Notes, summaries, assignments, exams, and problems for Medicine & Health

Acute Hepatitis: An Overview

Acute hepatitis is a necroinflammatory liver disease caused by infection from hepatitis viruses A, B, C, D, and E. The key difference between acute and chronic hepatitis is the duration, with the distinction typically made at 6 months.

Hepatitis A

Hepatitis A is caused by an RNA virus. Transmission is typically fecal-oral and can, in rare cases, be fatal, leading to fulminant hepatitis.

Epidemiology

Hepatitis A often occurs in cycles every 5 to 10 years, with seasonal predominance in childhood. The infection spreads through the fecal-oral route, often via contaminated food and water. Parenteral transmission is rare.

Symptoms

Symptoms include coluria (dark urine) followed by scleral icterus (jaundice) and hypocholia (pale... Continue reading "Understanding Acute Hepatitis, Cirrhosis, and Cholecystitis" »

Drug Administration Pathways

Enteral Routes (Oral Administration)

These routes involve administration through the gastrointestinal tract:

• Oral Mucosa: Primarily a passage for drugs during swallowing, not a significant absorption site.
• Esophageal Mucosa: Minimal absorption occurs during transit.
• Stomach Mucosa: Limited absorption. The acidic pH (2.5-3.5) favors the absorption of weak acids (pKa > 2). Absorption depends on the drug's pKa.
• Intestinal Mucosa (Small Intestine): Major site of absorption due to its very large surface area (villi) and high vascularization. The basic pH (5-8) favors the absorption of weak bases (pKa < 9).
• Large Intestine Mucosa: Less absorption compared to the small intestine and stomach. Alkaline pH. Primarily absorbs

Inhaled Corticosteroids and Bronchodilators: Administration

In a regimen of inhaled corticosteroids and bronchodilators, bronchodilators should be administered first. Steroids relieve symptoms but do not treat the inflammation.

Difference Between Bronchodilators and Steroidal Anti-Inflammatories

Bronchodilators act by dilating and opening the bronchus. Short-acting medications are used for immediate relief, while long-acting forms are used with scheduled corticosteroids.

Anti-inflammatories eliminate or alleviate inflammation of the bronchi. Steroids are the most widely used anti-inflammatories.

Health Education for Patients on Inhaled Glucocorticoids

• If using a combined regimen of bronchodilators and corticosteroids, inhale the bronchodilator first.

Pancreatitis: Inflammation, Causes, and Care

Acute Pancreatitis

Acute pancreatitis is a sudden inflammation of the pancreas that can range from mild to life-threatening, though it usually subsides. Gallstones and alcohol abuse are responsible for approximately 80% of cases. It is more frequently caused by gallstones or obstruction of the pancreatic duct by a gallstone lodged in the sphincter of Oddi, interrupting the flow of pancreatic juice. However, if the obstruction persists, activated enzymes accumulate in the pancreas and begin to digest its cells, causing severe inflammation.

Symptoms of Acute Pancreatitis

• A belt-like, intense abdominal pain in the upper abdomen, typically below the sternum. When pancreatitis is caused by gallstones, the

Healthcare Benefits in Spain

Healthcare aims to provide medical and pharmaceutical services conducive to preserving or restoring the health of beneficiaries. Coverage includes common or professional diseases, accidents (whether work-related or not), and maternity.

Eligibility for Healthcare Benefits

The following individuals are eligible:

• Workers, including those in the General Survey and special regimes, affiliates, and high-ranking or similar service personnel.
• Pensioners and recipients of regular benefits, including unemployment benefits or assistance.
• Relatives or carers in charge of the above, provided they meet these conditions:
  • Live with the holder and are under their care.
  • Do not perform any paid work or receive any pension.
  • Income or assets

Patents and Health Differences Between Countries

A patent is a set of exclusive rights guaranteed by a government or an authority to the inventor of a new product or a new manufacturing method, which could be exploited industrially for the benefit of the inventor and for a time-bound implementation.

Pharmaceutical patents relate to new medicinal products or production methods from pharmaceutical research.

The most commonly used method to reduce public pharmaceutical expenditure is the use of generic drugs, i.e., drugs that are developed after the brand-name drug's patent has expired. These are sold without a trademark, with a similar active ingredient, pharmaceutical form, composition, and equivalence to the reference brand drug.

The main advantage... Continue reading "Patents, Health Disparities, and Medical Technology" »

Vitamins and Minerals

Soluble Vitamins

Vitamin C: Protects, regulates, and facilitates chemical processes of other enzymes. Its main function is the formation of collagen, facilitates the absorption of iron, protects vitamin A and E from oxidation, and regulates cholesterol metabolism. Sources: green vegetables, citrus fruits, tomatoes. Deficiency: scurvy, irritability, bone pain, easy bleeding, poor healing. Toxicity: gastric irritation, kidney stones, false positive tests for fecal occult blood or glucosuria.

Vitamin B1 (Thiamine): Important coenzyme in the metabolism of carbohydrates. Sources: meat, grains, legumes. Deficiency causes: alcoholism, dialysis, diet high in carbohydrates. Beriberi, Wernicke's encephalopathy.

Vitamin B2 (Riboflavin)

Insulin Action Times

Understanding the action times of different insulin types is crucial for effective diabetes management. Here's a breakdown:

• Rapid-Acting:
  • Examples: Actrapid or Humulin Regular
  • Onset: 20-30 minutes
  • Peak: 2-4 hours
  • Duration: 6-8 hours
  • Note: Crystalline insulin
• Intermediate-Acting:
  • Examples: Insulatard or Humulin NPH
  • Onset: 45-60 minutes
  • Peak: 6 hours
  • Duration: 12-14 hours
  • Note: Protamine insulin
• Long-Acting:
  • Examples: Monotard or Slow
  • Onset: 60-90 minutes
  • Peak: 8-12 hours
  • Duration: 24 hours
  • Note: 70% zinc

When insulin is administered twice daily, typically 60% is given in the morning and 40% at night.

Managing Nocturnal Hypoglycemia

Nocturnal hypoglycemia with rebound hyperglycemia before breakfast (Somogyi effect) can be managed by checking capillary... Continue reading "Insulin Types, Administration, and Oral Hypoglycemic Agents in Diabetes" »

Health and Quality of Life

Health is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. This concept also includes the idea of well-being or quality of life.

Factors Determining Health

Several factors influence our health:

• Lifestyle: This includes behaviors such as nutrition and physical activity levels.
• Environmental Factors: Social conditions, healthcare access, climate, and environmental pollution play a role.
• Genetics: Hereditary information contained in our genes influences our predisposition to certain conditions.

Healthy Eating Principles

A Balanced Diet

A balanced diet incorporates all the essential elements that constitute our daily nutritional needs.

Understanding Fats

The energy from... Continue reading "Foundations of Personal Health: Nutrition, Exercise, and Well-being" »

**Chemical Risk Assessment in the Workplace**

Hygienic Evaluation

Methodology for detection and quantification of industrial pollutants and assessment of the risk for workers exposed to them.

• Environmental: Compare the actual exposure levels to theoretical allowable values.
• Biological: Determine the amount of pollutant or its metabolites in exposed workers.

Assessment Criteria

• Reference values
  • United States (ACGIH)
    • TLV (Threshold Limit Value)
    • BEI (Biological Exposure Indices)
  • Spain (INSHT)
    • VLA (Environmental Limit Values)
    • VLB (Biological Limit Values)
• Maximum values allowed
  • USA (OSHA)
    • PEL (Permissible Exposure Limit)
  • Spain (Current Legislation)
    • Regulation of Troublesome, Unhealthy, Harmful, and Dangerous Activities
    • Specific regulations (benzene, asbestos, lead,