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15:15, 10 March 2023 Nikolas talk contribs uploaded File:Agonist and antagonist drug action.png
15:07, 10 March 2023 Nikolas talk contribs created page Pharma topics which are now ancient artifacts (Created page with "''A long time ago, in a galaxy far far away, when I had pharmacology, the subject used to be split into three rather than 2. Pharma 1 and 2 in the first and second semester of third year, followed by Pharma 3 in the first semester of fourth year. With the change to the current (fourth-year two-semester) system came some small changes in the topic list. Some topics which were in the list when I had my exam were removed. Rather than delete them outright, I’ve decided to...") Tag: Visual edit
15:06, 10 March 2023 Nikolas talk contribs created page Category:Pharmacology 1 (Created page with "Flashcards for what was previously pharma 1 (topics are mostly the same but out of order): Anki here<ref>https://ankiweb.net/shared/info/1194549732</ref> and cram here<ref>https://www.cram.com/folders/pharmacology-1-260004</ref>. For what was previously pharma 2: Anki here<ref>https://ankiweb.net/shared/info/727870581</ref> and cram here<ref>https://www.cram.com/folders/pharmacology-2-245394</ref>. ''NB: Topic 28 is missing because it didn’t exist when I had pharma....") Tag: Visual edit
15:04, 10 March 2023 Nikolas talk contribs created page 74. Age-related alterations in thermoregulation (Created page with "The core body temperature of older people is lower than that of younger people (by approx. 0.5℃)<ref>https://www.karger.com/Article/Pdf/333148</ref>. Their tolerance of extreme temperatures is more limited. Most deaths related to hypothermia and hyperthermia occur in elderly, signifying the importance of this topic. Thermoregulation depends on organ systems like the cardiovascular and respiratory systems, the functions of which deteriorate with age. Not only autonomic...") Tag: Visual edit
15:04, 10 March 2023 Nikolas talk contribs created page 73. Basic concepts of gerontology (Created page with "Gerontology is the study of physiological and pathophysiological changes of aging. It also includes studies diseases that commonly affect elderly, as well as how diseases that affect both young and older people affect them differently. In the developed countries the society is aging in general. As healthcare improves more elderly people survive, and so the average age of the population increases. The number of people older than the age of 65 increases. This makes geront...") Tag: Visual edit
15:03, 10 March 2023 Nikolas talk contribs created page 72. Principles of exercise testing (spiro-ergometry). Anaerobic threshold and maximal oxygen (Created page with "Spiroergometry is a procedure in which a subject is subjected to progressively more difficult physical activity while their ventilation and cardiac function is monitored. The test subject usually walks on a treadmill which progressively increases the speed and incline to increase the difficulty. The functional capacity of the cardiac and respiratory systems can be measured. The purpose of this procedure is to diagnose or assess the severity of certain heart or pulmonary...") Tag: Visual edit
15:02, 10 March 2023 Nikolas talk contribs created page 71. Disturbances of consciousness, vigilance. Coma. Acute unconsciousness (Created page with "== Consciousness == Consciousness is defined as “the capability of the individual to perceive and process environmental stimuli”. The state of consciousness can be characterised by: * Its level, the state of wakefulness – the vigilance * Its content – the integrity of the responses, the cognitive abilities Vigilance is maintained by the ''ascending reticular activating system'' (ARAS) in the reticular formation in the brainstem and thalamus. This can be thought...") Tag: Visual edit
15:01, 10 March 2023 Nikolas talk contribs created page File:Glasgow Coma Scale.jpg
15:01, 10 March 2023 Nikolas talk contribs uploaded File:Glasgow Coma Scale.jpg
14:58, 10 March 2023 Nikolas talk contribs created page 70. Mechanisms and disturbances of bone remodeling. Osteoporosis, osteomalacia (Created page with "== Bone remodelling == Bone is a dynamically changing tissue that constantly undergoes degradation and formation. In physiological cases these two processes are of similar magnitude and the bone mass therefore doesn’t change much. This process is called bone ''remodelling''. Bone consists of 70% inorganic material like water and minerals and 30% organic material. The most important inorganic material of bone is ''hydroxyapatite'', a salt of calcium, inorganic phosphat...") Tag: Visual edit
14:57, 10 March 2023 Nikolas talk contribs created page 69. Hypocalcemia, hypercalcemia (Created page with "== Calcium homeostasis == Calcium in the serum exists in one of two forms; it’s either in the free, ionized Ca2+ form or bound to proteins, especially albumin. The proportion is approximately 1:1, meaning that 50% of serum calcium is free while 50% of serum calcium is bound. Only the free calcium is biologically active; if 100% of serum calcium was bound it would be equal to having no calcium in the serum, functionally speaking. The normal calcium level in the serum i...") Tag: Visual edit
14:56, 10 March 2023 Nikolas talk contribs created page 68. Parathyroid abnormalities (Created page with "== Parathyroid hormone == Parathyroid hormone (PTH) is produced by chief cells in the parathyroid gland. It’s the most important hormone in regulating the serum calcium concentration. PTH is secreted in response to: * Decreased levels of serum (ionized) calcium (ionized calcium < 1.25 mM) * Increased levels of serum phosphate (as phosphate creates a complex with calcium, causing the level of ionized calcium to decrease) * Adrenaline * Decreased levels of serum magnes...") Tag: Visual edit
14:54, 10 March 2023 Nikolas talk contribs created page 67. Pathophysiological aspects of glucocorticoid therapy (Created page with "Glucocorticoid drugs are drugs that are structurally similar to cortisol and have similar effects on the body. These drugs are mostly used for their anti-inflammatory effect. They’re among the strongest anti-inflammatory drugs available. These drugs can be administered topically, by local injection, by inhalation, orally or parenterally. == Indications == Cortisol replacement therapy: * Adrenocortical insufficiency * Congenital adrenal hyperplasia Acute systematic...") Tag: Visual edit
14:54, 10 March 2023 Nikolas talk contribs created page 66. Glucocorticoid hyperfunctional states (Created page with "Cushing syndrome or hypercortisolism is the condition where the level of glucocorticoids in the body is elevated. We can classify them as primary or secondary, depending on whether they’re caused by increased levels of ACTH or not. We can also classify them as exogenous or endogenous. == Etiology == Endogenous Cushing syndrome: * Primary hypercortisolism ** Cortisol-producing adrenal adenoma ** Cortisol-producing adrenal carcinoma * Secondary hypercortisolism ** ACTH...") Tag: Visual edit
14:53, 10 March 2023 Nikolas talk contribs created page 65. Secondary hyperaldosteronism (Created page with "Secondary hyperaldosteronism refers to increased production of aldosterone in response to increased renin levels, as part of the renin-angiotensin-aldosterone-system (RAAS). == Etiology == * Renal artery stenosis (often due to atherosclerosis) ** Atherosclerosis (90% of cases) ** Fibromuscular dysplasia of the renal artery (10% of cases) * Renin-secreting tumors * Chronic renal failure * Cirrhosis * Hypovolaemia * Congestive heart failure * Hypoproteinaemia * Diuretics...") Tag: Visual edit
14:45, 10 March 2023 Nikolas talk contribs created page 64. Primary hyperaldosteronism (Created page with "Primary hyperaldosteronism refers to the state where the adrenal cortex produces too much aldosterone. It’s most commonly caused by hyperplasia or neoplasm of the glomerular zone, and it’s a common cause of secondary hypertension. == Etiology == * Idiopathic bilateral hyperplasia of the adrenal gland * Aldosterone-producing adrenal adenoma (aldosteronoma) * Aldosterone-producing adrenal carcinoma * Ectopic aldosterone-producing tumors * Familial hyperaldosteronism...") Tag: Visual edit
14:44, 10 March 2023 Nikolas talk contribs created page 63. Adrenal (cortex) insufficiency (Created page with "Adrenal insufficiency refers to decreased production of adrenocortical hormones. It can be primary, where the problem lies in the adrenals, or secondary, where the problem lies in the ACTH-producing pituitary. Primary adrenal insufficiency is also known as Addison disease. === Etiology === Secondary adrenal insufficiency is more common than primary adrenal insufficiency. === Primary adrenal insufficiency === * Autoimmune adrenalitis – 80% of cases of primary insuffi...") Tag: Visual edit
14:41, 10 March 2023 Nikolas talk contribs created page 62. Adrenogenital syndrome. Disorders of gonadal hormones (Created page with "== Congenital adrenal hyperplasia == Adrenogenital syndrome is an outdated expression; nowadays ''congenital adrenal hyperplasia'' (CAH) is preferred. Congenital adrenal hyperplasia is a group of autosomal recessive diseases characterised by adrenal hyperplasia. It’s caused by enzyme defects of some of the enzymes that are involved in hormone synthesis in the adrenal cortex. The exact clinical manifestations depend on which enzyme is defective, but all types are char...") Tag: Visual edit
14:39, 10 March 2023 Nikolas talk contribs created page 61. Disturbances of the adrenal medulla and the sympathetic system – pheochromocytoma (Created page with "The most important disorders of the adrenal medulla are neoplasms, and the most important neoplasm is phaeochromocytoma. == Phaeochromocytoma == A phaeochromocytoma is a catecholamine-secreting tumor located in the adrenal medulla. It originates from the chromaffin cell which can produce catecholamines. This tumor is famous for following the “rules of ten”: * 10% of cases of pheochromocytoma occur bilaterally (90% occur unilaterally) * 10% of cases are familiar (90...") Tag: Visual edit
14:37, 10 March 2023 Nikolas talk contribs created page 60. Goiters (Created page with "Goiter refers to any abnormal enlargement of the thyroid gland. The most common cause worldwide is iodine deficiency. In the western world Hashimoto and Graves diseases are more frequent causes. Many conditions can cause enlargement of the thyroid, including neoplasms and inflammations. Goiters are classified according to three parameters: * The morphology (diffuse/nodular) * The thyroid function (hypothyroid/euthyroid/hyperthyroid) * The dignity of the thyroid (benign...") Tag: Visual edit
14:34, 10 March 2023 Nikolas talk contribs created page 59. Hypothyroidism. Specialities in the elderly (Created page with "Hypothyroidism is most frequently caused by an underactive thyroid, which produces fewer thyroid hormones than normal. It’s rarely caused by peripheral resistance to thyroid hormones. Goiter is often present, but this depends on the exact condition. Like most thyroid conditions are women more frequently affected than men. It may be acquired or congenital. The most common cause of hypothyroidism in the western world is Hashimoto’s thyroiditis. The symptoms of it are...") Tag: Visual edit
14:33, 10 March 2023 Nikolas talk contribs created page 58. Hyperthyroidism. Specialities in the elderly (Created page with "The thyroid gland consists of numerous follicles composed of thyroid follicular cells that surround secreted ''colloid'', a proteinaceous fluid containing large amounts of thyroglobulin, the protein precursor of thyroid hormones. The follicular cells produce thyroglobulin (a large protein) and secretes it into the colloid. The basolateral surface of the follicular cells faces the blood while the apical surface faces the colloid. Iodine (I) is an important part of the th...") Tag: Visual edit
14:30, 10 March 2023 Nikolas talk contribs created page 57. Pathophysiology of growth (Created page with "== Physiology of growth == For optimal growth must several factors be fulfilled: * Sufficient protein intake – ca 1 g protein per kg body weight per day, where 50% of these are complete proteins * Sufficient Ca, Mg and P intake * Sufficient vitamin and trace element intake * Sufficient calorie intake * Normal function of the relevant hormones ** Growth hormone ** Thyroid hormones ** Sexual hormones ** Insulin ** Vitamin D The mean growth rate after 3 years old is aro...") Tag: Visual edit
14:29, 10 March 2023 Nikolas talk contribs created page 56. Hyperprolactinemia (Created page with "Prolactin is produced by the anterior pituitary in pregnancy, sleep, lactation, stress, physical exercise and hypoglycaemia. It stimulates the growth of glandular tissue in the breast and is necessary to produce milk. Prolactin inhibits FSH and LH. Dopamine usually inhibits the secretion of prolactin. TRH stimulates the production of prolactin. Hyperprolactinaemia may be physiological in the situations described above, but it may also be pathological. Pathological hype...") Tag: Visual edit
14:29, 10 March 2023 Nikolas talk contribs created page 55. Disorders of the hypothalamo-pituitary system. Pituitary insufficiency (Created page with "Hormones are endogenous messenger molecules that are produced in glands or single cells. Hormones can act by endocrine, neurocrine, paracrine or autocrine pathways. The endocrine hormones are those which will be examined in the next bulk of topics. All hormones act by binding to special receptors on their target tissues or organs. Hormone release may be continuous or pulsatile or periodic and their effect may be altered based on this. For example will continuous release...") Tag: Visual edit
14:26, 10 March 2023 Nikolas talk contribs created page File:Hypothalamo-pituitary axis.png
14:26, 10 March 2023 Nikolas talk contribs uploaded File:Hypothalamo-pituitary axis.png
14:25, 10 March 2023 Nikolas talk contribs created page 54. Atherosclerosis and its cellular and molecular pathophysiology (Created page with "The most important risk factors for atherosclerosis are: * Smoking * Diabetes mellitus * Hypertension * Dyslipidaemia * Obesity * Homocystinuria * Alcohol consumption Atherosclerosis involves multiple phases and processes: * Damage of endothelium * Endothelial dysfunction * Inflammation of vessel wall * Activation of macrophages * Activation of smooth muscle cells * Calcification of plaque Damage of endothelium: The endothelium usually protects the rest of the vessel...") Tag: Visual edit
14:24, 10 March 2023 Nikolas talk contribs created page 53. Pathobiochemistry of LDL-metabolism. Primary and secondary hyperlipoproteinemia (Created page with "Before we begin this topic there are some basic concept about lipoproteins and lipids that you must understand. Lipoproteins are comprised of a protein-component and a lipid component. The protein-component of the lipoproteins are called ''apolipoproteins'', of which there are many different types. The lipid component is comprised of triglycerides, phospholipids and/or cholesterol. The function of lipoproteins is to transport hydrophobic lipids in the circulation. Ther...") Tag: Visual edit
14:21, 10 March 2023 Nikolas talk contribs created page 52. Disorders of nucleic acid metabolism. Gout (Created page with "The metabolism of nucleic acid involves breaking them down into pyrimidines or purines. The metabolism of purines (like AMP, IMP and GMP) is the most clinically important. thumb|321x321px|Breakdown of purines Breakdown of purines involves breaking them down to uric acid (or urate) with the enzyme ''xanthine oxidase''. Uric acid is poorly water soluble and is therefore prone to crystallize. Normal plasma level of uric acid is 6.4 mg/dL. T...") Tag: Visual edit
14:20, 10 March 2023 Nikolas talk contribs created page File:Breakdown of purines.png
14:20, 10 March 2023 Nikolas talk contribs uploaded File:Breakdown of purines.png
14:19, 10 March 2023 Nikolas talk contribs created page 51. Disturbances of amino acid metabolism (Created page with "These disorders are mostly congenital disorders, meaning the symptoms occur already from birth. Amino acids are important for the brain, so most of these cause mental problems. The most important disorders of amino acid metabolism are: * Disorders of amino acid transport ** Hartnup disease ** Cystinuria ** Methionine malabsorption syndrome * Disorders of amino acid metabolism ** Phenylketonuria ** Tyrosinosis ** Alkaptonuria ** Albinism ** Oxalosis ** Maple syrup urine...") Tag: Visual edit
14:18, 10 March 2023 Nikolas talk contribs created page 50. Hypo-, hyper- and dys-proteinemia (Created page with "== Hyperproteinaemia == Hyperproteinaemia occurs most commonly due to excessive protein intake. It can also occur due to dysproteinaemia or paraproteinaemia, discussed later. The RDA for adult males is 56 g protein every day. The requirement is 46 g in females and 71 g in pregnant or breastfeeding women. The requirement is higher in people who are physically active. Around 1 – 1.6 g of protein per kg of body weight is recommended for people who exercise depending on t...") Tag: Visual edit
14:17, 10 March 2023 Nikolas talk contribs created page 49. Hypoglycemia (Created page with "Hypoglycaemia is defined as a serum glucose level below 3.5 mmol/L. It most frequently occurs in diabetics in association with taking too much insulin or other glucose-lowering drugs. It may also occur in chronic alcoholics, beta-blockers and insulinomas. It’s most characteristic for type 1 diabetics. Alcoholics are usually in a fasting state, causing them to have low levels of glycogen in their liver. Also, alcohol inhibits gluconeogenesis. Both these factors contrib...") Tag: Visual edit
11:46, 2 March 2023 Nikolas talk contribs created page 48. Pathobiochemistry of the late complications of diabetes mellitus (Created page with "As explained in the previous topic are these four factors important in the development of microvascular disease in diabetes mellitus. == Pseudohypoxia == As already explained will hyperglycaemia increase the activity of the polyol pathway, which depletes NADPH and increases the NADH/NAD+ ratio. The latter causes a metabolic state of cells that is similar to hypoxia, called pseudohypoxia. The affected cells produce less ATP and more free radicals. Also, the amount of gly...") Tag: Visual edit
11:32, 2 March 2023 Nikolas talk contribs created page 47. Late complications of diabetes mellitus. Diabetic micro- and macro-vascular disorders. (Created page with "== Late complications == We’ve seen the potential acute complications of DM, DKA and HHS. The late (long-term) complications of diabetes are: * Macroangiopathy or macrovascular disease – disease of the larger blood vessels ** Caused by: Hypertension, atherosclerosis ** Coronary artery disease ** Cerebrovascular disease ** Peripheral artery disease * Microangiopathy or microvascular disease – disease of the smaller blood vessels ** Diabetic retinopathy ** Diabetic...") Tag: Visual edit
11:18, 2 March 2023 Nikolas talk contribs created page 46. Diabetic hyperosmolar syndrome (HHS) and coma (Created page with "Hyperosmolar syndrome, also called HHS, primarily affects elderly people with type 2 diabetes and not type 1. It can be thought of as the 2DM variant of DKA. Like DKA it’s a potentially life-threatening complication with approx. 15% death rate. Symptoms are mostly similar to those of DKA: * Vomiting * Polyuria * Polydipsia * Dehydration * Altered mental state, potentially coma There is no ketoacidosis (and therefore no hyperventilation) and no abdominal pain. It has...") Tag: Visual edit
11:59, 1 March 2023 Nikolas talk contribs created page 45. Diabetic ketoacidosis (DKA) and ketoacidotic coma (Created page with "Diabetic ketoacidosis (DKA) is a complication which primarily affects people with type 1 diabetes and not type 2. It’s a potentially life-threatening complication that involves: * Vomiting * Polyuria * Polydipsia * Dehydration * Altered mental state, potentially coma. * Abdominal pain * Hyperventilation (Kussmaul breathing) * Metabolic ketoacidosis It has a rapid onset (within hours). == Etiology == DKA is caused by absolute or relative insulin deficiency. It usuall...") Tag: Visual edit
11:56, 1 March 2023 Nikolas talk contribs created page 44. Etiology and pathogenesis of 2DM (Created page with "== Etiology == Genetic factors: The concordance between identical twins is around 80%, indicating a much stronger genetic factor than for 1DM. The specific genetic factors involved are not as well known as for 1DM, but it’s certain that HLA plays no role. Possible genes that are mutated in 2DM include: * GLUT2 * PPAR-γ * GLUT4 * GCGR – the glucagon receptor gene * TCF7L2 – a transcription factor that is active in β-cells – the most significant gene associated...") Tag: Visual edit
11:55, 1 March 2023 Nikolas talk contribs created page 43. Etiology and pathogenesis of 1DM (Created page with "== Etiology == The basic mechanism behind 1DM is a destruction of pancreatic β-cells. The other endocrine functions of the pancreas are usually maintained. The exact cause of the destruction isn’t completely understood. There are both genetic and environmental factors. Genetic factors: Concordance between identical twins is only 40% and between parent and child only 5%. This indicates that genetic factors play only a minor role. Certain types of HLA, especially HLA-D...") Tag: Visual edit
11:54, 1 March 2023 Nikolas talk contribs created page 42. General pathobiochemistry of diabetes mellitus syndrome (Created page with "This topic describes the biochemical changes in diabetes. The deficiency of insulin explains most of these changes. Many glucose transporter proteins (GLUT) exist, but GLUT4 is the only one that is insulin dependent. It is found in myocardium, skeletal muscle and adipose tissue. When insulin binds to the insulin receptor on these cells will intracellular vesicles that contain GLUT4 be transported to the membrane, so that the glucose transporter is embedded into the memb...") Tag: Visual edit
11:50, 1 March 2023 Nikolas talk contribs created page File:OGTT plasma glucose.png
11:50, 1 March 2023 Nikolas talk contribs uploaded File:OGTT plasma glucose.png
11:49, 1 March 2023 Nikolas talk contribs created page 41. Basic characteristics and forms of diabetes mellitus syndrome (Created page with "''I don’t know why the department calls it «diabetes mellitus syndrome». Nobody else does that. A syndrome is a constellation of symptoms that don’t have an identifiable cause, a definition diabetes definitely doesn’t fit. Diabetes mellitus is a group of diseases, not a syndrome.'' Diabetes mellitus (DM) is a group of metabolic diseases that are characterised by chronic hyperglycaemia due to absolute or relative insulin deficiency. The decreased insulin effect c...") Tag: Visual edit
11:48, 1 March 2023 Nikolas talk contribs created page 40. Hyperglycemia and glucose-tolerance tests. Diagnosis of diabetes mellitus. (Created page with "== Hyperglycaemia == Defining hyperglycaemia isn’t straightforward, as the plasma glucose value varies depending on stress, recent food intake, circadian cycle and other factors. The diagnosis of hyperglycaemia is necessary for the diagnosis of any type of diabetes mellitus. ''Alimentary hyperglycaemia'' is the hyperglycaemia that occurs after consuming a meal. The degree of which a food causes plasma glucose level to rise depends on that foods ''glycaemic index''. Fo...") Tag: Visual edit
11:46, 1 March 2023 Nikolas talk contribs created page 39. Fever and sickness-behavior. The biological value of fever (Created page with "High temperature slows or stops the proliferation of some bacteria, but the main biological value of fever lies in how the immune system is enhanced during it. Virtually all aspects of the immune system work better in an elevated core temperature; T-cell proliferation, immunoglobulin synthesis and phagocytosis and more are more efficient. The biological value of fever is disputed; there are down-sides to a fever as well. Despite this the evidence points to that a modera...") Tag: Visual edit
11:45, 1 March 2023 Nikolas talk contribs created page 38. Pathogenesis of fever (Created page with "A fever is an active core temperature elevation that occurs because the hypothalamus increases the set point temperature value. It doesn’t occur due to deficiency of warm-defence. The temperature is generally considered subfebrile between 37.5°C and 38.0°C, febrile between 38.0°C and 41.5°C, and hyperpyrexia above 41.5°C (40°C according to the book). Hyperpyrexia is a medical emergency as it usually indicates a serious underlying condition such as brain damage....") Tag: Visual edit
11:42, 1 March 2023 Nikolas talk contribs created page 37. Heat stroke and malignant hyperthermia (Created page with "== Heat stroke == Heat stroke is a medical emergency where a person has hyperthermia (40-41°C), anhidrosis and mental status alteration, possible even coma. It may be deadly; the outcome is influenced by the severity of the state and by the duration of the hyperthermia. Anhidrosis develops due to CNS damage because of hyperthermia. The lack of sweating allows the body temperature to continue to rise. == Malignant hyperthermia == Malignant hyperthermia is a life-threate...") Tag: Visual edit
11:42, 1 March 2023 Nikolas talk contribs created page 36. Warm-defense and heat-induced disorders (Created page with "The body’s defence against heat includes: * Skin vasodilation – increases heat loss by allowing heat to conduct away from the skin, increasing ''conduction'' * Sweating – as the sweat evaporates heat is lost by ''evaporative cooling'' * Arrector pili muscles relax – the flat hairs on the skin increase air flow around skin, increasing ''convection'' To lose as much heat as possible, cardiac output increases (probably due to sympathetic activation), which, in com...") Tag: Visual edit