Notes, summaries, assignments, exams, and exercises for Medicine and health sciences for University

Chest Pain, Dyspnea, and Cyanosis

Semiology

• Type of pain
• Location
• Factors that trigger
• Length
• Relieving factors
• Associated symptoms
• Angina equivalents

Chest Pain

Cardiac Causes

• Coronary
  • Acute: Unstable angina, SICA
  • Chronic: Stable angina

History and Physical Examination

• History: diabetes mellitus (DM), hypertension, smoking, dyslipidemia, obesity, sedentary lifestyle
• Young patients: consider cocaine or stimulant use
• Semiology of the pain (character, radiation, timing)
• Physical examination: vital signs and initial cardiovascular assessment

Noncoronary Cardiac Causes

• Pericardium: pericarditis, tumors
• Inflammatory: myocarditis, valvular disease

Noncardiac Causes

• Respiratory
  • Upper airway: bronchitis, tracheitis, tumors
  • Lower respiratory tract: pneumonia, atelectasis,

External Review in Poisoning Autopsies

Cadaverous Phenomena

• Lividity: Carbon monoxide (CO) presents redder than normal; asphyxia results in dark red; methemoglobin-forming poisons appear brownish.
• Rigidity: Carbon monoxide rigidity is higher than normal, often giving the deceased the appearance of a boxer. Strychnine poisoning causes early and lasting rigidity.

Color of Skin and Mucous Membranes

• Carbon Monoxide and Cyanide Poisoning: These present a more rosy appearance than the usual appearance of life.
• Phosphorus Poisoning: Results in a yellowish skin tone.
• Methemoglobin-forming Poisoning: Results in a cyanotic or brownish appearance.

Traces of Vomit and Feces

Examination may reveal bloody vomiting (hematemesis) or bleeding of the upper or lower digestive...

Chagas, Malaria & Cryptosporidiosis: Causes and Care

Chagas Disease: Etiologic Agent and Vector

Chagas disease: etiologic agent Trypanosoma cruzi. The vector is the blood-sucking triatomine insect (triatomine). In the insect intestine the parasite develops juvenile stages such as epimastigotes and trypomastigotes. It is transmitted through vector feces.

Human Infection and Life Stages

In humans, trypomastigotes circulate in the bloodstream, invade cells, and can be found as intracellular amastigotes that affect cells and tissues.

Clinical Manifestations

Clinical manifestations: general deterioration, dyspnea, headache, and lower extremity edema. There is an indeterminate or asymptomatic period that can last 20 to 30 years or more. Diagnosis is...

Fascioliasis and the Liver Fluke

Fascioliasis is a zoonotic disease caused by a trematode parasite known as the liver fluke. In this cycle, humans and herbivores serve as definitive hosts, while small freshwater snails act as intermediate hosts.

The parasite, better known as Fasciola hepatica (referred to as 'pirihuín' in Chile), is a digenetic fluke. It has the appearance of a lanceolate leaf with a well-defined cephalic cone.

Symptoms and Clinical Picture

The clinical picture is characterized by a hypersensitive state and hepatobiliary symptoms. Symptoms vary by stage:

• Invasion Period: Pain, hepatomegaly (enlarged liver), fever, and urticaria.
• State Period: Digestive disorders, pain, jaundice, and fever.

Treatment and Prevention

Treatment: The primary...

EHEC: Pathogenesis and Clinical Presentation

Enterohemorrhagic Escherichia coli (EHEC) interacts with intestinal colon cells by establishing a close bond, causing the dissolution of cell membranes and glandular epithelium, alongside extensive destruction of microvilli.

Transmission and Symptoms

EHEC is associated with the consumption of undercooked ground beef, milk, and unpasteurized fruit juices. Located in the intestine, it causes hemorrhagic colitis, abdominal cramps, and bloody, watery diarrhea, typically without fever.

Hemolytic Uremic Syndrome (HUS)

HUS, associated with serogroup O157:H7, is non-invasive; blood in the stool is caused by the action of the verotoxin.

ECEA Characteristics

Enteroaggregative E. coli (ECEA) is located in the small...

Reasons for Therapeutic Plan Failure

There are three primary reasons why a therapeutic plan may not achieve the expected results:

• 1. Inadequate Drug Selection: When the selected drugs are not appropriate for the condition.
• 2. Adverse Effects: The appearance of adverse effects that hinder treatment.
• 3. Patient Non-compliance: When the patient does not meet the requirements of their therapy.

Factors Affecting Drug Distribution Volume

The following factors contribute to the reduction of the volume of distribution of drugs in the body:

• Age
• Sex
• Nutritional status
• Weight

Key Pharmacokinetic Parameters

• Minimum Toxic Concentration (CMT): The concentration level from which toxic effects begin to appear.
• Minimum Effective Concentration (CME): The level at which the

Jaundice: Bilirubin Pigment in the Bloodstream

Jaundice is the yellowing of the skin and the whites of the eyes (sclera) caused by abnormally high levels of bilirubin pigment in the bloodstream.

Jaundice Symptoms (Clinical Manifestations)

• Yellowish skin and eyes.
• Dark urine (due to excess bilirubin excreted by the kidneys).
• Acholia (pale or white stools).
• Itching (pruritus).

If jaundice is caused by acute inflammation of the liver (acute hepatitis), it may also cause loss of appetite, nausea, vomiting, and fever. Obstruction of bile flow may produce symptoms similar to those of cholestasis.

Diagnosis and Management of Jaundice

Diagnosis is based on the analysis of laboratory and imaging tests to determine the underlying cause of jaundice.

Treatment Approach

• If

Mastering Progressive Tenses (Tiempos Progresivos)

A Progressive tense (tiempo progresivo) is a form of the verb that shows that the action is in progress. In other words, it means that the action continues.

The Past Progressive

The Past Progressive (pasado progresivo) is a form of the verb that shows that the action was in progress at some time in the past.

Example: Lisa was dancing yesterday at 8 o'clock.

The Present Progressive

The Present Progressive (presente progresivo) is a form of the verb that shows that the action is in progress in the present.

Example: Lisa is dancing now.

The Future Progressive

The Future Progressive (futuro progresivo) is a form of the verb that shows that the action will be in progress at some time in the future.

Example:

Hazardous Materials: Definitions and Safety

Hazardous Materials are all those materials, substances, or items that, by their volume or hazardous nature, imply a high, and certainly more than normal, risk to health, the environment, and property if they get out of control. These risks can occur during extraction, manufacturing, storage, transport, and use.

Key Definitions

Accident: An unwanted event or action that disrupts the normal work process, causing personal injury and/or material losses.

Chemical: A chemical, either alone or in a mixture or preparation, manufactured or obtained from nature, with the following categories of use: Plant Health, Industrial, and Consumer.

Toxicity: The ability of a substance to cause harm to a living organism.

Hazardous

Weaning

Weaning is the introduction of foods other than breast milk.

Steps for the Development of Food

• Period of 6 months of exclusive breastfeeding.
• The transition period between 4–8 months.
• Modified adult diet period between 6 and 12 months.

Recommendations

• Start no earlier than 4 to 6 months.
• Start with porridge.
• Use familiar staples.
• Start with one food at a time.
• Combine foods only after tolerance is established.
• At the end of the year, simply chop the food.
• Do not add salt, sugar, honey, or butter.
• Remove the bottle around 13 months.
• Offer the child the same food for at least 5 days.
• Gradually increase the amount of food (tablespoons).
• Adjust feeding times to the family schedule.
• Consider the family's allergic history.

Anthropometry

• Anthropometric evaluation