disease (CHD) is the leading cause of death in industrialized countries. Numerous risk factors, which can be reduced through both behavioral and lifestyle changes, as well as drug therapy, are known for its origin.

Multiple Endocrine Neoplasia (MEN) — Symptoms

The multiple endocrine syndromes are inherited autosomal dominantly and consist of two superior groups (I and II). The second group can be further divided into three subgroups (IIa, IIb and FMTC-only). The respective upper groups have different causes on moleculargenetic level. Characteristic signature diseases i.a. appear as part of these syndromes.

Sarcoidosis — Symptoms, Diagnosis and Treatment

Sarcoidosis, also referred to as Morbus Boeck or Morbus Besnier-Boeck-Schaumann disease, usually attacks the lungs and is therefore frequently taught within the scope of pulmonary diseases. The bottom line is, however, that this disease can also affect any other organ meaning that medical students may not only encounter its clinical picture in many exams dealing with various specialties but also in their clinical routines in different specialty disciplines. You will learn in this article how to accurately classify the progression and symptoms of sarcoidosis and to take the right steps to diagnose and treat it.

Pleural Effusion — Diagnoses, Treatment, Transudate and Exudate

Medical students often encounter patients with pleural effusion during internships and their residency. These patients do not always suffer from dyspnea and an accurate clinical examination is crucial for the diagnosis. In oral and written exams, explaining the difference between transudate and exudate is a frequent task. In this article, you can find all the important information regarding pleural effusion – for clinical practice and your studies!

Mitral Valve Prolapse (Barlow Syndrome) — Diagnosis and Treatment

Acquired valvular heart diseases may manifest as insufficiencies (i.e., the incomplete closure of the valve), as a stenosis (i.e., a narrowing of the valve), or as a combined valvular defect. In principle, all valves can be affected. The aortic valve stenosis and the mitral regurgitation are particularly frequent.

Mitral Stenosis (Mitral Valve Stenosis) — Symptoms and Treatment

Acquired valvular heart diseases may manifest as insufficiencies (i.e. the incomplete closure of the valve), as a stenosis (i.e. a narrowing of the valve), or as a combined valvular defect. In principle, all valves can be affected. The aortic valve stenosis and the mitral regurgitation are particularly frequent.

Mitral Insufficiency (Mitral Regurgitation) — Classification and Diagnosis

Acquired valvular heart diseases may manifest as insufficiencies (i.e., the incomplete closure of the valve), as a stenosis (i.e., a narrowing of the valve), or as a combined valvular defect. In principle, all valves can be affected. The aortic valve stenosis and the mitral regurgitation are particularly frequent.

Aortic Stenosis (Aortic Valve Stenosis) — Diagnosis and Treatment

Acquired valvular heart diseases may manifest as insufficiencies (i.e., the incomplete closure of the valve), as a stenosis (i.e., a narrowing of the valve), or as a combined valvular defect. In principle, all valves can be affected. The aortic valve stenosis and the mitral regurgitation are particularly frequent.

Aortic Insufficiency (Aortic Regurgitation) — Symptoms and Treatment

Acquired valvular heart diseases may manifest as insufficiencies (i.e. incomplete closure of the valve), as a stenosis (i.e. a narrowing of the valve), or as a combined valvular defect. In principle, all valves can be affected. The aortic valve stenosis and the mitral regurgitation are particularly frequent.

Pneumothorax — Diagnosis and Treatment

Whether in the emergency room or in the exam: The pneumothorax, one of the most important differential diagnoses of acute chest pain, has considerable importance both in clinical practice as well as in medical studies. In particular, the pathophysiology should be fully understood by every single medical student. Continue reading and score in your next exam!

Defeating Inflammation and Pain – Arachidonic Acids Derivatives

When it comes to joint pain, it is mostly the cartilage that is inflamed and chronic headaches often result from neural inflammatory processes. Overcoming this pain will often seem impossible. What is little known: Superhormones, which can regulate the hormonal balance of the body, exist – these are eicosanoids, derivatives of arachidonic acid, an omega-6 fatty acid. What effect do the arachidonic acid derivatives have on the body? How can inflammatory responses be influenced and rheumatic diseases completely cured? You will learn about this and much more, in this article!

Cardiac Insufficiency (CHF, Heart Failure) and Pulmonary Edema — Classification and Treatments

Heart insufficiency as a disease of old age constitutes a serious clinical picture as its complications often result in death. Cardiogenic pulmonary edema, as a consequence of heart insufficiency, as well as non-cardiogenic pulmonary edema, are diseases indicating immediate measures as they are accompanied by rapid respiratory insufficiency. This article will provide you with everything you need to know about the epidemiology, etiology, classifications, diagnostics and therapy for cardiac insufficiency and pulmonary edema.

Parathyroid Diseases

The four parathyroid glands (glandulae parathyreoidae, epithelial cells) are each located in close anatomical vicinity of the two thyroid lobes. Here, one differentiates between the upper and the lower pair, which each originate from the endoderm of the third or fourth branchial pouches, respectively. The epithelial cells of the parathyroid glands produce the parathyroid hormone PTH, which plays an important role in the context of calcium homeostasis. In this context, symptoms are, for instance, either increased (hyperparathyroidism) or decreased parathyroid hormone levels (hypoparathyroidism).

Multiple Sclerosis (MS) — Definition, Symptoms and Treatment

Multiple sclerosis (encephalitis disseminata) is a chronic inflammatory auto-immune disease of the central nervous system. Due to its wide range of symptoms, it is known as a disease with many manifestations and primarily affects younger female patients. It is not only one of the most common neurological diseases, but is also frequently the topic of questions in exams due to its broad spectrum of symptoms and diagnostics.

Asthma (Bronchial Asthma) — Classification, Diagnosis and Treatment

It is the chameleon of pulmonology: With as many different clinical phenotypes, making a diagnosis isn’t always easy, and pathogenesis is complex. In the following article, you will find all the important information about one of the most common chronic diseases in human beings: bronchial asthma.

Adrenal Gland Disorders – Aetiology, Symptoms, Diagnostics and Treatment

The adrenal glands are involved in the production and secretion of hormones and control different metabolic pathways. Impairments in the adrenal glands (above the kidneys) thus have a significant impact on bodily functions. Hypercortisolism, hyperaldosteronism, adrenocortical deficiency and phaeochromocytoma are typical for this type of disease. Medical students should be familiar especially with the pathophysiology of the regulatory circuits of these diseases. Not only because this will make their daily clinical understanding of these diseasesmuch easier, but also because these circuits are well-suited for exams.

Diseases of the Vagina and the Vulva

Colpitis and bacterial vaginoses are diseases of the vagina. Apart from the symptoms themselves, there is always the risk of an ascending infection. Also inflammations of the outer genitals are an important clinical issue. For one thing, vulvitis is very frequent and ubiquitous. Furthermore, the outer genitals are so sensitive that diseases can cause great discomfort for the patient, even if they often are harmless. Here you can read all about pathogens, diagnostics and treatment.

Diabetes Mellitus — Types, Complications and Treatment

Diabetes mellitus is a metabolic disease in which chronic hyperglycemia can lead to a number of different early and late complications. The high prevalence of the disease with its heterogenic variety of symptoms demands interdisciplinary care including many specialties. Therapy options can be very successful here. Therefore, good knowledge of the clinical picture is absolutely relevant for up-and-coming physicians as contact with diabetics is part of the daily routine.

Hypothalamus Pituitary Adrenal Axis

The hormone balance of the body is often organized in feedback control systems which adjust to the respective demands of the body. The most important example of such a system is the hypothalamus pituitary axis. In the following article, the interaction with the adrenal gland and the synthesis of glucocorticoids like cortisol serve as examples for the explanation of a complete hormonally regulated system. This is especially important in order to exactly classify and understand the genesis of some important endocrine diseases.

On Sleeping – Expertise for Physicians

Etymologically, the term "sleep" comes from a word meaning "to slack"; the term's similarity to the word "slack" is no accident. Sleep is susceptible to various interferences, and many diseases, some harmless and some serious, first exhibit symptoms during sleep. It is therefore important to deal not only with the scientific findings, but also with possible sleep theories because many facts about sleep remain unknown. In the following guide, you will see what sleep is actually about, what stages it occurs in, and what sleep disturbances individuals may experience.

Signal Transduction and Hormones

What makes the difference between a human being and a fungus? A fungal network can be split in the middle – and both halves will survive and grow further. This does not happen if a human being split since our faculties and vital functions are spread over several locations within our organism. Our cells are specialized and organized into organs. The system only works if the organs work together and communicate. Hormones are the messengers in this communication system. The most important ones, the hormone receptors, and the signal cascades, are explained in the following article.

Gall Bladder and Bile Ducts – Structure and Function

The gall bladder (Latin: vesica fellea or vesica basilaris) is the storage organ for the bile and has a storage capacity of 40 – 50 ml. On its way from the liver to the duodenum, the bile runs through a duct system which is referred to as the bile ducts. The function of the gall bladder and the bile ducts is an elementary prerequisite for the complex process of digestion and can be impaired by typical diseases which a physician should know and understand. In order to understand the process of digestion, the spleen and the pancreas are also important.

The Esophagus - an Elastic, Hollow Organ Between the Pharynx and Stomach

The gullet (Greek 'oesophagus') is a hollow organ, approximately 25 cm long, assigned the task of actively sending our food to the stomach. The following article will provide you with a compact overview of the anatomy as well as the most important diseases of this organ and explains the physiology of the act of swallowing in understandable steps.

Female Reproductive Organs – Follicle Maturation, Mucous Membranes and Mammary Gland Tissue

A number of hormone-mediated processes take place in the female genitals. The follicle maturation in the uterus, formation of the mammary gland tissue and lactation are processes that are basic knowledge to medical students. In the following, the most important facts are listed. Afterwards you can use the three exam questions to control your knowledge.

Embryology: The Development of the Kidneys and the Efferent Urinary Tract (Weeks 3-6)

The development of the kidneys and the efferent urinary tract is complex and unalterably interconnected. It is an essential part of embryonic development and closely connected to sexual development. Malformations lead to severe consequences and are often not compatible with postnatal life. In medical studies this is one of the most important themes in embryology.

Female Genitalia: Anatomy and Function of the Female Genitourinary System

Get prepared for your anatomy exams: Here, you will find the most important information on the structure and function of the woman’s internal and external sexual organs.

Endocrine Organs and the Endocrine System

The endocrine system is an important and complex topic of the preclinical studies. The control of bodily functions through the messengers (hormones) of the endocrine system is the subject of anatomy, physiology and biochemistry; an accurate understanding of the hormones and their functions is essential for the clinical routine as well. The endocrine organs, in the stricter sense, include pituitary, thyroid, parathyroid, adrenal gland and pineal gland. They are easy to identify by their characteristic structure in the histological examination, but there are several things that should be considered. This article summarizes the most important facts about the endocrine organs.

Pancreas: An Endocrine and Exocrine Organ

The pancreas is two in one: exocrine and endocrine gland. It is essential for digestion and the carbohydrate metabolism. Thus, a loss in pancreatic function leads to severe clinical symptoms. In this article, you will get a compact overview of the structure, functions, and diseases of the pancreas.

The Large Intestine: The Colon as an Important Part of the Digestive Tract

The large intestine (lat. intestinum crassum) is distally adjacent to the small intestine, extending from the ileo-caecal valve to the anus. It is divided into the caecum with vermiform appendix, colon, and rectum. Thus, it is forming the terminal part of the human digestive tract. Particularly relevant for the exam are the relation of distinct intestinal sections with regard to the peritoneum, the differences between large and small intestine, and the general understanding of anatomy and physiology. The overview below provides all important basics about the large intestine.

The Small Intestine – At the Center of Digestion

The small intestine (Latin: intestinum tenue) spans a range of about 3-5m from the pylorus of the stomach to the Bauhin’s valve located at the passage to the colon. This section of the digestive tract represents the body’s most essential site of nutrient uptake and water resorption. Understanding the small intestine’s structure and processes is a crucial part of any physician’s education. The following article comprehensively sums up the most important facts about this central part of the gastrointestinal tract and its three sections – the duodenum, jejunum and ileum.

The Liver – The Central Organ of Metabolism

The liver (Latin: Iecur, Greek: Hepar) is the generalist among all organs – acting universally as center of metabolism, storage unit, detoxifying- and excreting organ. Medical staff is frequently confronted with diseases such as liver cirrhosis, hepatitis and fatty liver. Therefore, anatomical and biochemical knowledge of the liver is part of every medicine student`s basic training. Read this compact overview on structure, functions and diseases of the liver.

The Kidney – The Urinary System’s Main Organ

The kidney (Latin: Ren, Greek: Nephrós) is the urinary system’s main organ. In order to understand the microscopic structure of this organ, it is useful to comprehend well its function. And for this, one has to learn about the different cell types and their structure. The nephron is the kidney’s functional unit and shall be particularly discussed here. After studying this article, you will be able to explain its components. These are the renal corpuscles, renal tubules and the collecting duct system. You will now read a short overview of the functions of the human kidney.

Hypocalcemia — Definition and Treatment

Calcium levels are regulated by a hormone known as the parathyroid hormone (PTH), which is secreted by the parathyroid gland. If the body fails to maintain the calcium levels within the normal ranges, hypercalcemia or hypocalcemia results. Hypocalcemia is the condition in which the serum calcium levels in the blood are low. The presentation of the patients with hypocalcemia can vary from asymptomatic to life threatening situations.

Gallstones — Causes, Risks and Treatment

The biliary tract is composed of the gall bladder and the bile duct system. Biliary diseases are a group of diseases which affect the biliary system which is responsible for the storage and delivery of the bile salts and acids from the liver to the intestine. The pathology can sometimes be due to abnormal bile composition and sometimes due to abnormal biliary tree function. Gallstones are common in the United States, especially among the Hispanic population. Increased lipid concentrations in the gallbladder, protein and gallbladder sludge are the most common risk factors implicated in the mechanism of gallstones formation.

Gastroesophageal Reflux Disease (GERD, Acid Reflux) and Barrett’s Esophagus — Diagnosis and Treatment

Gastroesophageal reflux disease and its complications, particularly Barrett’s esophagus, is a much favored exam topic. Due to its high prevalence amongst the west industrial countries and its increasing incidence, medical students are expected to come across symptoms associated with this condition all the more often in daily clinical practice. That is why you should definitely be well-prepared for such an occasion.

Acromegaly — Symptoms and Treatment

“Aging is not a beautiful thing.“ This sentence is heard by many patients of acromegaly at their visit to the doctor. The changes in the body are often not recognized or misclassified by medical professionals for a very long time. Often, a diagnosis is only reached after 9 or even 10 years. A visit to the endocrinologist can shed light on the condition, however. There is an excess production of somatotropin. In this article, you will find all facts relevant for exam preparation, tips and case studies regarding acromegaly for your clinical clerkship or your final exams.

Types of Germ Cell Tumors (GCT) and Non Germ Cell Tumors

Testicular tumors are common and potentially annihilating to the male population. With a brief prologue to testicular tumors; this article focuses on the significant, relevant types of testicular tumors such as Germ Cell Tumors (GCTs) and Non-Germ Cell Tumors (NGCT).Various clinical, patho-physiological and prognostic aspects of the same have been expatiated.

Scrotal Mass, Congenital- & Acquired Hydrocele and Spermatocele

Scrotal masses are embarrassing and seemingly exigent trouble for males. Benign scrotal lesions present as testicular masses that transilluminate as against solid testicular tumors which do not transilluminate. This article expounds about benign, relevant, common scrotal masses such as congenital and acquired hydrocele and spermatocele.

Pediatric Allergic Proctocolitis

There has been a recent insurgence in pertinent knowledge regarding cell-mediated non-IGE food allergic disorders. Pediatric allergic proctocolitis is a frequent, significant cause of infant colitis. This article expatiates on clinic-patho-physiological aspects of the same.

Pediatric Meconium Ileus

Meconium ileus implies the presence of an intestinal obstruction in-utero or in neonatal period secondary to abnormally thick meconium. This article expatiates on patho-physiological aspects of meconium ileus and expounds on clinical features of the same. The article concludes with treatment, complications and prognosis of meconium ileus.

Complement System and Chronic Inflammation

The complement system is a part of the innate immunity that functions to identify foreign materials (pathogens, apoptotic cells and cellular debris), and induce immune response to eliminate these materials.

Wound Repair

A wound is the loss of the normal integrity of the skin and underlying soft tissue leading to a devitalized structure. Wounds can result from a skin injury, such as in the case of surgery, puncture wounds and abrasions or can be secondary to skin necrosis as a result of ischemia or pressure. People with diabetes mellitus, peripheral ischemia, venous stasis, infection and bad nutritional status are vulnerable to wounds due easy skin disruption and difficult healing processes that may lead to chronic ulcers. The process of wound healing occurs to protect the underlying structures from infection or blood loss. Wound healing occurs through several physiological stages in healthy individuals that include hemostasis, inflammation, epithelialization (granulation) or proliferation and finally fibroplasia or remodeling.

Inflammation

Inflammation is the physiologic body reaction in response to injury. The body tries to protect itself from harmful pathogens and physical or chemical irritants. Immune cells, fibroblasts, intra- and extra-cellular mediators are all involved in protecting the body, clearing the inflammatory products and help with the healing damaged parts. Sometimes the whole pathologic disorder is secondary to the body's reaction and inflammation as in cases of hypersensitivity, granulomas and autoimmune diseases. The following article describes various forms of inflammation as well as the body's reaction to them.

Burkitt Lymphoma

Burkitt lymphoma (small non-cleaved cell lymphoma) is one of the most aggressive and rapidly growing non-Hodgkin's lymphomas, with obvious predominance in children and young adults. This type of tumor requires urgent therapeutic intervention as the CNS and the bone marrow are involved in the malignant process since early stages of the disease.

Androgen Receptor Antagonists

Androgen receptor antagonists are compounds that block androgen receptors and antagonize the effect of androgens such as testosterone. Several conditions such as hirsutism, acne and prostate cancer are known to be dependent on androgens and antiandrogens can help alleviate the symptoms of these condition or even improve the outcome in patients with metastatic prostate cancer.

Hypothalamic–Pituitary–Gonadal (HPG) Axis Differentials

The Endocrine system of the body consists of endocrine glands which produce metabolic changes through the secretion of chemicals called hormones. The Pituitary gland is considered the ‘Master’ gland of the body. Hormones produced by different endocrine glands have different mechanism of actions. They are interrelated to each other and often regulate each others secretion.

Hormone-Binding Proteins

Proteins which bind to hormones and carry them to the target tissues to produce a desired effect are called hormone-binding proteins (HBP). There are four major categories of HBPs depending on the type of hormone they carry. These include: sex hormone-binding proteins (SHBG), thyroid hormone-binding proteins, cortisol binding proteins (CBG), steroid hormone-binding protein – serum albumin.

Syphilis (Treponema pallidum)

Treponema pallidum is member of family Spirochaetaceae. They are Gram negative, but some regard them too thin to be Gram stained. It is a delicate, tightly spiraled, motile spirochete having tapered ends. These microbes are poorly stained, so not detected by conventional light microscopy.

Pediatric Vomiting and Diarrhea

Pediatric gastrointestinal disturbances are common, often simple to manage and yet, unfortunately, life threatening in some instances. Sometimes, seemingly innocuous vomiting can be a harbinger of a serious underlying disease. This article expounds on various patho-physiological aspects of pediatric vomiting and diarrhea, and expatiates on the rapid aggressive treatment of accompanying dehydration.

Pediatric Constipation and Encopresis

Constipation is a very frequent, rather tantalizing presentation in the pediatric population. One needs to be wary of organic causes of constipation and treat the same judiciously. This article expatiates on pediatric constipation and encopresis.

Plasma Cell Neoplasms including Multiple Myeloma

Plasma cells neoplasms are the cancers of plasma cells that are responsible for producing antibodies in our bodies. These abnormal plasma cells proliferate rapidly in the bone marrow causing extensive bone destruction. They also produce increased quantities of monoclonal immunoglobulins (M-protein) that build up in our body, leading to the thickening of the blood and damaging our kidneys.

Splenomegaly

Splenomegaly is the enlargement of the spleen. The spleen is an integral part of the immune system that provides efficient immunosurveillance (production of WBCs defending the body from various infections) and hematopoiesis (“cemetery” for damaged and worn off erythrocytes). The spleen is allocated in the left upper quadrant of the abdomen behind the ribs 9-11, on the left from the stomach, and the tail of the pancreas, above the left kidney, the splenic flexure of the colon.

Types of Leukemia

Leukemia is blood cancer, this condition is characterized by exceeded amount of immature white blood cells in the blood stream (blasts), which normally remain in the bone marrow for their further maturity or sent to special organs (spleen, thymus) to get ready for their proper functioning. White blood cells are responsible for the adequate immune reaction of the body to various antigens (infections, malignant cells, foreign bodies, allergens); hence, immature cells cannot cover this function fully and fail to perform in the way m proper white cell do. Thus, the body easily contracts different infections as it is not capable to fight them, as the disease advances the bone morrow becomes exhausted shooting even more damaged cells or stops producing blood cells at all (hemogenic collapse).

Penis Disorders: Types and Clinical Representation

Penile disorders are heterogenous and desolating to the male population. This article succinctly expounds Hypospadiasis, Epispadiasis, Phimosis, Paraphimosis, Peyronie’s disease, Priapism, Penile carcinoma in situ and Squamous cell carcinoma.

Lymphoid Neoplasms

Lymphoid neoplasms are divided into the two main groups: Hodgkin and Non-Hodgkin Lymphomas. The former ones are the most curable due to the specific pathogenesis of the ailment and recent advance in the methods of treatment (5 years survival for the patients with favorable prognosis 98% and 85% with a less benign one). The malignant cells form in the lymphatic system; mainly, they are represented by white blood cells, namely, immature B-lymphocytes. HL may take place in any part of the lymphatic system. This disease was described by Dr. Thomas Hodgkin in 1832 as a type of cancer of the lymph nodes.

Follicular Lymphoma

There are two types of lymphomas - Hodgkin Lymphoma (Hodgkin`s Disease) and Non-Hodgkin Lymphoma. The follicular lymphoma belongs to the second group. It is a slow-growing B-cell lymphoma, and the second most common sub-type of NHL; most often occurs due to chromosomal translocation t(14;18) causing bcl-2 gene rearrangement. Most of the patients with FL are asymptomatic; hence they remain undiagnosed for years and usually detected in the advanced stages.

Diffuse Large B-Cell Lymphoma

Diffuse Large B-Cell Lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL), accounting for one-third of all NHLs in the western world. It is a very aggressive, fast-growing neoplasm unless diagnosed and treated timely (survival is less than one year without a cure). This illness is characterized by painless enlarged lymph nodes. It has a very close affiliation with genetic issues, Epstein-Barr virus (EBV) and immunocompromised conditions (congenital and acquired: HIV, AIDS).

Non-Hodgkin's Lymphoma — Diagnosis and Staging

Non-Hodgkin's lymphomas (NHL) are hematological malignancies with high prevalence worldwide (accounts for about 4% of all cancer cases and 2.7% of all cancer deaths). They are cancers of the lymphatic tissues (mainly lymph nodes), affecting the lymphocytes, either B-cells (70%) or T-cells/NK cells (30%). NHLs are five times more common than the Hodgkin's lymphoma (HL). The following article discusses both B-cell type NHLs and T-cell type NHLs.

Haemophilus Ducreyi — Chancroid, Diagnosis and Treatment

In 1889, Auguste Ducrey at the University of Naples published his research about the causing agent of chancroid (ulcus molle or chancre mou) associated with the presence of genital ulcers, Haemophilus ducreyi, which is a gram-negative bacillus, was named after the scientist. Chancroid is a sexually transmitted disease (STD), very often found in HIV sufferers, and the etiologic agent in chronic skin ulcers in the South Pacific region.

Gardnerella Vaginalis — Symptoms and Differential Diagnosis

In 1955, a cause of nonspecific vaginitis (bacterial vaginosis) was described by two scientists: Gardner and Dukes. The bug was named Haemophilus vaginalis, later the name was changed to Corynebacterium vaginale, and finally the bacterium responsible for the condition obtained the name Gardnerella Vaginalis (1980) after the scientist who discovered it.

Syphilis — Types, Diagnosis and Treatment

The causative factor of syphilis is Treponema pallidum (TP), family motile Spirochaetaceae, which is very common all over the world. TP can be transmitted via close sexual contact or transplacentally (vertical way). Also, syphilis can be acquired or congenital, both of them having early and late stages. TP invades the host body through the breaches in the squamous or columnar epithelium affecting lymphatic nodes and disseminates with the blood stream to all parts of the body. http://treponemapallidum.org/treponema_pallidum.jpg Figure: Treponema palladium

Kallmann Syndrome — Diagnosis and Treatment

Kallmann’s syndrome is one form of reproductive failure due to severe hypogonadism that is associated with complete loss of the sense of smell. Kallmann’s syndrome is a genetic disorder and several genes such as KAL1, FGFR1, FGF8 and PROKR2 have been associated with the condition. While KAL1 is responsible for the x-linked inherited form of the disease, the other genes are found in patients with autosomal dominant Kallmann’s syndrome. Hormonal replacement therapy is indicated to correct the severe hypogonadism.

Chemotherapy Drugs — Steroids, Alkylating Agents, Antimetabolites and More

Chemotherapy (chemo) is the specific systematic treatment administered in oncological practice for malignant neoplasms in order to destroy chaotically dividing abnormal cells. Chemo is a part of anticancer treatment along with radiotherapy, immunotherapy and surgery. The drugs used in chemotherapeutic protocols cannot be purchased over the counter; they can be taken with prescription only. Cancer drugs influence and actions are directed to the malignant cell reproduction, cure, control, palliation or chemoprevention.

Thymoma — Staging and Treatment

The thymus is an important part of our immune system, located in the anterior mediastinum. Due to this fact, the diagnostics, access, and management of its neoplasms (thymomas) are somewhat difficult. The thymomas often involve the contiguous organs and are also frequently associated with other paraneoplastic conditions, making the condition even more complicated.

Endometrial Polyp — Symptoms and Diagnosis

Abnormal uterine bleeding (AUB) is calamitous for many women. With a brief prologue to AUB, this article focuses on the significantly relevant causes of AUB, such as endometrial polyp, leiomyoma and leiomyosarcoma.

Endometrial Hyperplasia — Diagnosis and Treatment

Endometrial hyperplasia is abnormal growth of the endometrium in the uterus. It is caused by excess estrogen unopposed by progesterone. Pathology shows an increased gland-to-stroma ratio and can show atypia. Atypia is linked to endometrial cancer, the most common gynecological malignancy in the developed world. Treatment includes progesterone therapy and if there is atypic hysterectomy is recommended. Lynch syndrome has a high lifetime risk of developing endometrial cancer.

Gynecomastia — Symptoms and Treatment

Gynecomastia is defined as the glandular enlargement of the male breast due to increased glandular cellular proliferation. Patients present with breast enlargement in addition to other symptoms related to the cause of gynecomastia, such as signs of liver disease or hyperthyroidism. Gynecomastia is also a normal occurrence in neonates and pubertal boys and observation, without any intervention, should be provided for cases in these age groups. If treatment is needed, it should be tailored against the etiology of gynecomastia. Symptomatic gynecomastia that does not resolve with treating the cause can respond to antiestrogens or aromatase inhibitors. Finally, surgical intervention should be offered only to severely symptomatic cases.

Erectile Dysfunction (ED; Impotence) — Symptoms and Diagnosis

Erectile dysfunction is defined as the inability to achieve or maintain a penile erection that would result in the inability to perform vaginal sexual intercourse. Systemic, neurologic and local diseases can cause erectile dysfunction which include but are not limited to diabetes, multiple sclerosis and Peyronie’s disease respectively. History and physical examination are important for the diagnosis of erectile dysfunction. Treatment can be medical with testosterone, sildenafil, or specific medical treatment according to the etiology. Surgical correction might include a penile prosthesis.

Hypogonadism — Symptoms and Diagnosis

Male hypogonadism is a condition characterized by decreased testosterone production and sperm quality or production. This can be the result of primary testicular failure or secondary testicular failure due to pituitary or hypothalamic disorders. Symptoms of hypogonadism include erectile dysfunction, decreased libido, and regression or absence of secondary sexual characteristics. Total testosterone levels are below 300 ng/Dl. Testosterone replacement therapy is the mainstay of treatment.

True Hermaphroditism — Ovotesticular Disorder of Sexual Development

Ovotesticular disorder of sexual development is characterized by the presence of an ovotesticular gonad that contains both ovarian and testicular elements. Patients are usually born with ambiguous genitalia but the diagnosis is rarely confirmed before puberty. The most common karyotype is 46, XX but 46, XY can be identified in approximately 10% of the cases. Medical treatment of ambiguous genitalia is usually emergency based to treat life threatening conditions such as salt-wasting syndrome in congenital adrenal hyperplasia. Conservative surgery to remove part of the ovotestis gonad is the treatment of choice for this condition.

Leydig Cells and Sertoli Cells — Sex Cord-Stromal Tumor of the Testis

Sex cord stromal tumors of the testis can originate from either Leydig cells or Sertoli cells. Leydig cells tumors are responsible for 70%. These testicular tumors are known to cause estrogen excess production and a low testosterone-estrogen ratio. Alpha-fetoprotein, human chorionic gonadotropin and lactate dehydrogenase levels are normal in this type of tumors. Ultrasonography confirms the diagnosis of a testicular mass, while biopsy and histologic examination confirm the diagnosis of either Leydig cells or Sertoli cells tumor. Treatment of choice is radical inguinal orchiectomy.

Intraductal Papilloma — Symptoms and Diagnosis

Ductal papillomas are commonly identified in women presenting with pathological nipple discharge. However, pathological nipple discharge can also be identified in patients with breast cancer. Patients with ductal papillomas can have either a solitary lesion or multiple papillomas. Solitary papillomas are usually central and large, while multiple papillomas tend to be peripheral and small in size. Whereas large solitary papillomas are not thought to be precancerous, small multiple papillomas seem to increase the risk of breast cancer. Patients with a single papilloma might benefit from microductectomy while those who have multiple papillomas are possible candidates for surgical intervention due to their increased risk of developing breast cancer.

Fibroadenoma of Breast — Diagnosis and Treatment

Fibroadenomas are benign breast tumors that arise in young women. Histological examination of these lesions usually reveals lobular hyperplasia. Known risk factors for breast cancer, such as early age of menarche or nulliparity, do not increase the risk of fibroadenomas. The diagnosis of fibroadenomas is based on the physical finding of a mobile, non-tender breast mass, that is slightly hypoechoic on ultrasonography and that has cell clusters in fine needle aspiration. Fibroadenomas that are asymptomatic and small in size should be treated conservatively, while ones that are growing rapidly in size and are symptomatic should be surgically excised.

Mastitis — Symptoms and Treatment

Mastitis is the inflammation of the mammary gland tissue, which can be lactational or non-lactational. It is most common in women within child bearing age. Routes of transmitted infection can be from the skin, lymph nodes or primarily in the mammary glands. Organisms isolated include staphylococcus aureus, staph epidemidis or streptococci. Swelling and rupture of mammary ducts will result in an abscess which will mimic breast mass or carcinoma.

Limbic System Disorders: Wernicke-Korsakoff Syndrome, Klüver-Bucy Syndrome, Alzheimer's Disease

The limbic system is a cluster of brain structures, mainly responsible for the emotion, behavior, and memory and arousal response. It is thought to be an outcome of the evolutionary response that occurred in all mammals including human beings. However, the development of this system is far greater in human beings compared to other mammals.

Types of Ovarian Cancer: Germ Cell Tumor (GCT), Dysgerminoma, Metastatic Ovarian Cancer and more

Ovarian cancer is becoming challenging every year due to the ever increasing number of new diagnoses. It is considered the 5th leading cause of cancer deaths among women; with about 14,000 deaths and more than 20,000 new cases every year.

Varicocele (Scrotum Varicose Veins) — Diagnosis and Treatment

Varicoceles are defined as abnormal dilations of the spermatic vein or the pampiniform plexus and are more common on the left side. Careful physical examination of the contralateral scrotal side is essential as bilateral varicoceles are common. While the diagnosis of varicoceles can be done clinically especially when seminal fluid analysis is impaired, imaging studies with color-flow Doppler remain an important part of the diagnostic workup. Symptomatic varicoceles or subfertile men with varicoceles should have their varicoceles surgically corrected either by a minimally invasive procedure, or by percutaneous embolization.

Cervical Cancer — Diagnostics and Therapy

Thanks to the early detection program, the incidence of cervical cancer is declining. Every woman from the age of 20 is admitted once a year and includes various examinations. If a malignant disease is suspected, further diagnostic steps should be taken and a treatment plan adapted to the patient should be developed. The following article will help you to diagnose cervical cancer reliably and to initiate the right steps in the therapy.

Testicular Cancer (Malignant Neoplasm of Testis) — Diagnosis and Treatment

Testicular cancer is an uncommon malignancy. Most of testicular cancers are of the germ cell tumor type and they can be classified into seminomas or nonseminomas. The most common presentation of testicular cancer is a painless testicular nodule. Alpha-fetoprotein can be elevated in nonseminomas, while beta-human chorionic gonadotropin is usually elevated in both seminomas and nonseminomas. Radical inguinal orchiectomy along with retroperitoneal lymph node dissection helps in confirming the diagnosis and can be curative in early stages of testicular seminomas.

Testicular Torsion — Diagnosis and Treatment

Testicular torsion is the most common cause of acute testicular and scrotal emergency pain. Patients usually have unilateral testicular torsion and the most common etiology is a high abnormal attachment of the tunica vaginalis. Abnormal attachment of the tunica vaginalis results in spermatic cord increased mobility and predisposes to spermatic cord twisting and subsequent testicular torsion. Testicular infarction and necrosis can ensue if the testis is not detwisted in the first 8 hours and is usually complete by 24 hours of torsion onset. Bilateral testicular fixation to the tunica vaginalis is recommended.

Prostatitis (Prostate Inflammation) — Diagnosis and Treatment

Prostatitis is a term that indicates inflammation of the prostate which can be infectious or non-infectious. Bacterial prostatitis is easier to identify clinically and their management is better established. The main diagnostic tools for prostatitis are clinical history and physical examination. Prostate massage by digital rectal examination is only recommended in patients with chronic prostatitis and not in acute bacterial prostatitis. Broad spectrum antibiotics are the mainstay therapy for bacterial prostatitis, while symptomatic treatment is indicated for chronic pelvic pain syndrome without evidence for uropathogens.

Cryptorchidism (Undescended Testicle) — Diagnosis and Treatment

Cryptorchidism is a term used to describe the failure of descent of the testicle into the scrotum. This condition is common among premature boys, 33% of them, and can still be identified in full-term boys in approximately 5%. Ultrasonography can help localize inguinal testicles, while abdominal magnetic resonance imaging or laparoscopy can identify non-palpable intraabdominal testis. Hormonal treatment is indicated at 6 months of life and surgical correction is needed if hormonal therapy failed. Surgical treatment should be attempted before one year of life to achieve better fertility outcome.

Non-Invasive Breast Cancer: Ductal Carcinoma In Situ (DCIS) — Diagnosis and Treatment

Non-invasive breast cancer can be either ductal carcinoma in situ or less commonly lobular carcinoma in situ. Ductal carcinoma in situ is of epithelial type, and there is usually no basement membrane invasiveness. Because of the lack of invasiveness, these tumors are unlikely to metastasize by the lymphatics or blood vessels. Ductal carcinoma in situ is usually diagnosed by a mammography and not by physical examination. Microcalcifications on mammography are the most common presenting feature. Local excision of the lesion is recommended to obtain histopathologic data and guide treatment. Total mastectomy or breast conservation therapy are the two options for the treatment of ductal carcinoma in situ.

Types of Peptide Hormones: Oxytocin and Vasopressin

The posterior pituitary secretes two hormones, oxytocin and vasopressin (anti-diuretic hormone). The word oxytocin literally means "quick birth" in Greek, which is an accurate description of the hormone's action. The following article discusses the positive and negative effects of oxytocin and vasopressin as well as their use as therapeutic options.

Vitamin D Deficiency (Hypovitaminosis D) and Osteomalacia — Symptoms and Treatment

Vitamin D is a fat-soluble substance vitamin. This vitamin is essential for proper function of the human body and is considered a hormone rather than a vitamin. Its synthesis takes place in the body – under ideal conditions, it may not be required in our diet. In bone tissue, where vitamin D is required the most, it is needed for deposition of calcium in bone and its lack usually leads to various pathologies including rickets in children and osteomalacia in adults. To understand the pathology of these diseases, we must first learn how this vitamin is produced and the effects it has on various systems in the human body.

Wilson's Disease (Hepatolenticular Degeneration) — Staging and Treatment

Wilson disease is an autosomal recessive inherited disorder related with copper metabolism. This rare condition is characterized by excessive deposition of copper in target organs like liver, brain, and other tissues.

Rickets (Osteomalacia) — Symptoms and Treatment

Rickets, though not a common disease in the affiliated population, is one of the diseases which affect the growth of children in the developing countries (where the nutritional deficiency is common). Rickets can be characteristically identified using the clinical features and they can be confirmed using biochemical investigation. In this article, we will discuss the various features of rickets in detail.

Leukemia (Blood Cancer) — Classification and Typification

When the physicist and Nobel Prize winner Marie Curie died in 1934, her blood was flooded by white blood cells. During her work as a researcher and the years of contact with radioactive substances, she had developed a leukemia. There are various causes and forms for the disease, which is also known as blood cancer. Learn here about these and you will be well versed in the popular examination topic Leukemia.

Lupus (Systemic Lupus Erythematosus; SLE) — Diagnosis and Treatment

The autoimmune disease lupus erythematosus belongs to the collagenoses and can show very different clinical symptoms: The symptoms range from mild conditions to severe organ manifestations which makes the diagnosis not easy sometimes. Read all the important facts about lupus erythematosus here to be prepared for the exam and the subsequent medical daily routine.

Chlamydia (Chlamydia Bacteria Infection) — Symptoms and Treatment

Chlamydiosis is caused by gramnegative bacteria from the Chlamydiaceae family. The mainly sexually and perinatally transmitted pathogens cause disease in the eye, genital and pulmonal area. Untreated chlamydial infections may have serious consequences. Learn all about pathogenesis, symptoms, diagnosis and treatment of infections with chlamydia in this article. As a result, we guarantee optimal preparation for clinical examinations and practical medical work.

Pyloric Stenosis (Gastric Outlet Obstruction) — Causes and Symptoms

Pediatric pyloric stenosis, also known as infantile hypertrophic pyloric stenosis, is a condition that is characterized by pyloric muscle hypertrophy and hyperplasia which leads to gastric outlet obstruction. Infants usually present in their third week of life with repeated, projective vomiting that is associated with an abdominal olive-like palpable mass. The clinical picture is usually enough to make the diagnosis, but ultrasonography can help confirm the diagnosis of pyloric stenosis in most of the patients. Surgical correction with a pyloromyotomy is the treatment of choice.

Hirschsprung's Disease (Congenital Megacolon) — Symptoms and Causes

Pediatric Hirschsprung Disease occurs when there is an absence of the ganglionic layer in the myenteric layer of the anus and the submucosa of the colon. This leads to the failure of relaxation of the colon, delayed passage of meconium, abdominal distension and constipation. Laboratory investigations are helpful if the patient develops enterocolitis where leukocytosis might be evident. Barium enema studies and histologic examination of biopsies confirm the diagnosis of Hirschsprung disease, and surgical resection of the aganglionic part of the colon is the current treatment of choice.

Salpingitis — Diagnosis and Treatment

Salpingitis is the inflammation of the fallopian tubes usually due to gonorrheal or chlamydial infections, but other gram-negative and anaerobic bacterial pathogens have been also implicated. Patients can present with lower abdominal pain, fever and an elevated erythrocyte sedimentation rate. Ultrasonography and diagnostic laparoscopy can help confirm the diagnosis of salpingitis and exclude other differential diagnoses or associated complications such as hydrosalpinx, adhesions, and tubo-ovarian abscesses. Antimicrobial management is the mainstay of treatment and surgical management should be reserved to patients with non-responsive tubo-ovarian abscesses or ruptured abscesses.

Anovulatory Cycles — Diagnosis and Treatment

Anovulatory cycles are a symptom and not a disease. Polycystic ovary syndrome, pituitary microadenoma, impaired GnRH release, and hypothyroidism are common etiologies for anovulation and should be excluded. Patients can present with amenorrhea which needs etiology-specific treatment or with acute dysfunctional uterine bleeding which might need emergency treatment. Emergency treatment can be either medical with estrogen or surgical with dilation and curettage. Oral contraceptive pills can be used in an attempt to make the menstrual cycle more regular before trying more specific treatments.

Fallopian Tube Cancer — Diagnosis and Treatment

Fallopian tube tumors are rare with an incidence of 3.6 per one million. Fallopian tube carcinoma is of epithelial origin and share similar pathogenesis mechanisms with epithelial ovarian cancer. Early obstruction of the fallopian tube results in rapid onset of symptoms such as abdominal pain and distension and patients with fallopian tube carcinoma usually present at an early stage. Treatment of choice for early stage fallopian tube carcinoma is surgical removal of the tumor and any involved pelvic structures.

Endometriosis — Causes and Symptoms

Endometriosis is a common disease in which ectopic normal endometrial tissue is implanted outside the uterus. The ovaries along with other pelvic organs can be involved. While laboratory investigations have a limited utility in the diagnosis, imaging and laparoscopic evaluation can be used to confirm the diagnosis of endometriosis. Medical treatment of endometriosis involves hormonal manipulation with oral contraceptive pills, danazol, GnRH analogues and progesterone supplementation. Surgical treatment can be either conservative or radical, depending on whether reproduction is wished to be preserved or not.

Pediatric Appendicitis — Symptoms and Surgery

The progression of symptoms with appendicitis typically occurs at a rapid pace, with a small diagnostic opportunity before perforation; therefore, it is very important for physicians to know exactly how to diagnose and treat appendicitis in children.

Intussusception — Symptoms and Differential Diagnosis

Intussusception occurs when a distal segment of bowel telescopes into the lumen of proximal bowel. This can happen at any age, but is most common in infants between three and eighteen months. It is the most common cause of bowel obstruction in three months of age to six year old children. This article gives you brief information about the epidemiology, etiology, pathology, signs and symptoms, diagnosis and treatment of pediatric intussusception.

Baby Colic (Infantile Colic) — Symptoms and Treatment

Pediatric colic is a very common symptom that occurs in infants during the first few months of life, and tends to disappear by the fourth month. Its causes are poorly understood and there are various theories explaining it as a reaction to food allergies, parental stress, gastrointestinal immaturity, maternal smoking and other factors. This article gives an overview of the condition with its epidemiology, etiology, symptom, diagnosis and differential diagnosis, and treatment.

Acute Abdominal Pain in Children — Differential Diagnosis

Acute abdominal pain is a common symptom in the pediatric population. As with adults, surgical causes must be excluded, but in children there is greater urgency due to lower physiological reserves. Being aware of the differential diagnoses of acute abdominal pain in children, both surgical and medical, is important knowledge for students, in addition to details about the assessment and management of key conditions.

Euthyroid Hyperthyroxinemia and Euthyroid Hypothyroxinemia — Differential Diagnosis and T3-Resin Uptake

The thyroid gland is an endocrine organ that secretes the hormones triiodothyronine (T3) and thyroxine (T4), which are, in turn, under the influence of the TSH and the TRH. Though hyper- and hypothyroidism remain the common clinically manifesting condition of the thyroid, in some cases, the patient remains symptomless with either excess or decrease in thyroxine levels, along with normal TSH levels. This is termed as euthyroid hyperthyroxinemia and euthyroid hypothyroxinemia, respectively. The cause is altogether different from the thyroid and should not be inappropriately managed as hyperthyroid and hypothyroid states.

Ovarian Cancer — Stages and Survival Rate

Ovarian cancer is of epithelial origin in 60% of the patients. Most patients present at an advanced stage due to the lack of specific symptoms except for mucinous ovarian cancer where abdominal distension is so severe that patients present very early in the disease. Once the diagnosis is suspected, the patient usually undergoes a transvaginal ultrasonography, abdomen-pelvic CT scan and CA-125 concentration measurement. If an ovarian cyst or mass is identified, its characteristics should be noted and a risk of malignancy index can be calculated. Treatment involves neoadjuvant platinum-based chemotherapy with or without surgery.

Polycystic Ovary Syndrome (PCOS, Polycystic Ovaries) — Causes and Treatment

Polycystic ovary syndrome is an endocrinological disorder where there is hyperandrogenism, ovarian dysfunction and multiple ovarian cysts. The most common presenting features are hirsutism, acne, metabolic syndrome and biochemical hyperandrogenism. Patients also have hyperlipidemia and an impaired glucose metabolism. Treatment involves oral contraceptive pills for menstrual abnormalities and hyperandrogenism, metformin for hyperandrogenism and infertility and clomiphene for infertility. Infertile women who do not respond to clomiphene might benefit from gonadotropins or laparoscopic ovarian drilling.

Pre-eclampsia (Toxemia) — Symptoms and Treatment

Pre-eclampsia is a condition that is characterized by an elevated blood pressure and proteinuria and that usually happens after 20 weeks of gestation. Women with pre-eclampsia can also develop hemolysis, thrombocytopenia and elevated liver enzymes known as HELLP syndrome or microangiopathic hemolytic anemia. Due to wide-spread endothelial dysfunction, they might also develop brain edema and eclampsia. Laboratory investigations show thrombocytopenia, proteinuria > 30 mg/day, hemolysis and elevated liver enzymes. The only known curative treatment for pre-eclampsia is delivery of the fetus.

Gestational Trophoblastic Disease (GTD) — Symptoms and Treatment

Gestational trophoblastic disease is a malignant tumorous disease of the placental trophoblasts and can be classified into partial or complete molar pregnancy. Patients with gestational trophoblastic disease are usually identified early in the disease by the detection of a markedly elevated hCG level and characteristic ultrasound findings, such as focal cysts in partial moles and extensive villi edema in complete moles. Complete evacuation of the molar pregnancy is indicated as first line therapy, while chemotherapy can be reserved for patients with recurrent disease or GTN. Future normal pregnancy is expected to be not affected by a previous history of gestational trophoblastic disease.

Primary Sclerosing Cholangitis (PSC) — Symptoms and Life Expectancy

Primary sclerosing cholangitis is a common cause of chronic liver disease in patients with ulcerative colitis. It is an autoimmune disorder and patients usually present with jaundice, fever, abdominal pain and elevated alkaline phosphatase. Endoscopic retrograde cholangiopancreatography is the best diagnostic tool to confirm the diagnosis of primary sclerosing cholangitis. Multiple strictures and dilations of the biliary system is usually observed. Symptomatic treatment, immunosuppression and ursodeoxycholic acid are used in early stage PSC. In later stages, liver transplantation might be the only option available to alter prognosis and survival.

Candidiasis (Yeast Infection) — Symptoms and Treatment

Candidiasis is an opportunistic fungal infection that can affect the gastrointestinal tract, skin, or be systemic in immunocompromised patients. Clinical presentation is different from one patient to another and is dependent on the severity of immunosuppression and the anatomical site of the infection. Patients with candidiasis need topical antifungals for localized disease and systemic antifungals for esophagitis and systemic candidiasis. The important distinction between patients with neutropenia and without neutropenia can affect the choice of antifungals in systemic candidiasis.

Pelvic Inflammatory Disease (PID, Pelvic Infection) — Diagnosis and Treatment

Pelvic inflammatory disease is infectious in etiology and is closely linked to sexually transmitted disease. Pelvic inflammatory disease is common in the United States with an estimated incidence of 2.5 million. The condition can be diagnosed clinically, with lower abdominal pain, cervical motion tenderness, an elevated erythrocyte sedimentation rate and fever. Once diagnosed, the patient should be put on empirical antibiotic therapy that should cover gonorrhea, chlamydia, gram-negative organisms and anaerobes. Patients with complications, such as abscess formation or sepsis, might benefit from laparoscopic surgery.

Duodenal Atresia — Symptoms and Treatment

Duodenal atresia is one of the most common inborn defects of the digestive system, namely of the intestine, that is often associated with other congenital malformations and genetic pathologies (21 trisomy). The frequency of occurrence of this disorder is affected by the hypoxia of the fetus in the first trimester of pregnancy and is caused by severe chronic respiratory and cardiovascular diseases, stress, diabetes, drug and alcohol abuse during pregnancy. Nowadays, duodenal atresia is one of the most common congenital defects in the neonates. Moreover, it is well-diagnosed and curable in most of the cases, if timely detected and not neglected.

Thyroglossal Cyst — Differential Diagnosis and Complications

The thyroglossal cyst forms one of the most common pathologies of the neck after lymphadenopathy. Though it is a benign condition, the complications which might arise because of it are a major concern. This condition is dealt with in a surgical point of view and is discussed in detail in this article.

Alcoholic Liver Disease — Laboratory Evaluation and Prognosis

The liver is responsible for detoxification of foreign materials, food, drugs and alcohol absorbed from the gut to the blood. Alcohol has detrimental effects on the liver, which may range from fatty liver, alcoholic hepatitis to liver cirrhosis. Alcoholic liver disease is the most common liver disease in western countries. Up to 20% of heavy drinkers will develop liver cirrhosis.

Nonalcoholic Steatohepatitis (NASH) — Symptoms and Treatment

Non-alcoholic steatohepatitis, one form of the non-alcoholic fatty liver disease spectrum, has been associated with obesity and lipid dysregulation. The patient usually presents with abnormal lipid and liver profiles. The most evidence based treatment for non-alcoholic steatohepatitis involves around weight loss, glycemic control and avoiding liver insulting drugs. Our current understanding of the pathogenesis of non-alcoholic steatohepatitis is still limited but novel and more specific treatments are being developed.

Liver Transplantation — Clinical Presentation and Post-Transplant Complications

In patients with end-stage liver disease (ESLD), the definitive treatment is a liver transplant. In the United States, the most common indication for liver transplantation is hepatitis C followed by alcoholic liver disease. Immunosuppression is indicated post-implantation and the most common complications are rejection and infection.

Anticonvulsants (Antiseizure Drugs) — Classification and Side Effects

A seizure is a brief episode of signs/symptoms resulting due to uncontrolled, abnormal electrical activity in the brain. In this article, we will study in detail about the classification, mechanism of action, and adverse effects and interactions of antiseizure drugs. First and second line drugs for various types of seizures will also be studied.

Ischemic Colitis — Physical Examination and Diagnosis

Ischemic colitis (ischemic disease of the colon) was first described in 1966. It occurs when there is an occlusion of branches of the superior mesenteric (SMA) or inferior mesenteric arteries; the vast majority of cases describe the lesion in the splenic flexure and left colon. This severe illness is very common among the elderly with pronounced cardiovascular disorders. The onset is followed by an acute stabbing abdominal pain and rectal bleeding with diarrhea in most of the cases. Ischemic disease of the colon requires immediate actions; the sooner the treatment is administered, the more benign the outcome is.

Schatzki Ring — Signs and Symptoms

Esophageal rings are the most common esophageal abnormality and Schatzki rings represent the majority of them. Schatzki rings occur in the lower end of the esophagus and can be classified into types A and B rings. Type A ring is a muscular ring while type B is mucosal constriction. Schatzki rings respond very well to dilation therapy.

Diabetes Insipidus (DI) — Causes and Symptoms

Patients with diabetes insipidus present with polyuria, urinary output > 3 L per day and can be central or nephrogenic in origin. In central diabetes insipidus, there is a decrease in the secretion of antidiuretic hormone (ADH), while in nephrogenic diabetes insipidus, the kidneys are unable to concentrate the urine due to ADH resistance.

C. Difficile Enteritis — Symptoms and Treatment

Hospitalized patients who receive antibiotics are at risk of developing Clostridium difficile colitis. Antibiotics change the normal colonic bacterial flora and C. difficile colonize the colon in these patients. C. difficile produces toxins that cause inflammation of the colonic mucosa. Even though clindamycin has been traditionally linked to the development of C. difficile colitis, almost all antibiotics can cause the disease.

Pancreatic Pseudocysts — Diagnosis and Treatment

Pancreatic pseudocysts are a complication of acute pancreatitis, and they are more common when the etiology is alcohol-related. These pseudocysts do not have an epithelial wall, and their fluid content is rich in amylase, lipase and trypsin. Abdominal CT scan is the diagnostic modality of choice to confirm the diagnosis of pancreatic pseudocysts and exclude complications. MRI or ERCP can be used to assess communication between the pseudocyst and the pancreatic duct, and if present, transpapillary drainage of the pseudocyst can be attempted.

Bronchogenic Carcinoma — Diagnosis and Treatment

Bronchogenic carcinomas include small cell carcinoma, squamous cell carcinoma, adenocarcinoma, large-cell carcinoma and undifferentiated carcinoma. Bronchogenic carcinoma is clearly associated with tobacco smoking. Once the diagnosis of bronchogenic carcinoma is confirmed by a biopsy study, disease staging with CT or FDG-PET is indicated because treatment is stage-based. While stage I and II disease benefit from surgical lobectomy, chemotherapy is essential for patients with stage III and IV.

Steroid Hormone Receptors

Endocrinology refers to the study of endocrine system; more specifically, it is the study of hormones, the receptors to which the hormones bind, the intracellular signaling cascade they invoke, and the diseases and conditions associated with them. It is a communication system comprising of endocrine glands and the hormones they produce. The hormones are released into the blood to guide processes such as metabolic activity, growth, sexual development, sleep-wake homeostasis, regulation of emotions, and others. The effect produced by the hormones might rest with a single organ or multiple organs throughout the body. This article specifically focuses on the intricacies of the steroid hormone receptors, which are generally intracellular in nature and can be found at all three places namely nucleus, cytoplasm and the plasma membrane.

Malignant Neoplasms — Metastasis

Malignant neoplasms have the ability to invade adjacent structures, spread through the lymphatic system or metastasize to distant organs by the blood stream. In order for tumorous cells to be able to metastasize, they should first become motile and be able to migrate. This is achieved by altered cell-to-cell and cell-to-matrix adhesion properties in addition to an epithelial-to-mesenchymal transformation process. In addition to this, angiogenesis and lymphangiogenesis play an important role in metastatic disease by providing access for the tumor cells to the blood stream and lymphatic system respectively.

Benign Neoplasms — Teratoma

Teratomas are germ-cell tumors and can be mature “benign” or immature “malignant”. They usually arise in the sacrococcygeal region, ovaries, testes or mediastinum. Sacrococcygeal teratomas can be diagnosed antenatally, while teratomas in other locations are usually diagnosed postnatally. The treatment of teratomas is surgical. Complete excision of benign teratomas can virtually result in a cure with minimal risk of recurrence in the majority of the cases.

AIDS Cholangiopathy — Diagnosis and Treatment

AIDS cholangiopathy is a rare form of AIDS-related sclerosing cholangitis that is believed to be infectious related. Cryptosporidium infection of the intrahepatic and extrahepatic bile duct system is believed to be the most common etiology of AIDS cholangiopathy. Ultrasonography and endoscopic retrograde cholangiopancreatography are the main diagnostic modalities for AIDS cholangiopathy. Highly active antiretroviral therapy has been shown to lower the risk of AIDS cholangiopathy, alleviate the disease if it occurs and increase survival.

End-stage Liver Disease (ESLD) — Pathogenesis and Liver Transplantation

Approximately, 5.5 million people in the United States have liver cirrhosis. End-stage liver disease affects mainly the middle-aged population and is considered as the seventh commonest cause of death in the United States. The majority of these patients die due to the limited availability of donor livers. Several complications are encountered in end-stage liver disease and include ascites, hepatic encephalopathy, malnutrition and renal failure. Hepatocellular carcinoma is another possible complication in chronic liver cirrhosis.

Polycythemia — Symptoms, Causes and Treatment

Red blood cells perform an important function of supplying adequate oxygen to all tissues. Increased synthesis of these red blood cells, arising either de novo or secondary to other conditions, is called polycythemia. Read on to find out more about the different types of polycythemia and how they may present.

Dehydration — Isotonic, Hypotonic and Hypertonic Fluid Disorders

Dehydration is an imbalance in the body fluid environment. The imbalance is due to less water intake while there is more water loss. The body can lose water through normal physiologic processes in respiration, urination and sweating, or some pathologic diseases through vomiting, diarrhea and fever.

Cushing's Syndrome and Hypercortisolism — Symptoms and Treatment

Cortisol preparations are frequently used drugs in modern-day medicine. A lot of people are durably dependent on their frequent use. Thus, hypercortisolism is a relatively common disease and, therefore, a quite common exam topic. Read all the important facts on hypercortisolism and Cushing’s syndrome in order to correctly diagnose this disease and initiate the main steps of the treatment.

Hepatic Encephalopathy — Definition, Pathogenesis and Clinical Features

Hepatic encephalopathy syndrome (HES) is a condition which occurs in patients with severely impaired detoxification function of the damaged hepatocytes of the liver because of various reasons, mostly due to cirrhosis.

Gastroparesis — Causes, Diagnosis and Diet

Gastroparesis is defined as a chronic motility disorder where there is a delayed emptying of the stomach without an apparent mechanical obstruction. Usually, both solids and liquids are affected. Gastroparesis is usually of undetermined causes, but can also be linked to previous abdominal surgeries or diabetes mellitus. Symptoms include nausea, vomiting and early satiety. Once diagnosed, the patient is instructed to follow a diet that has more liquid, promotility agents could be prescribed and antiemetics are used for symptomatic relief.

Esophageal Stricture — Symptoms and Treatment

The topic of this article is peptic strictures associated with benign and malignant after-effects of this condition and the management of these ailments as the number of such cases makes up to 80% of all esophageal strictures and represents a great interest for the researchers.

Meckel's Diverticulum — Symptoms, Diagnosis and Treatments

Meckel's diverticulum is named in honor of Johann Friedrich Meckel, who, in 1809, described the intrauterine origin of the condition, which is one of the most common inborn defects of the baby's small intestine stipulated by the partial obliteration of the vitelline duct (omphalomesenteric duct).

Dumping Syndrome — Causes and Treatment

Dumping syndrome, or “too rapid drainage of the stomach,” is a condition most often found in patients post-gastrectomy. Symptoms of this condition can be separated into vasomotor symptoms (such as palpitations, flushing or diaphoresis) and abdominal symptoms (such as diarrhea, nausea or cramps). The symptoms often resolve within several months. Medication is often helpful and surgical intervention is rarely necessary.

Parkinson's Disease and Other Movement Disorders

Abnormal movements can be presenting features of several neurodegenerative disorders, most commonly parkinsonism, or can occur as side effects of drugs, most commonly antipsychotics. A few other disorders can also present with abnormal movements. Drugs used in treatment of parkinsonism and other movement disorders mainly act on the central nervous system. In this article, we will study the pharmacology of these drugs.

Brown-Séquard Syndrome and Tabes Dorsalis — Anatomy and Lesions of the Spinal Cord

The spinal cord is the continuation of the brain stem medulla below the foramen magnum. This article discusses lesions and diseases of the spinal cord, highlighting the Brown-Sequard syndrome and Tabes Dorsalis.

Insulin in Diabetes

Diabetes not only causes destruction of the body as a whole but also leads to a lot of psychological stress. The patients need to do a lot of self-care, which remains a vital and essential factor in maintaining the glycemic control. Hence, a thorough understanding is expected from the physician side to explain the intricacies to the patient.

Temporal Arteritis (Giant Cell Arteritis) and Carotid Artery Stenosis — Symptoms and Treatments

Temporal arteritis, also known as giant cell arteritis (GCA), is the vasculitis of the superficial temporal artery. Inflammation of the vessel wall produces systemic, neurologic and ophthalmologic signs and symptoms. Carotid artery disease, also called carotid artery stenosis, is the narrowing of the lumen of the carotid arteries due to fats and choleserol deposition (plaque). The complete blockage of the artery, called carotid artery occlusion, can lead to cerebral ischemia and stroke.

Autoimmune Diseases

Autoimmune diseases are a group of disorders that are characterized by abnormal reactions of the immune system against one’s own body. These usually manifest during the middle years and are, most of the time, chronic. Approximately 3.2 % of the global population is composed of people who are afflicted with these, being generally more common among women.

Acute Liver Failure (ALF) — Causes and Treatment

Acute (or fulminant) liver failure is basically the end point of severe liver damage brought about by many different causes. It is characterized by a rapidly developing dysfunction in the hepatocytes. Affected persons may or may not have known past experiences of liver disease. The manifestations of fulminant liver failure can manifest systemically and are caused by changes in the integrity of hemostasis and mental status. Being a fatal condition, a rapid and accurate diagnosis of acute liver failure when a case is present should be done. This can be done clinically by using key observations in the history and physical examination. The timely use of other supplemental tools to reinforce the diagnosis should also be instigated.

Hepatorenal Syndrome — Classification and Treatment

Aside from the many metabolic and synthetic functions of the liver, it also plays a crucial part in the maintenance of other organ systems. This is why any alterations in its functions, such as in liver cirrhosis and portal hypertension can result in detrimental effects on the major organs and tissues remote from the liver such as the lungs, heart, and kidneys. Although liver diseases can affect different extrahepatic organ systems, there is somewhat a similar pattern when it comes to the development of the pathophysiology. One of the many extrahepatic syndromes that can manifest in patients having liver problems such as cirrhosis and portal hypertension is the hepatorenal syndrome.

Liver Diseases of Pregnancy

There are so many changes in the anatomy and physiology of the female human body during pregnancy. Aside from the profound reproductive system changes, there are also many reversible modifications in the other internal organ systems, all of which happen in order to accommodate the changing needs of the childbearing woman all throughout the 3 trimesters of pregnancy. One of the organs that change during pregnancy is the liver. Along with its changes comes the female individual’s predisposition to certain hepatic conditions that could put her and the fetus at increased risk for morbidity or mortality.

Space-Occupying Lesions in the Liver

The significant prevalence of mass lesions in the liver among the general population has prompted the emphasis on understanding each of the condition’s clinical presentation, diagnosis, and treatment. Another reason to fully understand the characteristics of the different space-occupying lesions in the liver is the fact that the treatment varies depending on the type of lesion found in the liver. Here, we briefly discuss the epidemiology and features of the different space-occupying lesions in the liver.

Spontaneous Bacterial Peritonitis — Symptoms and Treatment

The most prominent complications of having liver diseases such as cirrhosis include ascites. Derived from the Greek word “askos” which means “sack”, ascites is characterized as the collection of fluid in the peritoneal cavity. Aside from liver diseases, it can also be caused by a wide range of reasons necessitating different means of definitive management. Therefore, the identification of the nature and development of the fluid collection in the peritoneal space of a specific patient is very important. Once the population of bacteria in the intestinal lumen reaches certain numbers, they tend to translocate to the mesenteric lymph nodes, leading to the eventual invasion and colonization of the bacteria in the ascitic fluid.

Portal Hypertension and Esophageal Varices — Symptoms and Causes

The development of varices in the esophagus and the gastrointestinal tract is only one of the 3 complications caused by increased pressure within the portal system, the others being ascites and hepatic encephalopathy. All of these conditions are essentially brought about by diseases that impair the flow of blood through the liver such as in liver cirrhosis. The presence of collateral blood vessels in the portosystemic circulation allows for a normal blood flow into and out of the liver. However, these collateral do not hold blood well in times of increased portal pressure, making them vulnerable to massive dilatation and rupture.

Alcoholic Hepatitis, Alcoholic Cirrhosis & Non-Alcoholic Fatty Liver Disease (NAFLD)

The liver is designed for detoxification, among other functions. Excess alcohol intake will require the liver to work at a level greater than its optimum level, in order to detox the body. Long-term abuse of the liver working at this greater level will eventually break it down and make it vulnerable to diseases. One of the most common of these diseases is alcoholic hepatitis.

Lung Cancer (Bronchial Carcinoma) — Classification, Staging and Treatment

The lung is the major organ of the respiratory system and used to inhale oxygen and remove the metabolic waste in the form of CO2 from the body. Malfunctioning of the lungs can lead to serious complications and disturbs the normal living conditions. Lung cancer is one of the severe conditions which have a relatively high mortality risk. Previously, it was the leading cause of death among men in more than 25 developed countries. Now it has become a worldwide cause of death among men. Most common cause of lung cancer is smoking, especially in men. Prognosis of this condition is still poor for malignant tumors. Read everything important about it here.

Diagnostic Imaging: X-Ray and CT Scan in the Integrated Pulmonary Pathology

Radiological investigations like x-ray and CT scan are required for the confirmation of clinical findings. The field of radiology in the 21st century has become very advanced and through various radiological investigations, even the smallest calcifications and vascular pathologies can be diagnosed. The chest radiograph (CXR) is the most common radiological investigation.

Irritable Bowel Syndrome (IBS) — Pathophysiology, Clinical Features and Symptoms

Nowadays, junk foods like burgers, pizzas, and other flour-based meals are more likely consumed by the young generation. Mostly they are unfamiliar with the consequences of the usage, which then may lead to severe and painful irritable bowel conditions. Cramping, bloating, constipation, abdominal pain, gas, and diarrhea are some of the common problems that are to be tackled for the patients of IBS. One must have an eye on the signs and symptoms of IBS to reach to its severe conditions. Have a detailed description of IBS here.

Types of Diabetes: Type 1, Type 2 and Type 3 and Gestational Diabetes

In many diseases, early diagnosis is important for slowing the progression. This also applies to diabetes mellitus. Especially with type 2 diabetes, a timely detection of symptoms may limit the severe consequential damage and help patients to further have an asymptomatic life. Therefore, medical students should have keen senses about the patients with obesity, weight loss, polydipsia and polyuria.

Diabetes Therapy: How to Achieve Normoglycemia

In the case of diabetes mellitus, the primary therapeutic goal is to stabilize the concentration of glucose in the blood. Stabilization is accompanied by various forms of therapy, starting from simple dietary rules and leading to regular insulin injections. As a physician, it is very important to know all the therapeutic measures, and treat patients with an individual approach to protect them from fatal late complications of diabetes mellitus.

Diabetes Complications: Diabetic Retinopathy, Nephropathy & Neuropathy

Patients who have been suffering for years from high blood sugar concentration can expect serious consequences for their entire bodies. Accurate knowledge of the complications that may arise in the course of the disease is important not only for the exam. Physicians may significantly contribute to the problem, so that amputations, blindness, kidney damage and cardiovascular disease can be avoided.

Liver Cancer: Types of Hepatobiliary Tumors

Liver tumors are some of the more common neoplasms and are classified as either primary or secondary. Management varies depending on several factors such as type, size, and the spread of the cancer. Continue to read this article to learn key facts about the tumors of the liver including incidence, pathology, clinical features, diagnosis, and treatment.

Zollinger-Ellison Syndrome — Presentation, Diagnosis, Therapy

Zollinger-Ellison syndrome is one of the rare conditions that affect the duodenum or the pancreas. Tumors (gastrinomas) form in the duodenum or the pancreas, which secrete huge amounts of gastrin leading to excess acid production in the stomach. This excess acid results in the formation of related symptoms as well as peptic ulcers.

Modes of Ventilation

Sometimes ventilation is the only way to save a patient's life. Here you'll read about the different forms of mechanical ventilation, how it is different from spontaneous breathing and what modes of ventilation exist.

Interstitial Nephritis (Tubolainterstitial Nephritis) — Pathophysiology and Laboratory Investigations

Tubulointerstitial nephritis is an inflammatory condition affecting the tubules and interstitium, while sparing the glomerulus. Acute and chronic pyelonephritis, along with drug induced interstitial nephritis, is the predominant cause of tubulointerstitial nephritis. Urine examination shows characteristic eosinophiluria and WBC casts. The treatment involves the discontinuation of the offending drug, along with steroids, while treatment is mainly supportive in the chronic type. Progression to end-stage renal disease is seen in the majority of tubulointerstitial disorders.

Hiatal Hernia (Stomach Hernia) — Diagnosis and Treatment

Can you master the differences between the axial and paraesophageal hiatal hernia? How do the patients present clinically? And when is surgery indicated? This and all other relevant test content about this topic can be found in this article.

Chronic Kidney Disease (CKD) — Pathophysiology and Diagnosis

Kidneys are central metabolic organs in our body. They regulate our water and electrolyte balance amongst other things, and are responsible for the removal of potentially toxic substances and medications. Shockingly, many of today’s widespread diseases can lead to damaged kidneys and an impairment of their function. Chronic renal failure is a systemic disease with massive effects on the whole organism. It is not always easy to understand all of the various facets of the disease. This article should make the mechanisms and processes easier to understand, and will explain them in more detail.

Retinoblastoma (RB) — Inheritence, Staging and Special Types

The retinoblastoma is a tumor of infancy and childhood and accounts for about 2 % of all malignant neoplasia in children. Experts recommend a simple screening test to diagnose retinoblastomas early: The frontal photography of an infant using flash reveals the most common symptom of retinoblastoma – leukocoria – and can be essential for an early diagnosis in order to facilitate adequate therapy.

Acute Coronary Syndrome (ACS) — Causes and Treatment

The acute coronary syndrome is one of the most common causes of death in the industrialized countries. Since with every minute that passes, more heart muscle tissue is irreversibly damaged, it requires a rapid diagnosis and therapy. Every physician must, therefore, recognize the symptoms and immediately respond in an adequate fashion. Reading this article will prepare you to recognize the symptoms of acute coronary syndrome both in your future practice and on your exams.

Acute Renal Failure (ARF, Acute Kidney Failure) — Symptoms and Treatment

No matter in which clinical field you will be working in the future, you will be confronted with cases of acute renal failure. In this acute emergency illness, various pathomechanisms come together and lead to a principally reversible decrease in renal function, often involving disbalances of water and electrolytes. The different types of acute renal failure have to be understood well in order to develop an adequate treatment strategy. This article presents the main aspects of acute renal failure clearly and comprehensively.

Esophageal Diseases at a Glance

As an elastic and muscular hollow organ, the esophagus supports food intake. Disorders particularly affect the passage of food and the functioning of the sphincters. Cardinal symptoms of esophageal diseases are dysphagia, regurgitation, pyrosis, retrosternal pain, and coughing.

Neurology: Narcolepsy, Restless Legs Syndrome and Other Sleep Disorders

Permanent sleepless nights are torture: Sleep disorders are accompanied by much suffering for affected individuals. Which of the disorders that mostly occur nocturnally should you know about for your practice routine and the medical exam? The following article will introduce you to the fundamentals of sleep disorders, diagnostics as well as therapeutic remedies in cases of REM sleep behavior disorders and sleep myoclonus. Particular focus is laid on narcolepsy and restless legs syndrome. This article is concisely prepared with focus on the exam and will leave no questions concerning sleep disorders in neurology unanswered.

Anatomy of the Respiratory System and the Respiratory Muscles

Without oxygen, the human organism is not capable of living. It gains a major part of its energy from oxidative degradation of nutrients. The processes involved in this are called pulmonary respiration or external respiration. The carbon dioxide that is formed in the process of combustion has to be released. The gas exchange between air and blood takes place in the lung. When nutrients are degraded in order to gain energy, oxygen is consumed – a process that takes place in every individual cell of the body and is therefore called cell respiration or internal respiration. The detailed processes of cell respiration are the subject of biochemistry and will not be discussed here.

Signs of Brain Death

When a human being dies, he stops breathing and his heart does no longer beat. The cardiac arrest has been for a long time the measure to decide if a person is really dead. But in 1952, the heart-lung machine was invented. Thanks to it, human beings whose neuronal control centers failed can be kept alive. This saved a lot of lives and made organ transplants possible. We explain why the brain death diagnosis and the clearance for the removal of organs are still difficult medical decisions.

Hydrocephalus (Water on the Brain) — Symptoms and Surgery (Shunt and More)

Hydrocephalus or water in the brain is referred to accumulation of the cerebrospinal fluid (CSF) in the subarachnoid space and cerebral ventricles leading to increased intracranial pressure.

Coma — Definition and Types

Learn more about coma: the stages of coma, the Glasgow-coma scale, estimating the depth of the coma, the examination of the comatose patient and more. Review questions inclusive.

Central Nervous System Cancers — Diagnosis and Treatment

This article will explain basic knowledge that must be known about tumours of the CNS. This includes neuroepithelial tumours like astrocytomas and fibrillary astrocytomas. It also runs through oligodendroglioma, medulloblastoma, and meningeal tumours including meningioma and primary CNS lymphoma. The article covers definition of CNS tumours, epidemiology of CNS tumours, etiology and causes of CNS tumours, classification, pathophysiology, symptoms, diagnosis (including history and examination), therapy and prognosis.

Pediatric Neurology: Autism, Cerebral Palsy and More

This article runs through a significant amount of pediatric neurology. It explores embryological deficits which are completely covered in the etiology section. It will also run through definitions for intellectual disability, autism, developmental regression and neurocutaneous disorders. Etiology, diagnosis and management of these conditions is also discussed. This article runs complementary to Dr Rangaraj’s lecture on pediatric neurology.

Hemorrhagic Stroke (Cerebrovascular Accident, CVA) — Symptoms and Treatment

Hemorrhagic stroke is the second most common form of acute strokes. Patients can develop a hemorrhagic stroke due to many risk factors which include hypertension, cerebral amyloid angiopathy, neoplastic diseases and cerebral aneurysms. Hemorrhagic strokes can be classified into subarachnoid or intracerebral hemorrhage depending on the site of the hematoma formation. The semiology is usually similar to ischemic stroke; therefore, adequate brain imaging is very important for proper diagnosis and management.

Viral Encephalitis — Causes and Symptoms

Viral encephalitis is defined as the inflammation of the central nervous system due to viral agents. Several viruses can cause encephalitis but herpes viruses are the most commonly implicated. Patients present with confusion, altered level of consciousness, seizures and focal neurologic signs. Polymerase chain reaction testing can help identify the causative organism in few cases but antiviral therapy should be initiated immediately in any suspected case regardless of the diagnosis confirmation.

Albinism (Achromasia) — Definition and Genetics

Albinism is a hereditary condition that is characterized by low or complete absence of melanin production that can be confined to the eyes or wide-spread in the body. People with albinism present with white skin, white or yellow hair, and blue eyes. While the condition is rarely associated with any significant mortality, people with albinism tend to suffer from bleeding disorders, photosensitivity, and impaired vision. Treatment of visual impairment with low-vision aids and early eye patching might be needed.

Prion Disease (Transmissible Spongiform Encephalopathy, TSEs) — Symptoms and Diagnosis

Prion-related encephalopathies are uncommon causes of severe, progressive cognitive impairment that are fatal. Sporadic and familial cases have been described, but familial cases seem to be extremely rare. Sporadic cases are usually more severe compared to familial prion-related encephalopathies. Patients develop symptoms after a long period of incubation. The symptoms are mainly of global cognitive impairment, cerebellar signs and neurodegeneration on MRI. There is no current treatment for prion-related encephalopathies.

Skin Infections: Erysipelas and Molluscum Contagiosum — Symptoms and Treatment

Erysipelas and Molluscum Contagiosum are two different skin infections, the former caused by streptococci, the latter caused by one of the Molluscum Contagiosum viruses. While erysipelas is more common in diabetics and patients with preexisting medical conditions such as lymphedema, Molluscum Contagiosum infection can affect healthy children and adults. Erysipelas treatment includes antibiotics and symptomatic relief. Molluscum Contagiosum therapy consists of neglect, topical treatment, immune response modulators, or antiviral therapy.

Herpes Simplex (HSV, Herpes Simplex Virus Infection) — Symptoms and Treatment

Herpes simplex virus infections are caused by either herpes simplex virus type 1 or 2. Type 1 viruses are more commonly associated with non-genital herpes, while type 2 viruses are more likely to be responsible for genital herpes diseases. The most common presenting sign is ulcers. While the healing process is usually excellent and subsequent scarring is very rare, topical and systemic antiviral therapy might be indicated to fasten the healing process, or prevent complications in the immunosuppressed.

Folliculitis (Inflammation of Hair Follicles) — Symptoms and Treatment

Folliculitis is an inflammatory condition that is characterized by inflammatory cellular infiltrate of the hair follicles. Patients present with acute onset pustules and papules. Treatment is not indicated in most cases, but those with intense pain might benefit from antibacterial soaps, warm compressors and perhaps topical antibiotics. Patients with resistant folliculitis should receive systemic antibiotics, usually a cephalosporin. Those who have deep folliculitis should undergo incision and drainage of their dermal abscess.

Toxic Shock Syndrome (TSS) and Necrotizing Fasciitis (Flesh-eating Disease) — Symptoms and Treatment

Toxic shock syndrome and necrotizing fasciitis have been both linked to streptococcal infections, staphylococcus infections and anaerobic infections. Both conditions are life-threatening and treatment should not be delayed until diagnosis confirmation. While the main point in the management of necrotizing fasciitis is surgical debridement of the infected sites, antibiotic therapy is the most important therapeutic approach for toxic shock syndrome. Clindamycin seems to be a good choice for toxic shock syndrome and necrotizing fasciitis.

Impetigo (School Sores) — Causes and Treatment

Impetigo is defined as infectious maculopapular skin eruption. It can be caused by staphylococcus organisms or anaerobic bacteria. The condition is usually self-limited, but topical antibiotics are indicated to fasten the healing process. Patients with staphylococcal scalded skin syndrome can develop fever, fatigue, localized or diffuse bullous impetigo and cellulitis. The condition is caused by the exfoliation toxins produced by staphylococcus aureus and needs penicillinase resistant antibiotics such as oxacillin.

Childhood Epilepsy — Symptoms and Treatment

Seizures are the result of abnormal excessive neuronal discharge from the cerebral cortex that can lead to motor, sensory and autonomic manifestations. Seizures in children differ from adults in the etiology, presentation, treatment and prognosis. The children have less brain threshold for seizure activity so they are more vulnerable to seizure episodes than adults. At least 1% of children will experience afebrile pattern of seizure before the age of 14. EEG diagnosis is also different than adult seizures. Fortunately, childhood seizures can disappear with age without residual effects.

Membranoproliferative Glomerulonephritis (MPGN)

Membranoproliferative glomerulonephritis (MPGN) is a type of immune mediated glomerular disease. The name is an indication of its pathology, with thickening of the basement membrane and proliferative changes. MPGN is categorized into three types: type I, type II (also called dense deposit disease) and type III. Students should be familiar with an overview of this condition, including its pathological features that set it apart from other glomerular disorders, as well as the diagnostic approach and management of MPGN.

Intracranial Aneurysm (Cerebral Aneurysm) — Symptoms and Differential Diagnosis

This article looks at the basic science, diagnosis and treatment of ruptured and unruptured cerebral aneurysms. It provides a brief overview of cerebral aneurysm management.

Vertigo — Causes, Symptoms and Treatment

This article provides an overview of vertigo in clinical practice – how it presents, how to differentiate it from dizziness, common differentials, their pathophysiology, treatments and complications. It also introduces the reader to the Dix-Hallpike manoeuvre used in vertigo diagnosis and the Epley manoeuvre used in the treatment of benign paroxysmal positional vertigo (BPPV).

Dementia — Signs and Symptoms

The reason for the more often occurring dementia is an increasing life expectancy, which leads before the background of the postulated age-depending prevalence to a drastic increase of cases of sickness, but what is dementia and how can it be diagnosed?

Hemoptysis — Etiology and Diagnostic Approach

Hemoptysis can be defined as the expectoration of blood during coughing that originates from the lower respiratory tract. Per this definition, coughing of blood from an upper respiratory tract illness can be excluded. While coughing blood can be alarming to the patient, it is usually a self-limiting symptom. In clinical practice, only 5% of the patients who present with hemoptysis are found to have a serious medical condition that needs further treatment.

Types of Seizures and Epilepsy during Pregnancy

Seizures are the result of abnormal electrical activity in the brain, which can be either stimulatory or inhibitory. The abnormal activity consists of repeated consistent discharges that can lead to motor, sensory, autonomic or behavioral dysfunction.

Obstructive Sleep Apnea (OSA) — Symptoms and Treatment

Obstructive sleep apnea (OSA) is defined as episodic apnea, or cessation of breathing, during sleep, in which the period of apnea should last for more than 10 seconds. It is usually due to partial or complete collapse of the upper airway and is associated with snoring, restlessness, daytime headache and somnolence. The diagnosis relies on history and requires polysomnography for confirmation. Several medical as well as surgical treatment modalities are currently recommended and essential to prevent complications.

Types of Headache — Migraine, Cluster Headache and more

Headache is one of the most common symptoms in the emergency department and outpatient clinics. It can be a sign for serious illness that needs immediate action to prevent fatal consequences e.g. subarachnoid hemorrhage, meningitis and temporal arteritis. Headache also can be a sign of chronic physical and mental illnesses. Careful history taking and physical examination should be performed to any patient complaining of headache for proper diagnosis and management.

Spinal Cord Pathologies: Multiple Sclerosis (MS), Amyotrophic Lateral Sclerosis (ALS), Poliomyelitis and More

This article looks at spinal cord pathologies. It runs through various conditions including spinal cord compression, syringomyelia, anterior spinal artery occlusion, multiple sclerosis, amyotrophic lateral sclerosis and B12 deficiency.

Angioedema (Angiooedema, Quinck's Edema, Angioneurotic Edema) — Causes and Treatment

Angioedema refers to swelling involving skin, mucosa, and subcutaneous tissues. It may be an isolated symptom or may be a manifestation of an underlying disorder. Etiology of angioedema with urticaria and angioedema without urticaria differs significantly and clinical presentation guides further investigations. In this article, etiology, pathophysiology, clinical features, diagnosis, differential diagnosis, and management of angioedema are described.

Lichen Planus (Lichen Ruber Planus) — Causes and Symptoms

The primary pathophysiology of lichen planus is CD8 cell-mediated damage to keratinocytes. Lichen planus can be found in various sites on the body. Topical steroids remain the mainstay of the treatment, but there are many others medications (e.g., retinoids) and therapies (e.g., UV-B) that have been tried. In this article, we will study the etiology, pathophysiology, clinical features, diagnostic techniques and the common treatment modalities for this condition.

Ichthyosis Vulgaris — Causes and Treatment

Ichthyosis vulgaris is a skin disease in which patients present with a scaly skin. Though there is no perfect cure for this disease, many therapies have been used successfully to limit the disease. In this article, we will study the etiology, pathophysiology, clinical features, diagnostic techniques and the common treatment modalities for this condition.

Allergic Contact Dermatitis (ACD) — Causes and Treatment

Allergic contact dermatitis can significantly affect susceptible individuals to varying extents. The main modality of management is by avoidance of the offending allergen. In this article, we will study the etiology, pathophysiology, clinical features, diagnostic techniques and the common treatment modalities for this condition.

Mononeuropathy (Peripheral Neuropathy) — Causes and Diagnosis

This article runs through the common presentations, pathophysiology, differential diagnoses and common therapies for mononeuropathies. It looks in detail at a number of common nerve injuries including radial nerve, ulnar nerve, brachial plexus, phrenic nerve, common peroneal nerve and the femoral nerve. It covers common examination findings in order to make an accurate and specific diagnosis.

Bullous Pemphigoid (BP) — Causes and Treatment

Amongst all autoimmune blistering diseases, bullous pemphigoid is the most common one. Circulating antibodies are produced against the proteins present in the dermoepidermal junction (DEJ). In this article, we will study the epidemiology, pathophysiology, diagnosis, differential diagnosis, therapy and prognosis of bullous pemphigoid.

Pemphigus Vulgaris (PV) — Pathology Outlines and Treatment

Pemphigus vulgaris (PV) is a rare, chronic, autoimmune, intraepithelial disease characterized by blister formation involving skin and mucous membrane. PV is caused by autoantibodies, which are directed against target antigens present on the cell surface of keratinocytes. In this article, epidemiology, pathophysiology, sign and symptoms, differential diagnosis, diagnosis, prognosis and treatment of PV will be discussed.

Morphea (Localized Scleroderma) — Symptoms and Prognosis

Morphea or localized scleroderma is a rare disorder with characteristic clinical features. The treatment of this disease involves the use of long-term immunomodulators. In this article, we will learn about the clinical features including the different types of morphea, pathophysiology, laboratory diagnosis, treatment using different modalities, and the prognosis of morphea.

Atopic Dermatitis (Eczema) — Symptoms and Treatment

Atopic dermatitis is a common, chronic dermatological disorder of unknown origin characterized by intense itching and eczematous lesions. In this chapter, after introduction to general terminology for skin lesions, epidemiology, clinical features, diagnosis, and management of atopic dermatitis is briefly discussed. As the diagnosis is purely clinical, differentiation from alternative diagnoses is also important. Emollients, topical corticosteroids, and trigger avoidance constitute the mainstay of management.

Seborrhoeic Dermatitis (Seborrhoeic Eczema) — Causes and Treatment

Seborrhoeic dermatitis is a common chronic papulosquamous dermatosis with distinct infantile and adult forms, easily recognised clinically. Owing to its frequent recurrence in patients with HIV and AIDS, a careful evaluation of this pathology is warranted. The disease varies from mild to severe exhibiting a variety of forms including psoriasiform, pityriasiform and erythroderma.

Atypical Moles: Dysplastic Nevi and Benign Nevi

A nevus is a condition which occurs due to the increase in the number of melanocytes. The occurrence of the melanocytes can be both congenital as well as acquired and the melanin pigmentation can also be hypo- or hyper-pigmentation. The atypical differs from the benign nevus by the irregular shape as well as increase in size and number. The biopsy is required for diagnosis in doubtful cases and in which the confirmation is required. The treatment varies from observation (in majority of cases) to medical (chemical peels using beta-hydroxy and retinoic acid) and lastly surgical treatment for the nevus.

Plexopathy — Definition and Causes

Plexopathy is a peripheral neuropathy at the level of the brachial or lumbosacral plexuses leading to sensory, motor or sometimes autonomic deficits. The etiology for this pathology vary from compression, inflammation, or ischemia to radiation.

Lyme Disease (Borreliosis) and Relapsing Fever — Diagnosis and Stages

In the following article, we present you all the relevant facts, tips and exam questions from the first symptoms to the treatment of the infection with borrelia.

Viral Hepatitis — Epidemiology and Symptoms

Viral hepatitis can be caused by different kinds of viruses which include hepatitis A, B, C, D, and E. These viruses cause targeted inflammation of the liver. In the acute stage, patients develop non-specific symptoms such as nausea, vomiting, anorexia and abdominal pain. Later on, jaundice becomes evident. During this stage, supportive therapy is important. Antiviral therapy is indicated in the acute and chronic stages of hepatitis B and C.

Lichen Simplex Chronicus (Neurodermatitis) — Causes and Symptoms

Lichen simplex chronicus (LSC), also known as localized neurodermatitis, is a skin disorder characterized by the thickening of the skin (lichenification) due to excessive scratching. This is frequently due to an itch–scratch cycle that can develop due to various skin or psychogenic causes. The common sites are the ends of extremities, genitals and neck, and the symptoms can vary in severity. Stopping the scratching is crucial, and treatment (often with topical steroid cream/ointment) can be lifelong if the disease is recurrent.

Locked-in Syndrome — Causes and Treatment

Locked-in patients are not restricted in their higher neuronal functions when locked into a body that has become incapable of movement. While the former had to face miserable living circumstances and were moved to nursing homes, they can now be re-integrated into life with sophisticated therapies and techniques.

Neuromuscular Disease — Symptoms and Treatments

Disorders of neuromuscular origin can be due to muscular diseases, neuromuscular junction or their neurological supply. Neurological disorders can be in the peripheral nerves, motor cells in the spinal cord, motor tracts in the spinal cord, brain stem nuclei, tracts and cerebral cortex.

Tinea Infections — Symptoms and Treatment

Tinea infections are caused by different fungi species that are known to infest the skin, nails and hair. The infections can be classified according to the affected site into tinea corporis, tinea pedis and tinea capitis. Tinea corporis and tinea pedis can be easily diagnosed clinically and patients should receive topical antifungal therapy once the diagnosis is confirmed. Patients with tinea capitis should receive combined topical and systemic antifungal therapy. Patients with tinea nail infections should undergo a confirmatory test such as potassium hydroxide preparation or culture before initiating therapy.

Plantar Wart (Foot Wart) — Causes and Treatment

Plantar warts are hyper-keratinized skin lesions that are found on the planter surfaces of the feet and hands. They are caused by the human papillomavirus and are usually painless. Despite being painless, they can cause embarrassment to the patient and can interfere with normal daily functions such as walking when they are found in the plantar surface of the feet. Treatment can be either ignorance of the warts, topical non-specific therapy or destruction of the epidermal cell layer by chemical or physical agents.

Squamous Cell Carcinoma (SCC, SqCC) — Classification, Symptoms and Treatment

Cutaneous squamous cell carcinoma represents one of the most common malignancies in humans. The malignant tumour arises from suprabasal epidermal keratinocytes that invade the dermis and together with basal cell carcinoma, forms the most common malignancies of skin to affect humans. But unlike basal cell carcinoma that is thought to arise de novo, this non-melanoma skin cancer is thought to evolve from precursor lesions of actinic keratosis (AK) and Bowen’s disease. The clinical appearance is highly variable but a strong suspicion must be kept in mind if a non-healing lesion presents, specially on sun exposed areas. Histopathological evidence helps in establishing the diagnosis. While a multitude of treatment options are available, prevention in patients with predispositions should attract more attention.

Berylliosis — Symptoms and Treatment

Inhalation of Beryllium (Be) dust, or its vapors or compounds, or subcutaneous implantation of Beryllium can lead to either acute or chronic beryllium disease, also known as berylliosis. It can affect genetically susceptible individuals or workers exposed to the fumes or vapors of the metal. It was first described by Hardy and Tabershaw in 1946. Beryllium can cause either an immediate acute form of illness or insidious chronic berylliosis.

Stable and Unstable Angina Pectoris — Symptoms and Diagnosis

The main symptom of coronary heart disease is angina pectoris, which can be divided into a stable and an unstable form.

Skin Cancer: Basal Cell Cancer (BCC) and Melanoma (Malignant Melanoma)

Neoplasms of the skin can be hard to differentiate clinically, but nevertheless they can result in entirely different consequences. While the colloquially called “white skin cancer” describes rather harmless changes of the skin, the “black skin” cancer is feared. As other doctors from different specialties, other than dermatologist, are also consulted when discussing diagnostic findings of their patients’ skins, it pays off to know the most common types of skin cancer.

Medical Knowledge About Scabies

Many people have heard of the seven-year itch, but what is it actually? You know the parasitic disease under the medical term scabies. CAVE: In 25%, scabies are initially misdiagnosed! The cause of the severe itching is Sarcoptes scabiei – the itch mite. In the following article, you can read what every physician should know about the pathophysiology, diagnosis and treatment.

Sebaceous Glands Disorders: Sebostasis, Seborrhea, Acne Vulgaris and Co.

There are many disorders of the sebaceous glands. Acne is the most relevant condition in the field of dermatology that is tested in medical examinations. Acne vulgaris is also considered one of the most common skin diseases. The clinical picture of these conditions as well their treatment is covered in this article.

Vitiligo — Symptoms and Treatment

Vitiligo is a skin condition that is quite common. This is why you should be able to recognize it in clinical practice. Due to its association with other autoimmune diseases, vitiligo is also a frequently examined topic. This article explains the most relevant facts for purposes of clinical practice and medical examination.

Stroke (CVA, Cerebrovascular Accident) — Causes and Symptoms

Aspiring medical professions should know and differentiate between the various stroke symptoms of ischaemic stroke. Furthermore, they must be familiar with the basics of treatment to be able to respond effectively in an emergency. This article thoroughly and compactly presents the knowledge required for this, and is optimal both for preparing for the exam and clinical application.

Neurology: Hereditary and Acquired Polyneuropathies

The term diabetic polyneuropathy is probably the one you will be confronted with most during your medical studies. What are the most common causes of polyneuropathy, which are hereditary, which are acquired? How are they diagnosed and what types of therapy are available? The following article will provide you with answers to all of these questions. It has been prepared with the medical exam in mind and will not leave any questions regarding polyneuropathies unanswered.

Neurology: Infectious Diseases of the Central Nervous System

If a patient suffers from neurological symptoms, lots of differential diagnoses have to be considered. The following article is organized according to the different pathogens: bacteria, viruses, protozoa, and fungi. Learn and repeat everything from the approach at acute bacterial meningitis to virally triggered CNS infections with HSV, FSME, VZV, and CMV, and to opportunistic infections in immunodeficients. This way, no neurological question in the second state examination concerning infectious diseases of the CNS remains unclear!

Psoriasis and Other Erythematous Skin Diseases

With a morbidity rate of 2 - 3 %, psoriasis is one of the most common skin disorders in the Western world. It can be classified as one of the inflammatory, erythematous, hyperkeratotic skin diseases, which also include Reiter´s dermatosis and the group of pityriasis dermatoses. Learn more about psoriasis and its forms, and about the other diseases mentioned above.

Epilepsy — Symptoms and Diagnosis

Epileptic seizures can develop from the synchronous and paroxysmal activation of a group of neurons. There is high prevalence of a heterogeneous variety of epileptic syndromes in the population. A great number of people suffer from an epileptic seizure at least once in their lives, are worried, go to the emergency room, and seek for medical advice. It is therefore important for every physician to be familiar with the disorder and to know about treatment opportunities.

Cellular Pathology	✓
Cardiovascular Pathology	✓
Respiratory Pathology	✓
Renal Pathology	✓
Gastrointestinal Pathology	✓
Endocrine Pathology	✓
Reproductive Pathology	✓
Hematopathology	✓
Neuropathology	✓
Dermatopathology	✓

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Pathology

A complete review of Pathology—Learning Pathology has never been so comfortable

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Your Educators of course Pathology

Lecturio USMLE

Carlo Raj, MD

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